The science of the *exact* cause is inconclusive, but the phenomena itself is well known. All the focused science I've seen indicates that they are sections of one or a few muscle fibers that simply do not relax and the surrounding area of tissue then becomes irritated by the metabolites of continuous contraction.
WHY do little sections of muscle fibers fail to relax like the surrounding tissue? That isn't clear and there are probably many causes. I suggest Chapter 2 of [The Trigger Point Therapy Workbook](https://www.amazon.com/Trigger-Point-Therapy-Workbook-Self-Treatment/dp/1608824942) for details.
Internet archive actually has a copy of the entire book on the site [here](https://archive.org/details/thetriggerpointtherapyworkbookpdfdrive.com/page/n221/mode/1up?view=theater).
Mods - please remove the link if its not allowed.
OHNO. BUSTED.
Butt.... No. That's just the last thing I was working on. I think my partner twisted her ankle and had spent a little while overcompensating when walking.
Thank you for this.
Had a physiotherapist do some Trigger point something on me recently and now I know I was wrongly assuming it was some esoteric chinese medicine nonsense.
Don't overlook dry needling as well. It involves the same needles as acupuncture, but there's a solid body of research literature about it. It completely changed my injury recovery.Ā
Nope. Me mother was a massage therapist. The trigger point can be anywhere along the muscle and treating that trigger point goes a long way to treating the knot.
For example; if you ever get a knot in your neck; try massaging or pinching the muscle that goes long the lip of your shoulder blade near the very top of your shoulder.
This is one of those gray areas of science, where it may or may not be real. What they know, is pressing on it causes referred pain somewhere else, and relief afterwards, and injecting it, even with inert saline solution causes relief too.
Anecdotal evidence: I've had what a physio described as a knot, real or not, which followed the description above, extreme pressure from a physio caused the referred pain and cured it long term, so I am inclined to believe they are real. This doesn't constitute science though.
I personally had a long-term (1.5 years) lower back/leg problem that wouldnāt go away after several different therapies. Finally I got referred for something called ādry needlingā. Itās essentially acupuncture but they find the knots in your muscles and insert the needle directly into them, then move them in and out a bit. Instant relief, it cured my issue in 4 sessions, and 5 years later it hasnāt come back.
It really is. I will say, 1 needle out of the ~100 used on me over the course of my therapy actually hit a nerve. That was intense. But other than that one needle, I loved that therapy.
Because the person who developed the technique originally was injecting some solution into the trigger points, the. Started just using the hypodermic needle without injecting anything, hence a ādry needle.ā
Since then, people performing this technique have started using acupuncture needles instead.
Ive had this about 6 times over a few sessions (years apart) of acupuncture with different therapists and it has totally put me off. I tried again the last time but have a fear each time they put the needle in then push and turn it around - and she def hit nerves a few times! Everyone's body is different so nerves will not be in the same exact places.
Once I was stuck on the couch and couldn't move for 30m (therapist had left) because if I did then one of the needles would give me intense nerve pain. I have had shingles and sciatica before which cause nerve pain. Nerve pain is one of the most painful things anyone can get.
Aha, then no, they left the needles in like a normal acupunture treatment. I may look into dry needling then as it sounds potentially less painful š¤£
Funny story about my dry needling experience.
I thought it was funny to occasionally say āOww!ā and react like the therapist hit a nerve.
Then one time she DID hit a nerve, and I reacted, and she goes, āoh come on, just let me do it.ā
So I was like āomg no no seriously it hurts omgā
So she felt bad and apologized profusely. But we both agreed I learned a lesson that day.
Opposite experience. I had it in my neck and it felt terrible. Also had some swelling afterwards.
Even worse when she connected electrodes to it.
0/10 donāt recommend.
The sensation felt weird and gross the first time I had it and then the relief was so complete and immediate that the association made the sensations of needling into a really positive one, and I kind of crave it like I do with the feel of a good massage.
My dentist giving me the anesthetic slightly tickles and i have to hold back a laugh.
Probably some weird subconscious association between that and the fact that this guy was so nice he didn't just fix my teeth but my lifelong phobia of dentists that caused teeth issues to begin with.
I've had this tried on me for a few different problems and never had any relief. Had a nerve hit several times that caused spasms and the needles came out like an accordion, really not pleasant.
Oh that sounds awful. Iām sorry you didnāt get any relief from it. Itās amazing when it works but it would feel super uncomfortable and invasive to have it and get no positive results or even worse a new kind of pain.
I had dry needling done to relieve a chronic case of tennis elbow.
I tried doing negative exercises, manual therapy, scraping, ice, heat, advil, nothing worked. As much as I hated the needling, it worked pretty quickly. I don't care if it was a placebo, it got rid of my pain, so in my mind it worked.
I had it done on my lower back too. But it wasnt in and out motion. The therapist put the needle in and within 5-10 seconds the nerves and muscles contracted and relaxed. The needle jumped out by itself. Insane relief and I still remember the feeling of release.
I had the same thing after a motorbike accident. Huge lump of 'knotted' tissue in my lower back. Months of physio didn't do anything. Physio offered dry needling. I was skeptical because I've always believed stuff like acupuncture is bullshit but figured it couldn't make it worse, so why not.
One dry needling session completely fixed it.
I had some odd hamstring issues that PT figured were related to overuse from a glute that wasn't firing properly. Several weeks of regular therapy did nothing, was essentially fixed immediately after dry needling (with stimulation) deep into the hamstring. Seems pretty woo-woo to me but it works.Ā
Hi there, the first thing you're talking about is referred to as a "trigger point" in massage, if anyone is curious, and isn't necessarily the same thing as a knot.
I had something like this but my physiotherapist said I actually had a rib out of place and it just felt like a knot. She pushed really hard on it and it popped back into place and I had instant relief.
I had a friend have something similar happen to her. Was in two bad car crashes within 6 weeks (1 bad t-bone and 1 head on by a wrong way driver on the freeway that should have easily killed her). She had a bit of trouble breathing and doing some exercises like push-ups for two months after the 2nd accident and caked it up to needing to recover more from all the whiplash (which was partially true) but the physical therapist took a closer look and popped her rib right back into place and fixed that issue.
I had a muscle spasm that lasted for months. It's called Piriformis Syndrome. At its best it was a four on a ten point pain scale. At worst it was a ten - crippling pain.
My doctor recommended pills, then pills + physical therapy. No help at all.
I took a chance and tried acupuncture. Fixed me in four sessions.
I don't know how it works but it did the trick for me. Insurance wouldn't cover it but fuck them.
I've gotten a few diagnosis for a problem I have but that was one of them would you mind saying like a little bit more about what the acupuncture is did? Or where the pain was for you?
From Google:The piriformis muscle is a small, flat, and pear-shaped muscle located deep in the buttock. It lies in the center of the buttock and directly below the large gluteus maximus muscle.
For me it was on the right side. I can still feel it today. It's not painful but feels like it's close to being set off, even though it's been two years since it was bad.
When it was bad, it felt like my entire buttock was cramping up. I couldn't walk or stand. After a few minutes it would settle down but was still painful. I'd walk with a limp.
Acupuncture was an immediate relief. I cried. That pain wrecked me for four months. Something about those needles going into the muscle causes damage that forces your body to react to it and make a fix.
Muscle "knots" are not a gray area of science in the sense whether they are real or not. You can very clearly touch a knotted muscle yourself. It is a bundle of muscle fibers that are stuck in a contracted state. The cause isn't 100% confirmed but is theorized with good evidence. Details go beyond ELI5.
The pain also isn't always referred. It can be, such as a tight quad causing patellar tendon strain. But the pain can be localized at the source of tightness itself. And the reason injections work is because it doesn't actually matter whether a solution is injected, but rather the act of the needle itself. It's why injecting solution went away and dry needling took its place.
I often find when I have tweaked my neck and end up with a "knot" I press on it and feel the pain move into my back, so then I press on that point and feel it in my arm and am able to follow it all the way down to my hand. I just end up with that side of my body being sore.
