Chances are, most of us will have experienced painful, tender or swollen knots in our muscles at some point in the past, with up to 85% of the population shown to have suffered from knots at some point in their lives. Generally recognised as small, firm nodules of muscle that are painful to the touch, knots can affect almost any muscle in the body, including the back, shoulders, and even the feet and and calves.
While knots and trigger points can be frustrating and achy, in some cases, without effective treatment the pain can become chronic, with symptoms lasting six months or longer. This can greatly impact your ability to exercise and enjoy doing the things you love.
While many will accept that a knot has appeared in the muscles and may book in for a remedial massage or other treatment with their physiotherapist, it is less well-known exactly what these knots are, why they appear, and what the best course of action for them is. Here’s the low-down on muscle knots from our physiotherapy team based in Hong Kong Central and Wong Chuk Hang.
What Is A Knot In A Muscle?
Firstly, having a knot does not mean that your muscle fibres have become physically knotted, in a similar way to a sailing knot. Instead, a ‘knot’ is the common name for a myofascial trigger point. To better understand what these are, you should know that our muscles are made up of a series of long muscle fibres, and that you have a thin layer of connective tissue around each muscle called the fascia. When you incur any injury or damage to your muscles, it can result in inflammation paired with a spasm or contraction in your muscle fibres and the surrounding fascia, which creates your palpable ‘knot’.
Knots can form anywhere in the body where there is skeletal muscle, and it’s very common for our physiotherapists to find knots when clients come in with pain or injury, even if they haven’t yet discovered the knots themselves.. Knots generally feel achy, tense, swollen or inflamed, and in most cases, the pain tends to radiate through the surrounding muscles as well. Muscle knots can also restrict your range of motion in the area surrounding where they are located, as well as cause pain during certain movements.
Knots or trigger points can be classed into two categories:
- Active trigger points can continue to cause you pain throughout the day with movement
- Latent trigger points only hurt when you press on them. However, it is not uncommon for latent knots to progress to active ones, and bring with it a great deal of discomfort.
Myofascial trigger points frequently develop in response to new or more strenuous repetitive motions or the introduction of new movements to your workout routine. For example, if you begin running after a period of only lifting weights, you may experience knots in your calves due to the new movement pattern. Similarly, if you spend long periods of time hunched over a computer, you may develop knots in your upper back and shoulders from the strain on your muscles caused by holding one position for extended periods. Remember that developing knots in your muscles doesn’t necessarily mean you’ve “overdone it” - even slight or mild muscle damage can result in a knot.
Knots Can Contribute To Other Problems
While knots aren’t pleasant on their own, depending on their location, they can also lead to other seemingly unrelated problems throughout the body. This means they can frequently affect the way that other muscles and joints function, because of the impacts that the contracted muscles within the knot have on adjacent tissues. For example, when a knot is positioned around the neck or shoulders, they can contribute to problems like tension headaches. When trigger points are in your calves, they can restrict the available motion at your foot and ankle, leading to issues like forefoot pain from overloading this area. For these reasons, we don’t recommend ignoring trigger points, especially if you’re experiencing other issues at the same time.
Why Do I Often Develop Knots In My Muscles?It is true that some people are more prone to developing knots than others. While most causes can be attributed to muscles damage, other known risk factors include:
- Poor posture and ergonomics, especially when sitting at work
- Stress, both mental/emotional and physical
- Muscle tension
- Sleep disturbances
- Nutritional imbalances and dehydration
- Certain medical conditions such as fibromyalgia
- Other injuries and pains
Interestingly, while our physios often see trigger points in clients who lead relatively active lives, we also see a high number of trigger points in those that have a more inactive or sedentary lifestyle.
How To Get Rid Of Knots In Muscles
If you’re trying to manage your knots at home, you can try stretching the affected muscles, or trying some self-massage to work on the muscle fibres. Ensure the stretches are gentle, and don’t cause you further pain or injury. Both massage and stretching helps improve blood flow to the area, which supports the resolution of muscle knots.
Here at PhysioCentral, our approach to recurrent trigger points is to complete a full assessment to understand what’s causing your trigger points, any areas of tightness or weakness that are adding to the problem, and understand the severity of the problem (alongside any other pain or injuries you may be experiencing).
Next, we’ll create a tailored treatment plan, which may include everything from direct pressure to the area, massage techniques, stretches, myofascial releases, dry needling and more. The best treatment approach for you will depend entirely on what the bigger picture looks like in terms of our assessment findings, your diagnosis, the underlying cause of the problem, your personal factors and your goals.
What is really important to us, aside from helping you relieve the pain from your knots, is getting down to the root cause of the problem and addressing this. Without this, your knots may continue to recur in the future. This may involve working on your posture in your workplace, creating an optimal loading plan for increasing your weights or activity intensity at the gym, learning appropriate recovery techniques, managing existing muscle imbalances, and more.