Hypertonicity, Hypotonicity and Corrective Exercise

A lot of the training process can really be summed up in a couple quick sound bites. The goal we are trying to achieve with training is to balance the length tension dynamics within the musculoskeletal system. When you get this blend correct or in other words optimize this balance what happens is that people move more freely and create more force with less effort. If you can't balance the scales then you close the joint spaces so tightly that what happens is restriction of movement, pain and injury.

When discussing this dynamic relationship that occurs over a long term training process eventually what you run into are two specific points on the continuum. On one end is hypertonicity(too tight) and on the other end hypotonicity(too loose). What coaches should be trying to help athletes optimize is the balance in the middle. If we lose range of motion somewhere in the body there is going to be hypertonicity around that joint. This is pretty much guaranteed. That tightness or extra "tone" is protective of the joint and in order to protect it from creating further instability or injury the brain creates stiffness(excessive tone) around it. This is useful in small doses but ultimately too much of a good protective measure is eventually painful and your brain will get the signal that the joints are not articulating well. It's very common for people to exhibit all manners of joint pain because of excessive stiffness/tone.

There are a lot of ways you can help the brain manage the system better. One would be to use exercises in order to create mechanical tension in the system somewhere else that would help the brain distribute the neural drive across a broader section of tissues. This would over a longer period of time assist in removing the excessive protective stiffness in the tissues. However, you can also apply appropriate amounts of force to the tissues and they will also become more pliable. The balance of tension in the tissues and the resulting freedom of movement comes along with getting the blend right and the more optimal the tone the more freedom people experience.

On the other side of the continuum is hypotonicity(not enough tone). When you lack significant enough tone in order to keep moving without issues the challenge becomes generating force from the right places in order to keep the system "quiet". It's very common to have not enough stiffness in muscles that limit hyperextension of joints. Hamstrings, posterior tibialis, glutes, abdomen as well as the muscles of posterior side of the rib cage usually exhibit these dynamics. As a result the muscles that pick up the musculoskeletal slack usually become too stiff and limit active and passive ROM. People don't randomly exhibit joint ROM problems from a well tensioned system. Instead what happens is there is too much tone or not enough in some relatively predictable places and remediation of this dynamic balance of tension is pretty important to reset before loading the individual with exponentially more greater amounts of stress.

This should all be considered within a corrective exercise paradigm. The right exercises should be the ones that, when applied correctly, decrease joint stress/pain, increase movement freedom and improves circulation through the blood vessels. It's possible to gauge improvement of this dynamic by watching movement as well as communicating well with the client or athlete. When they start to move abnormally as well as start to exhibit signs of extra discomfort with the increase of training stressors that is the time for the coach/trainer to get extra curious about this balance.

Does the athlete or client have the right blend of exercises in the training plan?

Do they have enough access to soft tissue work in order to continue engagement with this level of stress in training?

Those should be the first two thoughts.

Beyond that there are other considerations like hydration and nutrition as well as other stressors in the background of the life of the client/athlete. However, some issues can not be remediated with exercises, soft tissue work and dialing in nutritional fundamentals. Other considerations should be factored in as well. If there has been a death in the family, or the loss of a friend or are they putting in extra hours at a demanding job there will be challenges that are impossible to overcome in short time frames. Since stress is not separated out in to different buckets the body absorbs all of the stressors and this can impact the training and restorative process for the tissues.

The best process to engage in is really the one that allows you to treat issues as they arise and change exercises to meet the demand of the state of the tissues. If you have an unnecessarily rigid training plan then what happens is that you miss opportunities to optimize the tone of the tissues. Also, if you are getting the corrective exercises wrong you are going to have a hard time resolving anything to begin with. Long term it is best to keep an open mind and adapt to the situations as they develop. The body is constantly adapting to all sorts of stressors and it is important to manage these adaptations daily.