What Exactly are Muscle Knots?

health wellness

The phenomenon of muscle knots is not uncommon. Essentially, muscle knots are sections within the various muscles of the body that have constricted and create pain that is consistent. The condition is common enough to merit the application of a scientific name, which is myofascial trigger points. While there is not currently a definitive medical explanation as to why muscle knots form, several theories are undergoing testing. Here is some information about the nature of the muscle knot, as well as some of the treatment methods that are in use today.

The generally accepted answer to why muscle knots form is that something triggers a reaction where the muscle never relaxes. In effect, the muscle is always in a state where it appears to be actively rather than passively in use. This is unusual, since even with such activities as weight lifting, running, or any type of heavy lifting the muscle goes through a series of off and on cycles. The constant active condition of the muscle leads to muscle spasms, which in turn acts as the root cause the muscle knot.

Surgically removing a portion of muscle knots has led to the discovery of the presence of unusual deposits of protein within the tissue. There is also a theory that an excessive amount of connective tissue surrounding the muscle may also contribute to the development of muscle knots. However, very little research has been done on the matter of connective tissue, so most doctors do not recognize that as a contributing factor in the development of a myofascial trigger point.

There are several recommended treatments for muscle knots. Some involve the application of massage therapy to calm the knots. While massaging the knot may be somewhat painful during the process, there are reports of a temporary easing of the muscle spasm process. Other treatments involve the application of hot or cold packs to the muscle knots, as a means of helping the muscle to relax. Electrical stimulation, as well as ultrasound treatments are also common ways to deal with muscle knots.

At present, there does not seem to be any one effective means of eliminating the presence of muscle knots, although different people respond to one or more of these treatments over time. While it is rare, there are reports of muscle knots disappearing during treatments. However, in most cases, treatments are more focused on managing the condition, rather than eliminating the presence of the muscle knots.

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41
Post 35: Chiropractors *are* doctors. They have the same class requirements as MD's and upon graduation receive a "Doctor of Chiropractic" degree.
- anon52874
39
I have muscle knots around my scapula on my left side. I also have full on failure of my long thoracic nerve on my right side my best guess is that too much stress has been transferred to my left side creating the knots. My physical therapist had a good technique where he identified the taut muscle originating from the spine, massaged the muscle stem and then lifted the scapula to release some of the pressure. It gave good temporary relief but is not a permanent solution.
- anon51825
38
Long story short. I got in a wreck in December of 2008. I was told that my pelvic on the right side was shifted up and that my neck and shoulder had muscle strain. I've had physical therapy, chiropractor visits, mri, blood work, nerve testing. I've been to my normal family doctor, orthopedic doctor and a neurologist. they all say it's my muscles. i get knots in my back, neck, back of my head and shoulders. I have a big deformed looking hunch in my neck located at c-7 that never goes away and when it rains it kills me and gets full of hot fluid. my shoulder i have stabbing pains in. i feel so confused because i know my body best and i feel like, okay if it's my muscles then why is it taking so long to heal? i just feel like the doctors are trying to figure it out but are not and are washing their hands of me and keep calling it muscles. The testing I've done so far is nerve damage, muscle damage through blood work, lophus screening. Help -- is there anything I should be demanding them to test for?
- anon50963
37
i have had knots in my neck and the crunchy sounds people talk about here. Finally after trying many things, with some workin very well, i have started to apply testosterone gel to the skin above and around the region of the knots. my theory is that, even though the gel is systemic, meaning that it goes into all the body, there are receptors for testosterone in the muscles there and i may stimulate growth and help grow the area, also i think that the stretching is more clear and permanent now because of the muscle growth. in other words, the gel caused the muscles to grow and repair so they feel safe to stretch and relax. how are growth stretching and relaxation related to muscle growth and testosterone would be interesting questions to answer. I know the gel goes to the capillary bed of the skin then forms a reserve where it slowly goes into the blood stream but i can feel some effects. also in mexico and many countries they have a strong cream which is anti inflammatory and perfect for these trigger points. it is a strong med in a cream but not approved here.
- anon50053
35
POST 32: Chiropractors are *not* doctors.

POST 31: I experience the same thing, primarily in my shoulders as well. I have been going to trigger point massage therapy and it helps a lot. It is important to ultrasound the areas prior to the massage as that warms the muscles and they respond better to the treatment. I also take an anti-inflammatory and use ben gay (no smell) in the evening so they don't tighten up while I sleep. It hasn't cured me but it is much more tolerable.

