– Derek M. Hansen –
The longer I work with athletes and the non-athlete population, the more I recognize the importance of managing muscle tone on a daily basis. For the lay- person, it is unfortunate that the term “muscle tone” has been associated with making muscles more aesthetically pleasing to the eye. You will often hear someone remark at how they need to “tone-up” the muscles of their stomach, arms or buttocks before heading off on their beach resort vacation. In actual fact, many people simply need to reduce the layer of fatty tissue covering the muscle below. While they may actually have highly toned muscles, their poor eating habits are likely ruining their chances of showing off their hidden “ripped” physique. The concept of muscle tone, however, has greater implications for general health, comfort and, of course, sporting performance. Learning more about how to manage your muscle tone can change your life for the better.
General Definitions of Muscle Tone
I was originally introduced to the concept of muscle tone or “tonus” from my readings of Charlie Francis (Speed Trap and the Charlie Francis Training System) back in the late 1980’s and a chance opportunity to hear him speak in 1986. He presented the concept of muscle tone in one of two different contexts: firstly with muscle preparedness for performance and secondly with the status of muscle in relation to fatigue, recovery and dysfunction. In my many discussions with Coach Francis, he defined muscle tone as the ratio of fired to unfired fibers within a given resting muscle. Thus, a muscle with high tone has a higher proportion of fired fibers versus unfired fibers. Accordingly, a muscle with low tone has a higher proportion of unfired fibers. A muscle with higher tone will give the appearance of being partially contracted and may look more visually appealing to the beach crowd. So, the next time you are using your Thigh-Master to “tone-up your thighs,” it is quite possible – given an appropriately lengthy workout – you are actually increasing the muscle tone in your thighs.
Other definitions of muscle tone have a similar message. Most of them discuss muscle tone as a partially contracted state of muscle that assists with posture and/or maintains the muscle in a constant state of readiness. Muscle tone is most commonly cited in literature on specific neuromuscular diseases such as cerebral palsy (CP). The symptoms of CP in children are often severe and wide ranged, including spasticity (extremely high muscle tone) and impaired motor organization and functioning, including deficits in sitting, standing, locomotion and daily living skills. Damage to the brain in stroke patients also can result in hypertonicity (high muscle tone) and abnormal reflex reactions making walking difficult. I have also worked with a number of elderly patients with cognitive deficits (advanced dementia) who exhibit extremely high muscle tone, even though they are relatively immobile. Strategies designed to reduce muscle tone (i.e. massage, hydrotherapy and static stretching) have shown promise in managing muscle tone in these patients. In patients with Down Syndrome, abnormally low muscle tone can be problematic, impacting their ability to hold posture. Research in all of these areas can help to improve our knowledge of muscle tone management when dealing with both athletes and the general population.
The implications for appropriate muscle tone are tremendous when talking about training and performance. A muscle with relatively high tone can be useful when you are trying to harness the elasticity of the muscle-tendon complex for explosive movements and high-speed sports. However, a muscle with extremely high tone can be problematic when a high degree of muscular coordination is required. High-speed coordinated movements require an ability to contract and relax muscles (agonists and antagonists) in an efficiently sequenced pattern, providing a combination of stiffness, movement and suppleness within tenths or even hundredths of a second. A muscle with extremely high tone cannot provide the relaxation and coordinated control required for these movements and can result in poor movement patterns and, even worse, severe injury. This complexity of tone can be seen with running related hamstring injuries, where the velocity of movement and coordination of contraction must be precise to not only provide powerful hip extension and smooth knee flexion, but also strong co-contraction on ground contact. A high proportion of muscle fiber must be available to fire in order for a sprinting stride to be executed properly and safely.
In terms of muscle readiness for high-speed events, such as the 100 meter sprint, an athlete wants to have a measured degree of elevated muscle tone to provide the stiffness for the rapid ground contacts and elasticity required to attain and maintain maximum velocity. There has been a lot of discussion and research recently regarding “potentiation” of muscles for speed and power. In most cases, I believe these routines are primarily raising muscle tone and stiffening the musculo-tendon systems for force production and high-speed movements. In the past, a well-coordinated warm-up routine would provide a similar effect.