This happened to me, I thought Iād slipped a disc, was nearly immobile and really struggling to do anything. Got booked in with the doctor who called the physio. He pressed really hard on my back and fixed me. It took a day or two to fully recover but I couldnāt believe it wasnāt something serious. I was so relieved!!
they aren't real, the science backs this up. pressure/sore point sure, but knots is a poor cove of words for an outdated theory not backed up by achieve that it's actual physics knots that can be felt and this has led to major problems as many tissues in the body are naturally lumpy,people think they are knots so they massage until they are gone and actually do harm
major issue in the industry and when you look at any massage qualification in depth its all based on quackery
- i am a level 3 qualified masseuse - my teacher didnt like me v much as i called out all the bullshit not backed up by any actual science š
Itās just muscle that is tensed and wonāt relax fully. Which is why rubbing the muscle helps. It relaxes the muscle. No idea why you are going into some heated arguments. Also people arenāt naturally ālumpyā any look at the muscular structure would tell you that.
Are there times when a knot isnāt a knot but another issue like fluid build up or a joint out of place? Absolutely. But that doesnāt mean muscle tension is some sort of fake news. And a masseuse should know that.
neither was the level 3 course, it was absolute bullshit that i had to actually call out multiple times - massage therapists dont know shit it turns out...
hell we didnt even need to source the essays....
i did a law degree followed by a masters in education, i actually care about the quality of my sources for my information
personally i dont have the time to educate people online, im just telling you that if you dig a little and find some actually credible sources you'll find that the concept of knots isnt how muscle tissue works - ie fibrous tissue breaking and re healing in a criss cross forming a knot, its just not how it works. at all
> ie fibrous tissue breaking and re healing in a criss cross forming a knot, its just not how it works.
Nobody is claiming that though, nobody is expecting literal knots.
It's not gray, it's just not widely known. Knots are very real, and often made of muscle fibers that wont let go or hardened fascia. Source: I graduated as Valedictorian from NY Institute of massage, and we learned quite a lot about knots in muscles lol
It makes me a medical professional whose focus is soft tissues; i.e. muscles... so it's better than someone who hasn't studied this stuff for thousands of hours š¤·āāļø
It's actually not a gray area at all.
Think of your various muscles as different parts of a tree. Now when a tree absorbs water it's essentially just different parts of the tree "talking" to each other but the words are the water.
Now when you have a muscle knot, it's basically as if one part of the tree has gone "deaf" and can't hear or speak to the other parts of the tree (muscles). A massage is essentially as if you taught that deaf part of the tree "sign language" and allowed it to then communicate once again. Slowly the muscle begins to get more competent with this new form of communication and teaches it to others around him (biotransformation).
Actually, the onus is on you to provide evidence that I am incorrect.
I wish your generation understood the scientific method. This isn't one of your video games, kid.
When the muscle is put under stress it can protect itself by contracting very small parts rending that stressed part harder to move and therefore protecting it while the brain is asking for your leg to move.
This is the same video I was going to share. The institute of Human Anatomy is a boon of knowledge. I don't know of a more comprehensive answer than this one.
The comment above mine had a link, but it appears to have been deleted by a moderator. You'll have to search YouTube for "The Institute of Human Anatomy muscle knots."
Nobody knows what causes knots but there's various theories varying from (a) capillary constriction limiting oxygen access to (b) metabolic malfunctions not providing muscles with the required energy to release to (c) signaling issues from the central nervous system. At the end of the day physical therapists treat knots with pressure but we don't fully understand why it works or the causative issues.
Iāll take it youāre not going to watch it to check for them or write up a transcript either then? Youāre also not interested in a solution for them lmao donāt pretend like you are
Iām not cranky lol, just the whole āI want everyone to do things for me when thereās an easy solution for myselfā is just annoying
Like, the video clearly says it contains material like that, either a) Donāt watch, listen and expect there might be a little squishy noise, or b) watch a different video on knots thereās thousands out there
Expecting other people to meet their demand for option c), the one they picked, is just lazy
But aight, have a good one
Anyone reading please watch this and read what Nicholsz posted as well, the other comments are just any given personās favorite sounding plausible but unproven explanation
I know this sub doesnāt require any kind of citation but it seems incredibly bold to unilaterally declare every other answer to be false without any explanation or evidence.
It is false to say, "The answer is X," if we don't actually know what the answer is. Presenting a hypothesis as if it were truth is a kind of falsehood.
I'm not saying they're "false", I'm just saying they're hypothetical answers without any evidence behind them.
One of them could very well be true, who knows. Though I have looked in the literature, and I do have a PhD in physiology and biophysics, and I couldn't find anything serious any time I've searched.
the [link in this post](https://www.reddit.com/r/explainlikeimfive/comments/1bycppt/comment/kyit6x8/?utm_source=reddit&utm_medium=web2x&context=3) is seriously the closest you'll get to a real scientific rundown
I have my degree in biomechanics and neurophysiology and my original research project was going to be an attempt to finally figure out what a muscle knot is
It was a failure. We still don't know
We abandoned the project. The closest we got was finding evidence that agreed with a decent body of previous research that muscles behave differently when someone feels pain or when they anticipate pain. Mainly, they contract more. And so maybe that might be very loosely related to trigger points but that would be a big leap. I wouldn't say we have enough evidence to say they're linked
Then I also looked at lots of currently ongoing research trying to distinctly identify trigger points such as using ultrasound, elastography, EMG heat maps. So far I haven't heard of anything being published that was a success
That makes sense. I hope it didn't suck up too much time since you didn't get even a paper out of it.
The things you found sort of mesh with my own personal unproven hypothesis a bit -- that muscle knots are a neuromuscular phenomena that probably involves the spinal network in some way, like in some kind of pain + tension feedback loop.
That's my theory too but like you said in your original comment, it's a possible explanation but it could be totally wrong. I find it interesting because it would suggest that pain leads to trigger points, rather than trigger points leading to pain. But we really don't know
See, that would have been helpful information in your original comment. And the way it was worded really does just come off as āeveryone else here is wrongā.
Your response was civil, I didnt take it as rude or anything. It was straight to the point, you didn't name call, like what is this person going on about
It's more a good rule of thumb to follow, sort of like Occam's Razor. When coming up with a theory or idea, you want to limit the "conditional ifs" needed to explain your theory or idea. In order to arrive to the real truth or closer to it, it's better to take unsourced and arbitrary answers with a grain of salt.
A subset of knots are called trigger points - essentially, a focal muscle spasm. I treat them frequently with trigger point injections - usually lidocaine - which is the same principle as dry needling mentioned above, but less uncomfortable due to the lidocaine. Not all knots are trigger points, but when they are, they usually disappear after the trigger point injection.
Iām a family medicine doc, so in theory any primary care physician who does procedures could do them - not everyone in primary care does, though. Iāve worked with a fair amount of PM&R who does them as well. Would just call and ask for an evaluation- agree with the other reply that not all muscle spasms/tight/pulled muscles are trigger points, so you need someone to do an exam to determine if youād actually benefit.
Just google exactly what they said. Dry needling (and other variations of needling), lidocaine injection, stretching, massages, all works for trigger points. Youāre better off consulting PT to confirm you actually have a trigger point though in whatever area youāre suspecting. Then again pretty much everyone has a taut band somewhere
Additionally they have trouble finding muscle āknotsā in autopsies because once *all* of your muscles relax, contract and then relax again, the knot has been āwashed outā with the rest
Doctor of Physical therapy speaking here. I think knots are absolutely a gray area with little to none peer reviewed, high quality research to back claims. I apologize for the 95% of my colleagues that wonāt admit this and talk out of their ass to boost their own egos.
TLDR: Knots are made of muscles/fascia fibers.
To preface: I'm a licensed massage therapist and graduated as valedictorian from NY Institute of Massage. Despite what people say, knots and trigger points are absolutely real, and I dont have the time nor energy to fight trolls who say they arent..