- anon49591
34
31: It could be that you have an active trigger point or points that are referring pain. Find yourself a good trigger point therapist (usually massage therapists who have been trained in this) not someone who specializes in Swedish.
- anon47948
33
In response to post 31, maybe it's fibromyalgia. I have fibromyalgia and it's extremely painful. Many of your symptoms fit the disorder. The popping or cracking is unusual but it may be worth a try. There are medications out there that may help. Mine isn't bad enough to be on the medication.
- anon46601
32
Everyone here that is complaining about pain, but there is relief out there. The problem goes deeper than muscle knots. You all need to get your spines checked by a chiropractor. These doctors care about health and well being, they align the spine, and instantly your body starts to heal itself once the nerve interference is gone. check it out!
- anon43803
31
I have no idea if anyone can help me but I figured it couldn't hurt. I have a crazy pain condition that has been traveling in my body for three years. I don't know if it is an auto immune or an orthopedic problem. My upper arms and left shoulder are in pain every day. It seems to be in the connective tissue and/or muscle because it hurts me to move my arms but doesn't bother me as much if i am still. Also the tissue in my upper arms pops and cracks. It is literally as if the tissue is cracking in different spots. when it cracks it somewhat relieves the pain, however, it's momentary and i literally wake up every day with this debilitating pain. I have no other medical issues but this one is becoming so overwhelming it makes it difficult to exist. I have been to eight different physicians, been tested for a ton of things and no one knows what is wrong. One suggestion was early stages of a connective tissue disease but three years later and a variety of medications have not helped or pointed to any specific diagnosis or solution.
- anon43552
30
I have had neck problems for 2 decades. The worst when I merely slept wrong and was immobilized for 3 months because of a pinched nerve, I'm assuming (conventional doctors didn't know or help), that even caused black-outs. I am in a profession where I use my arms a lot so that only exacerbated the problem. If you ran your fingers along my neck it was crunchy. I finally started doing some upper body weight resistance training (push-ups, military and swimmers press, etc.) just to get toned but found it completely eliminated the crunchiness in my neck and I have not had neck pain/problems since. Your posts have enlightened me on some things that I can do to prevent any further muscle issues, i.e. A.R.T., lots of stretching and more water. Thanks.
- anon39971
29
About twice a year I wake up with wicked uppper back / shoulder / neck knots. I've noticed that sometimes I wake up in the night and "crack my neck" if I'm feeling a little stiff but it can actually send my back/shoulder muscles into a knot. I take a hot shower and reach with the opposite arm and massage myself with a slippery film of soap during the shower and if possible get someone massage me right after hot shower. If the pain allows, I will go for a 3 mile run which heats up all my muscles, fills them with more water, and allows me to stretch further than usual. Slowly after 3 or 4 days things are better.
- anon35558
28
I am only 18 and for the past 3 years I have had knots in my shoulders. I get massages once in a while but they come back, is there a way to permanently get rid of them or at least for something longer than a week?
- anon33735
27
I experienced cracking shoulder blade muscles for the first time today only after having an Indian head massage! I often hold tension in that area and it can be achy, but has never been sore as it is now after the massage. It has been 8 hours, I expect it to be worse in the morning. I'm wondering if I should get regular massages to go over them to sort it out long term, or if it's better to go with gentler treatments like heat/baths?

28 female - likely causes of knots for me = sitting at desk for extended periods, stress, lack of water, carrying heavy bags on shoulders

- anon31779
26
Water, water, water.

Drink more water. Ever see a plant wilt? That's a big part of what's happening with muscle knots.

- anon31610
25
I've had muscle knots in my back and neck for several years now. Heat, massage and chiropractic adjustment all make a positive difference but the most effective has been botox injections into the muscle. My neurologist was using botox for muscle pain and migraine headaches. It made a huge difference in the amount of pain and reduced the knots to manageable levels.
- anon23715
24
Active Release Technique (ART) works great on "knots". Most injuries, pulls, tears, over use of muscles... will cause dense scar tissue in the affected area which binds up and ties down tissue that needs to move freely. ART is a non-invasive hands on treatment mixed with movement that will help to break up the scar tissue and get oxygen to the tissue. And yes, stretching and posture are crucial to keeping these "knots" and scar tissue away.
- anon22742
23
I've been dealing with this for 8 years, it came on suddenly a week after my daughter was born, from poor posture while breast feeding my daughter. My hands and wrists were painful, tingly and numb. I wore splints constantly for 5 months. The ONLY one who helped me was my chiropractor. He adjusted my back, and did electric stimulation of the muscles in my upper back. I was out of splints and had substantial results within a month of visiting him 3 times a week. Eventually, I saw him only 1-2 times a month.

