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What Are Muscle Knots? What Can I Do to Relieve Muscle Knot Pain?

You feel it, don’t you? That nagging, persistent ache in your shoulder, the tight band across your lower back, or that tender spot in your neck that just won’t quit. You press on it, hoping for relief, only to be met with a sharp, deep discomfort that sometimes radiates outwards. If this sounds painfully familiar, you’ve encountered the unwelcome presence of a muscle knot.

What Are Muscle Knots? What Can I Do to Relieve Muscle Knot Pain?
Photo by Kindel Media

Trigger points, also known as muscle knots, can lead to pain, stiffness, reduced range of motion, and even contribute to chronic conditions if left unaddressed. Understanding what causes these knots and how to “untangle” them is the first step.

These culprits of physical discomfort are more than just a simple ache; they are a complex physiological phenomenon. Let’s dive in.

What Are Muscle Knots?

Contrary to what the name suggests, a muscle knot isn’t a literal knot like you’d find in a rope. Instead, a muscle knot is a small, hyper-irritable spot within a taut band of muscle tissue (Dommerholt et al., 2006). Think of your muscle fibers as individual strands of spaghetti. When they are relaxed and healthy, they slide past each other smoothly. However, when a knot forms, it’s as if a small section of those spaghetti strands has become overcooked, stuck together, and contracted into a dense, sensitive lump.

This lump is clinically known as a myofascial trigger point.

  • “Myo” refers to the muscle itself.
  • “Fascia” is the thin, web-like connective tissue that wraps around and separates every muscle, bone, organ, and nerve fiber in your body. It’s an intricate network that provides structure and allows for smooth movement.
Muscle knots, also known as myofascial trigger points, are tight, painful areas in muscles. They can cause discomfort, stiffness, and reduced range of motion.
  • Letter A represents a muscle fiber in its relaxed state. It is not working (neither contracting nor stretching).
  • Letter B illustrates a knot in the muscle fiber where many micro-sarcomeres have contracted into a muscle knot. It is this knot that feels painful when massaged, which many refer to as a “good pain.”
  • Letter C illustrates the part of the muscle that extends from the knot to where your muscle attaches to the body (like on a bone). When the muscle is stretched like this, the muscle fibers lengthen unnaturally and ultimately cause pain to seemingly uninvolved areas of the body (referred pain).

When muscle fibers are injured or stressed, they can get stuck in a contracted state. This contraction restricts blood flow to the immediate area, creating a miniature energy crisis. The affected muscle patch can’t get the oxygen and nutrients it needs to relax, and at the same time, metabolic waste products build up. This combination of stuck fibers, reduced circulation, and waste buildup creates that hard, palpable, and often painful trigger point.

Check out more information on the areas.

Why Does Pressing on a Knot Cause So Much Pain?

If you’ve ever had someone dig an elbow into a knot in your back, you know the intense pain it can cause. And sometimes, we feel the pain in a different area. This is known as referred pain. But why is this tiny spot so tender? The pain is a multi-faceted response.

This leads to one of the most defining and frustrating characteristics of myofascial trigger points: referred pain. This is pain that you feel in a location different from the actual source of the knot. It happens because the trigger point irritates a nerve that shares a pathway with other body areas. A classic example is a trigger point in the upper trapezius muscle (the muscle sloping from your neck to your shoulder), causing a tension headache that feels like a band around your head. This is why treating the site of the pain (your head) might not work if the true culprit is a muscle knot in your shoulder.

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A stiff and achy neck may be a muscle knot in the Trapezius, a large muscle bundle that extends from the back of the head and neck to the shoulder.

What Causes Muscle Knots?

