Muscle Knots – a quick guide to having them less often.

Posted on Zama October 25, 201

by David Whitlow III, LMT

Muscle Knots are such a common problem. We all have them from time to time, so how do we get them?  Muscle knots develop mostly because of three different categories:

1. Injury
2. Overuse
3. Sedentary Lifestyle

Many knots are caused because we use our bodies enough to injure ourselves or overuse the muscles we have. Unfortunately the most common source is a sedentary lifestyle. Professional experience has taught me that sitting at my computer right now typing away is building up knots right now. Regardless of the cause, a persistent knot will remain until it is broken up… in more than one way.
The first way to break up a knot is to understand a very basic principle around knots: They need intervention. Something called the “Pain-Spasm-Pain” cycle causes a knot to stay a knot. One of the three categories from above causes the pain, and a spasm follows suit, which causes more pain and more spasm. This cycle continues unless you interrupt it. The following will help to intervene:
1. Massage is well known for, “Getting the knots out, ” and really helps with persistent knots.
2. Stretching is one of the very best things to do to reduce and avoid knots.
3. If a knot is causing a movement pattern which in turn causes swelling, then using ice for no more than 10-15 minutes can help.

Reduce knots by doing the following:
1. Avoid sitting while hunched over. Stretch!
2. Get plenty of exercise, and consult your physician if you don’t know how much you should get.
3. After you exercise, Stretch!
4. Hydrate (Coffee and Beer don’t count)
5. Get your B Vitamins, and plenty of Potassium and Calcium

Why does massage help?
Besides breaking up the pain-spasm-pain cycle, massage brings new blood supply, and with it oxygen, so muscles can function properly. Some muscles become rock hard and the supply of blood is less fluid. Breaking up the physical knot and bringing oxygen in will gradually restore normal function. Massage will not always vanquish an unwavering knot in one session though. Often enough knots need frequent sessions to be completely terminated. Even once the pain from a knot is reduced to a memory the trigger point can become latent and come back later on.

Why do I get the same knots over and over again?
We tend to develop patterns in life. Our job, posture, activity, inactivity and so on. These patterns cause the same muscles to be used or ignored. When they are painful and persistent they are considered active trigger points. A latent trigger point won’t have as much feeling unless someone or something touches it, pinches it, or puts pressure on it. Knots can affect the way we move, stand, sit, our overall strength, and how we carry ourselves among other things. The most shocking part is that we may not even know we are being affected until it is has become a serious pattern modification in our lives.

Why do knots cause pain in different areas when they are getting massaged?
Knots, or trigger points have the unique quality of referring sensation to other very specific areas in the body. Many areas will refer pain to specific points throughout the body and trigger point therapists will use these specific points to treat specific conditions. A few very common conditions that can be treated with trigger point therapy are:
-Headaches
-Carpal Tunnel Syndrome
-Fibromyalgia
-Plantar Fasciitis
-Disc Pain (often referred to as radiculopathy)
-Sciatica
-TMJ
And many more…
Knots are possibly the most common thing a massage therapist hears as a primary complaint. These little nodules in our muscles cause unnecessary stress for us at various points in our lives. With a little education, a lot of peace can happen. I hope this helps.

For those of you who want to know the physiology, biology, and biochemistry of knots, I have provided a little link here for you. This article has information about knots and it is some of the most comprehensive in the area of physiology of trigger points I have seen. It is a great resource for the science minded.

Sports Massage and Recovery

Although the effectiveness of massage to flush out lactic acid after exercise has been disproven, there are benefits to validate its use in sports. "In my own experience," said Keith Grant, head of Sports and Deep Tissue Massage Department at McKinnon Institute, "I've seen that massage is effective. How our body reacts to things depends on both the state our body is in (state of memory), as well as the input." Grant combines his knowledge as a scientist with personal experience as a massage instructor and runner to support his conclusions.

Pointing to a study by Tiitus and Shoemaker (1995) in which effleurage did not increase local blood flow, Grant said, "This is a mechanistic way of looking at what's going on." The difficulty, he noted, in interpreting research results comes from looking for direct, mechanical effects. "Clinically, we see a different story," he said. "Through our techniques we work with the nervous system to relax muscles, but that's not a direct mechanical effect. "I believe the effects of massage also involve the neurological and emotional. My reason for that is the neurological side controls the current (base) state of the muscle activation. The emotional controls the chemical messengers that affect the immune system. What seems likely is massage acts as a new input to a system with a memory. Massage stimulates the mechanoreceptors and can gate off pain receptors. It floods the body with new sensory input. We are using the nervous system to reset the muscle to greater relaxation.

"In my observation, fatigued muscles tend to remain hypertonic and shortened. When we cajole specific muscles to relax and lengthen via mechanical and neurological input, we reduce their metabolic activity. When the muscle relaxes, it's not using energy as much, not metabolizing as fast, not producing waste products and because it's more relaxed, it's not compressed and not exerting pressure on surrounding tissues. This means circulation is better. It's not because we're pushing fluid around. It's because we've put the body in a more optimum state, so the body naturally increases circulation on it's own. By massaging muscles and adding input to the nervous system, we are facilitating the body in recovering faster from exercise. It's not the massage that's doing the healing, it's the person's body."

In a British study of boxers, massage was reported to have a significantly positive effect on perception of recovery, giving scientific credence of its benefits as a recovery strategy. According to the authors, their results support arguments by some researchers that "the benefits of massage (in sports recovery) are more psychological than physiological."20 Grant takes that a step farther. "As a trained scientist, I use what I observe and what I know about physiology to come with a hypothesis. From my own experience in running, when you exert to the point of substantial fatigue, you come back feeling more fragile, in an emotionally vulnerable spot. To have the sense that someone is nurturing, in a sense taking care of you, is a very psychologically emotional thing. In supporting the person, we improve their immune function and their ability to heal, by influencing the chemical environment of their body. It has to do with psychoneuroimmunology, the whole chemical homeostasis of their body -- neurochemicals and the relationship between mood, or feelings, and the immune system.

"There is some evidence that following heavy exercise, both L-glutamine (an amino acid manufactured by the body) and the immune system take a dip. I look at the healing effect of massage as, in some way, counteracting that dip. When you provide support it has a positive effect on immune function. If the person doesn't feel supported and nurtured, it will have a negative effect on the chemical environment, opening them more to catching colds, not healing as fast and decreasing their ability to train. It ties into the whole emotional state of a person. The athlete has to stay healthy in order to continue training. With massage, they can train harder because they are able to recover faster."


Facts vs. Myths
Remember the old theory about the earth being flat? The more we learn, the more we realize how much we don't know. That's why research in massage is so important. "These concepts and ideas are firmly entrenched in our early training, and in the medical profession, said Lowe. "Things that have been disproved continue to persist. It takes a long time to trickle down. If we say there is no research that supports massage works for inflammation, there may not be research - or it may not be true. We don't really know yet and we need to investigate that further. This lactic acid concept illustrates the perpetuation of misinformation that can happen if we don't have the research base. When we are looking for credibility with others in health care, they want to know on what we base our opinions. A lot is passed along on hearsay, not on scientific information. What we need to keep our eyes on is how to reduce that as much as possible so we do have accurate information."

Shirley Vanderbilt is a staff writer for Massage & Bodywork magazine.