“What are knots in muscles?”

sebastian small

As massage therapists, this is the question we get asked the most frequently. And it’s usually when we’re massaging a client’s shoulders, where small areas of muscle can feel hard, and ‘crunchy’ or ‘stringy’.

So what causes this? Obviously the muscle fibres haven’t literally tied themselves into the knots you’d get in a piece of string. What has happened, though, is that those muscle fibres have contracted (shortened) – as a result of physical activity, or postural imbalance, or stress – and then stayed shortened. The place this happens most noticeably is in the shoulder and neck area, where permanent (chronic) muscle tension can so easily build up, but it can occur anywhere in the body.

When muscle fibres contract they become shorter, fatter and bunched up, and this creates a physical squeeze on the circulation in the area. Vital supplies of fuel for the muscles in the form of oxygen and nutrients from the blood are reduced, and the removal of noxious waste products by the lymphatic system becomes less efficient. The result? Muscles that become exhausted, irritated, possibly inflamed, and painful.

This is the start of a vicious cycle – the pain and spasm cycle. When we feel pain, our muscles contract, and contracted muscles cause more pain. So our muscles contract further, there’s more pain, and so it goes on.

Over time, if not addressed, chronic muscle tension causes other changes in the muscle tissues, which become stiff and hardened (and sometimes stuck together) – a process called fibrosis. Because the natural toxins become trapped inside the muscle they often solidify – similar to the limescale build up in a kettle. Remedial and deep tissue massage techniques target these crunchy deposits, dissolving the calcified substance into a smaller powder material. As a result of easing the tension within the muscle, blood flows easier and takes these powder particles away to enable them to be processed and discharged from the body.  And there we have it. These small areas of bunched, hardened muscle fibres are those hard, crunchy, tender areas (‘knots’) that we find as we massage chronically tight muscles – or as you rub your own sore shoulders.

And sometimes nervous system involvement will add another layer of pain, as nodules of contracted muscle tissue become what are known as Trigger Points, which refer pain to distant parts of the body. Such nodules cause the body’s connective tissue to get snagged and impinged during movement. The restriction of motion, that these knotty nodules cause, regularly trigger a pain elsewhere in the connective tissue by overloading the bio-mechanical harmony during natural movement. Pain caused by these nodules or trigger points doesn’t resolve by massaging the symptom alone. For permanent relieve it is essential to treat and resolve the offending knot that is triggering the pain elsewhere.

As massage therapists, though, this is all in a day’s work. This kind of soft tissue dysfunction is what massage was created for. Chronic muscle tension, fibrosis and Trigger Points respond fantastically well to the right kind of massage, and we love getting your muscles out of the pain and spasm cycle and back into the virtuous circle of pain-free relaxation.