Muscle knots: causes, prevention and the best treatments

What are muscle knots

What the lumps are

Of course there is no actual knot in the muscle. The lumps are actually a part of your muscle that has spasmed or tightened, bunching up.  This will cause:

• the whole muscle to tighten
• pressure on the blood vessels which restricts blood flow
• they will be tender and shoot pain when pressed upon
• when they get bigger can shoot pain without being pressed upon

The technical name

We will use the term “muscle knots” in this guide, but the technical name is (myofascial) trigger points, or trigger points for short. The scientific articles we mention will use this term.

They are not scar tissue, adhesions or inflammation

We have seen guides advising that muscle knots are parts of muscles with scar tissue, adhesions and inflammation. While muscles can have these this is not what forms the lumps you feel. The people giving this advise do not understand what they are treating, so give totally inappropriate advice.

The symptoms of muscle knots

As mentioned muscle knots can cause stiffness, tiredness plus a host of muscular aches and pains. One reason for such a wide range of symptoms is that muscle knots can shoot pain well away from the actual lump. Scientists have mapped much of this, as shown in the following diagrams.

How are muscle knots diagnosed

Muscle knots do not show up in any medical scans or laboratory tests (so medical doctors usually don’t find or diagnose them). They can only be found and diagnosed by a properly trained professional physically examining the muscles, looking for the tightness, lump, tenderness and shooting pain.

For more information

Your complete guide to (myofascial) trigger points

What causes muscle knots

You may read lists of things that cause muscle knots, However, the two main underlying causes are:

1. prolonged or abnormal stress on the muscles, and
2. restricted blood flow, which causes a lack of nutrients and build up of waste products in the muscles.

Prolonged or abnormal stress on the muscles

This can be either repeated stress or constant tension

Repeated stress

This occurs when muscles are repeatedly worked without having time to recover. An example would be repeatedly doing the same task, such as a trades person might do or even repeatedly using a keyboard.

Constant tension

This is where muscles are under continued stress without being able to relax and recover. As we will see in the next section when a muscle is under tension it also presses on blood vessels restricting blood flow.

Example two: Emotional stress and tension

Emotional stress and tension can cause muscles around the head and neck to tighten. The muscle knots these cause are a major cause of headaches.

Example three: Muscle knots themselves cause muscle tightness

As discussed above muscle knots themselves cause muscles to tighten and restrict blood flow. Therefore, once you have muscle knots they create the perfect environment to keep growing and for more to develop. This is why once you have them they almost never go away on their own, and why they keep coming back after being treated. Later in this article we will show you how to overcome this to successfully get rid of them.

How to prevent muscle knots

There are a number of things you can do to help prevent muscle knots. These all involve minimising or eliminating the two main underlying causes. Let’s look at some examples.

Treat existing muscle knots

As we have seen existing muscle knots cause muscles to tighten and restrict blood flow, which cause more muscle knots to develop and the existing ones to worsen. Later in this article we will show you the best way to treat them.

Sitting at a computer

1. Set up your work station to minimise postural and other stresses. An excellent resource that shows you how to do this is our Victorian Government Worksafe guidelines
2. Take regular exercise breaks to help reduce muscle tightening and help get blood pumping though your muscles.

Other jobs and activities

1. Minimise repetitive stresses and prolonged tightening of your muscles. our Victorian Government Worksafe guidelines give specific advice for a large range of jobs and activities.
2. Take regular exercise breaks to help reduce muscle tightening and help get blood pumping though your muscles.

Emotional tension and stress

Emotional tension and stress and be a significant cause of muscle knots, especially in the head and neck muscles. As an example, during the exam period in Chiropractic College fellow students sought regular treatments. This is not our area of expertise, so if this is a concern we advise that you seek appropriate advice.

Spinal and postural abnormalities

Issues with your spine and posture are a very common cause of muscles to be abnormally tight. For more information about this and what to do please see this article

Regular muscle care

Causes of muscle knots can easily be minimised, but it is practically impossible top eliminate them altogether. Therefore it is great to do some ongoing muscle care to keep them from tightening and to keep an excellent blood flow. To do this we recommend:

1. regular exercise and stretching
2. regular massages (Later in this article we will show you the best do self massage so you can do this without the expense and inconvenience)

What is the best treatment for muscle knots

If you have had treatment for muscle knots before you will understand that there are a wide range of potential treatments, but which ever treatment you use the muscle knots always seem to come back. In this guide we will explain why the pain keeps coming back and what you can do about it.

Why muscle knot pain keeps coming back

Muscle knots are long term changes to your muscles. They start small and gradually grow, but do not start causing pain until they are much larger. Typical courses of therapy such as needles, laser or manual techniques just quieten down the muscle knots enough so they stop hurting, but do not reverse the long term changes.

How to relieve muscle knots permanently

Note: For a thorough guide will full instructions please see our Trigger point therapy guide . However, we give a summary here.

To rid muscle knots permanently we need to acknowledge that our treatment and management need to address long term changes rather than just the pain. There are two parts to this strategy:

1. keep the treatment going after the pain goes away, for long enough to eliminate the problem
2. eliminate or reduce anything that helps muscle knots grow

The ongoing treatments

In the example above while most of the muscle knots were still there some were gone and the rest had diminished in size. This means that you need to continue treatments for long after the pain goes away. For most using professionals to do this would inconvenient and prohibitively expensive, but this is easily achievable using an easy, effective self-treatment. For self treatment we have two options:
1. Pressure techniques
2. Vibration massage (recommended)

Pressure techniques

Pressure techniques have been used by professional therapists, and there are a large number of websites and videos advising this treatment. Technically it does work, but is hard to do, not that effective and hurts so much people rarely persist long enough to get lasting benefits.

Vibration massagers for personal use

When we were looking for a suitable vibration massager for our patients to use all the effective machines seemed to be "professional" products for therapists to use. These were expensive and not designed for self use. Because of this we built our own that pack the effectiveness of a professional unit into an economical one for self use. They are now used, recommended and sold by over a thousand clinics across half the world (some examples). For information about these and where to get them please use these links.
The General Purpose Massager
The Ultimate Quad Head Massager
Read what professionals say about DrGraeme massagers

Eliminate or reduce anything that helps muscle knots grow

While your muscle knots are being treated it is important to avoid the things discussed above cause muscle knots to develop.

How to treat muscle knots for various conditions

In this section we will link to resources to help you with muscle knots for various conditions. These will use the technical term “trigger points’, but you know its the same thing.
Shoulder pain
Fibromyalgia
Headaches and migraines
Tennis elbow
Back pain
Calf pain