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546
Posted by2 months ago

Eli5: What are muscle “knots”

How do we get them, and how do therapist massage them out?

122 comments
91% Upvoted
level 1

I wouldn't say it was toxins or waste build up. I would say it's a tiny part of the muscle cramping up.

There are 2 ways to release a muscle knot: either stimulatie blood flow, or cut off blood flow. A muscle needs a little bit of energy to move, but it also needs a little bit of energy to release too. Stimulating the blood flow is the less painful massage one. But also works slower. Think more along the lines of hours or even days, than minutes. Cutting of blood flow by putting pressure on the knot, is more painful, but works in about 30 seconds. The root problem might not be solved, could be that it's knotting up, because you avoid pain somewhere else, or you have posture problems. So it might come back within a few minutes.

A knot takes up space, which lessens the blood flow to that particular part of the muscle. That's why putting pressure on it, might make it go away. The knot releases and blood flow is restored. The sooner after you "catch" the knot, the more likely it is to work at once.

319
level 2

That's why even simple stretching daily (making your muscles contract and release fully) makes wonders for your long term muscle pains/soreness.

140
level 2
level 2
level 1

From what I understand reading "The Trigger Point Therapy Workbook", muscle knots AKA trigger points are kind of like tiny muscle cramps. Your muscles are made up of bundles of "fascicles". Those fascicles are made up of bundles of muscle fibers. And those muscle fibers are made up of bundles of "Myofibrils". It goes down another level to "Sarcomeres" which are then made up of two different filaments. When a muscle is contracted, millions(?) of these filaments bind together and cause the muscle fibers to contract.

With cramps, the entire muscle typically gets forcibly contracted and usually releases itself fairly quickly. With a trigger point, two of the filaments get stuck together for some reason (bad posture, injury, etc.) and can't release. When enough of these filaments get stuck together, an entire section of the muscle becomes contracted and stays that way for a while, sometimes indefinitely if it isn't addressed. Supposedly blood flow is restricted to that part of the muscle and so massaging the area pushes blood back into it so it can release.

I'm sure I didn't get that 100% right but that's pretty much it. There's alot of other things like supposed "toxin" build up in the muscles due to the by-products of muscle contraction not being able to be removed, what with the blood flow being cut off and all. I don't know about all that.

I do know they hurt like a bitch and digging into them with a lacrosse ball fixes them, and there needs to be alot more research done. I've had too many clients complain that they have "bad knees" and then I have them lay with their quads on a foam roller for 5 minutes and suddenly there is no more knee pain. This goes for back, neck, hips, etc. as well.

135
level 2
Comment deleted by user · 2 mo. ago
level 2

What are your experiences with massage therapy guns?

3
level 2

I swear by two tennis balls inside a tied sock. Hurts a lot less than a lacrosse ball.

5
level 1

I have been summoned. I'm an LMT

So the smallest unit of a muscle cell is a sarcomere. Its made up of actin and myocin. A muscle contracts by sucking calcium into the sarcomere which makes the actin and myocin slide past each other. If they over-contract, and stay that way, due to developing a high level of tonus, or resting tension in the muscle, they basically get stuck together and jumbled up. Kinda like a knot of sarcomeres. Tho the similarities probably aren't as literal as that.

This limits the blood delivered to the area, and as a result, potassium can't get in to take the place of calcium and tell the muscle to relax. This causes a trigger point.

The way we get rid of them is basically rubbing and irritating it enough to create inflammation. It swells with blood and washes the area out and hopefully solves the issue. We can use cupping to physically suck blood to the area, we can stretch the Fascia (connective tissue) to make room for the muscle to relax.

The only other problem is the Fascia will go back to its original constricting shape in about 4 hours. So you need to stretch alot after a massage and drink lots of water. But most spa therapists who don't train deeper into trigger point therapy wouldn't necessarily know to tell you that.

15
level 2

Is it normal to need multiple treatments to deal with a chronic knot, assuming the patient is actively working out and stretching?

