Protective Muscle Guarding

Part Five in the series entitled "Threats to a Proper Knee Replacement Recovery"

This is an educational essay designed to help patients who are facing challenges with their knee rehabilitation at home or in an Outpatient PT setting. We want to acknowledge the valuable contributions of Jason Shepherd, BScPT, Injury Prevention Consultant to this article. To find the other articles on Knee Flexion, Knee Extension, Infection and Deep Vein Thrombosis click here: Threats to a Proper Knee Replacement Recovery.

What is Protective Muscle Guarding?

Dr. Erik Dolton, PhD, has spent considerable time studying the condition known as Protective Muscle Guarding. He says, "when the brain senses bony instability or tissue damage in-and-around the knee joint, information is compiled and 'fast-tracked' to the brain where a determination is made as to the degree of threat and appropriate response the situation demands."

Dr. Dalton continues, "Layering the area with protective muscle guarding is a common decision handed down by the cortex. A protective spasm is the brain's reflex attempt to prevent further damage to injured tissues. By 'splinting' the area with a spasm, muscle 'locking' effectively reduces painful joint movements. The brain simply acts to protect the body: 'When in question, lock the muscle.'" Helping patients avoid PT pain is a major concern of Physio Therapists for knee and other surgeries.

At its most basic level guarding occurs when your therapist pushes your knee one way and you push right back, negating his attempt to help you gain knee flexibility as your body attempts to protect itself.

Today's physical therapist will always be confronted with the mysteries of muscle guarding. And this condition must be dealt with quickly as continued guarding inhibits proper knee rehabilitation. A therapist cannot administer effective therapy if a patient’s protective muscle guarding stops the therapy dead in its tracks. And oftentimes, in addition to the brain’s instinctive reflexogenic response to incoming potentially painful movement, there is the natural reaction to consciously protect oneself from danger. Getting past muscle guarding can be the difference between success and failure (and some unpleasant consequences) for your rehabilitation. For more on guarding and "the pain cycle" see the graphic from Nova Active Rehab, and click here.

Another View on Protective Muscle Guarding (a.k.a. Protective Muscle Spasm)

Notes from Cathedral Chiropractic

Muscle guarding is part of our wonderfully effective self protection mechanisms. However if left untreated it may stop being part of the solution and become part of the problem. As humans we have evolved very effective forms of protection both from injury and from further injury.

* We protect ourselves from injury by having very fast reflexes. When we talk about reflexes we're not simply talking about what happens when we hit your knee with a reflex hammer, more about your body’s ability to correct an unexpected action. For example stepping off an unexpected curb could result in a nasty ankle sprain if your reflexes are unable to react sharply to prevent a fall.