Why Physical Therapy Is Your Best Option If You Just Feel Tight

Everyone experiences “tightness” to some degree throughout their lives and likely relatively frequently. If you’re active and push your body in demanding ways often, you’ll likely experience tightness. The same is true if you sit at a desk for work for eight hours per day. A stark contrast in the two ends of the activity spectrum should show you that it’s prevalent and can be hard to avoid at times. 

Why you’re tight and what to do about it?

Now that we understand it’s a prevalent thing and interferes with folks at a wide variety of fitness levels, let’s talk about why it may present and how we can address it. 

Too little movement. Forward head and rounded shoulders affect most of Western culture as everything we do tends to be in front of us (working on a computer, reading, using a smartphone) to name a few. This alone isn’t necessarily a bad thing, but if you can’t move out of this posture or lack general awareness of posture then that may certainly lead to stiffness/tightness and need addressing. 

If you’re a physically active person and regularly stress your body with exercise, let’s consider your mode of exercise. Most people tend to stick with the exercise that they enjoy doing the most - which is great. But to my point, if you’re a barbell athlete for example, most of your movement tends to be done in a straight-ahead plane of motion (bench, squat, clean, snatch, jerk, deadlift, etc.). Unless it’s deliberately programmed for, you may lack mobility into rotational and lateral planes of motion. 

Too much movement. You’re someone who has been told you’re “Double-jointed” your whole life, you can probably do the splits, touch the ground flat-handed, and so on. If this describes you, then you’re someone we would refer to as hypermobile. Again, not a pathology, but it’s extremely common to have complaints of chronic tightness but present with more mobility than anyone could ask for. This is where neuromuscular control/strengthening comes into the picture. 

Strength and control. Someone with a lot of mobility is likely to be weaker or have less control in the positions that they don’t regularly move their body through. A hypermobile person likely has deficits in strength and control throughout the range of motion and this can lead to an unhappy musculoskeletal system. If you’re someone with a lot of mobility, you must have the muscular capacity to control the excessive mobility that you have for efficient movement patterns. 

Why physical therapy is your best source for a long-term solution 

At this point, I hope that you realize that tightness isn’t pathological, most of the time. So that may lead you to the question, “Why is physical therapy what I need? I thought you needed to be hurt to see a physical therapist.” Wrong! That is the physical therapy of the past where the primary role was to treat symptoms and provide feel-good treatment until the primary complaint has resolved. Fast-forward to 2024. Many physical therapists have adopted a fitness-forward approach that shifts our primary role from symptom management to optimizing movement and performance. That can mean many different things to different people. Let’s stick to the concept of tightness. 

Seeing a Doctor of Physical Therapy allows you to be individually evaluated to determine what the most likely culprit of your tightness is. Based on the findings, treatments that are tailored to your specific needs are prescribed and built upon. Deciding whether you would benefit from gaining new motion or improving strength/control of the motion that you already have is the first step toward addressing your tightness long-term and no better person for the job than a physical therapist! 

The prescribed treatments are likely to vary between providers. However, the goal should be the same based on your individual needs. Manual therapy and modalities such as dry needling are still very effective at opening a window of opportunity for optimizing movement when paired with complementary exercise. 

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Thanks for reading, 
Dr. Mike