Many of us just go about our day using our muscles, and we don't need to think twice about how they work, they just do! But if we want to know how to treat problems when they arise, it really helps to understand their basic function. Today's post will be for those who have not studied muscle physiology before, and it may come in handy for future posts about how to work on your own trigger points at home, how to determine the direction you would stretch a muscle, or otherwise just be interesting to learn.
Contraction of individual fibers/groups
A muscle's action is to pull its ends together. On a large scale, the muscle attaches to bones and across a movable joint, pulling one side of the joint closer to the other... and on a small scale each tiny muscle fiber contracts to shorten the small band of muscle. It contracts in one direction, that is, the direction of its fibers. The protein filaments that make up the muscle fiber start at a maximum length and contract by pulling(1) the outside bands closer to the center. There are many of these microscopic fibers in each muscle, and nerves feed into them in small groups called "motor units". The interesting thing about these small groups is that they follow an "all-or-none" principle, meaning that if the nerve sends the signal to contract, then they all contract, or none of them do. But since the groups are relatively small, you can only use a few motor units to lift something light, and then recruit more and more muscle fibers when you lift something heavier.
Energy needed for contraction
For the muscles to contract, they must use up energy. I will devote a separate post to cellular respiration, the means of creating the energy we use. Basically, energy is stored in the muscle ready to use in two forms: creatine, and a form of glucose (a sugar aka carbohydrate, it is stored as glycogen in the muscle) that your muscles will use as a quick burst of power, but will only last a short time. This energy is quick but inefficient, and produces lactic acid which can be used for more fuel. When you have used up all the sugar storage, your body can then start to convert fatty acids into sugars to restore the sugar levels ready for more energy. In longer endurance activities, more fats are burned than sugars, and the energy production is much more efficient than quick/powerful movements. Proteins can be used for fuel too, but that usually means your body is breaking down muscle to use for energy to keep you alive, which is usually a bad thing. Similar to how sugars can be stored in the muscle for energy, oxygen can be stored as well for the more efficient energy production process.
To conduct the signal for contraction, Calcium, some neurotransmitters such as acetylcholine, and hormone regulation (such as epinephrine, insulin levels) are all important parts of the process as well.
The main summary here is: sugars tend to feed your quick/powerful muscle fiber types, fats tend to feed your endurance muscles. Part of the explanation of fatigue is running out of these nutrients in the muscle, and despite eating the nutrients there is only so much your blood can carry to every muscle in your body to restore the energy supply.
Muscle contraction is an electric process, using chemical transfer from nerves to start the electric signal to contract. In the mid 1780's the discovery was made that frog legs would jump when a wire sent electricity through them.
Types of contraction
Muscle contraction during movement comes in two flavors. We call them "concentric" for when you shorten the muscle, and "eccentric" for when the muscle is elongated but still firing. You can think of the concentric portion as your biceps lifting a weight, and the eccentric portion as your biceps slowing the fall of the weight as the elbow straightens.
The third type of muscle contraction is isometric, where you are just holding the weight and keep it from moving.
Changes to muscles
When you use a muscle, you make it stronger. Even more interesting is that a trained muscle group can adapt to store more of the fuel needed for energy production. Other changes include an adaptation of the nervous system, muscle fiber types, enzyme content of the muscle, and hormone adaptations that allow the muscles to function more efficiently. This will be explored in more depth in the future.
Contraction by reflex
One of my favorite features on the subject of how muscles work (and one that will get several of its own posts in the future) is that the skeletal muscles can be voluntarily contracted, contracted by external electric pulse, or contracted by reflex. I'll tell you why that's exciting to know, but to do that, a little about how it happens:
In your muscles and tendons are special cells that receive information from the surroundings. They cause an automatic response when they detect changes in muscle length or tension. So when someone drops a heavy book in your hands, part of the response isn't something you even think about, your arms automatically lift up in response to the sudden weight in your hands (sometimes more than necessary). The knee-tap test (very useful video) your doctor does, when he/she taps a tendon on your knee and makes you kick, is an example of this reflex. The other reflex forces your muscle to relax to protect itself against damage from contracting too much. It inhibits contraction without you even having to think about it.
The really cool thing about reflexes is they happen automatically, you don't have to think about them! The other cool thing is that your massage therapist can take advantage of this information to help your muscles relax. This works because when you contract your biceps on the front of your arm, your triceps on the back of your arm must relax or else your arm doesn't move anywhere. The inhibitory signal is sent through your nervous system to relax the muscles opposite of those that are contracting. This is an automatic process, so it can sometimes help with muscles that are too tight, and in managing cramps. The next time you get a charlie horse, you can try identifying the group that is cramping, then contract the opposite group in order to attempt to force the signal to relax the cramping muscle.
