From the Guidelines
In chronic joint pain, the muscles involved are typically shortened rather than lengthened, as they attempt to stabilize and protect the painful joint by increasing muscle tension around it. This muscle shortening occurs as a protective response to pain, where the body tries to minimize further injury by reducing joint movement 1. Over time, this protective muscle guarding becomes chronic, leading to persistent muscle shortness and tightness. Key factors contributing to this shortening include:
- Muscle guarding as a response to pain
- Reduced movement and exercise due to pain
- Altered biomechanics and joint loading This shortening creates a vicious cycle as the tight muscles pull on joint structures, increasing compression and potentially worsening pain. Treatment approaches should focus on gradually lengthening these shortened muscles through:
- Gentle stretching
- Myofascial release techniques
- Physical therapy, which can be supervised by physical therapists in a class setting or individually 1 Heat therapy before stretching can help relax the tight muscles, making them more receptive to lengthening. Regular movement and appropriate exercise, such as walking, cycling, or aquatic exercises, are also essential to prevent further shortening and restore normal muscle length 1. Understanding this muscle shortening mechanism is crucial because addressing only the joint without treating the surrounding muscle dysfunction often results in incomplete pain relief and persistent movement limitations.
From the Research
Muscle Length in Chronic Joint Pain
- The length of muscles involved in chronic joint pain is not directly addressed in the provided studies 2, 3, 4, 5.
- However, study 6 found that persons with chronic hip joint pain exhibit reduced hip muscle strength, which may be related to muscle length or function.
- The study 6 suggests that weakness in the hip rotator and hip abductor muscles is present in individuals with chronic hip joint pain, but it does not specifically address whether the muscles are lengthened or shortened.
- Study 5 mentions that chronic musculoskeletal pain patients show signs of local/central sensitization and spread of pain, which may be related to changes in muscle length or function, but it does not provide direct evidence on this topic.
- Overall, there is limited direct evidence on whether muscles involved in chronic joint pain are lengthened or shortened, and further research is needed to fully understand this relationship 4, 5, 6.