Seeking advice, and the sensation of tension without muscles actually being tight

[Mac M]

I'm looking for any insights or guidance that anyone may have. I've already found some great info in these forums and glad to be here.

This post is a bit long, as I'm trying to be thorough. 

Context:

I'm 44 years old, and very healthy and active (aside from this). I eat well, ran a marathon last year, and was doing body weight workouts until the issue I'm about to describe got bad enough to take over my focus.

Symptoms early on:

About 7 months ago I was hit with extremely tight shoulders a few days after an intense hot pilates class. I initially thought I was just sore from the class. Then this was on and off for a few months, then it hit hard and didn't relent. At this point the pain would move around the neck, shoulders, traps, between the shoulder blades. At times it was pretty debilitating, and really exhausting.

Milestones:

After lots of work on this, I've had two major milestones in improvement:

1) The first big improvement happened when I started doing a lot of intense stretching. Note that this was before I discovered Kit and these programs, so was doing more stretching that is generally recommended here, but from what I could tell it only helped me feel better, and did not cause harm. 

2) The second was after I had an MRI and was told my the radiologist and a osteopath that I had 3 bulging discs in my cervical spine, C2-C5, two of which were more on the the right side, the other more on the left side. Both people said that they weren't severe and were nothing to worry about yet, aside from the discomfort they might be causing. I then saw a neurosurgeon who said I did NOT have bulging discs and that my cervical spine is more straight than it should be and that that could be causing imbalances. So, that left me unsure how to proceed. But I knew that looking down even for brief periods made me feel terrible, so I stopped doing that, and started doing neck retractions. Within a couple days I saw another big leap in progress.

Additionally, I've had myofascial release 3 times, which seemed to help a lot the first time (symptoms pretty much fully subsided for about 10 days, a couple days after the myofascial massage), and helped less the subsequent times. Then I wonder if the first time it was just a coincidence that I felt better a couple days later.

Current symptoms:

These days, it's usually very mild in the morning and gets worse within an hour or two. I wouldn't call it "painful", but an ongoing sense of extreme tension. In other words, if it was just 5 minutes a day, it wouldn't be a huge deal, but when it doesn't stop, it's terrible.

I almost constantly have a feeling of tension in the right side of my neck, on the side and towards the back, as well as my upper traps (mainly the right side but can be both sides). When I tilt my head to the left side I definitely feel those right side neck muscles are quite tight.

But also, even towards the end of the 18 minute relaxation audio session, I still have that sensation of tension on the right side of my neck, and towards the back of the neck. But when I go to feel that area, all the muscles feel loose, and not tight at all. I've also had a number of different types of massages and am generally told I don't feel unusually tight. I'm curious what this indicates.

My efforts:

While I've been good about staying on top of this -- I spend time every day working on it -- what I have not been good about it sticking to a single routine/plan for a long period. I'm constantly re-assessing and adjusting my plan. I found some posts here suggesting to slow down and stick to a plan, so I'm going to work on that. I've seen a handful of physical therapists that seemed great, but none have led me to a solution.

I have done a lot of work becoming more aware of my body and the sensations in it, and noticing when I tense up, usually in the jaw and shoulders. So I'm aware that I do this, and I do my best to relax and breathe when I catch this. I mostly notice this when at my desk (I use a standing desk), and when my kids are being a pain :)

I have the Overcome Neck Pain Course and have been working through it. Admittedly, I'm struggling going as slowly as suggested, because I have been already doing a lot of similar stretches fairly intensely leading up to discovering this course, and nothing has seemed to cause more pain or make things worse. Stretching always feels great.

The other thing I'm struggling with, is that I've been doing the GMB Elements course, and go back and forth on whether or not that's a good idea before I resolve this. And I've been running a couple times a week. There are not any activities that hurt, and actually being active makes me feel better (temporarily), not worse.