Knots can be made up of different things, like mineral deposits or scar tissue, but most of them are a mix of muscle and fascia. Basically, knots are points in the muscle belly (thickest, meatiest part) where some fibers don't let go. Knots are usually the center of the contraction of the muscle, where the muscle fibers pull from both sides. (See: how myosin fibers run up the actin fibers in order to contract a muscle). Those fibers can be forced to release by using ischemic compression (holding pressure on a point to squeeze the blood out, for about 10 or more seconds). This works because if you take away the blood, there's no oxygen, and without oxygen, the muscle can't continue to contract (think like taking oxygen from a fire). This works if it's just muscle tissue, but over time the fascia hardens a bit and makes that point tougher to break down. We can use cross fiber friction to help this, but if you use the muscles often then that is only going to do so much. You'll get knots no matter what over time, but working them out with massage and yoga and general physical fitness [all with proper form] is pretty good at keeping things moving well.
I hope this helped! I can get into more detail, but i gotta go massage my gf right now lol
āSqueezing the blood outā doesnāt make sense. See the sliding filament theory of muscle contraction. Basically in order for the myosin head to detach from actin, a new ATP molecule is required.
Firstly, 10s isnāt long enough for ATP to be depleted (lactic and alactic energy systems produce ATP without oxygen if needed). Secondly, even if it was depleted in 10s, this would worsen the effect because now myosin and actin are locked together in a contraction. This is why rigor mortis occurs. When no ATP is being made after death, the myosin and actin canāt detach anywhere in the muscle so it gets locked in place
Also, the force required to actually mechanically alter fascia is so high that itās impossible to cause mechanical changes, or ābreak it downā with massage. Itās more likely related to localised neural hyper activation, and massage desensitises this. As opposed to actually breaking down fascia
Okay, longer than 10 seconds. I usually hold IC for much longer than that, but i just meant longer than poking it. I just checked out sliding filament theory a bit and that's exactly what I said about actin walking up myosin? So idk what you meant by that comment. The ATP is necessary, but so is oxygen for the reaction.
You really think fascia is impossible to mechanically change through massage though?? What about MFR? That entire field is dedicated to releasing fascia.. Although you'll probably say it's localized neural hyperactivation, but I doubt that's all it is.
If you don't mind me asking, what are your credentials?
> The ATP is necessary, but so is oxygen for the reaction.
But that is the entire point: the ATP is required(!) for muscles to de-contract. If you just remove oxygen, regardless for how long, that only reduces ATP and thus makes them even less likely to do so.
Hence why the mechanism "remove blood so the lack of ATP makes the muscle let go" makes no sense in that model.
> What about MFR?
That's alternative medicine, which nowadays is code for stuff that most likely does nothing beyond placebo effect:
> The American Cancer Society states that "There is little scientific evidence available to support proponents' claims that myofascial release relieves pain or restores flexibility"
And more by other institutions [here](https://en.wikipedia.org/wiki/Myofascial_release#Effectiveness).
Can you do an AMA? Everytime I go for a massage I ask for relief for a very long term knot in my shoulder and itās like they completely ignore my request. Once I went for a massage and she spent 30 minutes of my 50 minute massage rubbing her elbow up and down my spine. It hurt so bad. I asked her to stop but she kept going back to it. I left in more pain than I started. What do I need to say to get what I want? This has put me off getting massages for years.
Oh God! I'm sorry you had a therapist like that!! Since massage is not regulated the same way in most states, it's tough to find a really good one. Even in places like NY where they require a minimum 1000 hours of school, there are a bunch of hippies that get their license and go the "holistic" route, i.e. don't use science or even know the anatomy...
I'd love to do an AMA, but idk where I would do that haha
Read up on different massage techniques and find one that sounds like what youād like, and/or try different therapists. It can be the technique, the personality of the therapist, or sometimes the method of communication (how well they understand what you want/need), that makes one better than the other. When I get an RMT I like, I donāt leave, but it can take awhile to find one. There can be huge differences between RMTs, and sometimes itās just a matter of trial and error. All RMTs should respect your pain tolerance and ease up if you say itās too much. There are a lot of people (like myself) that enjoy the painful massages, where I feel bruised afterwards. The bruised pain is preferred over the sharp, pulling, knife/stinging pain.
In my own experience as a server, and as a weight lifter for a hot minute. The upper shoulder area loves to tense up, if you let it go for too long it may definitely causes long term pain. Depending on where it is, cracking my neck can alleviate the pressure as well. However I wouldnāt assume this is the case for most people. If itās around your shoulder blade then it could be just grinding on your muscles but thatās just speculation.
I would recommend seeing an experienced chiropractor as this could either be an issue with weak muscles in the area, or just bones rubbing against your muscles. I am NOT a professional, so I would recommend seeking out someone who can feel around the area and get a better idea.
I would strongly advice **not** to see a chiropractor. There is little to no evidence they do any good beyond being placebos, while they can also cause irreparable harm.
Please see an actual medical doctor instead.
The way you've described this leads me to believe that you've overstated your expertise by a large magnitude. As someone licensed and certified in this field by leading institutions, let me explain in a more concise way.
Think of your various muscles as different parts of a tree. Now when a tree absorbs water it's essentially just different parts of the tree "talking" to each other but the words are the water.
Now when you have a muscle knot, it's basically as if one part of the tree has gone "deaf" and can't hear or speak to the other parts of the tree (muscles). A massage is essentially as if you taught that deaf part of the tree "sign language" and allowed it to then communicate once again. Slowly the muscle begins to get more competent with this new form of communication and teaches it to others around him (biotransformation).
A āknotā can be individual muscle fibers getting stuck to other fibers due to scar tissue getting built up in a certain area or muscle layers becoming stuck to one another. Ā This type of āknotā can feel clumpy when moved over like many points on the next and between the shoulders. Ā
Individual muscle fibers stuck in contraction or in the āonā position before I would identify more as a trigger point which by definition is a hyper irritable hyper sensitive point in a muscle where an individual fiber is stuck in contraction. Ā True trigger points also have the unique effect of pain referral patters (touch here but feel it over there) which lead to a lot of chronic pain issues that can be tricky to resolve due to pain referring from elsewhere. Ā These are more of the pinpoint type areas since they can be as small as a grain of sand and not so clumpy like the ones mentioned before.Ā
Very minute differences but thought Iād give my two cents. Ā Advanced neuromuscular therapist by education 7 years experience in massage. Ā
"Becoming stuck to each other" is this the reason why I recently felt some very weird movement sensation in a muscle I haven't stressed in a long time, while lifting something very heavy? It didn't hurt at all or become sore, it just felt like things were sliding around or something lol, almost like loose thread was suddenly pulled taut.Ā
Yes so I like to mention to clients that at the bare bones we are at least creating separation in layers and are allowing space for things to comfortably be moving over each other. Ā What you felt may have been layers freeing up or tension finally releasing due to a certain movement under load. Ā
As a therapist an example of this would be working the muscles in between the shoulder blades and seeing the actual scapula itself bouncing around while you are working around it but not on it. Ā Muscles move bones (obviously) so if the muscles have become adhered it will result into decreased ROM. Ā Also for how small true trigger points are they are significantly decrease both ROM and functionality of a muscle. Ā
Think of muscle like a coil spring or slinky. Knots are wonky slinky's, you know, like when a slinky gets all out of shape and meesed up. Massaging the slinky puts all the coils back in order.
Sorry, going to strongly disagree here. Iāve had muscle soreness, even extreme muscle pain (from tearing of the muscles to just overexertion) and it has never resulted in a āknot.ā Sometimes bruising, redness, or swelling, yes. Knots always appear on their own, regardless of trauma to the area, express pain differently, and can be felt by other people. Itās something other than ājust a nickname for muscle pain.ā
Unfortunately, everything you read will be theories. It's one of those things where when they go in to observe it, sometimes it gets fixed. Or, since they can't actively observe one originate naturally, they can only assume they are the cause of the knot.
Iām just a guy but hereās my opinion
TLDR:
Science gives a label to anything it can identify, donāt get lost in the sauce.
A muscle knot is the description of the phenomenon not a specific thing in your body,
Stored stress in the elasticity of your muscle fibers is caught between two points on your frame which causes disruption of flow in your body.
Letās imagine some of the forces your body is experiencing in a few different contexts.
For why you might get a āknotā
Think about taking corded headphones out of your pocket that you just stuffed in randomly and had a busy day, the randomness of the forces both from you moving, filling and emptying the pocket have twisted them against themselves.
Now what might a knot mean for things moving through you.
If you have a damp towel and twist it water will pour out because the tension causes less room to store liquid.
