Most of us have woken with a new ache in our bodies. Whether it be a stiff neck or a shoulder lump with stabbing pain, you’ve developed a muscle knot. Typically, you are now faced with discomfort and a lack of mobility. Muscle knots are commonplace, but that doesn’t mean they are typical or preventable.
Muscle knots, medically known as myofascial trigger points, are painful or tender areas in a muscle. They are caused by muscle spasms, when the muscle fibers are tense and contract, releasing toxins and affecting blood flow. They can occur anywhere in the body where there is muscle or fascia but are most common in the neck, shoulders, back, and legs. Typically, muscles knots are benign, caused by strain, poor posture, or overexertion. However, muscle knots can be indicative of more significant health issues and shouldn’t be ignored.
We are all bound to experience a muscle knot at some point in our lives, primarily as many works at desks and are increasingly immobile. Preventing, treating, and managing them is of the utmost importance to prevent chronic issues and avoid a lifetime of pain.
What Are Muscle Knots?
Muscle knots are formed when muscle fibers become inflamed, tighten, and contract, even when the muscle isn’t moving. Typically, muscle fibers are organized, running in parallel to each other. When “knotted,” the fibers are disorganized in a localized area, hence the term knot.
Alas, the issue of a muscle knot is not purely structural; there are also chemical imbalances at the knot site that increase inflammation, pain, and an overactive immune system. Current scientific understanding is that these are all side effects of the muscle constantly contracting, having reduced oxygen flow, and blood circulation. These factors result in acidic tissue fluid around the knot compared to normal muscle tissue, with higher acetylcholine, noradrenaline, and serotonin levels. When you hear the phrase “toxic knot,” these are the biochemicals the term refers to. All treatments are designed to break this cycle by stopping the production of acetylcholine through muscle contraction and increasing oxygen and blood flow to the site to “flush” away the build-up of these biochemicals.
Where Do Muscle Knots Occur?
Muscle knots can develop in any part of the body with muscle or fascia (the connective tissue around muscles and organs). Typically, we notice knots more when they affect our mobility, so it seems they have increased occurrence in our neck, shoulders, and upper back. However, some may notice them more in their glutes, calves, shins, and lower back. These areas of the body are most susceptible to repetitive motion injuries, so you will get knots in these areas more regularly.
How Do Muscle Knots Develop?
Movement and inactivity will easily cause muscle knots to form. Working out without a proper warm-up and warm-down can create knots, principally if you repetitively work a single group of muscles. Conversely, sitting at a desk or behind the wheel for an extended period will cause knots to develop as the muscle fibers start to seize from inactivity.
Diet also plays a significant role in the development of muscle knots. Eating unhealthy foods or those lacking nutrients have adverse effects on your muscle fibers. Processed food tends to be high in sodium compared to fresh produce. The results in an ionic imbalance for your cells, essentially dehydrating them (see below).
Most of us know that dehydration can lead to undesirable side effects, including lightheadedness, headaches, and fatigue, but muscle knots are a symptom too. Water is essential to our bodies working properly, and our muscles need sufficient blood perfusion (circulation), blood pressure, and thermal regulation to function optimally. All those elements come from hydration. Further, without the right amount of water, the electrolytes in our muscles become imbalanced too. The effect is muscles that spasm, forming knots. An extreme case is when the muscle contracts for a prolonged period which is how muscle cramps develop. So, drink your recommended amount of water per day (based on your body composition, climate, and activity level) to keep those knots at bay.
Mental health issues will also influence how your muscles feel. Anxiety and stress are significant contributors to muscle knot formation. When we are not relaxed, there is a great deal of tension in our neck and shoulders, which means we are forcing our muscles to contract for extended periods. In essence, our muscles feel over-exertion.
What’s the Difference Between Active and Latent Trigger Points?
