If you’ve ever strained your neck or back, you’re very familiar with muscle guarding, although you may not even be aware of the term. After experiencing the pain of a neck or back strain, you may have turned your entire body to look at someone or something to avoid using your neck or back muscles. That’s muscle guarding in a nutshell. We all do it from time to time and it’s a very human protective mechanism that is built into us. It causes us to tense and spasm our muscles around an injured area to restrict movement to avoid pain.
Muscle guarding has been around as long as humans have been, but researchers have recently begun to study its long-term effects on the body and pain. Sometimes muscle guarding can be a good thing and protect us from further injury. However, too much muscle guarding can cause real problems, such as in the condition called Frozen Shoulder Syndrome, where the shoulder muscles basically freeze into position, causing movement to be very restricted if not impossible. Frozen Shoulder Syndrome usually will heal itself in a couple of years with Physical Therapy, but many patients choose to have their shoulder surgically manipulated to release the “frozen” muscles.
This also can happen with patients who have knee replacements, where their arthritic knee joint is removed and replaced by an artificial knee joint. For those who have never had knee replacement surgery, it is major surgery, and the recovery can be quite painful. Patients must move and bend their replaced knee quickly and do their rehabilitative exercises every day for the best outcome. Because of the post-surgical pain, some patients will muscle guard to the extreme, and it will prevent them from doing their post-surgery exercises. Many of these patients will have to have a post-replacement knee manipulation procedure. Their surgeon will manually manipulate the replaced knee (while the patient is under anesthesia) and loosen the musculature (and any scar tissue/adhesions ) restricting movement of the knee caused by muscle guarding and their failure to move the knee.
Muscle guarding in its chronic form has symptoms which include pain, soreness and tenderness in the affected area, tendon soreness and a restricted range of motion. Fatigue and tendon tension can also be an issue. Long term, the guarded area of the body may become weak, fatigued and may actually suffer atrophy because of disuse of the surrounding musculature. Patients with fibromyalgia will often muscle guard as a part of their symptomology.
Researchers are now finding that the symptoms validate to the brain that muscle guarding is appropriate, and this reinforces the need for the body to continue doing so, causing a cycle of pain and reinforcement of the signaling to the brain of this discomfort.
Problematic muscle guarding can be treated with Physical Therapy and seems to respond well to the modalities of heat, cupping, dry needling and manual massage. Our therapists can also use the H-Wave® four-channel electronic stimulation machines to ease muscle tension and can prescribe TENS units for the patient at home. I can also prescribe non-narcotic pain-relieving relaxant medications for more troublesome cases.
Relaxation techniques and meditation programs can be easily learned and will be useful with muscle guarding. Cognitive behavioral therapy may be helpful in retraining the brain to understand that the muscle stimulus which it fears to be painful may not be so and in fact, may be only a memory of an experience now past. Our pain psychologist, Dr. Andrew Martin, can help to uncover what emotional support treatment might be right for you if you suffer from chronic muscle guarding.