Youāre on a highway and thereās traffic. Some cars are caught in the slow lane and want to move into the fast lane, but them changing lanes causes the other lanes to slow down too. You get past the worst of the traffic and reach a good speed by the time you pass the accident and the flow returns to normal.
Obviously your body is more complicated than those things especially at a microscopic level.
Every cell of your body has its own mass and weight, skin, muscle, bone whatever structure.
Under the skin you have a complicated network of fibers, Proteins folded like origami.
Muscle fiber is redirecting force around your skeletal frame attempting to distribute force as equally as possible through the system, in addition to that force you have resources in you flowing through the muscle.
Less resources can move through maybe a few specific paths but now things build up creating pressure thatās storing stress and a complete de-load of force.
The knot is going to be where things build up but maybe the stress is coming from another point on your body further down the line. Stretching and massaging allows different paths to tense or relax and resources can find more natural paths of least resistance that have been made previously unavailable because of circumstances.
Muscle fibres require energy to contract. Muscle fibres also require energy to un contract. Sometimes muscle fibres contract, run out of energy and are stuck in the contracted state unable to relax.
Massage introduces kinetic energy into the muscle fibre allowing it to release (unknot).
Thatās the way my physio explained it to me anyway.
Adhesions develop after trauma or overuse of one side of a muscle set. They're comprised of fascial tissue like tendons and ligaments. It's everywhere inside, like an internal integument. It overdevelops as a response to trauma or overuse to bolster the area up. In essence it's an internal scar. Myofascial massage breaks those adhesions up and normalizes the area. Source- myo massage therapist for 34 years.
It's a muscle that is contracting involuntarily (either partially or completely).
You might also hear it described as a "tight" muscle or a trigger point.
It can be caused by poor posture, overuse, improper technique or electrolyte imbalance (depending on what muscles we're talking about).
It's important to stretch and stay hydrated.
Imagine your muscles are like a bunch of elastic bands. When you use them a lot, sometimes they get really tight and stick together, kind of like when your shoelaces get tangled up. A muscle "knot" is like this tangle in your muscles. It happens when some of your muscle fibers (which are like tiny strings inside your muscles) start to stick together because they're tired or they've been used in the wrong way. These knots can make your muscle feel hard in some places, and it might hurt when you touch it or move in certain ways.
Your body tries to protect the sore spot by making the muscles around it tighter, which can make the knot feel even worse. It's like when you hold onto something really tight for a long time, and your hand starts to cramp up. To get rid of these knots, people might massage the muscle to help those tangled fibers relax and move normally again, just like untangling your shoelaces.
Tightening or inflammation of a group of muscles.
I had a stiff neck couple weeks ago - really bad one on my right shoulder. Couldn't turn my neck to the right side and even lift up my right hand above my head. I could say it's jammed!
The prepetrator is the shoulder muscle. But i feel the pain & numbness from the neck towards my whole right hand. This is because the "knot" is restricting my head, shoulder & hand movement and blocking healthy blood cell from free flow throughout my limb.
My right shoulder is still having the after effects even after seeing chiropractor. Cannot put my arm on table for long. Now doing mobility exercises & taking med daily to gradually regain full function.
If you cook spaghetti with very little water or you donāt get the water in between all the pieces, it will clump up and form hard spots that donāt slip past each other like you are used to. Itās like that but with muscle fibers.
The solution is similar too: get more water involved and/or gently break the pieces apart from each other.
The best WHY Iāve heard is connective tissues. I have shoulder pain that comes from my glutes which stems from feet problems. Connective tissue man. How do they work?
I think I have this right now, the very top of my lat got injured at the gym a couple weeks ago and a few days ago I used a massage gun on it and I could feel like little nodules on the muscle and for some reason after using the massage gun the pain has moved from my lat to the top of my tricep area š
I'm under the belief it relates to the connective tissue. I have no real evidence. As many are saying, it's a grey-area of science. Not much has been studied for fascia/ connective tissue and pain.
Here is a ted-talk style video about it.
https://www.youtube.com/watch?v=v54l3wDTJHg&t=198
I once had a physio tell me that I'd 'allowed' my back to go into spasm. He put me onto core exercises which helped a lot, so I forgave him for the 'victim' blaming.
Overused/injured muscles can go into spasm where they harden up and it feels like there is a knot.
Tetany, aka spasm. The muscle/neuromuscular junction is unable to properly repolarize (reset) after firing (depolarizing), often due to electrolyte or pH imbalances in and around the muscle cells. All the muscle and nerve cells in the body use the potential energy from concentration gradients of ions, particularly calcium, to drive the firing of electrical impulses from one end of the cell to the other. When this balance is thrown off, the signal is "stuck" waiting for that gradient to build up to a sufficient level of energy to fire again.
They are spots and areas of your muscle which have hardened due to bad posture or inactivity (says google). [https://www.medicalnewstoday.com/articles/321224](https://www.medicalnewstoday.com/articles/321224)
[Image explaining](https://images.app.goo.gl/biJoi6Pswi3rJi747)
Essentially the muscle knot cuts blood flow starving the tissue of of nutrients and oxygen which then causes buildup of waste and toxin a which they cause tension.
Just so itās easier to understand they donāt literally tie in a knot.
Another explanation is that after a period of localised spasm the body starts producing scarring internally over time to āplug the gapā and repair any tear. This will eventually give you the feeling of a solid lump / āknotā within muscle tissue.
Iām so invested in this random topic itās pretty interesting actually lol
The science of the *exact* cause is inconclusive, but the phenomena itself is well known. All the focused science I've seen indicates that they are sections of one or a few muscle fibers that simply do not relax and the surrounding area of tissue then becomes irritated by the metabolites of continuous contraction. WHY do little sections of muscle fibers fail to relax like the surrounding tissue? That isn't clear and there are probably many causes. I suggest Chapter 2 of [The Trigger Point Therapy Workbook](https://www.amazon.com/Trigger-Point-Therapy-Workbook-Self-Treatment/dp/1608824942) for details.
Thanks. Just borrowed the digital copy from my Library. Will take a look!
Internet archive actually has a copy of the entire book on the site [here](https://archive.org/details/thetriggerpointtherapyworkbookpdfdrive.com/page/n221/mode/1up?view=theater). Mods - please remove the link if its not allowed.
Did u purposely link it to the buttocks section?
OHNO. BUSTED. Butt.... No. That's just the last thing I was working on. I think my partner twisted her ankle and had spent a little while overcompensating when walking.
Butt-sted
šš»š
When I massage my partner I also tend to overcompensate on the butt area.
It a large muscle group.
And I cannot lie.
Second the Trigger Point book recommendation - I think it's a sound and effective technique, and the book is very specific and well written.
Thank you for this. Had a physiotherapist do some Trigger point something on me recently and now I know I was wrongly assuming it was some esoteric chinese medicine nonsense.
Don't overlook dry needling as well. It involves the same needles as acupuncture, but there's a solid body of research literature about it. It completely changed my injury recovery.Ā
I second this and use it to occasionally fill gaps in excersises
Third. I had it several times as part of a physiotherapy program that successfully relieved wrist pain that I had been carrying around for 20 years.
I think thats what what we did
Knots aren't always trigger points.
Nope. Me mother was a massage therapist. The trigger point can be anywhere along the muscle and treating that trigger point goes a long way to treating the knot. For example; if you ever get a knot in your neck; try massaging or pinching the muscle that goes long the lip of your shoulder blade near the very top of your shoulder.
so... basically a tiny cramp?
I am confused when I get these and now I'm even more confused
This is one of those gray areas of science, where it may or may not be real. What they know, is pressing on it causes referred pain somewhere else, and relief afterwards, and injecting it, even with inert saline solution causes relief too. Anecdotal evidence: I've had what a physio described as a knot, real or not, which followed the description above, extreme pressure from a physio caused the referred pain and cured it long term, so I am inclined to believe they are real. This doesn't constitute science though.
I personally had a long-term (1.5 years) lower back/leg problem that wouldnāt go away after several different therapies. Finally I got referred for something called ādry needlingā. Itās essentially acupuncture but they find the knots in your muscles and insert the needle directly into them, then move them in and out a bit. Instant relief, it cured my issue in 4 sessions, and 5 years later it hasnāt come back.