Muscle knots don’t just appear out of nowhere. They are your body’s response to some form of stress or strain. Research suggests some common causes include (Shah et al., 2015):

  • Repetitive Strain and Overuse: Repeatedly performing the same movements, whether at your desk, during your workout, or while doing daily chores, can overload specific muscle groups. Imagine constantly hunching over a computer, carrying a heavy bag on one shoulder, or even gripping a mouse too tightly; these repetitive actions can lead to muscle fatigue and strain.
  • Acute Muscle Injury: A sudden trauma, like a fall, a car accident, or an unexpected jerk, can cause muscle fibers to contract defensively and then get stuck in that contracted state.
  • Poor Posture: Prolonged periods of incorrect posture place undue stress on specific muscles, forcing them to work harder to maintain stability. This constant strain can lead to the development of trigger points. For example, forward head posture often leads to knots in the upper trapezius and levator scapulae muscles.
  • Stress and Emotional Tension: When stressed, your muscles naturally tense up as a protective mechanism. Chronic stress can lead to sustained muscle contraction, making you more susceptible to knots, especially in the neck, shoulders, and jaw. As your body experiences mental or emotional stress, your body’s “fight or flight” (the sympathetic nervous system) response kicks in. It releases hormones like cortisol and adrenaline, which cause increased muscle tension.
  • Nutritional Deficiencies: Certain vitamin and mineral deficiencies, particularly magnesium, potassium, and B vitamins, can impact muscle function and recovery, potentially contributing to knot formation. Dehydration can also play a role. (Travell & Simon, 1983).
  • Prolonged Immobility: Ironically, not moving enough can also lead to muscle knots. When muscles are not regularly stretched and moved through their full range of motion, they can shorten and become stiff, increasing the likelihood of developing trigger points.
  • Poor Sleep Habits: Inadequate or uncomfortable sleep positions can strain muscles, making it harder for them to relax and recover, which promotes knot formation.
  • Underlying Medical Conditions: In some cases, muscle knots can be a symptom of underlying conditions such as fibromyalgia, chronic fatigue syndrome, or even certain autoimmune disorders. It’s always wise to consult a healthcare professional if you experience persistent, widespread pain.

How Do Muscle Knots Affect the Body?

The immediate impact of a muscle knot is localized pain and tenderness. However, their influence extends far beyond that:

  • Reduced Range of Motion (ROM): A tight, knotted muscle cannot fully lengthen. This directly restricts the movement of the associated joint, making everyday activities like reaching overhead, turning your head, or bending over feel stiff and difficult for the body.
  • Compensatory Movement Patterns: When one muscle is restricted, your body will naturally try to find alternative movement methods. This often involves inefficiently recruiting other muscles or joints and, potentially, harmfully, leading to new aches, pains, and imbalances. For example, if your hip flexors are knotted, you might overarch your back to compensate when walking or lifting.
  • Muscle Weakness: A perpetually contracted muscle can become weak because it’s unable to relax and then contract fully with optimal force. This can impact athletic performance and daily functional strength.
  • Chronic Pain Syndromes: If left unaddressed, muscle knots can contribute to persistent pain, headaches, jaw pain (TMJ dysfunction), and even radiating nerve-like symptoms (radiculopathy) due to nerve impingement.
  • Decreased Flexibility: When the muscle cannot fully lengthen, the result is reduced flexibility. This makes stretching, yoga, or even touching your toes challenging and uncomfortable.
  • Decreased Mobility: Muscle knots create tension that directly compromises mobility by restricting joints’ normal, fluid movement. As a result, overall mobility decreases, making everyday actions like squatting down or reaching overhead feel stiff and limited.

What Can I Do to Get Rid of Muscle Knots?

Many practical strategies exist to find relief, ranging from professional help to at-home self-care. The key is often a combination of approaches.

How Does a Medical Professional Treat Muscle Knots/Trigger Points?

  • Massage Therapy: This is often the first line of defense. A skilled therapist can use techniques like deep tissue massage and specific trigger point therapy to apply sustained pressure to the knot, which helps to manually break up the adhered fibers and flush out metabolic waste by increasing blood flow.
  • Physical Therapy: A physical therapist can treat the knots, identify and correct the underlying postural issues or muscle imbalances causing them, and provide a personalized program of stretches and strengthening exercises.
  • Dry Needling: This technique, performed by a trained professional (like a physical therapist or chiropractor), involves inserting a thin filiform needle into the trigger point. The goal is to elicit a local twitch response, which can help release muscle tension and initiate a healing response.