Now, I get much milder symptoms occasionally when I do gardening, painting, or work that requires upper body strain. My current chiropractor (I go only when I experience symptoms now) adjusts me, and breaks the knots up- which hurts like hell- but after it's done, I get a flushed feeling (slightly euphoric)and feel immediately better. But I know I need to give my muscles time to recuperate (a week), and I do use Ibuprofen as an anti-inflamatory only if I really hurt, and celebrex ONLY if I really over did it (I discovered that does AMAZING pain reduction after accidentally giving myself whiplash after jerking my head backwards when I walked into a hanging bike in the garage (doh!).

I also just bought a back massage mat that fits on a stiff back chair, that has a shoulder massager, and I break those knots up really good using that. That seems to be very helpful to.

Anyhow, I continue to do what I love to do, I just need to learn to let my body heal when I have pushed it too far. In summary- a GOOD chiropractor (find one that is younger (they tend to be more excited about it, and up to date on newer technique I've found). Find one that will break up the knots and will work on muscle too (ask if they do that).

If you don't have insurance, a lot of new chiro's will work with you "out of pocket", and negotiate a visit rate you can afford. My first one accepted $15 per visit (because I went 3x a week) until I had insurance that accepted him.

- anon22722
22
I have been reading through these post and find I am experiencing something with similar symptoms in a different region. I have what feels like a muscle knot in my lower right abdomen near an old hernia surgery scar. It goes away when it is treated with ultrasound and heat but comes back for no apparent reason. It rarely shows up during or after physical activity. I have done MRI, Ultra Sound and EKG and they have found nothing. Both my doctor and my pain specialist have referred me to a surgeon to double check for a hernia and it has come back negative. I first noticed it after a fall i took about a year ago where i did the splits on a pair of stairs. I have been physically active most of my life and was in fairly good shape when the fall happened. Since then I have transitioned to a job that requires sitting for 8 hours a day. i have backed off on exercise just as a caution. anyone have any ideas or suggestions i would greatly appreciate it. i have been using anti-inflammatory patches that my doctor prescribed but they are only minimal help. The area feels like a knot or a charlie horse but like i said, 4 test and two surgeons later they don't think it's a hernia...
- anon22033
21
I am now 27, male, 6'3" tall and very athletic.I have had muscle knots in my back for about 4 years now (mostly around shoulder blades and upper shoulders). The problem started when I began working full-time in an office. I started going for massage which helped as a treatment, but my therapist was experienced enough to tell me that bad posture was the main problem. I was reaching forward too far to my keyboard and phone, which kept my back, neck and shoulder muscles stretched for prolonged periods, preventing blood and oxygen to flow effectively through these muscles.

Correcting posture is huge to prevent and calm trigger points. However, prolonged sitting is NEVER good. get up and walk around every 20 minutes or so and stretch throughout the day.

When my Son was born (3 years later), i changed jobs and was working only part time, 3 days a week. During the next few months, my knots went away completely and I felt 100% again. I'm very sure that the prolonged sitting was the main cause but through consulting with many experts and extensive reading I know that regular stretching, strengthening exercise, drinking plenty of water and relaxing are all part of the healing process.

Our bodies are simply not made to stay in the same position for 8 hours a day. The only position that is ok for prolonged periods is lying flat on your back.

