What is a muscle knot?

How do back muscle knots work?

• And how to prevent and/or get rid of them?!

• Answer:

  These are three separate questions: 1: How do (back) muscle knots work? 2: How do you prevent getting them? 3: How do you get rid of them?   For the purposes of this question, I'm going to address all "muscle knots", since muscle knots throughout the body have similar etiology, physical attributes and they respond to the same treatments.   1.  How do mucle knots work?      Muscle knots, as they are most commonly called, are usually myofascial trigger points.  There is a great deal of research being done to understand what, exactly, a myofascial trigger point is, but my citations will mainly be from Myofascial Pain and Dysfunction, the Trigger Point Manual by Janet Travell, MD and David Simons, MD, which is known in pain treatment as "The Red Bible".  "Clinical Characteristics of Myofascial Trigger Points: a myofascial trigger point (TrP) is a hyperirritable locus (knot) within a taut band of skeletal muscle, located in the muscular tissue and/or its associated fascia (connective tissue). The spot is painful on compression and can evoke characteristic referred pain and autonomic phenomena.  A myofascial TrP is to be distinguished from a TrP in other tissues, such as skin, ligament and periosteum.       We classify myofascial TrPs as either active or latent. An active TrP causes the patient pain.  A latent TrP is clinically silent with respect to pain, but it may cause restriction of movement and weakness of the affected muscle.  A latent TrP may persist for years after apparent recovery from injury; it predisposes to acute attacks of pain, since minor overstretching, overuse, or chilling of the muscle may suffice to reactivate it.  Both latent and active TrPs cause dysfunction; only active TrPs cause pain." [Chapter 2, part B, pg.12]    Symptoms: 1) Myofascial pain is referred from trigger points in specific patterns characteristic of each muscle. 2) TrPs are activated directly from acute overload, overwork fatigue, direct trama, and by chilling. 3) TrPs are activated indirectly by other TrPs, visceral disease, arthritic joints and by emotional distress. 4) Active myofascial TrPs vary in irritability from hour-to-hour and day-to-day. 5) Trigger Point irritability may be increased from a latent to an active level by many factors. 6) The signs and symptoms of myofascial TrP activity long outlast the precipitating event. 7) Phenomena other than pain are often caused by myofascial TrPs. 8) Myofascial TrPs cause stiffness and weakness of the involved muscle.[",pgs.13-16]   Possible explanations of trigger point phenomena include: 1) Hyperirritablity via increased sensitivity of TrPs to pressure could be mediated by sensitized mechanoreceptors (receptors that have the role of responding to mechanical pressures)  or noiciceptors (receptors that have the role of responding to painful stimulus). 2) Increased tissue metabolism and reduced circulation More research is being done, but there hasn't been a definitive physiological explanation demonstrated yet.  The highest hopes for this lie in current functional magnetic resonance imaging (fMRI) due to the dynamic and changing nature of trigger points and muscle/fascia.    2.  How do you prevent getting a trigger point? 1) Poor work habits/ergonomics are by far the largest cause of chronic myofascial TrPs.  It is crucial to use the body as properly as possible to avoide straining or developing over-fatigue in muscles. 2) Note movements or postures that produce pain, and then find a way to eliminate or modify them so as to avoid overload. 3) Immobilization of muscles in a shortened position for a prolonged period (sitting, lying down in one position) tends to develop active TrPs. 4) Nerve compression, such as radiculopathy or nerve impingement, favors development of TrPs in muscles supplied by that nerve's root at the spine. Take care not to use postures or do actions that can result in nerve impingment, like over-bended wrists during computer use or head-down position during computer use or reading. 5) "Nervous tension" associated with acute emotional stress or psychological tension produces sustained musclular activity that can induce TrPs. Try to manage your stress, including healthy diet, exercise, sleep, and stress-reducing techniques such as listening to music, meditation, yoga, etc. 6) Viral diseases commonly produce muscle pain; see your doctor if you suspect any infection that doesn't clear up in a timely manner.[3:7, pgs.55-56]   3.  How do you get rid of a trigger point? For this answer, I will copy my answer from :    First, be certain that you actually have trigger points.  There are other, more serious problems that can mimic the referral zones of myofascial trigger points.  See a competent doctor who can rule these factors out. Once you have a firm diagnosis, the above texts are useful in finding the trigger points and understanding what factors cause them.  They also offer useful everyday advice on what actions or positions to avoid to keep from re-activating the muscle's trigger point into the pain cycle.  I would stick with Clair Davies' books : and recommend also Sharon Sauer and Mary Biancala's book on self-treatment for lower back pain.   EDIT:  The NAMTPT website has a great *free* feature called the "symptom checker" that allows you to see common areas of pain and which trigger points (and their location) are most likely in need of treatment to eliminate the pain: http://www.myofascialtherapy.org/symptom-checker.html Things that should immediately help a true myofascial trigger point (that does not include much inflammation, swelling or an entrapped nerve) would include heat, some sort of non-heating anti-inflammatory cream (I use Myoflex cream) and avoidance of whatever actions seem to make it worse. To release a trigger point yourself, you will need to use your fingers or some sort of compression tool such as a Backnobber or Theracane: http://www.backnobber-store.com/pressurepositive-backnobber2.html?source=google_Back_Nobber&gclid=CO_s1viB268CFegbQgodv3EhPQ EDIT: You can also use a simple tennis ball or raquetball.  No expensive tool is needed, some just reach "difficult" spots better.  You can also put a tennis ball in a sock to use it as a compression tool against a wall.   What you are trying to accomplish is directing the blood to the trigger point, which has muscle-fatigue chemicals and pain chemicals suffusing it and are locking the affected fibers into a state where they can't contract or expand properly.  You aren't trying to "break it up" by rubbing across it; this can, in fact, bruise and/or irritate it.  A myofascial trigger point is not the same thing as an adhesion or scar tissue, although sometimes they coincide.  This is what I've found works best: 1.  Heat the tissue:  the connective tissue will be softened, the muscle will be more relaxed and some of the blood being directed will already be there due to vasodilation.  Sometimes this alone is effective enough to reduce the pain. 2.  Perform compression to the trigger point using only enough pressure to "just feel it", not as much pain as you can stand.  If you press too hard and you are tensing against it, you will not gain a release.  A muscle cannot tense and relax at the same time.  Hold the compression steady for a minute or two; you are "showing the blood where to go".  Wait until you feel a "softening" or "dissolving" feeling in the knot (trigger point), and hold it until it feels "done". 3.  Stretch the muscle slowly though it's comfortable range.  Don't force the end of the stretch or you could reactivate the trigger point.   * I know this answer is very, very long;  but muscle pain is a plague of humanity - it deserved my best effort to answer it well.    Finally, I just came across a good article on positive effects of Pressure therapy (as recommended above) and Phonophoresis using Hydrocortisone: http://www.sciencedirect.com/science/article/pii/S0003999311006836 The effects of pressure release, phonophoresis of hydrocortisone, and ultrasound on upper trapezius latent myofascial trigger point. by  Javad Sarrafzadeh, Amir Ahmadi, Marziyeh Yassin   Archives of Physical Medicine and Rehabilitation (2012) Volume: 93, Issue: 1, Pages: 72-7 Abstract To compare the effects of pressure release (PR), phonophoresis of hydrocortisone (PhH) 1%, and ultrasonic therapy (UT) in patients with an upper trapezius latent myofascial trigger point (MTP). Results: All 3 treatment groups showed decreases in pain and PPT and an increase in cervical lateral flexion range of motion (P<.001) compared with the control group. Both PhH and PR techniques showed more significant therapeutic effects than UT (P<.001).