Assessment and Measurement of Muscle Tone
Once I discovered the importance of muscle tone on everyday function and performance, I was eager to determine a method for measuring muscle tone. Using my portable surface electromyograph (EMG) device, I found that I could not accurately record changes in resting muscle activity, regardless of amplification power. The background “noise,” caused by surrounding electrical devices (i.e. lights, computer, radio) created a stronger signal than any level of high muscle tone generated by the nervous system. So, I was not able to independently measure muscle tone changes through electronic means.
My further readings in the area of electromyography determined that no single form of EMG (surface or intramuscular) could adequately detect a signal from resting muscle tone. This result generated an interesting question. Would a person with extremely high muscle tone be consuming significant amounts of nervous energy while at rest? If we eliminated the high muscle tone condition, would this person have more energy for productive activities and even experience a high quality of sleep and rest? I persisted with this line of questioning despite the writings of J.V. Basmajian in Muscles Alive:
“Most neurophysiologists now agree that electromyography shows conclusively the complete relaxation of normal human striated muscle at rest. In other words, by relaxing a muscle, a normal human being can abolish neuromuscular activity in it. This does not mean there is no “tone” (or “tonus”) in skeletal muscle, as some enthusiasts have claimed. It does mean, however, that the usual definition of “tone” should be modified to state that the general tone of a muscle is determined both by the passive elasticity or turgor of muscle (and fibrous) tissues and by the active (though not continuous) contraction of muscle in response to the reaction of the nervous system to stimuli. Thus, at complete rest, a muscle has not lost its tone even though there is no neuromuscular activity in it.”
Some of the best writing on muscle tone can be found on a web site provided by Neurosoma. Neurosoma appears to be a therapeutic technique designed to address high muscle tone (often referred to as hypertonia) and the negative effects of such a condition. I know nothing about the Neurosoma technique, but was impressed with the unprecedented information presented on their site regarding muscle tone. They regard hypertonia as muscle tone run amok – the muscles are unable to relax. Hypertonia results in numerous other problems, many of which are associated with joint pain and dysfunction, as well as nerve impingements. The Neurosoma site describes muscle tone as contractions that are “turning on and off, but overlapping so smoothly and steadily, with no spiking contractions, that the electromyography doesn’t read it. In regular skeletal muscle contraction of course, the EMG shows muscle contraction very clearly as spikes, and can measure how many pulses per second as well as the strength of each pulse.” So, by their definition, there may actually be nervous system involvement in resting muscle tone. However, it is so subtle that it does not create the spike normally detected by EMG.
I personally find it hard to believe that there is absolutely no neuromuscular activity in a high muscle tone subject. My own personal findings measuring Heart Rate Variability (HRV) pre- and post-treatment have shown that activities such as massage and passive static stretching significantly reduce the involvement of the sympathetic nervous system (fight or flight response). Athletes quickly demonstrate a strong parasympathetic response (rest and digest response) as a result of these activities. My conclusions: a relationship does exist between muscle tone and nervous system output and status. Muscle loosening and enhanced range of motion are the result of these muscular therapies and subjects also note an improved quality of sleep and a general sense of well-being. Could it be that reducing muscle tone in healthy individuals actually reduces the amount of nervous system stress they incur throughout the day and night?
Perhaps the easiest method of determining muscle tone status is to simply use your hands to touch the muscle and perform passes along the muscle. I will do this on a daily basis with athletes who I suspect are at risk for injury based on their abnormally elevated muscle tone. With very little experience, you can quickly detect excessively high muscle tone in an athlete. In one specific case, a muscular football running back I was working with had abnormally high muscle tone in his quadriceps, hamstrings and glutes, resulting in significant knee and hip pain. Despite several hours of massage and carefully applied static stretching, we could only manage a minor reduction in resting muscle tone. After several days of investigation, I finally discovered the athlete had a prescription for Adderall, a drug used for treatment of Attention Deficit Disorder (ADD). Many ADD medications act as stimulants and can elevate the sympathetic nervous system and, hence, increase resting muscle tone. A reduction in the dosage for this medication helped to effect a more manageable resting muscle tone, relieving the chronic joint pain experienced by this athlete. He also responded much more favorably to soft-tissue treatment.