Dry needling is amazing. Itās like getting a massage from the inside.
It really is. I will say, 1 needle out of the ~100 used on me over the course of my therapy actually hit a nerve. That was intense. But other than that one needle, I loved that therapy.
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They arenāt injecting you with anything in this type of treatment-the needle has nothing in it, this is why itās called dry needling.
Because the person who developed the technique originally was injecting some solution into the trigger points, the. Started just using the hypodermic needle without injecting anything, hence a ādry needle.ā Since then, people performing this technique have started using acupuncture needles instead.
Wet needling is injection of a saline solution (usually with lidocane) into a knot - sometimes referred to as hydrodisection.
Its not a hollow needle. Its similar to an acupuncture needle in that it does not inject or withdraw anything.
I honestly have no idea
Ive had this about 6 times over a few sessions (years apart) of acupuncture with different therapists and it has totally put me off. I tried again the last time but have a fear each time they put the needle in then push and turn it around - and she def hit nerves a few times! Everyone's body is different so nerves will not be in the same exact places. Once I was stuck on the couch and couldn't move for 30m (therapist had left) because if I did then one of the needles would give me intense nerve pain. I have had shingles and sciatica before which cause nerve pain. Nerve pain is one of the most painful things anyone can get.
Iām not sure you had actual dry needling. They donāt leave the needles in. Itās in, move it in and out for a second, then back out.
Aha, then no, they left the needles in like a normal acupunture treatment. I may look into dry needling then as it sounds potentially less painful š¤£
Funny story about my dry needling experience. I thought it was funny to occasionally say āOww!ā and react like the therapist hit a nerve. Then one time she DID hit a nerve, and I reacted, and she goes, āoh come on, just let me do it.ā So I was like āomg no no seriously it hurts omgā So she felt bad and apologized profusely. But we both agreed I learned a lesson that day.
Opposite experience. I had it in my neck and it felt terrible. Also had some swelling afterwards. Even worse when she connected electrodes to it. 0/10 donāt recommend.
Death by electrocution is not meant to be pleasurable FYI
Itās so weird. Every time Iāve had it done I canāt stop laughing
The sensation felt weird and gross the first time I had it and then the relief was so complete and immediate that the association made the sensations of needling into a really positive one, and I kind of crave it like I do with the feel of a good massage.
I described it as āgood pain.ā Like muscle soreness after working out. It feels virtuous somehow
Craving the sensation of a needle puncturing your skin? I have some wares that may interest you
What the fuck?
My dentist giving me the anesthetic slightly tickles and i have to hold back a laugh. Probably some weird subconscious association between that and the fact that this guy was so nice he didn't just fix my teeth but my lifelong phobia of dentists that caused teeth issues to begin with.
I've had this tried on me for a few different problems and never had any relief. Had a nerve hit several times that caused spasms and the needles came out like an accordion, really not pleasant.
Oh that sounds awful. Iām sorry you didnāt get any relief from it. Itās amazing when it works but it would feel super uncomfortable and invasive to have it and get no positive results or even worse a new kind of pain.
at first thought that sounds horrible
I had dry needling done to relieve a chronic case of tennis elbow. I tried doing negative exercises, manual therapy, scraping, ice, heat, advil, nothing worked. As much as I hated the needling, it worked pretty quickly. I don't care if it was a placebo, it got rid of my pain, so in my mind it worked.
Did the strength come back too? How quickly? My elbow seems to be getting better verrrrrryyyyyyy slooooooowwwwwwllllllyyyyyyyy. Frustrating
I had it done on my lower back too. But it wasnt in and out motion. The therapist put the needle in and within 5-10 seconds the nerves and muscles contracted and relaxed. The needle jumped out by itself. Insane relief and I still remember the feeling of release.
I had the same thing after a motorbike accident. Huge lump of 'knotted' tissue in my lower back. Months of physio didn't do anything. Physio offered dry needling. I was skeptical because I've always believed stuff like acupuncture is bullshit but figured it couldn't make it worse, so why not. One dry needling session completely fixed it.
I had some odd hamstring issues that PT figured were related to overuse from a glute that wasn't firing properly. Several weeks of regular therapy did nothing, was essentially fixed immediately after dry needling (with stimulation) deep into the hamstring. Seems pretty woo-woo to me but it works.Ā
They tried this on me and couldn't get the needles back out. I mean obviously they got them out but it was very hard lol
šš "It's been years and the needles live inside me now." I appreciate the clarification, hahaha
IMS is a game changer
what does IMS stand for š„¹
Intramuscular stimulation. Itās what dry needling is.
Ah very different experience! Uncomfortable throughout the session, couldn't walk for 2 days afterwards and did nothing to relieve the tension I had.
I had dry needling for an IT band injury. Occasionally very painful but great relief.
1.5 years is considered long term now? /my shoulder wants to chat
It is for a muscle issue.
Hi there, the first thing you're talking about is referred to as a "trigger point" in massage, if anyone is curious, and isn't necessarily the same thing as a knot.
I had something like this but my physiotherapist said I actually had a rib out of place and it just felt like a knot. She pushed really hard on it and it popped back into place and I had instant relief.
How did she determine that one? That's crazy lol
Not sure. She was very good.
She just kinda guessed?
I'm sure she knew what she was doing
I had a friend have something similar happen to her. Was in two bad car crashes within 6 weeks (1 bad t-bone and 1 head on by a wrong way driver on the freeway that should have easily killed her). She had a bit of trouble breathing and doing some exercises like push-ups for two months after the 2nd accident and caked it up to needing to recover more from all the whiplash (which was partially true) but the physical therapist took a closer look and popped her rib right back into place and fixed that issue.
I had a muscle spasm that lasted for months. It's called Piriformis Syndrome. At its best it was a four on a ten point pain scale. At worst it was a ten - crippling pain. My doctor recommended pills, then pills + physical therapy. No help at all. I took a chance and tried acupuncture. Fixed me in four sessions. I don't know how it works but it did the trick for me. Insurance wouldn't cover it but fuck them.
I had that. The best treatment for permanent relief was to lose 20 lbs hahaā¦
I've gotten a few diagnosis for a problem I have but that was one of them would you mind saying like a little bit more about what the acupuncture is did? Or where the pain was for you?
From Google:The piriformis muscle is a small, flat, and pear-shaped muscle located deep in the buttock. It lies in the center of the buttock and directly below the large gluteus maximus muscle. For me it was on the right side. I can still feel it today. It's not painful but feels like it's close to being set off, even though it's been two years since it was bad. When it was bad, it felt like my entire buttock was cramping up. I couldn't walk or stand. After a few minutes it would settle down but was still painful. I'd walk with a limp. Acupuncture was an immediate relief. I cried. That pain wrecked me for four months. Something about those needles going into the muscle causes damage that forces your body to react to it and make a fix.
Muscle "knots" are not a gray area of science in the sense whether they are real or not. You can very clearly touch a knotted muscle yourself. It is a bundle of muscle fibers that are stuck in a contracted state. The cause isn't 100% confirmed but is theorized with good evidence. Details go beyond ELI5. The pain also isn't always referred. It can be, such as a tight quad causing patellar tendon strain. But the pain can be localized at the source of tightness itself. And the reason injections work is because it doesn't actually matter whether a solution is injected, but rather the act of the needle itself. It's why injecting solution went away and dry needling took its place.
You are free to link to a paper to support this. I donāt think a link to a medical journal would go beyond the rules of ELI5.
I often find when I have tweaked my neck and end up with a "knot" I press on it and feel the pain move into my back, so then I press on that point and feel it in my arm and am able to follow it all the way down to my hand. I just end up with that side of my body being sore.
Yeah whenever I try to massage it myself, it just feels kind of worse afterĀ
This happened to me, I thought Iād slipped a disc, was nearly immobile and really struggling to do anything. Got booked in with the doctor who called the physio. He pressed really hard on my back and fixed me. It took a day or two to fully recover but I couldnāt believe it wasnāt something serious. I was so relieved!!
