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What Are Muscle Knots and What Can You Do About Them?


A number of people who lift weights, and even those who don’t, suffer from a phenomenon called “muscle knots.” It certainly sounds like a painful condition – and it is. In fact, muscle knots can interfere with your weight training performance and make movement uncomfortable. Let’s take a look at what this phenomenon is and why you’re more prone towards it if you’re very active OR too sedentary.

The medical term for muscle knots is myofascial trigger points. Although there’s still lots experts don’t know about myofascial trigger points or muscle knots, they believe these painful points arise from areas of muscle tissue that’s hypercontracted. In other words, the muscle fibers are pulled too tightly at one or more points on a muscle. As you might imagine, myofascial trigger points can be painful and uncomfortable. Plus, when you weight train, it decreases your flexibility and raises your risk for injury.

What Causes Muscle Knots?

No one knows the exact cause of myofascial trigger points. A popular theory is that trigger point pain comes from the build-up of metabolic waste products.  When an area of muscle is tightly contracted, it obstructs blood flow to that portion of the muscle and metabolic waste products accumulate. In turn, these products stimulate pain receptors.

Other experts believe muscle knots are more of a nerve-related phenomenon and have little to do with metabolic waste products. Don’t dismiss the metabolic waste theory since some studies support this idea. Suffice, it to say, there’s still much we don’t know about what’s happening at the tissue level.

How do you GET muscle knots? If you lift weights or play a sport, repetitive motion over time places stress on muscle fibers. Over time, they can “rebel.” When muscle fibers rebel, they tighten up, in this case, to the point that the sarcomeres overlap more than they should and the muscle over-contract in a discrete area, to the point that you can sometimes feel a knot.

So, you can get muscle knots from repetitive motion, especially when you don’t use proper form. Less commonly, an acute sports injury sets the stage for muscle knots later on. Yet you don’t have to be physically active to develop muscle knots. Poor posture and sitting hunched over at a desk is another common cause as is too LITTLE exercise.

Identifying Myofascial Trigger Points

The obvious way to identify muscle knots is to press on a muscle and see where it hurts. Myofascial trigger points are usually discrete point areas of tenderness on an overly tight muscle. If you apply firm pressure to one, you’ll often feel a sharp pain. To confuse the matter, you can have trigger points that “refer” pain to other parts of the body. Sometimes referred pain manifests in ways you wouldn’t expect like a myofascial trigger point in your neck referring pain to your head and causing recurring headaches.

You can also have latent trigger points where you feel no pain unless you apply direct pressure, but, instead, you experience restricted range-of-motion in the affected muscle.

How to Deal with Muscle Knots

Whether you have muscle knots from too much repetitive motion or slumping over at your desk at work, there’s a lot you can do at home to ease the discomfort of muscle knots. One of the most effective ways to relax trigger points is to apply firm pressure to the hypercontracted areas and hold it for 30 to 60 seconds. You can also use your middle three fingers to massage the trigger points using a firm, circular motion.

A tennis ball also comes in handy for massaging myofascial trigger points. Whether you use your fingers or a ball, massage the areas one to two times a day for best results. You can also buy larger therapy balls for kneading the larger muscles like your back. The goal of self-massage is to relieve tension and encourage the hypercontracted portion of the muscle to relax and release. Apply firm pressure so that it’s slightly uncomfortable but not outright painful, and be consistent about your massage.

Persistent Muscle Knots?

What if the pain persists after self-massage? You might need the help of a physical therapist or massage specialist. First, get a diagnosis from your doctor to make sure there’s not another cause for your discomfort.  If you have multiple trigger points, your doctor will want to rule out fibromyalgia. Then consult a physical therapist. They have some additional tricks up their sleeve to help you get relief. One technique called dry needling involves injecting the areas with a thin, empty needle. This procedure may help although no one is quite sure how it works. One theory is it works by deactivating sensitized nerves.

Another technique some physical therapists use to treat myofascial trigger points is called the Spray and Stretch technique. For this procedure, they spray the painful muscle with an anesthetic that numbs it as they simultaneously stretch it. By masking the pain with the anesthetic, you can stretch the tightened muscle to its normal length. The stretching helps relieve the spasm and break up the trigger point. Other therapies include injecting the trigger point directly with an anesthetic agent to block the pain.

Preventing Muscle Knots

.   Is there anything you can do to prevent trigger points from forming?

.   Always do 5 minutes of dynamic stretching before beginning a workout and follow-up with stretching afterward.

.   Avoid doing the same repetitive movements over and over. Vary the exercises you do and the angles at which you do them.

.   Make your work environment ergonomically friendly. You shouldn’t have to slouch, bend over, or assume an unusual posture while you work. Ask a friend or colleague to critique your form when you sit at your desk.

.   Work on your standing posture as well.

The Bottom Line

Muscle knots, or myofascial trigger points, are common among active people as well as those who sit too much. Once you’ve identified the points, a little self-massage may be all you need to get relief. But keep stretching, muscle knots have a tendency to recur.

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