Potentially relevant:

In 2007 I had Bankart Repair on my right shoulder to fix my shoulder that kept dislocating. Aside from a decreased range of motion, it was good for years. Then a couple years ago I started noticing slight intermittent impingement. It was never severe so I wasn't always good about doing my physical therapy exercises. Part of me wonders if this contributed to whatever is going on now. About a month ago I started hanging from rings multiple times a day and the impingement is mostly gone, except for when my arm goes in a couple specific directions. But it's definitely improving, and the lower trap pain seems to be much less.

I also had a pretty stressful 2 years leading up to this, though by the time the actually started, things were much less stressful. I still wonder if it's connected though.

Conclusion:

I'm left not knowing what's causing this. Things people suggest are: mysfascial issue, issues caused by shoulder scar from Bankart Repair, tension, bulging discs, straight cervical spine, central sensitization, upper crossed syndrome (though I've been told my shoulders are slightly rolled forward, but nothing that should cause problems). It makes it tough to know where to focus.
Suggestions?

I'd love any thoughts/insights on any of this, especially:

1) Is the sensation of tension, without actually having tense muscles, common? Do we know the potential causes? Is this normally what tension is like, or does tension generally indicate muscles that are actually physically tight?

2) Suggestions on how I proceed from here?

3) Is it okay to do things like GMB Elements now if it doesn't hurt?

 

[Kit_L]

https://kitlaughlin.com/forums/index.php?/topic/1415-relaxation-vs-rom-interesting-article/

This is one of the articles we suggest you read before posting; one of the reasons is to have a common language for discussion.

To answer your q. 1 (above, "Is the sensation of tension, without actually having tense muscles, common? Do we know the potential causes? Is this normally what tension is like, or does tension generally indicate muscles that are actually physically tight?"), the answer is yes, extremely common especially following a period of stress, but few talk about it. More to come after you've read the linked discussion.

[Mac M]

@Kit_LThanks for the reply. I read a portion of that thread previously (it's long!) and just read through the whole thing.

So many great nuggets in there. My main takeaway is a big inspiration to work on relaxation, on its own and in everyday activities. I know it would benefit me in many ways.

I've recently been listening to your lying relaxation audio clips twice a day. I've noticed big improvements in my ability to notice sensations in my body both during the sessions and outside of them. Today for example, while laying down and turning my head slowly to the side, I noticed for the first time the weight of my cheek as gravity pulled it to the ground as I turned my head. Sounds small but it was a strong sensation that until now went completely unnoticed.

I also love your discussion of the separation of the mind and body. Related to that, there are definitely times when my mind is wandering and I come to, to realize my pain is gone, then after I'm thinking about it briefly, I can start to feel the pain again. There's obviously an interesting connection there.

[Kit_L]

These kinds of insights start with 'small' things like the weight of your cheek, but in reality, there are no small things; it's the mind that cuts reality into parts that give that impression. If we are completely relaxed, nature/everything comes to us seamlessly, and we are fully present in it and part of it.

The repeated experience of deep relaxation will change everything, in time.

A realisation I had once that might be helpful is that pain is a sensation and suffering is the story we tell ourselves about it. The mind literally creates the suffering. The next time you experience pain, of any kind, really feel it  and try to go beneath the story/emotional response to see if this might be true.

[Jim Pickles]

Interesting - so different from the normal situation where muscle tension is present. It suggests to me that it is a neural response.

"Related to that, there are definitely times when my mind is wandering and I come to, to realize my pain is gone, then after I'm thinking about it briefly, I can start to feel the pain again."

Do you know about "centralized pain" (or "central pain")? That is, after a painful experience, the brain has learned the pain pattern, and starts to generate its own pain, repeating the pattern, even once the original cause has gone. You can do a search and read about it. You need to find ways of exercising or mind activities that cause to pain to disappear, for short times at first, and then explore and practice to make them longer and longer. The activities could be mental distractions or other exercises. It is important to keep moving, and not rest the painful area too much, because if there is no neural stimulation coming from those areas, then the pain signals will invade the unstimulated parts of the central nervous system, and this will make the centralized pain stronger.

Same thing as Kit is saying really, but put in a different way.

