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All About Muscle Knots: What They Are and How to Relieve Them


Picture of a rope knot meant to represent a muscle not, or trigger point


You probably know what muscle knots feel like - those painful, crunchy little nodules under your fingers when you massage your achy shoulders. Have you ever wondered what muscle knots actually are, how exactly they form, and how you can get rid of the pesky little buggers? You're not alone. Wander into a roomful of bodyworkers and ask them what question they get asked over and over (and over), and I guarantee almost all of them will say: Do your hands get tired? Followed by: Am I a total mess?? And, finally: What exactly is a muscle knot, anyway?


So, let's dive in and find out what muscle knots are, how they form, and what we can do to prevent them.


What is a Muscle Knot?


The first thing to know is that Muscle knot is a colloquialism for myofascial trigger point or just trigger point. But ask a person if they have any myofascial trigger points, and you might get a blank stare.


A trigger point is a hyper-irritable spot within a taut band of muscle. They can cause localized or referred pain - pain felt right where the knot is or in another part of the body. They're typically small and can felt as a nodule or bump within the muscle tissue. Some people name them, like: "the boss" or "my teenager."


Research into the exact nature and function of trigger points is ongoing, but what we do know is that a knot is a bundle of muscle fibers stuck in a contracted state and that this sustained muscle contraction at the site of a trigger point compresses local blood supply, leading to an energy crisis in that area (fatigue).


The Science Behind Trigger Points


While the exact mechanisms behind trigger points are still being studied, researchers have proposed several theories about how they develop:


Muscle Overuse: Repetitive motions or sustained contractions can lead to localized areas of muscle tension. For example, hours spent hunched over a computer, lugging too-heavy bags home, or a long night's sleep - on a funky pillow.


Trauma: Acute injuries, or micro-trauma from poor posture and muscle compensation.


Stress: Psychological stress increases muscle tension, predisposing certain areas to knots.


Types of Trigger Points


Trigger points can be classified in several ways:


  1. Active vs. Latent: Active trigger points cause spontaneous pain often felt as a throbbing ache or sudden, sharp pain. Latent trigger points only hurt when pressed.

  2. Primary vs. Satellite: Primary trigger points develop independently and satellite trigger points form in response to stress in surrounding muscles stemming from the primary knots.

  3. Central vs. Attachment: Central muscle knots are in the muscle belly and attachment knots are at muscle-tendon junctions.


Symptoms and Effects


Trigger points can cause a range of symptoms, including:


  • Localized pain and tenderness

  • Referred pain in other areas of the body

  • Muscle stiffness and reduced range of motion

  • Weakness in the affected muscle

  • Autonomic responses like sweating or goosebumps


Trigger points also cue the body's pain-spasm-pain cycle, the body's protective response against musculoskeletal pain and injury. During this response the muscles that surround a point of pain and stiffness spasm and become stiff, acting as a splint to protect the injured muscle. Those protective muscles then become painful themselves creating a cascading effect of radiating pain. Furthermore, when a trigger point weakens a muscle and reduces the range of motion, the surrounding muscles become overloaded due to the strain of overcompensation. These symptoms can significantly impact daily life, affecting sleep, work performance, and overall quality of life.


Referred Pain: A Hallmark of Trigger Points


Referred pain is a key characteristic of trigger points. Referred pain means that where a person feels the pain is different from where the trigger point is actually located and the pain is often described as spreading or radiating.


Trigger points can cause referred pain in seemingly unrelated areas. For example, trigger points in the upper trapezius can cause pain in the head, shoulder blade, or arm. Muscle knots act as ongoing sources of nociception (pain signals) that contribute to pain propagation and widespread pain. This can make treating muscle knots tricky for a practitioner without a keen understanding of anatomy and the nature of trigger points. Proper treatment of trigger points can help interrupt the pain referral process.


The patterns of referred pain caused by muscle knots are consistent and have been mapped out. Triggerpoints.net is one free online resource that allows you to see these well-known patterns. Using an interactive digital model, you can select an area of pain and discover where the likely trigger point is located.


Diagnosing and Assessing Trigger Points


There's no definitive test for muscle knots and healthcare providers typically rely on palpation, patient history, and exclusion of other potential causes of pain. Usually, a provider will suggest treatment for muscle knots as a first step to managing moderate pain of unknown origin and move to imaging and other testing if the pain doesn't resolve.