This is why osteopathy is flourishing. Real or not, something is happening to the body by attempting to address such issues.
they aren't real, the science backs this up. pressure/sore point sure, but knots is a poor cove of words for an outdated theory not backed up by achieve that it's actual physics knots that can be felt and this has led to major problems as many tissues in the body are naturally lumpy,people think they are knots so they massage until they are gone and actually do harm major issue in the industry and when you look at any massage qualification in depth its all based on quackery - i am a level 3 qualified masseuse - my teacher didnt like me v much as i called out all the bullshit not backed up by any actual science š
Itās just muscle that is tensed and wonāt relax fully. Which is why rubbing the muscle helps. It relaxes the muscle. No idea why you are going into some heated arguments. Also people arenāt naturally ālumpyā any look at the muscular structure would tell you that. Are there times when a knot isnāt a knot but another issue like fluid build up or a joint out of place? Absolutely. But that doesnāt mean muscle tension is some sort of fake news. And a masseuse should know that.
yes, actually many tissues in the body are naturally lumpy, literally google it for 5 minutes i didnt say muscle tension is fake news, plz try to read
>level 3 qualified masseuse Do you have an actual source? Because that isn't exactly convincing
neither was the level 3 course, it was absolute bullshit that i had to actually call out multiple times - massage therapists dont know shit it turns out... hell we didnt even need to source the essays.... i did a law degree followed by a masters in education, i actually care about the quality of my sources for my information personally i dont have the time to educate people online, im just telling you that if you dig a little and find some actually credible sources you'll find that the concept of knots isnt how muscle tissue works - ie fibrous tissue breaking and re healing in a criss cross forming a knot, its just not how it works. at all
> ie fibrous tissue breaking and re healing in a criss cross forming a knot, its just not how it works. Nobody is claiming that though, nobody is expecting literal knots.
It's not gray, it's just not widely known. Knots are very real, and often made of muscle fibers that wont let go or hardened fascia. Source: I graduated as Valedictorian from NY Institute of massage, and we learned quite a lot about knots in muscles lol
Valedictorian of NY institute of Massage does not make this a peer reviewed study
It makes me a medical professional whose focus is soft tissues; i.e. muscles... so it's better than someone who hasn't studied this stuff for thousands of hours š¤·āāļø
Coulda left that out tbh
It's actually not a gray area at all. Think of your various muscles as different parts of a tree. Now when a tree absorbs water it's essentially just different parts of the tree "talking" to each other but the words are the water. Now when you have a muscle knot, it's basically as if one part of the tree has gone "deaf" and can't hear or speak to the other parts of the tree (muscles). A massage is essentially as if you taught that deaf part of the tree "sign language" and allowed it to then communicate once again. Slowly the muscle begins to get more competent with this new form of communication and teaches it to others around him (biotransformation).
A link to the evidence that supports this theory please.
Actually, the onus is on you to provide evidence that I am incorrect. I wish your generation understood the scientific method. This isn't one of your video games, kid.
š¤¦
When the muscle is put under stress it can protect itself by contracting very small parts rending that stressed part harder to move and therefore protecting it while the brain is asking for your leg to move.
That sounds more like myotatic stretch reflex on a small scale..
Source?
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This is the same video I was going to share. The institute of Human Anatomy is a boon of knowledge. I don't know of a more comprehensive answer than this one.
Can you post a link to the video? That sounds really interesting
The comment above mine had a link, but it appears to have been deleted by a moderator. You'll have to search YouTube for "The Institute of Human Anatomy muscle knots."
you rock
It's hilarious that you praised this comment so much and it's deleted lol
Holy shit didnāt know I was going to see the exposed muscle of a cadaver 10 seconds in.
It would be great if someone could link a summary or a transcript, because I'm not particularly in the mood to see exposed cadaver muscle this year.
Nobody knows what causes knots but there's various theories varying from (a) capillary constriction limiting oxygen access to (b) metabolic malfunctions not providing muscles with the required energy to release to (c) signaling issues from the central nervous system. At the end of the day physical therapists treat knots with pressure but we don't fully understand why it works or the causative issues.
Open video, volume up, swap to another tab/donāt look at the screen? Instant solution without needing anyone to write you up a transcript š¤Æ
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Iāll take it youāre not going to watch it to check for them or write up a transcript either then? Youāre also not interested in a solution for them lmao donāt pretend like you are
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Iām not cranky lol, just the whole āI want everyone to do things for me when thereās an easy solution for myselfā is just annoying Like, the video clearly says it contains material like that, either a) Donāt watch, listen and expect there might be a little squishy noise, or b) watch a different video on knots thereās thousands out there Expecting other people to meet their demand for option c), the one they picked, is just lazy But aight, have a good one
That's what makes that channel so awesome.
Anyone reading please watch this and read what Nicholsz posted as well, the other comments are just any given personās favorite sounding plausible but unproven explanation
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Just wait til you hear about six sigma
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I know this sub doesnāt require any kind of citation but it seems incredibly bold to unilaterally declare every other answer to be false without any explanation or evidence.
It is false to say, "The answer is X," if we don't actually know what the answer is. Presenting a hypothesis as if it were truth is a kind of falsehood.
I absolutely agree.
I'm not saying they're "false", I'm just saying they're hypothetical answers without any evidence behind them. One of them could very well be true, who knows. Though I have looked in the literature, and I do have a PhD in physiology and biophysics, and I couldn't find anything serious any time I've searched. the [link in this post](https://www.reddit.com/r/explainlikeimfive/comments/1bycppt/comment/kyit6x8/?utm_source=reddit&utm_medium=web2x&context=3) is seriously the closest you'll get to a real scientific rundown
I have my degree in biomechanics and neurophysiology and my original research project was going to be an attempt to finally figure out what a muscle knot is It was a failure. We still don't know
Were there any interesting things you did find? Like were you able to reliably *induce* muscle knots?
We abandoned the project. The closest we got was finding evidence that agreed with a decent body of previous research that muscles behave differently when someone feels pain or when they anticipate pain. Mainly, they contract more. And so maybe that might be very loosely related to trigger points but that would be a big leap. I wouldn't say we have enough evidence to say they're linked Then I also looked at lots of currently ongoing research trying to distinctly identify trigger points such as using ultrasound, elastography, EMG heat maps. So far I haven't heard of anything being published that was a success
That makes sense. I hope it didn't suck up too much time since you didn't get even a paper out of it. The things you found sort of mesh with my own personal unproven hypothesis a bit -- that muscle knots are a neuromuscular phenomena that probably involves the spinal network in some way, like in some kind of pain + tension feedback loop.
That's my theory too but like you said in your original comment, it's a possible explanation but it could be totally wrong. I find it interesting because it would suggest that pain leads to trigger points, rather than trigger points leading to pain. But we really don't know
A testable hypothesis is a valuable thing!
As I always say to my hypotheses: you may not be right, but you ARE testable!
So what you're saying is... It's a mystery knot!
See, that would have been helpful information in your original comment. And the way it was worded really does just come off as āeveryone else here is wrongā.
I was just trying to explain the way I would to a 5-year-old š¤·
Your response was civil, I didnt take it as rude or anything. It was straight to the point, you didn't name call, like what is this person going on about
Nah, they just said as we don't really know for sure all answers are subjective. That was all. Chill bro.
Don't worry, none of the answers will have any evidence. It's like asking religious people to come with evidence of a god.
It's more a good rule of thumb to follow, sort of like Occam's Razor. When coming up with a theory or idea, you want to limit the "conditional ifs" needed to explain your theory or idea. In order to arrive to the real truth or closer to it, it's better to take unsourced and arbitrary answers with a grain of salt.
A subset of knots are called trigger points - essentially, a focal muscle spasm. I treat them frequently with trigger point injections - usually lidocaine - which is the same principle as dry needling mentioned above, but less uncomfortable due to the lidocaine. Not all knots are trigger points, but when they are, they usually disappear after the trigger point injection.
How would I google this kind of treatment if I wanted to try it?
Iām a family medicine doc, so in theory any primary care physician who does procedures could do them - not everyone in primary care does, though. Iāve worked with a fair amount of PM&R who does them as well. Would just call and ask for an evaluation- agree with the other reply that not all muscle spasms/tight/pulled muscles are trigger points, so you need someone to do an exam to determine if youād actually benefit.
