"Muscle Tension"

Medical Q&A [Moderated]
1

Hi Austin and Jordan,
I have been listening to the podcasts on pain and the reality of massage/foam rolling/etc. (and I have read Austin’s “Aches and Pains” article), but there is one thing that wasn’t addressed that I can’t quite make sense of. I understand that things like muscle “knots” don’t really exist. But surely muscle tension does, right? By that I mean a muscle that doesn’t seem to relax the way it should–a muscle that is always “turned on”/flexing to some small degree. I am generally an anxious person and I am also on a stimulant medication that causes a lot of muscle tightness/tension (I don’t really have a vocabulary to use now that none of those things really exist…). Sometimes I get actual spasms, but mostly it’s “knots” in my triceps, pecs, and behind my scapulae (I get a ton of pain behind my left scapula). After reading the article/listening to the podcasts, I’m just not sure what to make of that anymore. It’s not that I don’t believe you and the research studies. I do. But I feel like all of that can’t just be in my head/that none of it is physiological, especially considering that it is largely the result of a medication. I guess I’m just hoping you can shed some light on what might be going on and how we are supposed to think/talk about these issues that exist in a practical/experiential sense, but not in a literal/physiological sense.

Thank you for your time.

2

Do you experience the involuntary movements that would presumably result from involuntary muscle contractions?

3

No “twitching” or anything, but I can tell my muscles are not relaxed. When I notice it I am able to take a breath and relax them. The clearest presentation of that kind of “persistent contraction” (for lack of a better term) is that my jaw gets tight and I grind my teeth a bit. That same type of contraction also happens in my shoulders, forearms, and chest. Based on your article, I assume that the pain I experience is largely from the fatigue from all of that.

4

I’m not sure it’s useful to go down a theoretical rabbithole here tbh.

There’s some interesting data on perception of back “stiffness” not being reflective of any true mechanical stiffness (see here: Feeling stiffness in the back: a protective perceptual inference in chronic back pain | Scientific Reports ) and I suspect it’s similar when it comes to perception of muscle tightness.