Other methods of assessment include basic observation, including assessing biomechanics of movement and listening for heavy foot-falls during running. Athletes that are fighting the internal resistance of their own musculature will demonstrate obvious signs of biomechanical inefficiency. You will also visually and audibly notice a plodding gait, as opposed to a light, efficient stride. These athletes will also commonly experience a greater degree of soreness and more prolonged soreness following training due to their higher levels of muscle tension.
My research also revealed that one company has also created a state of the art myotonometer that can accurately measure resting muscle tone. This myotonometer is produced by Neurogenic Technologies, Inc. and “quickly quantifies muscle stiffness, muscle tone, muscle compliance, muscle strength and the level of severity of the spastic condition.”
Unfortunately, the price tag for this novel item was much too high to justify replacing my simple “hands-on” assessment technique. However, such as device could prove to be invaluable for an accurate measure of muscle tone in comparison studies (i.e. effect of different therapies on reducing muscle tone).
Implications of Inappropriate Muscle Tone
The muscles and soft-tissues of the body are designed to generate force, but they are also intended to absorb force and reduce wear-and-tear on the skeletal structures and joints. Similar to the suspension on a car, the muscles and tendons should provide stability and support, while not allowing the “vehicle” to shake itself apart. Athletes with very high muscle tone are susceptible to a series of problems if their muscles and soft-tissues are not managed appropriately. Provided below are a number of problems that can originate from excessively high muscle tone:
– Knee pain. There are many different causes of knee pain and unless you are installing hardwood floors on a daily basis, the cause of the pain can be directly related to high muscle tone in the surrounding structures. Runners can experience lateral muscle tightness (in the vastus lateralis and the iliotibial tract) that places asymmetrical stress on the patella, impacting its tracking. Tightness and discomfort can appear within the knee, as well as in the patellar tendon between the bottom of the patella and the top of the tibia. Knee pain can also come from an imbalance in tone between the quadriceps and hamstrings resulting in significant imbalances during eccentric movements where significant co-contraction is required. While many believe that over-active quadriceps are the culprit, many times the high tone in the hamstrings does not allow for enough available muscle fibers to fire appropriately to balance the co-contraction. The result is more sheer stress on the knee joint, significant discomfort and the potential for ligament injury.
– Low back pain. The muscle tone of the large hip flexors, known as the iliopsoas muscles, can play a significant role in chronic low back pain. These muscles are responsible for a variety of functions including hip flexion, spinal support and torso rotation. The iliopsoas attachment points originate in the lower thoracic and lumbar spine and can put tremendous stress on the lower vertebrae as resting muscle tone elevates and the overall muscle shortens. Individuals who sit for long periods of time (i.e. cyclists, office workers, drivers) will experience significant low back discomfort as their hip flexor muscles shorten and place more tension on the lower back.
Athletes with extremely high muscle tone in their gluteal muscles will also experience low back discomfort. Many sports involve a lowering of the center of mass, involving the gluteal muscles and quadriceps. If the glutes are not functioning properly (due to high muscle tone) athletes will tend to bend over more at the back, rather than squat down. This action puts more stress on the lower back muscles by transferring a load that is typically handled by the stronger gluteal muscles. Because these muscles are so strong, elevated muscle tone in the gluteal muscles can result in significant discomfort along the pelvic crest and into the lower back. I believe that sacro-iliac (SI) joint mobility is also compromised, locked into place by hypertonic gluteal muscles, transferring more stress into the lower back and hamstrings during explosive movements.
