We’ve all felt them right? Hard lumps or nodules in our muscles which radiate pain and discomfort. They often appear with little to no warning and can suddenly become sources of awful pain and discomfort.
“Muscle knots” are a tricky one to pin down, for a couple of reasons. But before I get into that I just want to make one thing clear: your muscle is not “knotted”.
When I first heard the term muscle knots, I imagined a clump of muscle fibres that had literally got wound round each other while exercising. Silly though this may sound, it’s something that comes up quite a lot with clients I see.
SO IF NOT THAT, WHAT ARE THEY?
Well, the most widely accepted definition for a “muscle knot” is a myofascial trigger point.
The current theory is that these trigger points are small patches of tightly contracted muscles. A highly localised, isolated spasm.
Once in spasm, the section of muscle manages to cut off its own blood supply, which leads to less oxygen to the muscle fibre and more contraction: a metabolic crisis. This creates a kind of “muscle sickness” that you feel as pain, discomfort and and many, many other weird phenomena that I’ll get on to in a moment.
SO WHAT CAUSES THIS?
There are so many aggravating factors that lead to the development of trigger points that it is hard to get to a root cause. Some of the most common factors are:
Muscle fatigue (from overtraining, or odd movement patterns due to posture or injury)
Muscles being “stuck” in awkward positions (repetitive behaviours and movement habits – think “text neck”)
Sensory annoyances (hat, wallets in back pockets, that kind of thing)
Lifestyle factors: sleep deprivation and smoking being the two most important
Myofascial trigger points, once developed, can lay dormant (known as a latent trigger point) for a long time. They can then become active all of a sudden, leading to severe pain that comes seemingly “out of nowhere”.
One of the most common activating factors for trigger points is stagnancy, being still for a long period of time. This is thought to be a reason why people develop muscle pain early in the morning.
HOW DO I KNOW IF I’VE GOT TRIGGER POINTS?
Trigger points are crafty. They will often arise at the same time as other injuries, contributing to the pain and confusing the issue. They behave erratically and can be excruciatingly painful for days at a time and then just vanish – only to come back two days later.
They are also notoriously hard to find. I mentioned hard lumps at the start, but often there is nothing there that you can feel, or a hard lump you do feel is actually just normal hard tissue or bone. It’s very hard to determine a trigger point just by touch.
There are, however, key indicators that should tell you whether you have trigger point pain or not:
You have intense sore spots in muscles which produce a “yep, that’s the spot” sensation (often accompanied with writhing and expletives)
You notice a tight band of muscle along or near the sore spot
The pain you have is in muscles rather than in your joints
There is a dull, aching, nagging sensation in the muscle
Your muscle feels stiff, and areas of it feel weak and heavy
It’s painful or kind of uncomfortable to contract your muscle
It is aggravated by over exertion or effort
You have an old injury in the affected area
Trigger points are also characterised by referred pain – pain that travels out from the point itself in a predictable pattern. These patterns are fairly well mapped out in textbooks, but if you don’t know what they are they can make tracking down the culprit really tricky.
For example, a common pattern is pain that comes up and over the head to behind the eyes, which is associated with trigger points in the muscle at the front of the neck. This is a common cause of tension-type headaches.
OKAY, I THINK I’VE GOT TRIGGER POINTS, WHAT DO I DO?
The easiest and best way to get rid of trigger points is to rub them. Seriously.
Self-massage can be very effective in getting rid of most trigger points. Once you have located what you think is a trigger point, rub it for a couple of minutes until you feel a “release” in the muscle tissue. If you find a very specific point that is very painful, particularly if you notice referred pain from that point, you can hold that point until you feel the pain subside.
Tigger points can be seriously tricky though, and sometimes the point you’re looking for is far removed from the pain you’re feeling. If that’s the case then it can be really helpful to see a professional. A decent massage therapist should be able to recognise your pain and identify the culprit.
Muscle knots can be a nightmare, but with the right information and help they can be dealt with pretty quickly. If you think you’re dealing with stubborn trigger points then get in touch to see how I can help.
If you like to go it alone and are happy to read into this a bit more, you can find the most comprehensive guide to trigger points at painscience.com. It’s a brilliant resource, incredibly well researched and where I got most of the information for this blog.