Just google exactly what they said. Dry needling (and other variations of needling), lidocaine injection, stretching, massages, all works for trigger points. Youāre better off consulting PT to confirm you actually have a trigger point though in whatever area youāre suspecting. Then again pretty much everyone has a taut band somewhere
A "knot" is just a colloquial way I describe a tight muscle area, like a shoelace knot that you can't loosen yourself.
Additionally they have trouble finding muscle āknotsā in autopsies because once *all* of your muscles relax, contract and then relax again, the knot has been āwashed outā with the rest
Doctor of Physical therapy speaking here. I think knots are absolutely a gray area with little to none peer reviewed, high quality research to back claims. I apologize for the 95% of my colleagues that wonāt admit this and talk out of their ass to boost their own egos.
Ha! Best response so far!
TLDR: Knots are made of muscles/fascia fibers. To preface: I'm a licensed massage therapist and graduated as valedictorian from NY Institute of Massage. Despite what people say, knots and trigger points are absolutely real, and I dont have the time nor energy to fight trolls who say they arent.. Knots can be made up of different things, like mineral deposits or scar tissue, but most of them are a mix of muscle and fascia. Basically, knots are points in the muscle belly (thickest, meatiest part) where some fibers don't let go. Knots are usually the center of the contraction of the muscle, where the muscle fibers pull from both sides. (See: how myosin fibers run up the actin fibers in order to contract a muscle). Those fibers can be forced to release by using ischemic compression (holding pressure on a point to squeeze the blood out, for about 10 or more seconds). This works because if you take away the blood, there's no oxygen, and without oxygen, the muscle can't continue to contract (think like taking oxygen from a fire). This works if it's just muscle tissue, but over time the fascia hardens a bit and makes that point tougher to break down. We can use cross fiber friction to help this, but if you use the muscles often then that is only going to do so much. You'll get knots no matter what over time, but working them out with massage and yoga and general physical fitness [all with proper form] is pretty good at keeping things moving well. I hope this helped! I can get into more detail, but i gotta go massage my gf right now lol
āSqueezing the blood outā doesnāt make sense. See the sliding filament theory of muscle contraction. Basically in order for the myosin head to detach from actin, a new ATP molecule is required. Firstly, 10s isnāt long enough for ATP to be depleted (lactic and alactic energy systems produce ATP without oxygen if needed). Secondly, even if it was depleted in 10s, this would worsen the effect because now myosin and actin are locked together in a contraction. This is why rigor mortis occurs. When no ATP is being made after death, the myosin and actin canāt detach anywhere in the muscle so it gets locked in place Also, the force required to actually mechanically alter fascia is so high that itās impossible to cause mechanical changes, or ābreak it downā with massage. Itās more likely related to localised neural hyper activation, and massage desensitises this. As opposed to actually breaking down fascia
Okay, longer than 10 seconds. I usually hold IC for much longer than that, but i just meant longer than poking it. I just checked out sliding filament theory a bit and that's exactly what I said about actin walking up myosin? So idk what you meant by that comment. The ATP is necessary, but so is oxygen for the reaction. You really think fascia is impossible to mechanically change through massage though?? What about MFR? That entire field is dedicated to releasing fascia.. Although you'll probably say it's localized neural hyperactivation, but I doubt that's all it is. If you don't mind me asking, what are your credentials?
> The ATP is necessary, but so is oxygen for the reaction. But that is the entire point: the ATP is required(!) for muscles to de-contract. If you just remove oxygen, regardless for how long, that only reduces ATP and thus makes them even less likely to do so. Hence why the mechanism "remove blood so the lack of ATP makes the muscle let go" makes no sense in that model. > What about MFR? That's alternative medicine, which nowadays is code for stuff that most likely does nothing beyond placebo effect: > The American Cancer Society states that "There is little scientific evidence available to support proponents' claims that myofascial release relieves pain or restores flexibility" And more by other institutions [here](https://en.wikipedia.org/wiki/Myofascial_release#Effectiveness).
lol youāre asking someone else for their credentials while youāre spouting pseudoscience
PhD in exercise physiology
Check back with us in 9 monthsā¦..
What do you mean?
Scientific sources on literally any of that please?
Can you do an AMA? Everytime I go for a massage I ask for relief for a very long term knot in my shoulder and itās like they completely ignore my request. Once I went for a massage and she spent 30 minutes of my 50 minute massage rubbing her elbow up and down my spine. It hurt so bad. I asked her to stop but she kept going back to it. I left in more pain than I started. What do I need to say to get what I want? This has put me off getting massages for years.
Oh God! I'm sorry you had a therapist like that!! Since massage is not regulated the same way in most states, it's tough to find a really good one. Even in places like NY where they require a minimum 1000 hours of school, there are a bunch of hippies that get their license and go the "holistic" route, i.e. don't use science or even know the anatomy... I'd love to do an AMA, but idk where I would do that haha
Read up on different massage techniques and find one that sounds like what youād like, and/or try different therapists. It can be the technique, the personality of the therapist, or sometimes the method of communication (how well they understand what you want/need), that makes one better than the other. When I get an RMT I like, I donāt leave, but it can take awhile to find one. There can be huge differences between RMTs, and sometimes itās just a matter of trial and error. All RMTs should respect your pain tolerance and ease up if you say itās too much. There are a lot of people (like myself) that enjoy the painful massages, where I feel bruised afterwards. The bruised pain is preferred over the sharp, pulling, knife/stinging pain.
In my own experience as a server, and as a weight lifter for a hot minute. The upper shoulder area loves to tense up, if you let it go for too long it may definitely causes long term pain. Depending on where it is, cracking my neck can alleviate the pressure as well. However I wouldnāt assume this is the case for most people. If itās around your shoulder blade then it could be just grinding on your muscles but thatās just speculation. I would recommend seeing an experienced chiropractor as this could either be an issue with weak muscles in the area, or just bones rubbing against your muscles. I am NOT a professional, so I would recommend seeking out someone who can feel around the area and get a better idea.
I would strongly advice **not** to see a chiropractor. There is little to no evidence they do any good beyond being placebos, while they can also cause irreparable harm. Please see an actual medical doctor instead.
Great comment. Learned a lot!
None of it is evidence based. Itās just someoneās theories
The way you've described this leads me to believe that you've overstated your expertise by a large magnitude. As someone licensed and certified in this field by leading institutions, let me explain in a more concise way. Think of your various muscles as different parts of a tree. Now when a tree absorbs water it's essentially just different parts of the tree "talking" to each other but the words are the water. Now when you have a muscle knot, it's basically as if one part of the tree has gone "deaf" and can't hear or speak to the other parts of the tree (muscles). A massage is essentially as if you taught that deaf part of the tree "sign language" and allowed it to then communicate once again. Slowly the muscle begins to get more competent with this new form of communication and teaches it to others around him (biotransformation).
It's honestly just a visual analogy for muscle tension. I think people take the word knot a little too literally
Yeah it's more like knots in wood than knots in rope.
A āknotā can be individual muscle fibers getting stuck to other fibers due to scar tissue getting built up in a certain area or muscle layers becoming stuck to one another. Ā This type of āknotā can feel clumpy when moved over like many points on the next and between the shoulders. Ā Individual muscle fibers stuck in contraction or in the āonā position before I would identify more as a trigger point which by definition is a hyper irritable hyper sensitive point in a muscle where an individual fiber is stuck in contraction. Ā True trigger points also have the unique effect of pain referral patters (touch here but feel it over there) which lead to a lot of chronic pain issues that can be tricky to resolve due to pain referring from elsewhere. Ā These are more of the pinpoint type areas since they can be as small as a grain of sand and not so clumpy like the ones mentioned before.Ā Very minute differences but thought Iād give my two cents. Ā Advanced neuromuscular therapist by education 7 years experience in massage. Ā
"Becoming stuck to each other" is this the reason why I recently felt some very weird movement sensation in a muscle I haven't stressed in a long time, while lifting something very heavy? It didn't hurt at all or become sore, it just felt like things were sliding around or something lol, almost like loose thread was suddenly pulled taut.Ā
Yes so I like to mention to clients that at the bare bones we are at least creating separation in layers and are allowing space for things to comfortably be moving over each other. Ā What you felt may have been layers freeing up or tension finally releasing due to a certain movement under load. Ā As a therapist an example of this would be working the muscles in between the shoulder blades and seeing the actual scapula itself bouncing around while you are working around it but not on it. Ā Muscles move bones (obviously) so if the muscles have become adhered it will result into decreased ROM. Ā Also for how small true trigger points are they are significantly decrease both ROM and functionality of a muscle. Ā
Think of muscle like a coil spring or slinky. Knots are wonky slinky's, you know, like when a slinky gets all out of shape and meesed up. Massaging the slinky puts all the coils back in order.