– Shoulder pain. Because the shoulder is such a complex joint with multiple muscles controlling and stabilizing the shoulder structure, small changes in muscle tone in individual component parts can drastically change the health and stability of the shoulder. This is particularly true in cases of throwing athletes who move their arm in a high-velocity, ballistic fashion. My personal experience has shown that while others may claim the shoulder needs to be strengthened, often the shoulder exhibits extremely high tone in specific areas rendering those muscles ineffective and not available for contraction. In actuality, the shoulder may need to be treated in such a way to reduce muscle tone and enhance recruitment of key stabilizers and prime movers. In throwing athletes (i.e. baseball, football quarterback, javelin), often the posterior muscles used in decelerating the arm exhibit extremely high muscle tone. The shoulder is “thrown” out of balance and the forward motion of throwing is resisted by the antagonists. Soft-tissue treatment of the posterior muscles can often yield relief to referring pain the anterior muscles.
– Shinsplints. Unless you have been kicked in the tibia by a steel-toe boot, it is likely your shin pain during and after running is caused by extremely high muscle tone in the calves. The tightness in the compartments of the lower leg can create pain in the shins on two levels: firstly by placing extreme tension on the attachment points along the tibia and, secondly, by eliminating the contractile abilities of the calf muscles and reducing the shock-absorbing abilities of the foot and lower leg. Each stride results in magnified lower-leg trauma on foot contact, perpetuating the shin-splint problem. Until the muscle tone in the lower leg is reduced, there will not be enough available muscle fiber to dampen the force of ground contact, regardless of how much money you spend on footwear. A period of time must be taken where running volume is significantly reduced, and proper soft-tissue therapy is administered on a regular basis.
– Plantar fasciitis. Similar to shinsplints, problems in the foot typically originate from high muscle tone in the lower leg and calf. The muscles of the calf are continuous – via connective tissue – with the muscles of the foot. If the calves tighten and shorten excessively, the strength, mechanics and durability of the foot muscles can be compromised. Additionally, any dysfunction within the calf can lead to a redistribution of force to other areas such as the hip and foot. At some point, the compensational shift will lead to a volume overload in these areas and result in another soft-tissue problem.
Once you understand the impact of muscle tone changes, the rehabilitation process becomes a much more straightforward process of restoring healthy muscle tone in various areas of the body. There are many instances when injury symptoms persist well beyond the stage of tissue healing and strengthening. Proper comfort and coordination can only be restored when all muscles are in balance and have the available fiber to recruit when needed.
Methods of Managing Muscle Tone
There are many methods available to manage muscle tone. Your ultimate choice of method may depend on your patience, financial means, pain tolerance and/or personal skill-set. Many people rely on a combination of methods used in a specific sequence throughout the week. Whatever your choice, you have to recognize that you will need to implement that method or combination of methods on a regular basis, as muscle tone must be managed on a daily basis for the rest of your life if you wish to maximize your quality of life. Some of the methods that you may wish to implement in your regular program of muscle tone management are provided below.
The basic action of passing over the muscles during a massage will help to reduce muscle tone over the duration of the treatment. A more superficial surface massage will have a minor impact, while a deeper treatment will have a more profound impact on reducing overall muscle tone. The impact of massage is best described by Charlie Francis’ overview of the approach to preparing for the 100-meter sprint at the Olympics. The initial massages administered by a therapist leading into the Olympic Games will be of a deeper nature, because the athlete does not want to have their muscle tone at too high a level. If the muscle tone is too high during the tapering training sessions and the initial qualifying round of the competition, the athlete will not only fatigue much more quickly, but may also be at higher risk of injury over multiple repetitions and races. As the athlete progresses past the initial qualifying race, the massage will become more superficial in nature, facilitating blood flow while not reducing muscle tone. Higher muscle tone is desirable for the more highly contested heats of the competition as it allows for greater force production and elasticity due to greater stiffness in the soft-tissues, particularly in the lower leg and feet. Prior to the final of the 100 meters, the massage tends to be administered in more of a slapping nature, enhancing athlete alertness with no risk of reducing tone. Well after a competition has been completed, deep tissue massage can be used to bring muscle tone down and separate muscle adhesions. The process is akin to that taken by a Formula 1 racing mechanical crew when they dismantle the racecar’s power plant to clean the engine components, replace the fluids and replace worn parts.
