Did you know that muscle makes up more than 70 percent of your body’s weight? Muscle tissue has such a large presence in our bodies because it is responsible for so much of our movement – inside and out. Muscle is the key tissue behind big efforts like walking, lifting, laughing and speaking. It is also behind the smallest movements, like changing the diameter of a branch of an artery.
However, muscle does not work alone. It is a metabolic machine that is always in concert with connective tissues, with collagen and bone, and with the nervous system, both central and peripheral. Understanding that connected relationship helps us explain what muscle knots are, and how to get rid of them.
What are muscle knots?
Muscle knots are focal areas of taut muscle and fascial (connective) tissue, kept in a state of contraction. Muscle knots are also called trigger points, and it is important to note that this contracted area may or may not be painful. But it will certainly be full of a self-propelling set of chemicals that cause a cascade of effects that sustains the contraction. And to us it feels like a knot.
How do muscle knots develop?
The science of trigger points currently points to an externally-driven change (pressure, biochemical event, position stress, etc.) that turns on a chain reaction of microscopic muscle fiber changes, neurochemical changes, vascular changes, even central nervous system changes. All forces combine to create the contraction that will not completely let go.
How are muscle knots treated?
Several methods work – but be prepared to get involved as a patient or client. The passive approach is the one that doesn’t stick.
- Dry Needling/Acupuncture
Proven to work, based on a couple methods of invading the tissue and forcing a twitch response. Start that response in the contracted area and you create a positive change.
- Massage/Body Work
Area tissue can be treated to facilitate a fluid shift, which can lead to a positive response in the tissue.
Yoga and other exercises that focus on alignment and core strength while in motion can work well to change the demand on either the knotted muscle or its antagonist. This is very effective for permanent pain relief.
- Manual therapy/manipulative therapy
Using a joint in the area or directly manipulating the trigger point has clear results, palpable while in treatment.
- Therapeutic taping
Using principles of fluid flow, muscle recruitment and pain relief, tape can be used to tame knots and change the reason they happened in the first place. Consult your medical team for how to use tape that specifically meets your needs.
What DIY technique can I try today?
Using a massage tool (TheraCane, foam roll, knob tool, tennis ball, etc) try one of these methods:
- Constant, progressive pressure: Using the blunt points of your tool, apply a pressure to the heart of your trigger point/sore spot. Press at a level that is felt and is the slightest bit irritating; hold this position until the feeling of irritation passes, then add pressure to find the next threshold of irritation. When that feeling passes, release and leave the area with a smooth touch for 10-15 seconds to finish the treatment.
- Active movement: Using one of your massage tools, apply pressure to the sore area. Plan to keep this pressure steady while you add movement. For example, if you use a TheraCane on the base of the neck, keep the pressure while you nod your head up and down. If you are sitting and using a foam roller on the arch of your foot, keep the pressure while you bend and straighten the knee.
Moist heat applied for approximately 10 minutes to the area can be a real help. Create a moist heat source with a hot, wet towel that is wrapped in a dry towel, then applied directly to your trigger point. Increasing blood flow will start a flushing of trapped chemicals. For better results, combine heat with one of the more active techniques below.
While stretching is a logical approach to treat something that is tight, it is not effective over time when this is the only technique used. Stretching does not provide enough of a trigger to the area to elicit the fiber, fluid, and neuro response that is needed to really remove a knot. You will do no harm when you stretch — there is value in stretching — but you will not relieve a trigger point with this effort alone.
What kind of provider treats muscle knots?
There are several professionals that provide these techniques with safety and excellence: Physical and Occupational Therapy, Athletic Training, Osteopathy, Acupuncturists, Chiropractors, and more.
What matters is combining the technique with your effort. Facilitating change in the trigger point is the start, but the tissue needs to be taught to avoid a return to the familiar. The easy path is the one the body will take, unless you provide a new pattern through exercise or restorative efforts that match your specific problem.
Ridgeview Medical Center is an independent, nonprofit, regional health care system located just 35 minutes west of Minneapolis on Highway 5. Its network includes two hospitals—located in Waconia and Arlington—a multitude of primary and specialty care clinics, emergency services and specialty programs, and Two Twelve Medical Center in Chaska—a free-standing 24/7 emergency and urgent care facility with multi-specialty clinics and services.