- anon21494
20
Thank you. :> [Formerly anon20427 ]
- BldyMalice
19
anon20427: I was going to post a link for you but it won't let me. Try a google search for "Upper Back Pain Rehabilitation Exercises"
- anon20555
18
anon20427: I had similar problems due to computer work that became almost debilitating. What worked for me was physical therapy: a combination of "trigger point therapy" massage, stretching, therapeutic ultrasound, cardiovascular exercise, and specific exercises to strengthen the muscles in my neck and upper back to improve my posture. A good physical therapist should know about all of these treatments. While all of the treatments were helpful, exercise is what ultimately seems to keep the pain from reappearing. I highly recommend that you see a physical therapist! Best wishes.
- anon20550
17
I'm currently 16 and female, and I've had a very bad back since I got into my car accident a year or so back. I have terrible posture and I know it - I'm an internet addict. There's always a hotspot of burning, fiery pain that sits under my right shoulder blade (I assume it's from my mouse/computer posture and drawing as much as I do), but recently it's been some serious stiffness in my neck that's been throwing me off. It hurts, for sure, but it's not the pain that's tormenting me so much as the pinching, numb feeling at the back of my head. A couple times I have fallen against walls from the sudden loss of balance when getting up that comes from this foggy feeling. It's like I'm barely keeping myself from losing consciousness when it starts to stiffen up. It's done it 3 times today in my different classes, and it's starting to affect my ability to focus on schoolwork. I'm constantly plagued with tense muscles, soreness, and knots.. And my sister (parent..?) never takes me seriously when I start complaining that I need something to be done about it. Heat packs don't seem to help because the knots aren't loosened or come back extremely fast. Any tips, tricks, or solutions would be greatly appreciated. :<
- anon20427
16
I was diagnosed with arthritis at an early age (in my teens) so now, in my 50s, I have the joints of an octogenarian! Muscle knots have been a problem for me for the last 2 decades. I have both chronic trigger points (feet, hands, gluts, thighs and upper arms) and some that appear suddenly and dramatically.

The worst muscle knot ever was in my upper back in the shoulder blade region. I had helped push a car off on to the side of the road in the morning and by evening the knot had assumed massive proportions. It ended up being the size of a large (semi-submerged) grapefruit. My doctor prescribed oral muscle relaxants (cyclobenzoprene) - which do work on my chronic trigger points. Unfortunately the oral drugs did nothing for this alien-looking mass.

After several other failed attempts (mechanical massage, heat, cold, etc) the doc injected the "lump" with a rather substantial amount of Valium. The results were immediate and dramatic, with the bulge reducing in size by half within the first 30 minutes. It took 2 more injections over the course of a week to get the muscles to unknot completely.

- anon20094
15
A lot of people underestimate the power of posture, which can either create knots or dissolves them. I sprained my back in three places about year ago, and it was so painful that I went to the doctor three times and finally the physical therapists. Although I diligently exercised and stretched according to the physical therapists instructions there was no result. The pain was still there. I finally figured out that the knots surrounding the sprain couldn't relax because my posture was constantly activating it; I was arching my lower back too much. Tucking in my pelvis while rolling my shoulders back was like a magic cure. Instantly the pain went away and stayed away. I therefore encourage everyone who has chronic back and neck pain to examine the way he or she walks, stands, sits (especially at the computer) and lies down. Eventually, one can find and rest into the natural curve of his or her spine, which will allow the neck, shoulders and back to take a much deserved and needed rest.
- anon17350
14
About a week ago, while I was playing in my football game, I had a 230 lb. guy land on my front left ribs area. I was winded for a few, but felt a crushing pain in my rib area. Had the sport doctor look at me and she said no ribs broken and probably just winded. And she said to just keep stretching the muscle. Days go by and the pain is there and those first few days is very painful getting up off the couch etc. Then went to urgent care abour 3 days later and took an x ray which came out negative. Then I worked out and did tricep and chest workout and and I had to stop in the middle cuz I felt like I irritated it a lot worse. Then, about 5 days after the game, went again to urgent care clinic and the doctor said it was a muscle spasm and to lay off the weights and all physical activity for about 10 days and to take ibuprofen and then he prescribed me these pills to take one only at night as it relaxed the muscles. This pain to me feels like it's not going away. It's lingering on the left mid section of my body under my arm front and back. Also, I read online that it might be a knot if the spasm does not heal after roughly three days. What can I do to make this go away asap?
- anon16923
13
I had a "crunchy" knot in my lower-mid back and successfully got rid of it by regularly stretching that part of my back. When stretching that part of my back, it felt like something in the muscle was being broken up and as I continued stretching and working through the breaking in the muscle I could gradually stretch further and the crunchiness would go away. It would sometimes be quite sore afterward but not in a bad way. The next day the crunchiness would come back, but after doing this several times a week over a few months, the crunchiness is now gone completely and doesn't come back.
- anon15699
12
Yes this pain is very common and I have read information which states that this pain is autoimmune. The problem is very common and when I went to the doctor they wanted to do surgery.

So I said goodbye and went home to stretch and followed the advice of the web site and I got better. I gave up my health insurance and for 100 dollars a year I am under the care of a remote consultant at the web site.