Massage can be considered a fundamental tool for the management of muscle tone. It not only serves as a treatment method, but also a valuable diagnostic tool. Regular massage can keep the muscles in good working order and provide a coach, athlete and therapist with a consistent status check between workouts and competitions.
Deep Tissue Massage
While not as comfortable as a regular massage, some individuals prefer to undergo the masochistic route of intensive deep tissue massage. While regular massage will tend to coax the muscle into “releasing” through a series of passes and movements that facilitate circulation, stretching and relaxation, deep tissue works aggressively, using thumbs, knuckles and elbows to over-stimulate the muscles and fatigue them into releasing their contraction. Although deep tissue massage and other similar methods such as “Rolfing” yield effective results, rendering the subject into a mere jellyfish of soft-tissue, it can be an unbelievably painful experience. Some argue that aggressive methods that fatigue the nervous system can have negative implications for long-term muscle tone management. Some patients have relapses that involve a more aggressive return of spasticity within 24-48 hours of the original treatment. However, others swear by these treatments and boast to their friends about how their therapist manhandles them every week.
Static stretching has long been a basic means of relaxing muscle tissue and restoring resting muscle length. Studies documenting the use of static stretching in warm-up prior to explosive activities prove that static stretching can reduce muscle tone dramatically. Subjects that have undertaken a static stretching routine immediately prior to sprint or vertical jump tests have demonstrated significant reductions in performance. This result mirrors the guidelines for muscle tone management provided by Charlie Francis over 30 years ago using massage at major 100-meter competitions. Higher muscle tone is preferable for the 100-meter final.
Given that static stretching is an effective means of reducing muscle tone, how come there is still ongoing debate over how it should be performed? My work several years ago with a therapist named Nikos Apostolopoulos provided me with greater insight into the application of a passive method of static stretching. His use of a stretching method developed by himself, known as “Microstretching,” involved specific stretching exercises held for 60 seconds at an extremely low level of muscle tension. While everyone else was pushing and pulling their way to painful, excessive ranges of motion and muscle tension, Apostolopoulos was achieving great reproducible results by erring on the side of less tension and being patient. The passive stretches were reducing muscle tone by not triggering the muscle spindle fibers and not creating pain and discomfort that could adversely arouse the sympathetic nervous system. The result was a muscle that had reduced tone and restored resting length.
Effective static stretching demands incredible awareness on the part of the individual performing the stretch. Anyone can push a stretch as hard as possible, but it takes a skilled individual to understand how little tension is required to effect a productive stretch. When you move a limb through its range of motion, stretching of the tissues occurs well before your conscious self detects any tangible feeling of stretch or elongation. It is this zone of the unconscious awareness of a stretch where individuals will find the best results when seeking muscle tone reduction.
While I have limited personal experience with acupuncture and related therapies (i.e. intramuscular electrotherapy), I am well aware that this method has worked effectively to reduce muscle tone for thousands of years. Traditional Chinese medicine practitioners have long put forward the notion of the flow of energy (or “Chi”) through the body and the use of acupuncture to eliminate disruptions in the circulation of energy and restore the proper energy flow. Charlie Francis was convinced that the use of needles in acupuncture created an electro-chemical reaction in and around the area of a motor point that influenced the muscle’s ability to de-contract and relax. His comment to me was that the results of acupuncture couldn’t be about the exact insertion of the needle into a specific part of the muscle. “Even people who are inexperienced at acupuncture are getting significant results, when I know they are not close to hitting the motor point like the experienced practitioners,” he would tell me. “So, it must be that the needles are doing what the ancient Chinese physicians were telling us and rechanneling electrical impulses that control muscle contraction and tone.” His assertion is supported by use of both surface electronic muscle stimulation and intramuscular electronic muscle stimulation – both of which achieve significant results on a regular basis despite less than exact placement of pads and needles.