When seeking professional help for your muscle knots, you may hear the physician talk about your knots as either having active or latent trigger points. This can sound alarming, but they are assessing if you have constant pain (active) or if it only hurts when pressure is applied to the area (latent). Whether the muscle pain is active or latent does not alter the treatment, nor the potential for long-term damage to the muscle; the longer either type of trigger point persists, the more dysfunctional a muscle becomes.
How Do You Treat a Muscle Knot?
Muscle knots will never go away on their own, though it can appear that way. We naturally practice some of the treatments below through daily activities, including heat therapy when we shower, exercise when we walk, and subtle stretches. Also, when we have a muscle knot, the automatic action is to massage it with our hands. So, in a sense, they appear self-healing, but you have taken steps to relax the muscle fibers subconsciously.
Luckily, most muscle knots are something that you can self-treat. There are many methods available, and what’s best for you will depend on how you developed the knot, your level of discomfort, and what is available to you. If you have tried everything on the list below, then please consult a professional.
Often, muscle knots linger long after the pain has dissipated, so keep treating the area for at least a few days to ensure the knot is fully resolved. Unresolved muscle knots cause your muscles to shorten and weaken, which can generate issues later in life.
- If you have a painful, debilitating muscle knot, the last thing on your mind might be to exercise. However, aerobic activity is one of the best things you can do. Exertion increases your heart rate, which increases the blood and oxygen supply to the knotted tissue – both of which help the tissue around the knot. Depending on your injury, you might find swimming to be the best exercise as it is low-impact, so it won’t cause pain as you move your arms, shoulders, and neck.
- Both ice and heat have significant benefits when treating a knot. While ice is used to relieve pain and will not resolve the knot, it can make other treatment methods, such as massage, feasible. Heat, however, will help relax the muscle, allowing the cessation of spasms causing pain.
- The goal of massaging your knot is to loosen the tense muscle fibers that are contracting. An effective method is a trigger-point massage. To do this, press on the knot for 5 to 10 seconds, then release. Do this continuously for up to five minutes and repeat five times a day until the knot is resolved. Other than trigger-point therapy, a general message of the surrounding tissue is productive as it increases blood flow to the affected area and prevents the knot from growing. Note, after a massage, the knot will be painful and likely feel hot and inflamed. For relief, a muscle rub is an excellent route to take as they contain ingredients such as magnesium, hemp, and essential oils that relax muscles or offer a soothing, warming element.
Accessories can help create the correct message for your needs and offer aid when you can’t reach the affected site. To stimulate trigger-point massage, you a roller ball, a tennis ball, or use a roller for a more generalized pressure. If you want something more mechanical, a percussion massager can hit the spot directly. A heated shiatsu neck massager is a popular product too, as you can massage and heat your muscles simultaneously, without needing a partner to assist.
Regardless of which type of massage you opt for, do not go too hard as this can lead to increased irritation. In all instances, start slow and increase pressure and time gradually, stopping you when you experience increased pain.
Pain Relievers (Oral)
- If your muscle knot is causing severe discomfort, it might be necessary to take an oral pain reliever. Ideally, you will take a nonsteroidal anti-inflammatory drug (NSAIDs for short) as they will reduce the swelling around the muscle and relieve pain. Common examples of such medications are aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve).
- Pain relievers (Topical)
- There are many options to bring relief to only the site of your knot, if an oral pain reliever isn’t right for you. You can use topical numbing agents, which usually contain lidocaine. A few essential oils will help, e.g., basil, capsicum, clove, lavender, lemongrass, or peppermint.
Pain Relievers (Topical)
- There are many options to bring aid to only the site of your knot if an oral pain reliever isn’t right for you. You can use topical numbing agents, which usually contain lidocaine. A few essential oils will help, e.g., basil, capsicum, clove, lavender, lemongrass, or peppermint.
- If your muscles knots are persistent and/or reoccurring, you might want to see a physical therapist to address the underlying issue that is causing your knots to form. The physical therapist will help treat your pain and teach you techniques to reduce discomfort or reoccurring knots. They can also assist with creating a treatment plan to build up any muscles that have lost strength due to injury.