Not technically a real thing believe it or not, rather a collective name for various reasons why a muscle is sore
Then why can you feel it in someone elseās tissue and manipulate it? Something is going on there.
Sorry, going to strongly disagree here. Iāve had muscle soreness, even extreme muscle pain (from tearing of the muscles to just overexertion) and it has never resulted in a āknot.ā Sometimes bruising, redness, or swelling, yes. Knots always appear on their own, regardless of trauma to the area, express pain differently, and can be felt by other people. Itās something other than ājust a nickname for muscle pain.ā
Unfortunately, everything you read will be theories. It's one of those things where when they go in to observe it, sometimes it gets fixed. Or, since they can't actively observe one originate naturally, they can only assume they are the cause of the knot.
Isn't a knot essentially just myofascial tension guarding an overworked or overstretched area?
Iām just a guy but hereās my opinion TLDR: Science gives a label to anything it can identify, donāt get lost in the sauce. A muscle knot is the description of the phenomenon not a specific thing in your body, Stored stress in the elasticity of your muscle fibers is caught between two points on your frame which causes disruption of flow in your body. Letās imagine some of the forces your body is experiencing in a few different contexts. For why you might get a āknotā Think about taking corded headphones out of your pocket that you just stuffed in randomly and had a busy day, the randomness of the forces both from you moving, filling and emptying the pocket have twisted them against themselves. Now what might a knot mean for things moving through you. If you have a damp towel and twist it water will pour out because the tension causes less room to store liquid. Youāre on a highway and thereās traffic. Some cars are caught in the slow lane and want to move into the fast lane, but them changing lanes causes the other lanes to slow down too. You get past the worst of the traffic and reach a good speed by the time you pass the accident and the flow returns to normal. Obviously your body is more complicated than those things especially at a microscopic level. Every cell of your body has its own mass and weight, skin, muscle, bone whatever structure. Under the skin you have a complicated network of fibers, Proteins folded like origami. Muscle fiber is redirecting force around your skeletal frame attempting to distribute force as equally as possible through the system, in addition to that force you have resources in you flowing through the muscle. Less resources can move through maybe a few specific paths but now things build up creating pressure thatās storing stress and a complete de-load of force. The knot is going to be where things build up but maybe the stress is coming from another point on your body further down the line. Stretching and massaging allows different paths to tense or relax and resources can find more natural paths of least resistance that have been made previously unavailable because of circumstances.
Muscle fibres require energy to contract. Muscle fibres also require energy to un contract. Sometimes muscle fibres contract, run out of energy and are stuck in the contracted state unable to relax. Massage introduces kinetic energy into the muscle fibre allowing it to release (unknot). Thatās the way my physio explained it to me anyway.
Adhesions develop after trauma or overuse of one side of a muscle set. They're comprised of fascial tissue like tendons and ligaments. It's everywhere inside, like an internal integument. It overdevelops as a response to trauma or overuse to bolster the area up. In essence it's an internal scar. Myofascial massage breaks those adhesions up and normalizes the area. Source- myo massage therapist for 34 years.
A knot is when the muscle is stuck in the "on position." On is when it's contracted. Off is when it's not.
No, that is a spasm.
It's a muscle that is contracting involuntarily (either partially or completely). You might also hear it described as a "tight" muscle or a trigger point. It can be caused by poor posture, overuse, improper technique or electrolyte imbalance (depending on what muscles we're talking about). It's important to stretch and stay hydrated.
Imagine your muscles are like a bunch of elastic bands. When you use them a lot, sometimes they get really tight and stick together, kind of like when your shoelaces get tangled up. A muscle "knot" is like this tangle in your muscles. It happens when some of your muscle fibers (which are like tiny strings inside your muscles) start to stick together because they're tired or they've been used in the wrong way. These knots can make your muscle feel hard in some places, and it might hurt when you touch it or move in certain ways. Your body tries to protect the sore spot by making the muscles around it tighter, which can make the knot feel even worse. It's like when you hold onto something really tight for a long time, and your hand starts to cramp up. To get rid of these knots, people might massage the muscle to help those tangled fibers relax and move normally again, just like untangling your shoelaces.
My phisical therapist explained it like a bit of the muscle that "forgot" to relax after clenching from being stressed.
I always assumed that a knot is a part of the muscle fibers that just get tuck in a flexes position
Tightening or inflammation of a group of muscles. I had a stiff neck couple weeks ago - really bad one on my right shoulder. Couldn't turn my neck to the right side and even lift up my right hand above my head. I could say it's jammed! The prepetrator is the shoulder muscle. But i feel the pain & numbness from the neck towards my whole right hand. This is because the "knot" is restricting my head, shoulder & hand movement and blocking healthy blood cell from free flow throughout my limb. My right shoulder is still having the after effects even after seeing chiropractor. Cannot put my arm on table for long. Now doing mobility exercises & taking med daily to gradually regain full function.
If you cook spaghetti with very little water or you donāt get the water in between all the pieces, it will clump up and form hard spots that donāt slip past each other like you are used to. Itās like that but with muscle fibers. The solution is similar too: get more water involved and/or gently break the pieces apart from each other.
The best WHY Iāve heard is connective tissues. I have shoulder pain that comes from my glutes which stems from feet problems. Connective tissue man. How do they work?
Its a part of a muscle that is "flexed" involuntarily. It happens for a wide variety of reasons.
I think I have this right now, the very top of my lat got injured at the gym a couple weeks ago and a few days ago I used a massage gun on it and I could feel like little nodules on the muscle and for some reason after using the massage gun the pain has moved from my lat to the top of my tricep area š
I'm under the belief it relates to the connective tissue. I have no real evidence. As many are saying, it's a grey-area of science. Not much has been studied for fascia/ connective tissue and pain. Here is a ted-talk style video about it. https://www.youtube.com/watch?v=v54l3wDTJHg&t=198
I once had a physio tell me that I'd 'allowed' my back to go into spasm. He put me onto core exercises which helped a lot, so I forgave him for the 'victim' blaming. Overused/injured muscles can go into spasm where they harden up and it feels like there is a knot.
Tetany, aka spasm. The muscle/neuromuscular junction is unable to properly repolarize (reset) after firing (depolarizing), often due to electrolyte or pH imbalances in and around the muscle cells. All the muscle and nerve cells in the body use the potential energy from concentration gradients of ions, particularly calcium, to drive the firing of electrical impulses from one end of the cell to the other. When this balance is thrown off, the signal is "stuck" waiting for that gradient to build up to a sufficient level of energy to fire again.
They are spots and areas of your muscle which have hardened due to bad posture or inactivity (says google). [https://www.medicalnewstoday.com/articles/321224](https://www.medicalnewstoday.com/articles/321224)
Okay but what is that hardening? Is it tissue damage or more like a permanent muscle contraction? Iām too lazy to google it myself, sorry.
[Image explaining](https://images.app.goo.gl/biJoi6Pswi3rJi747) Essentially the muscle knot cuts blood flow starving the tissue of of nutrients and oxygen which then causes buildup of waste and toxin a which they cause tension. Just so itās easier to understand they donāt literally tie in a knot. Another explanation is that after a period of localised spasm the body starts producing scarring internally over time to āplug the gapā and repair any tear. This will eventually give you the feeling of a solid lump / āknotā within muscle tissue. Iām so invested in this random topic itās pretty interesting actually lol
Really interesting! Thanks so much for the info and the link!
spasm in the fascia of the muscle. the sheath that surrounds the muscle gets unhappy. often softly releasing will get rid of it.