There is a certain amount of contraction that goes on throughout the body at all times, this is called the resting tone of the muscle. The partial contraction helps with posture, it keeps you from flopping around like a rag-doll. When you stretch your muscles, you are not actually elongating the muscle itself (which would cause damage or tearing of the muscle) but you are removing the inhibitory nerve signal to maintain tone. So stretching is more of a nervous system function than an actual change to the muscle structure (or at least it should be, injury would result from elongation of the muscle).
This post is full of links that will take you much deeper into each subject, and I will be expanding on each subject more in the future! Please let me know if you found this post helpful and tuned with the right amount of introductory information for how muscles work.
An interesting muscle group that deserves it's own post. This muscle is sometimes involved in lower back pain, leg and knee pain, and causes a forward rotation of the hips. It's often involved in overuse injuries, or when lifting something while twisting the trunk of the body, and can sometimes manifest as a 'twinge' in the lower back.
If you've had a session with me (or another therapist) for lower back pain, you may have heard about this muscle. It's a difficult one to describe without the use of visual aid, so in today's post we will unpack what the Psoas muscle group is, and some tips on how to keep it healthy.
The psoas muscle group is a combination of the iliacus and psoas major, and is generally called the Iliopsoas. I often simply say "psoas" to imply both muscles. The psoas originates at the lower spine, and sort of 'fuses' with the iliacus muscle at the inner thigh (a spot on the femur called the lesser trochanter).
It's a little difficult to explain because it is on the front side of the spine. So to actually palpate the muscle, we have to do so through the abdomen. This can seem fairly invasive compared to other treatments, but can be done safely and effectively with manual therapy. There are even some guides on how to do some self treatment.
The iliopsoas is a hip flexor, which means it helps lift your leg forward, or bring your knee toward your chest. It also has a little role in rotating your leg outward, too. Knowing those directions will help when we want to stretch this muscle, because in order to stretch it we have to move it in the opposite direction to how it normally contracts. In day-to-day life the iliopsoas muscles help us maintain our posture, walk, run, and stabilizes the lower spine. They are innervated by the L1-3 and femoral nerves.
When the psoas is tight, it can contribute to a number of problems. One of the most common is Lower crossed syndrome, where the pelvis tilts forward, resulting in a curved and strained lower back. In some cases it can show up as locked lower back with the head tilting forward like a hunchback. In both cases, getting psoas work (massage, stretching, trigger point work) can be beneficial.
Testing the psoas muscle can be helpful to determine the cause of knee and leg pain as well as lower back pain. The hip flexor muscles can be indicated in patellofemoral pain syndrome.
Trigger point work and stretching for the psoas can help to relieve lower back pain, groin and leg pain, knee pain, and can help to correct issues further down the leg and foot, as well as the upper back.
The psoas is in a short position when we are sitting, so for many of us it seems that it is no surprise it might be tight. Moderately stretching this muscle group is useful for most people as a form of general maintenance, and massage can be a great way to help keep the muscle in healthy tone. (I always caution against over-stretching)
The psoas can be stretched by bringing the leg back as in a deep lunge, either standing or kneeling down.
Why do my muscles hurt after exertion? Is that normal?
This post is here to tell you that yes, muscle soreness is totally normal after exercise. It usually peaks a day or two after exercise, and then fades off after about 72 hours. There are a lot of ideas about why it happens, and what you can do about it. Not everything you may have heard is accurate, though. But let’s go over the basics here.
Delayed Onset Muscle Soreness (DOMS) (1) is generally a painful response to new activity. Whether lifting something heavier than normal, using muscles you haven't used in a long time, or doing more repetitions than normal, the pain comes from micro-trauma, or small tears that occur in the muscle during normal exercise. These micro-tears are necessary for the muscle to grow(2).
It's not just the micro-damage, but there is also a response in the nerve signals to repair the muscle stronger than it was before (3), but also to grow new nerves (4). The combination is most likely to result in pain. One very interesting study found that pain occurred even in a muscle group that was not exercised, which suggests a neural component of the pain associated with DOMS (5).
The way muscle gets damages is mainly by eccentric contraction, which is the lengthening of the muscle while under stress (6),(7).
It was once thought that lactic acid buildup in the muscle was the cause of the pain after exercise, but this has been demonstrated to be false (8), (9). Your lactate actually clears out of your system pretty quickly compared to how long you are sore.