- You will need a professional for this therapy, and it is best for toxic knots. Like acupuncture, the needle is inserted at the point of the knot and is designed to relieve pressure. The needle also forces the muscle to move. While this therapy is beneficial, the effects are generally short-term.
- Electrostimulation or transcutaneous electrical nerve stimulation (TENS) can be used by a professional to relax the muscles. You may have experienced this when at a chiropractor’s office. You can do this yourself at home, too, and the system works by relaxing the muscles to stop the spasm. Most users report that the process is pain-relieving and is best used in conjunction with gentle massage and stretching.
- If your knot is in a tough to reach area or hasn’t responded to other treatments, your healthcare professional may suggest ultrasound wave therapy. The waves penetrate deep into the muscle, hoping to relax them. Of all the treatments used for muscle knots, this is the one with the least data, and therefore, its effectiveness is unknown.
How To Prevent a Muscle Knot
Healthy habits will help reduce the formation of muscle knots in the first place. I may seem intuitive from the causes above to do the opposite, but here are some ideas to help keep your muscles healthy, flexible, and strong.
- When lifting weights or doing any physical training, be sure to rest your muscle groups. Alternating workout days targeting muscle groups will prevent muscles from being overused, which can form knots.
- It’s hard when we are on a long drive or have a job that demands we spend our days at a desk to keep our bodies loose and muscles flexible. It’s essential, though, to take breaks on those drives to walk and stretch and get up from your desk every hour. It’s best to go for a walk first to warm your muscles up – which means increasing the blood flow to the muscles, helping them disperse the toxins that have been building while not being used. Once you’ve done a lap of the rest stop or office area, stretch your neck, shoulders, and back.
Better Body Positioning
- If your issues are induced by poor sitting posture, it might be time to get a new chair – one that is ergonomic. Many muscle knots develop from not sleeping in the correct position. You might need to look into a new mattress, a better pillow, or start using a body pillow to get the proper spine alignment.
- Make stretching part of your daily routine, and you can work out most knots before they become bothersome. If you are unsure how to stretch effectively, you will find plenty of videos to follow on YouTube. Further, if your mobility allows, practicing yoga will correct your posture, strengthen your muscles, and stretch you simultaneously.
- Improving your diet to include fresh fruits and vegetables, as well as lean proteins and grains, will help maintain a better electrolyte balance that will keep your muscle cells working optimally. If you are having issues with tightness in your muscles, avoid sugary items, heavily processed foods, or anything high in fat. Specific foods to treat muscle knots are bananas (for their potassium), spinach (high in magnesium), and apple cider vinegar (which has lots and anti-inflammatories to reduce the swelling).
- Maintaining proper hydration is difficult as it’s a constant process. You might think chugging a few glasses of water at once will do the trick, but, alas, the human body does not work that way. Think of your muscles as a car engine, and it’s low on oil, and you drive it for a while. Just because you now fill up your oil doesn’t mean that the previous damage hasn’t been done. Same with hydration and your cells. Try using a marked water bottle to keep your hydration on track throughout the day.
- Most muscle knots that are not a result of positioning are due to stress. We can’t prevent stress in our lives, but we can learn and practice habits to reduce stress’s effect on our bodies. Meditation, mindful breathing, and gentle exercise are all validated techniques to live a less stressful life. Remember, you get more stressed if you are sleep-deprived, so get enough sleep regularly too.
Muscle knots are commonplace, but most are preventable. By practicing healthy habits such as a nutritious diet, hydration, and exercise, you will experience far fewer muscle knots in your life. When muscle knots occur, they need treatment – they will not dissipate on their own. Luckily, there are many self-treatments available to get rid of your muscle knots — these range from movement, massage therapy, temperature therapy to rest. If your knots are persistent and/or reoccurring, seek professional help, as chronic knots can weaken the muscle and lead to long-term ill effects.