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A Knotty Question

One of the most common questions I get from clients is, "is that a knot?" or "what is a knot?" Most people have them, whether or not you realize it.

The technical term for a knot is a 'trigger point' or adhesion, and when a massage therapist works on a knot, this is better known as trigger point therapy.


So, what is a knot?

A knot is a tender spot in a muscle and is often painful when pressure is applied. It can be crunchy/clicky and you can sometimes hear the noise when it's being worked on. One thought is that they impinge on the nerves surrounding it, causing pain. Another is that the knot is so compact that blood is prevented from getting into the area, causing the body from healing the knot through its natural means of oxygen and nutrients.

They can cause tiny spams in the surrounding muscle that you can't always feel but can become very sensitive.


Two types of knots:

  1. Passive Trigger Points -- these hurt only at their precise location.

  2. Active Trigger Points -- these refer pain outward in the body.


What causes knots?

There are a number of factors leading to knots forming in the body. Poor posture is a huge culprit, due to the strain it puts on muscles. This is why many people with desk jobs suffer with them. Lack of movement can also contribute to knots forming. If you're into sports, that can also lead to muscle tension and tightness through working the muscles, and soft tissue injuries can cause knots. The last major cause is stress! We carry mental tension in our bodies which leads to physical discomfort.


Do I need to worry if I have knots?

No! Knots are benign, and while they can cause pain and limited range of motion, they are not dangerous.



Where are knots located?

They are located in the muscles and fascia (connective tissue under the skin holding all organs and muscles in place). They can occur anywhere in the body. The most common places are the trapezius muscles (between neck and shoulders), quadratus lumborum muscles (lower back), hamstrings and calves.


Referred Pain

Some knots send or 'refer' pain to different areas of the body, which is why clearing a knot in the scapula area can relieve pain in the arms. Pain can manifest in various ways - it can be a headache, a feeling of pressure, a shooting pain or nerve pain.


Trigger Point Therapy

This is a soft tissue technique where a massage therapist locates and loosens trigger points. It's one of the main tools used by a therapist to relieve pain. As a knot is being worked on, it may be sensitive or uncomfortable, but as its loosened, the pain should decrease. Pressure to the trigger point(s) works by cutting off circulation to the tissue, increasing a chemical called nitric oxide, which signals your body to open up microcapillaries. The increased blood flow then helps the healing process.


After a massage session, it is recommended to drink plenty of water. Toxins build up in muscle tissue and massage helps to release them, so water intake will help to flush them out after a massage.

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