How do you get rid of muscle knots?

What is a muscle knot? It is a common term to describe an area that hurts and feels like a lump or bump. Muscle knots may also be called trigger points, myofascial trigger points, palpable nodules, or knots. So, what are they? The answer is debatable; my educated guess is they have something to do with sarcomeres getting stuck in a contracted position. Ultimately, at the core of what people refer to as muscle knots are areas of the body that experience pain or discomfort.

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Most Knots Are Not Knots

Exploring what a knot is can be fun and exciting, and feeling them fade away can be wonderful. Knots do exist, but they are rare, often misidentified, and can lead to an unhealthy perception of our body.

If they are so rare, why do so many massage therapists tell me I have so many? Sure, nearly every massage therapist you visit will find them and try to work them out. They may say things like, “Oh wow, you have a lot of knots.”, or “This knot is really tough; this is going to hurt, so make sure you breathe!” Then, they apply a tremendous amount of focused pressure to the area until you are squirming on the table. What they feel are most likely not knots. When they are misidentified, addressing them aggressively can result in unnecessary discomfort, bruising, or a negative feedback loop of pain.

When I massage, I refrain from searching for knots and mentioning them to my client if I feel them. The reasons are threefold,

The body is asymmetrical
Potential misassessment due to insufficient anatomical or physiological knowledge
The risk of palpatory pareidolia

The Body is Asymmetrical

Lying on the massage table, I felt comfortable. I was ready to experience some peace and ease after performing massages throughout the week. I felt the therapist’s fingers move around, and I could tell she was searching for knots. Her fingers slid from one side of my back to the other; it was clear she noticed a difference. “You have some tight muscles in here.” She began pressing harder and more vigorously.

It was clear she found what she believed was a knot, because the muscles on one side of my body were thicker than those on the other. As she began to work, I told her the area she was addressing was not experiencing any discomfort. Still, she continued. After a few moments, I told her to stop massaging so aggressively. She attempted to leverage her power differential as a massage therapist to convince me that the area required aggressive attention. Fortunately, I had the will to tell her to stop and move on.

The therapist felt asymmetry

The therapist felt asymmetry and convinced herself she needed to massage the area vigorously. Her poor assumption is why humility is so essential when practicing massage. We need to be aware that we are not the experts on other people’s experiences. As a massage therapist, we may possess the skills to help them feel terrific, but they have existed in their body their entire life. Their awareness of their body is more important than what we believe they need.

Sure, one side of my body may have felt thicker than the other, but this is not an indication of pain or a problem. The body is asymmetrical, which is easily identifiable with a cursory glance at our own body. Just because something is different on one side than the other, it doesn’t mean anything is wrong with it.

Insufficient A&P Knowledge

Sitting outside of my favorite coffee house, reading a book on massage, I noticed a young woman who was curious about the title of my book. “What is your book about?” She inquired, and I provided her with a brief overview of the topic.

“I often massage my boyfriend, but he is a wimp. His back is covered with knots, and he cries like a baby when I push on them.” She laughed through her smile.

I asked her how the knots felt when she pressed on them, and she said they were very hard. Then I asked if the bumps ever went away after she massage them, and she said no. I took a sip of my coffee and enjoyed the cool sensation of the gentle breeze against my skin. “When you massage your boyfriend’s back, are the knots on both sides of the spine running nearly the full length of his back?”

“Yeah, how did you know?” Her eyes beamed with surprise.

“Those aren’t knots. They are most likely the transverse processes of his vertebrae. Your boyfriend is complaining because you are applying a tremendous amount of force to a sensitive area.” I watched her eyes widen as I explained. We chatted for a bit, and I offered suggestions on how she could massage him without causing him pain and discomfort.

Professionals fall prey to the same mistake

Though this person was not a massage therapist, I have encountered professionals who fall prey to the same mistake. They feel something and assume it is a knot, when in fact it is a bone. As a result, they pin the muscle between the sharp point of their finger and the bony landmark, crushing the muscle in between.

Some years ago, while I was receiving a massage from a therapist, I noticed they were over-focusing on my shoulder blades. “Boy, you have some knots in here. Do you want me to take care of them for you?” She began applying pressure.

It hurt as her pressure increased, but it wasn’t because her fingers were on a knot. Instead, she felt the spine of my scapula and mistook it for a muscle knot. In effect, she had created a vice with my body and her hand. After a moment of discomfort, I told her the area she was pressing on was not a knot. She stopped and listened as I explained to her that she was pushing on a bone.

Palpatory Pareidolia

Resting supine, I enjoyed the quiet peace of receiving a Swedish massage. The session was nearly complete as my therapist began massaging my legs. I could feel her hands exploring the soft tissues of my quads. Her pacing slowed down as she circled certain areas of my vastus lateralis. “You have a lot of knots in your IT band!” She said.

I regularly massage my legs, and I knew of no muscle knots in the area she was palpating. She began to press in seemingly random spots, most of which felt meh, a typical nothing-burger kind of sensation. Then her finger jabbed in as she smushed the muscle under my skin. It hurt, but not because there was a knot there. The pain was a reaction from my central nervous system, warning me of potential injury. Additionally, that area of the leg can be hyper-sensitive to touch.

“Remember to breathe.” She said maintaining pressure.

I asked her to stop, and she reassured me that this was what was needed to resolve the muscle knot. Again, I told her to stop applying pressure. Reluctantly, she agreed.

“Point at the location of the knot.” I requested, and she pointed to the location. Upon feeling the area, I detected no physical indication of a muscle knot.