2
level 2

Would you be able to expand on this a bit? I find it very interesting.

From what I know it is all fascia. What you are saying is that over contraction is what causes sarcomeres to clump together (you have not explained how this causes pain). Do you know how these processes might relate?

Thank you,

1
level 1

I edited and combined my comments on this top level for clarity. This topic is dear to my heart as a yoga teacher (fascia is a big factor in yoga) and as my PhD is related to fascia as well.

Muscle knots are also known as sites of myofascial pain. We have something called fascia running between and inside every muscle all through the body. It is all connected in lines spanning the whole body. When fascia sticks together it creates knots. The reason fascia will stick together is due to the muscles not moving enough (in the right ways), giving the proteins in each layer the chance to entangle with one another. (eventually this will make muscles actually stick together and reduce your mobility!) This in turn reduces the fluid flow between the layers, lessening the exchange of waste products of the muscle (toxins) to the blood.

Grab a handful of your shirt and twist it. Notice how there is now tension on the whole shirt? Similarly, that twist happens in the fascia. This happens naturally and accelerates with dehydration, bad posture, and incorrect movements. This tension will hinder the mobility and strength in the whole line.

When a muscle uses energy required to contract it creates waste products, we can call them toxins. The toxins (reactive oxygen species and others) build up which causes an inflammation reaction which causes pain. The mechanism is quite complex. Other explanations here are more focused on the muscle itself which I believe plays a big part in this as well.

By placing pressure and stretch on the knots you are moving the muscle and layers of fascia apart, breaking the tangles of the “knot”. Now fluid can flow, and toxins will release. This is why you need to drink lots of water after a deep tissue massage to reduce the concentration of toxins as you process them out of the body. Else you will get headaches and the toxins will not wash out of the muscle. When massage therapist talk about toxins they are correct. But they can sound a bit woowoo because they do not know this explanation.

Unfortunately, fascia is not as known as it should be due to it not being given any attention on during cadaver prosection during medical school. It is deemed to be in the way of the interesting muscle and organs. Partly this is due to the preserving agents used to conserve cadavers changing the texture of the fascia.

Please allow me to include an excellent reference:

Jafri,M. S. (2014). Mechanisms of Myofascial Pain. International Scholarly ResearchNotices, 2014, 1–16.https://doi.org/10.1155/2014/523924 

19
level 2

This is the only reasonable response I have read on this thread. Calling knots “toxins” is untestable, unverifiable, and nonsensical. Knots themselves don’t exist in a western medicine context but this answer is the most valid of the lot.

3
level 1

Just throwing this in there as a supplement to what everyone else is saying. Your muscles use sodium for the "contract" signal and potassium for the "release" signal. If you find you're getting a lot of muscle knots, you could theoretically be low on potassium. I always eat a banana when I'm dealing with stiff shoulders. It's not some kind of miracle cure that'll replace massaging the knot out, but hey, bananas are delicious, so what have you got to lose really?

3
level 1

I worked in a sports medicine doctor's office at a spa. "Knots" are muscle spasms (that you can see under ultrasound).

2
level 1

Okay all of these people in the comments are full of shit. I'm a med student and I don't know everything. BUT.. as far as I'm aware there is no such thing as a muscle knot. Muscles can however be sore, overworked and painful. This just means you need to let your body do it's work and recover. Muscles can't knot and waste products don't accumulate in a localized area in a muscle. One of the thing the body is most specialized at is getting rid of waste, so no, a massage isn't helping to get rid of waste.

Tl:dr muscles dont knot, don't believe these comments spouting pseudo science

11
level 2

But when my husband tells me his neck is sore and I rub it, I feel harder areas that are not symmetrical. When I put increased pressure on those harder areas, he says yes, it’s a knot there. Are we delusional?

6
level 2

Everyone is aware that muscles don’t literally tie into knots but the experience of having an intense sore spot in a muscle that radiates soreness out to other areas and is relieved by massage is well known.

21

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