"Do you think that is air your breathing now?" -Morpheus

My clients are very familiar with this interaction at REFIT

“I am tight in my right knee”

“ Interesting, I reply what did you do?”

“ I have no idea it just hurts.”  

“ You know I am going to need more words.”

“ My knee is feeling pain here and it it feels very tight”

“Ok hop up on the table and we will take a look” as I begin to palpate the left hip and right glute.

“You know it is my knee rig…..ohhhhh  what the actuall!@$#@ is that ?”

“Most likely the bigger cause of your issue.. i reply Now hop up and walk around”

 Clients often come to me with “tightness”.  They also know I ask another 30 probative questions about the tissue and immediately palpate the area in both directions.

According to a new study at the University of Alberta’s Faculty of Rehabilitation Medicine I have good cause to do so

“A conscious experience of feeling stiff does not reflect true biomechanical back stiffness,” explained Greg Kawchuk, professor and back and spine expert in the Department of Physical Therapy. “When we use the same word, stiffness, to describe a feeling and how we measure actual stiffness, we assume these words are describing the same thing. But that is not always the case.”

The study asked participants to describe their sensation and then actually measured the range of movement to determine the level of “stiffness” through movement. “There was no relation between biomechanical stiffness and the reported feeling of stiffness,” he said. “What people describe as stiffness is something different than the measurement of stiffness.”

Tasha Stanton, lead author and senior research fellow of pain neuroscience at the University of South Australia, said that “the feeling of stiffness may be a protective construct that is created by our nervous system.”

“It’s our body’s way of protecting ourselves, possibly from strain, further injury or more pain.”

While in this study  focus has remained on the back in general we know that stiffness through the body is pretty universal of a sensation.  Clients often come to me with issues in the hips, knees, shoulders, legs all using the same terms to describe often very different issues and even more often from a source other than where they are feeling it.

“Words are important. The words patients use to describe a problem in the clinic may not be the same thing we as clinicians measure in the clinic,” said Kawchuk. “We need to find out what it means exactly when someone says they have a stiff back. We now know it might not mean that their back is mechanically stiff.”

What I chuckle at is what “THEY now know” my clients have been experiencing for over 10 years.