The good news is that as you adapt to the new movement or exercise, your body actually builds support in the area you are exercising! (10) That's kind of amazing if you think about it... You have tiny little workers running around reinforcing the areas of your body that you are using, and conserving resources in areas you aren't using.
Is there any way to avoid the muscle soreness that accompanies exercise? Well, the first thing I always say is that if it works for you, then do it. But as far as the studies tell us, there's really no significant way to avoid it. You'll be sore, but you will adapt, and you will become stronger and more stable, with lasting benefits for years to come.
In terms of research, stretching before and after did not significantly reduce muscle soreness (11). While you do want to stay hydrated, it may not be accurate to say that increasing your water intake will lead to less cramping or pain (12). In sprinters, the delayed onset of pain did not respond to anti-inflammatory drugs (13) and anyway it doesn't appear that inflammation is a necessary component to the adaptations that occur in muscles after exercise (14).
Interestingly enough, it seems that there is a way to temporarily reduce the pain that occurs after exercise: to exercise some more (15), (16), so long as it is intense enough.
Massage therapy was found to be effective for some people in reducing some of the symptoms of muscle damage (16).
Other treatment ideas may have lower success in studies, but if it makes you feel better then by all means, do it! You could try heating, icing, or a combination of the two!
There are many factors that could lead to a slower recovery from exercise, and some people may experience more pain than others. For example, low Vitamin D levels are related to widespread pain (17), (18), (19), (20), and even muscle weakness (21).
There is still a lot to learn about how pain works, and how we can deal with it. I hope this gives you a little introduction to what's happening in the muscles, and maybe leaves you with in awe at how fascinating the body is!
“What are Trigger points?”
The introductory version.
Have you ever felt a pinch in a muscle, or a spasm that sent a feeling like a jolt or searing pain? Maybe it felt like you were unable to rotate your head like you should, perhaps you couldn’t reach back with your arm as far as you normally would, or even bend over to pick up something. Well, there are actually many things that could be causing this pain, but today I’m going to break down just one of those many possible causes. Today I’m going to talk about pain originating from a muscle.
Now, pain doesn’t come from muscles, it comes from nerves. That’s the signal system the body uses to convey the things you feel, through a variety of receptors. But when I say pain from a muscle origin, I mean skeletal muscle, not pain coming from two bones pinching a nerve, or from your stomach being irritated.
How does a muscle cause pain? This warrants its own post (coming soon™), but to summarize: in many ways. You don’t have to pull a muscle for it to hurt. You can underuse a muscle and it can cause pain- yes that’s right, you can sit around all day and that could lead to your muscles becoming atrophied or “shorter”, causing pressure to be placed on a nerve. It could be from dehydration, or even a lack of some dietary minerals. It can come from a lack of blood flow getting through to deliver important nutrients. It could be a sudden intense event, or doing one movement many times (overuse injury). It could come from sleeping on it funny, from twisting in a way its not used to… whatever the reason, your muscle can get little “knots” that feel very sensitive. Some of these knots are called “trigger points” and the resulting pain is called “myofascial pain syndrome”.
The painful areas may not necessarily be where the trigger point is. For example you may feel pain or numbness in the hand, but the tight muscle might be in the neck or shoulder. The hand would be considered a “referral zone”. There are many of these zones, where pain is referred, and a therapist who studies trigger point therapy learns many of these patterns.
Why don’t I just ignore my pain and carry on?
Well, there is a certain amount of “tough it out” that is good for you. On the other hand, there are reasons that your body is telling you it’s in pain. Mechanisms kick in that cause your balance to shift, your mobility to change, and these compensation habits can have lasting effects. Some are subtle, but for an obvious example, let’s say your knee is hurting and you shift your weight to the opposite leg. Over time, your weight to the leg that feels fine, and you begin to build stronger muscle on only that side. Perhaps your lower back may start to ache, as the rest of your body stabilizes itself to keep you upright. You could further extrapolate from here that your shoulders might then be affected, and your neck, and who knows maybe even your brain becomes lopsided (probably not)… but it may be sufficient to say that small adjustments over time can lead to imbalances that could have been prevented. You can work on your trigger points at home or with a massage therapist.
The actual mechanisms behind trigger points (what causes them) is a fascinating and debated topic that I will cover in later posts.
What's going on with me, research articles, interesting little blurbs. This blog is an attempt to consolidate research into an easily digestible format.
Alex Moon has been a Licensed Massage Therapist since 2012, did his undergraduate studies at Utah State, and is currently working on his Doctorate in Physical Therapy.