Treating Trigger Points


There are various approaches to treating trigger points. The most effective and efficient treatment usually combines two or more of the following and can take time to resolve.


Manual Therapy: Techniques like deep tissue massage, myofascial release, and trigger point therapy can help alleviate pain and tension by targeting specific trigger points. A practitioner skilled in working with trigger points can recognize familiar referral patterns and hone in on the precise area that needs to be treated. But even a general relaxation massage can go a long way to encourage muscle fibers to let go. These therapies often include some stretching which further facilitates softening and relaxing the muscle the affected muscle fibers. At-home massage techniques with a foam roller, tennis ball, or massage gun can also be effective.


Dry Needling: This involves inserting thin needles into trigger points to elicit a local twitch response and promote relaxation. Dry needling can be performed by acupuncturists, physical therapists, and some qualified massage therapists. Always be sure to ask about a practitioner's qualifications.


Stretching and Exercise: Gentle stretching and specific exercises can help improve muscle flexibility and strength. Strengthening is an important part of treatment because often we develop knots in a muscle from overuse and strain due to weaknesses or restrictions.


Heat and Cold Therapy: Applying heat or cold can help reduce pain and muscle tension. Ice application constricts the blood vessels and reduces inflammation in the tissues. Heat application encourages fresh and healthy oxygen-rich blood to rush back into the tissue, promoting healing. Ice also acts as a natural analgesic, numbing the source of pain, and is an excellent first choice.


Medications: Pain relievers, muscle relaxants, or topical treatments may be prescribed in some cases. It is important to note that pain relievers (including ice) often provide only temporary relief however sometimes a period of relief from pain is enough to halt the pain-spasm-pain cycle allowing you to pinpoint the precise area that needs to be addressed.


Prevention Strategies


While it's not always possible to prevent trigger points entirely, several strategies can help reduce their occurrence and severity:


  • Maintain good posture

  • Create an ergonomic work area

  • Take regular breaks during repetitive activities

  • Stay hydrated and maintain a balanced diet

  • Engage in regular strength training and stretching

  • Avoid overloading your muscles

  • Utilize proper lifting and carrying techniques

  • Manage overall lifestyle stress

  • Limit phone scrolling

  • Get adequate sleep


The Bigger Picture: Myofascial Pain Syndrome


It's worth noting that persistent or widespread trigger points can be part of a larger condition called Myofascial Pain Syndrome (MPS). MPS is a chronic pain disorder characterized by multiple trigger points and widespread muscle pain. While individual trigger points can be bothersome, MPS can have a more significant impact on overall health and quality of life. Only a medical doctor can diagnose MPS.


Conclusion

Myofascial trigger points, or muscle knots, are more than just a minor annoyance. They can cause significant pain and discomfort, affecting our daily lives in various ways. There are many strategies available for managing and preventing these painful points.


If you're dealing with persistent muscle pain or suspect you might have trigger points, it's always a good idea to consult with a healthcare professional. They can help develop a personalized treatment plan to get you back to feeling your best. Our bodies are resilient, and with the right approach, those knots can be untangled. Stay active, mind your posture, manage stress, and don't hesitate to seek help when needed. Your muscles will thank you!




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Hey there, I'm Juliette (She/her) – I'm a Bodyworker and Writer.

I run a thriving massage practice in the East Bay California, where I've helped thousands of people feel amazing in their bodies.
 
When I'm not helping people feel better in their bodies or writing about wellness, practice-building and the messy art of being human, you can find me hanging with my family, curled up with some chocolate and a book, drinking room-temperature tea or hiking the gorgeous Bay Area with my pup.

My daily grind involves battling my brain to carve out a space for healthier living, personal growth, and a pinch more self-love. It's an ongoing challenge!

Join me as I explore wellness of the head, heart and body. 
 
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Stay curious, stay humble, stay kind.

XOXO, 

Juliette

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Juliette Wilk is a licensed and certified Massage Therapist with 20 years of experience. She runs a thriving private practice in East Bay California, where she's helped thousands of people feel better in their bodies. When she's not helping people achieve a state of bliss or writing on wellness and practice-building topics, you can find her hanging with her family and pup, curled up with a book, drinking room-temperature tea or hiking the gorgeous Bay Area. Work with her or read more @ lifebalancemassage.net

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