- anon14850
11
I have those "crunchy" spots too. They almost feel like stringy tendons when you rub across them, although I know I have no tendons there. I have had them in various spots on my back. The only thing that seems to help is a deep tissue massage. I don't know if anything is causing them, except that they do coincide with some stress I've been going through. Have you guys had stress lately as well?

- anon14300
10
I have the crunchy knots by my shoulder blades too. I bought a Iknead from brookstone and that beast does some real damage to it. I can also rotate my shoulder backwards and if I angle it just right I'll crunch that knot right out. Now I have to figure out how to get rid of the pain i have near my tailbone. I kinda want to hang upside down and let my weight drop from my feet I bet that would work. I'll let you know!
- anon13990
9
I've been a practicing Massage Therapist for 3 years now. Many times these "knots" are just latent trigger points. They can stimulated by sudden unexpected exertion, excessive heat/cold, lack of or over use, over stretching or over contraction, and to a lesser extent- stress and dehydration. If it is in your abdomen, I wouldn't be too alarmed. You may just want to try a different method of abdominal work. I will always and forever suggest pilates. It works the core to create balance through the body. The AbGlide that you are using is actually a very advanced technique that TV commercials have managed to make easy for everyone. Hope this helps.
- anon13611
8
I have had an issue with a very sore spot in my muscle in my back, just over the shoulder blade. When I rub it, it feels for lack of a better term, "crunchy". It's like a spot of muscle is very hard and cracks and pops under your fingers as you rub. If someone intensely and deeply rubs it (very painful but with the aid of a hard rubber ball works very well) it will relax a bit, but always comes back in a few days. I just started working out last January and about a week ago I strained the area below my neck, right next to the spot. Now I'm getting concerned that I'm not going to be able to work out like I normally do because my back has been sore for about a week now. The "Crunchy" spot still causes the most issues. Has anyone ever had this or heard of it before?
- jayqboy
7
If you have a specific muscle problem like in the piriformis, you should try Active Release Technique (A.R.T.). Its very well known in the sports world. Its a hands on treatment method, somewhat like massage, but involves movement and is far for effective in treating muscle knots. Many chiropractors do A.R.T. but its not limited to chiropractic and some massage therapists are certified in it as well.
- pwc1234
6
First off, i'm a 27 yr old male. I have had a muscle knot in the left thoracic portion of my back since sept of '07. The injury originated from painting a ceiling for 4 hours. I have had an xray and MRI done on my spine and found nothing thus far. The only medication/s i've found to work are 1000mg of aspirin, 2x daily and recently i've found 1mg clonazepam daily to work wonders. I must have this in order to do my job and all I do is accounting work at a desk all day! I took the aspirin for 3 straight months daily and it tore me up inside. My doc told me it was "ok" to take that much. The clonazepam has been working great for two weeks so far. If you can get your doc to prescribe it, it works great for me, but does have side effects. My insurance through my company is just going to start next week, thus far i've been paying out of pocket so maybe I can find out more down the road and update. This has been a horrible problem for me and i've just started to believe that it is an active trigger point. Good luck and feel better.
- anon9992
5
Massage therapy seems to be the main course of treatment other than surgery. Keep in mind the massage therapy can take several forms, including use tools such as tennis balls or massage sticks as part of the treatment. If massage or electrical stimulation therapy to relax the knots does not work, surgery may be the best option. Discuss with your doctor.
- mdt
4
I have stress knots on both sides of my neck. They get smaller by massage but never completely go away. Sometimes they hurt really bad and my neck feels tense. Taking a warm bath and getting a massage helps sometimes. Is there a permanent cure?
- anon9009
3
i get muscle knots in my back. i usually get them after i sleep in a wrong spot or walking home carrying a heavy bookbag. i am only 16 and i get them all the time. i usually have my mom press real hard on the muscle knot over and over and it eases it away but it hurts really bad while she is doing it.
- anon7910
2
I have a muscle knot/spasm in my gluteal region. At first I thought it was a bump and had gone through and MRI and Ultrasound to diagnosis and nothing was found. I had a pelvic exam and they discovered my Piriformis muscle is in a knot. I have gone through PT, Acupuncture and now getting massages and it is like I am sitting on a rock. It is so stubborn. the last Masseuse was so shocked at the size of the knot. I just don’t know if it will go away. Any suggestions?
- anon5344
1
I have got the muscle knot in the middle area of stomach by overdoing he AbSlider machine. It is not painful though but its been there now for a while?

What should I do?

- anon4180

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Last Modified: 17 November 2009

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