Stiffness after sitting

[maxismall]

What is the physiology behind stiffness occurring (quads) after periods of immobility eg driving or sitting on sofa for 20 minutes? Does it mean my pred dose is not high enough? The stiffness improves after moving about. Thank you.

[PMRpro Ambassador]

It is a phenomenon called myogelosis - the structure of the muscle fibres is changed in their relation to one another and this appears to make them less able to relax so they change consistency.

pubmed.ncbi.nlm.nih.gov/103...

It is often linked to myofascial pain syndrome - and the result is that muscles harden when not being used and getting them to "soften" again is a difficult and protracted process.

Massage can help and so can extracorporeal shockwave therapy which "breaks" the adhesions between the parts of muscle fibres. Inflammation probably makes it worse so it may improve with more pred but not necessarily and frequent but small amounts of movement probably also keep them softer, In some ways you could think of it a bit like making a jelly - if you leave it, it starts to set but if you stir it with a spoon you break up the gelling structure. Warmth also prevents a jelly setting - and I used to find warmth also helped reduce myogelosis.

[maxismall in reply to PMRpro]

Love the jelly analogy. You have helped me understand what's going on & what I can do to improve things a bit. You are a star & I value your support immensely.😊

[bright-horizon in reply to PMRpro]

I am like a board after a nights sleep. If I get up and have a warm shower followed by gentle stretching, the stiffness eases.

[Nextoneplease in reply to PMRpro]

Fantastic analogy, thanks pro 😊

[Ridge in reply to PMRpro]

That is so helpful PMRpro, thank you. I have often wondered if it was a sign of PMR beneath the surface which has not quite fitted a flare or under Pred med. The jelly analogy is brilliant. It also explains the high muscle enzymes I can’t seem to get rid of. Myogelosis a new word for my dictionary!!

[PMRpro Ambassador in reply to Ridge]

How high and which enzymes? High muscle enzymes may suggest something more than PMR - also managed with pred usually but possibly a LOT higher dose to start.

[Perigrina in reply to PMRpro]

Many thanks for this and the link. I found the more I exercised (gently), several times a day, the better I was, and also during the night when I woke. But I couldn't find any relevant research (except to say too much was harmful). This is really helpful, especially for people who feel it hurts too much to exercise.

[PMRpro Ambassador in reply to Perigrina]

Depends on the "hurt" though - if it is post-exercise then it may be a problem. The trouble is, you don't know it was too much until it is too late - hence the way I always suggest returning to activity.

[Gimme in reply to Perigrina]

Same here, I have found that I benefit from moving around in the night, if I wake. I often wake at around the magic 4.30 and can't go back to sleep. I have been known to be tidying up the kitchen in the middle of the night, which loosens up those sore grumpy muscles just nicely. I live in a terraced house, so I bet I am popular with my neighbours. 😳

[Gardening2811 in reply to PMRpro]

Thank you so much for this and thank you to Maxismall for asking the question too- so helpful!

[FRnina in reply to PMRpro]

Oh thanks so much, PMRpro. Enlightenment at last! Myogelosis is a new word for me and that is a clear explanation of what's happening. I fit the phenomenon exactly. The hot-water bottle is becoming my best friend.

[Teekay2 in reply to PMRpro]

I have a small TENS machine which I have started using on my knees. Does this help or just dull the pain?

Sitting with a hot water bottle on my back now after doing some gentle Qigong exercise which eases my back after a night of moving around in pain and waking difficult to move.

[PMRpro Ambassador in reply to Teekay2]

Just dulls the pain I think and only while being used. But if it lets you move that will help too. You can get "mobile" ones.

[Oh-my]

My GP told me during my first diagnosis interview to keep moving and to use heat pads or something similar. I have always found a hot shower first thing has really helped - gentle moving and heat. They never explained why. Thank you for asking the question.