Trigger Point Therapy and Related Approaches
For those of you who cannot stand the thought of having a needle inserted several inches into your muscles, there are less invasive ways of stimulating motor points. Use of the fingers can be quite effective for targeting motor points that control muscle activation. Acupressure techniques are used across several manual therapy techniques to stimulate motor points and achieve a release in muscle spasm or undesirable contraction. As with any manual therapy technique, there are good practitioners and those that are not so good. Look for a therapist that is more concerned about locating the correct motor points and strategically targeting the muscle tissue in a progressive manner. Many therapists will opt for jamming their elbow into your soft-tissues and watching you squirm. It won’t take long for you to find out what kind of therapist you have landed. Effective soft-tissue therapy does not need to be a torture session. If you do not want to pay someone to inflict punishment on your body, you can take something as simple as a tennis ball or foam roller and use it to find key motor points to effect a muscle release.
Electronic Muscle Stimulation (EMS)
I have found myself in situations where I did not have the time or energy to employ massage and stretching on an athlete that had significantly tight glutes and hips. Many of the deep muscles were extremely tight, but also inaccessible to hands-on techniques because of the various tight layers of superficial muscle covering them. Using the “peeling the onion” technique of working the outer layers in order to address the inner layers would require hours of hands-on work and result in significant personal exhaustion. In these cases, I have deferred to the use of different forms of electrotherapy to treat the deeper muscle tightness. I have used low-frequency, alternating current electronic muscle stimulation to fatigue spastic muscle into relaxation. I have experienced some limited success with interferential current to facilitate muscle relaxation. And, I have employed pulsed direct current (PDC) at relatively high frequencies and intensities to effect significant muscle loosening. These electrotherapy techniques have worked well as pre-cursors to other forms of muscle tone reduction, allowing for more effective stretching and massage with more compliant tissues.
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I have also noticed that athletes and non-athletes with high muscle tone exhibit a corresponding fascial (muscle sheath) tightness that can exacerbate overall tightness and muscle restrictions. Evidence indicates that there is constant “communication” between the muscle and its surrounding tissue compartment, providing stiffness and support for both posture and movement. When the muscle tissue experiences significant trauma – either through the volume and/or intensity of contraction – both muscle and fascia interact in a manner that stiffens the entire system, also involving the tendons that are an extension of the myofascial continuum. While this stiffness of muscle and fascia should be a short-term adjustment, many times the tightness can persist over the long term, creating significant restriction and discomfort. Conventional massage and static stretching may help to relieve a portion of the tightness, but special care must be taken to stretch the fascial anatomical structures, thereby allowing the underlying muscle tissue to de-contract and restore resting length. Numerous myofascial release techniques are available to assist individuals in self-treatment, as well as guide them to experienced practitioners who can help them “unwind.” These techniques can accompany a general program of muscle loosening and tone reduction.
It is apparent that awareness and knowledge of appropriate muscle tone is a key element of athlete preparation and recovery. Athletes that employ methods that control muscle tone for the different situations that arise in training, competition and recovery will not only be more successful, but also minimize their risk of injury. It is also important for coaches to understand how muscle tone can elevate during different phases of training, influenced by training volume, hardness of playing surfaces, stress experienced outside of training, and environmental conditions (i.e. temperature, altitude, humidity). Coaches must then assume a flexible approach that not only adapts the training methods, but also introduces greater recovery and regeneration techniques to manage muscle tone.
For the average person, lack of activity can elevate tone as significantly as too much activity. Regular exercise and stretching can help to offset abnormally high muscle tone. Prolonged sitting or standing can lead to significant problems related to chronic pain in the neck, lower back, hips, knees and feet. Since a good portion of the population is required to sit or stand in their daily jobs, it is important to address your muscle tone changes on a daily basis. This does not mean that you need to get daily massages, but it does mean that everyone should have a strategy for enhancing their muscle health and appropriately managing muscle tone. A good place to start is by referencing a basic anatomy book to determine location of muscles and relevant attachment points. Once you have a good understanding of functional anatomy, it is much easier to successfully treat soft-tissue injuries and related joint pain using basic principles of muscle tone management.