Knots in Muscle

The #1 reason clients tend to get a massage is because they have an annoying “knots in muscle” aka adhesion or myofascial trigger point. And a knot can cause a lot of pain and affect the activities of daily living if you don’t address the problem.


What Is a Muscle Knot?

A knot forms when the muscle is in constant contraction or doesn’t relax. And the muscle fibers get tiny tears called micro trauma. All those muscle fibers start to bunch up to form a knot within the muscle belly. But science really doesn’t know 100% for sure how and or why the form. Actually science and doctors know very little about muscle pain. Even though a muscle injury is one of the top reasons a patient sees the doctor if they are in pain.


Why Do Muscle Knots Form?

The exact science behind trigger points is still evolving. Researchers have proposed several theories, but there isn’t one universally accepted explanation.

One of the most common theories suggests that muscle knots develop when small groups of muscle fibers remain contracted and fail to fully relax. This persistent contraction can reduce blood flow to the area and create a cycle of irritation and discomfort.

Several factors may contribute to this process:

Repetitive Movements

Doing the same motion repeatedly can overload certain muscles.

Examples include:

  • Working at a computer all day
  • Lifting patients or clients
  • Carrying children
  • Repetitive factory work
  • Long-distance driving

Over time, the affected muscles may become tight and irritated.

Poor Posture

Many people spend hours looking down at phones, hunching over computers, or sitting in positions that place stress on the neck and shoulders.

These postural habits can create excessive tension in specific muscle groups and contribute to the development of trigger points.

Muscle Overuse

Athletes frequently experience muscle knots because they ask their muscles to work hard and recover quickly.

Running, strength training, cycling, swimming, and other sports can all contribute to trigger point formation, especially when recovery is inadequate.

Stress and Anxiety

Emotional stress often creates physical tension.

Think about what happens when you’re stressed: your shoulders rise, your jaw clenches, and your neck tightens. If this pattern continues day after day, those muscles may become chronically tight and painful.

Injury

Even a minor strain or injury can create protective muscle guarding.

The body naturally tightens muscles around an injured area to protect it. Sometimes those muscles remain tight long after the original injury has healed.

Lack of Movement

Ironically, doing too little can be just as problematic as doing too much.

Long periods of sitting can decrease circulation and contribute to stiffness and trigger point development.


knots in muscle

What Does a Muscle Knot Feel Like?

Symptoms vary from person to person, but common signs include:

  • A tender spot in a muscle
  • A feeling of tightness or stiffness
  • Aching pain
  • Reduced range of motion
  • Pain that worsens with activity
  • Pain that refers into another area
  • Muscle weakness
  • Headaches related to neck tension

Some knots are merely annoying. Others can become severe enough to affect work, exercise, sleep, and daily activities.


Where Do Muscle Knots Commonly Occur?

While knots in muscle can develop almost anywhere, some areas are more common than others.

Neck and Upper Trapezius

This is one of the most frequent locations.

People who work at desks, spend time on smartphones, or experience high stress often develop knots in the upper shoulders and neck.

Between the Shoulder Blades

Poor posture and prolonged sitting can contribute to trigger points in the muscles of the upper back.

Lower Back

Low back muscles work constantly to support posture and movement, making them prone to tightness and discomfort.

Glutes and Hips

Runners, cyclists, and people who sit for long periods frequently develop trigger points in the gluteal muscles.

Calves

Athletes often experience calf trigger points due to repetitive loading during running and walking.


Types of Massage that can help

The most popular service I offer is the deep tissue massage. This is detailed focused work. Most clients that are struggling with painful knots are seeing me for the whole back, neck and shoulders. This is usually a one hour session. Let's go over some more options. 

Myofascial release is very similar to deep tissue massage. However it is much more detail oriented. There is no oil or lotion used and the area that I work in is smaller. 

Cupping is also another good choice. Most clients have their back done and that will take about 30-45 minutes. It just depends on how tight the soft tissue is. I generally end with very smoothing massage strokes and essential oils to help calm down the nervous system. 

Manual lymphatic drainage can be helpful too. Sometimes knots in muscles are over active because there is too much fluid in that area. Extra fluid does cause too much pressure in the tissue and can irritate inflamed nerves.    

You can read more about how often to get a massage here. This is the short answer. If you are in constant pain, book a weekly massage for 4-6 weeks. Once it becomes a dull pain then it’s bi-weekly sessions. And maintenance is every 4-6 weeks.  


How to Prevent Muscle Knots

Your best offense is a good defense. If you know you are prone to these painful little suckers then you need to be proactive in prevention. A simple yoga routine can do wonders for busted muscle knots. Yoga postures that are spinal twists are my favorite for help to get rid of knots in your back. You can also buy a foam roller. You can roll on it every day. It will hurt at first, but if you take the time to do it every day the foam roller will hurt less and less. Here is a short video to show you how to use the foam roller.

And if you are feeling brave an inversion table helps to separate the vertebra of your spine and gets your blood flowing in the opposite direction.

If your knot is really bothering than ice the area for 20 minutes then allow the area to warm back up to room temperature, usually that takes about 20 minutes also. The ice is going to help calm down the chronic inflammation that happens when you have knots in the muscle of your back.

Move Frequently

One of the simplest strategies is to avoid staying in one position for too long.

If you sit for work:

  • Stand every 30 to 60 minutes
  • Take short walking breaks
  • Stretch periodically throughout the day

Movement helps maintain circulation and reduces muscular tension.

Strength Train

Strong muscles generally tolerate stress better than weak muscles.

A balanced strength training program can improve posture, movement quality, and resilience against injury.

Focus on:

  • Core strength
  • Upper back strength
  • Hip stability
  • Functional movement patterns

When Should You Seek Professional Help?

However, it’s wise to seek professional evaluation if:

  • Pain persists for several weeks
  • Symptoms continue worsening
  • Pain interferes with sleep
  • You experience numbness or tingling
  • You develop significant weakness
  • Daily activities become difficult

There are plenty of pain management options you can talk to your doctor about. Sometimes clients do need help from medication to help the massage to work better and the results to last longer. 


Who Can Help Treat Muscle Knots?

There are a few different health care professionals that can help you

  • Chiropractic
  • Physical Therapy
  • Acupuncture
  • Massage Therapy

All of the above are skilled in soft issue dysfunction. You just may need to try a few to see what works best for your body. And no matter which type of professional you choose to work with, it is going to take multiple sessions to take feeling lasting results


Final thoughts on knots in muscle

Knots in muscle is one of the most common pain complaints from clients. While research in this topic is ongoing. What we do know is sitting too much and not moving rough throughout your day does cause that tissue to become inflamed. Knots aka trigger points tend to form in muscles that are weak and over stretched from lack of proper function. The best thing to do is keep moving. If you have a desk job. Do the best you can to take as many walk breaks as you can in between projects. There are some great videos online to help you with muscle stability exercises. Three of my favorites are Knee over Toes Guy, Squat University and Athlean X. If coming up with your own exercise plan seems too much thinking. Then I suggest going to physical therapy. 

Having a good trigger point pain relief exercise routine is going to help massage therapy work better and the results will last longer. If you are in the West Boylston, MA area and are dealing with ongoing knots, you can book your next appointment with me through my online calendar HERE.