Check out more Frequently Asked Questions on muscle knots.

What Can I Do to Treat My Muscle Knots?

  • Self-Massage: Investing in simple tools can help self-treat muscle knots. Some of our favorite tools include:
The Original 18" Handheld Foam Roller Massage Stick
  • The Original™ 18” Foam Roller Massage Stick—Perfect for personal use, it works great for upper and lower body massage. Quickly massage any part of the body without getting down on the ground. Firm design – no bending or breaking. Helps relieve muscle knots, aches, cramping, spasms, and stiffness.
TigerBall-Web
  • Tiger Ball® 2.6 Massage-on-a-Rope®– muscle-friendly and easy for self-help myofascial release. The secret sauce is the rope that positions and keeps the ball in place while using it! It applies pressure and compression directly to sore, tight muscle knots in hard-to-reach areas of your back, shoulders, and neck.
TigerBall5
KTJR_Web
  • Knotty Tiger® Jr. Roller Ball Knot Buster. It is our therapy-clinic-grade massage tool, often used by massage therapists for chair massages. The massage ball rolls easily over clothes and skin, saving your hands and fingers from fatigue.
HydroHug Hot Water Pillow Relieves Muscle Pain
  • Apply Heat: We love the HydroHug® Hot Water Therapy Pillow. It works like a hot tub without getting wet! Fill with warm water and apply; soothes sore muscles and increases circulation.

Key Takeaways

  • Muscle knots, aka myofascial trigger points, are not literal knots but rather small, hyper-irritable spots within a taut band of muscle tissue where muscle fibers are contracted.
  • Muscle knots can cause localized pain, tenderness, and referred pain.
  • Common causes of muscle knots include repetitive strain, acute muscle injury, poor posture, stress and emotional tension, nutritional deficiencies, prolonged immobility, and poor sleep habits.
  • If left unaddressed, muscle knots can lead to reduced range of motion, compensatory movement patterns, muscle weakness, chronic pain syndromes, decreased flexibility, and decreased mobility.
  • Muscle knots can be treated with professional help, such as massage therapy, physical therapy, and dry needling, as well as at-home self-care methods, such as self-massage and applying heat.
  •  

Conclusion

Don’t let muscle knot pain dictate your life. Start by listening to your body’s signals. Try some of the self-care techniques mentioned above, like gentle stretching or self-massage with a foam roller, to see if you can find relief.

References

Dommerholt, J., Bron, C., & Franssen, J. (2006). Myofascial trigger points: An evidence-informed review. Journal of Manual & Manipulative Therapy, 14(4), 203–221. https://doi.org/10.1179/106698106790819991

Shah, J. P., Thaker, N., Heimur, J., Aredo, J. V., Sikdar, S., & Gerber, L. (2015). Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. PM&R, 7(7), 746–761. https://doi.org/10.1016/j.pmrj.2015.01.024

Travell, J. G., & Simons, D. G. (1983). Myofascial pain and dysfunction: The trigger point manual, Vol. 1. The upper extremities. Williams & Wilkins.

For more information on our awesome tools and programming:

Website: www.tigertailusa.com

Email: [email protected]

Disclaimer: This information is for general knowledge and informational purposes only and does not constitute medical advice. Consult a healthcare professional before starting any new exercise program.

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JulieZuleger

Dr. Julie Zuleger has over 20 years of experience as a Licensed Massage Therapist, Certified Strength and Conditioning Specialist (CSCS), Corrective Exercise Specialist, RYT-500 Yoga Instructor, and Human Movement Specialist. Julie promotes self-care using massage tools and stretching-based programs and teaches continuing education courses for yoga teachers, massage therapists, athletic trainers, strength and conditioning, fitness, and wellness professionals. Julie holds a PhD in Education and is the Director of Kinesiology and Education at Tiger Tail USA.