We can feel things that are not present

The therapist felt something and assumed it was a knot without communicating with her client. Again, this is why humility is necessary. We must have the humility to know we are not the expert in every situation. Just because we feel something, it doesn’t mean it is there.

In massage, we can feel things that are not present. This phenomenon is palpatory pareidolia. When I learned about this concept from reading Paul Ingraham, it transformed my understanding of massage. Rather than solely relying on what we feel, we need to fact-check our observations with the client.

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Not a Muscle Knot?

If it is not a muscle knot, why does it hurt when the therapist presses on it? First, not all areas that hurt when touched are knots. There are predictable areas of the body that hurt or feel uncomfortable when touched. These are the patterns of pain almost everyone experiences. Many of these pain patterns are also common in other mammals. Dogs, cats, and even horses have predictable areas of discomfort. Knowing this is important because it helps us recognize which kinds of discomfort are normal.

What causes these areas to hurt? There could be an array of reasons. It may be an area where you hold stress in, a spot that needs attention, or a trigger point from another location. It could be an over- or underused muscle, or your central nervous system has decided the area needs to be protected.

Just because there is a slight bump on your back, it doesn’t mean anything is abnormal. Our body is asymmetrical. Take the time to explore your body. You will discover an array of beautiful differences between one side and the other. Body asymmetry is normal and natural; unless something appears out of nowhere, there is nothing to be concerned about. If you notice something abnormal developing, seek medical attention instead of trying to squish it away.

Develop Your Body Awareness

How acquainted are you with your body? We typically touch only a few places, so they may seem weird or unusual when interacting with certain spots. We should explore the magnificence of our physical form to discover its fascinating textures and shapes. We may touch one area and think something must be wrong with it because it feels different from what it feels like on someone else’s body. The reality is we are all unique, and our bodies feel different. There are similarities, but no two people are the same.

Rather than hunting for knots, take some time to learn about your body’s natural shapes and formations. Many areas that massage therapists locate muscle knots in are bony landmarks or areas of the body that are asymmetrical. Other times, they are thick, dense, and strong muscles. Muscle knots are often misidentified because many people lack effective body awareness, or their therapists cannot accurately identify bones and bony landmarks.

A lack of awareness regarding the locations of the body’s bony landmarks often leads to a false assessment of muscle knots. The therapist will feel a lump or bump and, believing it to be a knot, will push into it. As a result, it creates a vise-like structure that crushes the muscle, causing pain and discomfort for the client.

You Are The Expert Of Your Body

When you massage yourself, you will feel all sorts of bumps, hard spots, and fascinating textures. Exploring the soft tissues of your body will acquaint you with how it feels, so when someone says you have a muscle knot, you will know your body’s natural and healthy bony landmarks. This familiarity is essential because when people tell us our body has an abnormality, we tend to become obsessed and hyper-focused on it.

When massage therapists advise clients that they have a muscle knot, people tend to over-massage themselves at home or throughout their daily lives. As a result, they may bruise themselves from overworking the area. People tend to use their fingers like ice picks, jamming them into the knot and pressing as hard as possible to release the tension. Due to this, I am cautious when using the term’ knot’ to describe an area of a client’s body.

In addition to increasing the likelihood that the client will bruise themselves with self-massage, it may also contribute to a negative self-image. We live in a world that constantly inundates us with negative influences; I want to serve as a lighthouse at the edge of the sea, guiding people toward positivity and good things. To achieve this, I search for ways to uplift others, guide them to advocate for themselves, and remind them why life is bright and delightful.

The Feeling of a Muscle Knot Is Still Important

I love language, people, relationships, and the human experience. Everyone has their unique story; each is beautiful, bold, and as heart wrenching as the cosmos is old. At the core of massage lies the human experience, the journey of life, and the pursuit of peace.

Between each person’s story is an ocean separating all our islands. Fortunately, we are social creatures, and we love connecting with others. Unfortunately, communication is challenging because we all experience life in different ways. When we meet and speak, we send emissaries from our soul on boats to get to know their inner golden glow.

A muscle knot is a term we have learned to communicate how our body feels. It creates a bridge between one person and another, allowing empathy to take place. While I refrain from telling my clients they have muscle knots, I do not stop them from using the term.

Instead of taking the words at face value, I encourage my client to explain their pain in greater detail. This helps me assess how they are truly feeling, rather than assuming they experience the world in the same way I do. This creates a space for me to critically evaluate their discomfort and adapt my massage approach to their unique needs.

The Importance of Muscle Knots

When someone tells me they have a muscle knot, I want to know what that term means to them. Is it an area they can feel with their hand? Is it a spot that someone told them was a knot? Is it an area that hurts when touched or is always uncomfortable?

Sharing this information can help reduce anxiety and provide the therapist with critical insight into the client’s pain patterns.

When someone shares this information, it may accomplish two things:

It can help reduce the pain associated with stress and anxiety. Pain often creates anxiety, and anxiety magnifies our perception of pain. Talking about our discomfort to someone can reduce our anxiety and stress, and the pain caused by it.
It allows the client to articulate their degrees and types of discomfort. This information helps the therapist personalize the client’s massage session.

When the client describes their knots, I attempt to discern whether they are asking me to look for bumps and lumps, address a bothersome sensation, or both.

If they describe a bump or lump, this provides a roadmap for assessing the knot during the massage. This helps determine the appropriate method for addressing it.

In most instances, the term knot indicates an area that hurts. It is a way for the client to express where they are experiencing pain. Whether there is or is not a palpable knot is irrelevant. I do not require physical evidence of pain to believe it exists. If you tell me you hurt, I will believe you.