[Kit_L]

@Jim Pickles: dear friend, you are assuming that the reported "sensation of tension without muscles actually being tight" is accurate. We cannot rely on the accuracy of this assertion, because further down in the same post he mentions tremendous tension in particular muscles. The idea that you can feel the sensation of tension in the muscles without them being actually tight is just an idea—this has to be tested. By testing, I mean that a skilled massage therapist or similar needs to  press on all the places that we expect someone to hold tension, and the patient report no painful sensations. If someone has no muscular tension, the practitioner feels no resistance—and as you probably know, this never happens. In the vast majority of the population the posited relationship is not what's happening: they feel tense because the muscles ARE tight (or perhaps better, resistant to external pressure) There is no experience of muscular tension without actual muscular tension being present, no matter what the mind is saying!

There's much more to this than just this simple story though. Robert Schleip told me of an experiment that he and three other Rolfers ran on one of their colleagues, who was also a Rolfer, where they anaesthetised him – their research facility is right next to a medical school. The three Rolfers and Robert worked on this guy and did all the things that they normally do in the standard Rolfing sessions, while the patient was unconscious. What they found was that when he regained consciousness there was no change at all in his range of movement or posture and all other things they test before and after Rolfing sessions. Robert told me publicly that he is convinced that unless the mind is actively involved in the process of the Rolfing, no actual change happens to the tissues. This is completely consistent with the points that I am putting here. It is not possible to separate the mind and the body in the way we conventionally do.

[Mac M]

I had a massage just last night and the therapist said I felt "very tight" all over my upper back and neck.

I'm realizing I'm using the term "tight" in two different ways. My neck muscles feel "tight" on the right side when I tilt my head to the left. Tight in this case referring to shorter, less flexible.

When I mention my shoulders and neck feel "tight" as I'm laying down attempting to relax, but they don't feel tight to the touch, I'm referring to hardness. That is they don't feel hard to the touch as my mind expects them to given my perception of the sensations I'm feeling there. Which then leaves me wondering what the sensation is if my muscles feel soft to my touch but my mind is perceiving something more. And this is where I am curious about the centralized pain idea. Or if you have any other thoughts I'm all ears. 

As a side note, I've started reading A Guide to Better Movement which talks a lot about the role of our neurological mappings on our perception of sensations. Very fascinating.

[Kit_L]

If the therapist said you were tight, then he/she felt that there was resistance in the muscles—and that's exactly what I was talking about in my last post. That resistance is, at its root, protective tension and all living creatures exhibit it. No one has ever responded to stress or a threat by opening, lengthening, and relaxing.

Practising relaxation techniques lowers this resistance, over time. Stretching does too, but via different but related mechanisms, and stretching allows areas to be targeted. In the deeply relaxed person, there is no resistance; the body feels like butter when relaxed. This has zero negative effects on the capacity to generate power when needed, too. Being able to relax simple lowers the resting muscle tonus. This is what we experience as the opposite to being anxious.

Your muscles may not feel hard to your touch, but if the therapist reports that they do, then likely they are, no matter how they feel to you. 

Your perceptions in this realm are likely not accurate, which is what @Jim Pickles was pointing to, I believe. These can be changed. On re-reading your posts, I believe that you will benefit from practising the relaxation exercise (we have hundreds of audio files free over on our site) intensively. For example, on a six month retreat in Taos, New Mexico, I did 4 to 6 lying relaxation practices a day for months until my body changed permanently. These practises allow the body–mind to remake their relationship; the result in my case was permanently lowered muscular–mental tension, and this has remained.

See here: https://stretchtherapy.net/relaxation-wiki/

[Mac M]

Thanks Kit. I've already spent time on the relaxation wiki and have been relaxing to one of your 18 minute relaxation audio recordings at least twice a day for the last 5 days or so and plan to keep on it.

Thanks again for the thoughts and feedback.

[Kit_L]

@Mac M: there are about 200 different ones on the site; use any that appeal. Each focuses on some 'small' different aspect. Changing the instructions will help.