Muscle Knots

You’ve probably heard the phrase “you’ve got a knot in your muscle” many times, but do you actually know what has caused it? This article should help explain the processes that lead to this problem.
A “knot” or Trigger Point as they are correctly called can be an extremely painful problem and can occur within any muscle. Usually they are diagnosed by a therapist feeling the muscle looking for a “knot” or a collection of taught bands of muscle fibers, trigger points usually are painful to touch and can refer pain to other areas, however sometimes they can be ‘latent’ meaning they are present but not painful.

If only it were that simple…

It’s not just lifting something too heavy or sleeping awkwardly that contributes to this problem. Vast amounts of research has been done that shows when we become stressed our bodies release a very similar cocktail of chemicals to that of a muscle injury. This can have a HUGE impact on the pain we feel, basically because we already have too many of those chemicals from the muscle injury combined with some more from being stressed and there you go you now have a very painful neck, back, hamstring etc.

Stress doesn’t just come from work or home but it can also be from pre match or race nerves, this too causes a similar response.

So how did it get there?

For a trigger point to occur the muscle fibers themselves have been contracted in a sub-standard way. This can occur because of; a sudden increase in load (eg lifting something heavier than usual), sustained positions where the muscle is contracted (eg sleeping awkwardly), poor eccentric control (lengthening) of the muscle (i.e. the muscle is weak) or repetitive muscle contractions in a de-conditioned muscle.
This triggers a chemical reaction; firstly blood vessels narrow which limits blood flow and therefore oxygen to muscle which injuries it. It also causes the pH (or acidity) to increase. As a result chemicals flood into the muscle which sets of ‘nociceptors’ (these are little receptors that send messages to the brain which creates the pain we feel). At the same time our ‘sympathetic nervous system’ is triggered (this controls the amount of adrenaline we release)

These processes combined then lead to different set of chemicals to be released which increases the number of contractions of muscle fibers in the area. Meaning the fibers are constantly contracting and create this area of ‘taught bands’ or ‘knot’ that we feel and cause pain.

So what can be done to help?

Increasing the control of muscles through simple strength training has proved effective to help this problem. Stretching also seems to have positive effects. Relaxation techniques can also help at times of stress and worry.

It seems that the best way to ‘release’ the area is using physiotherapy interventions, here at LRS Physiotherapy we use evidence based techniques to help resolve these problems, they include;

Soft tissue manipulation

Trigger point release


‘Stimulus +’ (a small electrically current which alters muscle contraction)

Muscle energy techniques

Deep tissue massage

Teaching stretching techniques both static and dynamic

Advice on injury prevention

To summarise;

A trigger point occurs because our muscles are injured; a chemical reaction happens which increases the contractions of muscle fibres which lead to an area of taught and active muscle fibres which create pain.