What is not a knot? De-gunking the myth of muscle malodies
"What are knots? Where do they come from?" These are two of the most common questions I get as a massage therapist. My light-hearted answer to these two questions is: "Well, cells poop!"
This often elicits laughter and an incredulous "What?!" I then proceed to explain.
Knots, in reality, are no laughing matter. They cause a lot of discomfort and can even inhibit movement. A knot in the wrong place can effect something as simple as breathing. I had an experience with a client who is a singer. She called the center where I work in a panic. She had a gig that night and was unable to sing. Inhaling was agony for her and during the consultation part of the massage she said her back felt tight. It turned out my client had good sized knot in her lower Trapezius/Rhomboid area. It took two massage therapists to work the knot out. I worked on the knot the first day, and got her to the point to where she could sing without pain. On the next day she returned and a fellow therapist worked on the rest of the adhesion, because my fingers were too sore from the previous day.
To understand what knots are and where they come from, it is first important to know how a muscle contracts. The whole process is amazing! It is fascinating to think this is happening in the body each time a person moves. The explanation is scientific, so bring out your science cap. Here is how it all works:
There are two movements a muscle can make: Concentric, which is shortening the muscle, a good example of this is would be doing a chin up on a bar. The bicep muscle is shortened to bring the chin up to the bar. The second movement is eccentric which is lengthening the muscle, this would be extending the arms to come down from the bar. A second way to understand concentric and eccentric movement is a sit-up. Concentric movement would be bringing the upper half of the body closer to the knees, and eccentric movement would be returning the lower half of the body to the floor position. In this article though, when I speak of muscle contraction I am talking about the movement of a muscle in general.
Muscle movement begins at the cellular level. The two proteins that make this movement possible are myosin and actin. When the two proteins come together they change the shape of the muscle cells. The contraction (movement) of the muscle happens when the actin filaments (the filaments are rod like structures) glide over the rod-like myosin filaments. It is the glide movement that changes the shape of the cells which makes a contraction or movement.
So, now that the explanation of how muscle contraction (movement) happens, the next question would be: What are knots? Honestly, there is no concrete answer. The current thinking is that knots are a build-up of metabolic waste from the cell. The build-up of this cell waste occurs when the smallest unit of the muscle, called a sarcomere stays contracted, due to over use of the muscle or other factors such as fatigue, trauma, pain, or stress. This permanent contraction of the sarcomere cuts off its blood supply. The result from this “strangulation” is an augmentation of waste which irritates sensory nerve endings.
The sarcomere consists of over lapping proteins. These proteins that look like two three pronged rods coming at each other from opposite directions. These rods that are being pushed together contain the protein Actin. When the muscle contracts the proteins Actin (on the rod) and Myosin (on the muscle fiber filament), latch onto each other and pull, furthering the overlap of the rods. When the muscle lets go of the contraction the proteins just release. However, there are times, when the proteins in the sarcomere grab onto each other during muscle contraction and then do not let go when the muscle is relaxed. Instead, the proteins interlock even more tightly. This would be like pushing these rods together until they overlap to the point of being jammed together. When this occurs the waste from the muscle cell begins to build up and the person develops what the layman calls a knot and what Massage Therapists call a trigger point or adhesion.
The next question is: What does a person do to get rid of these pests that can bring life to a screaming halt. Here are some things that can help:
1. Massage- on a regular basis, meaning at least once a month.
2. Stretch- A regular stretching routine keeps the muscle lengthened and flexible. The routine does not have to be a long one. 10-15 minutes of stretching each day is very helpful to the body.
3. Tennis ball therapy- Rolling a tennis ball in the affected area alleviates muscle tension. If there is tightness in the neck roll the tennis ball there. Sitting on a tennis ball can reduce gluteal tightness. The tennis ball can be placed between the person and a wall or the floor. Example: If experiencing tightness at the Sacroiliac (SI joint) area, place tennis ball at the SI joint and the wall (if standing) or the floor (if lying down) and push on to the tennis ball. This is using the body’s own weight to relieve tension. Foam rollers are another tool that can be used to lessen the tension that result in a knot(s). This is great therapy between massages and chiropractic appointments.
4. Drink plenty of water- Water! Water! Water! It simply cannot be over stated. Keeping hydrated keeps the muscle moving smoothly and the metabolic waste flushed out.
5. Hot soak in the tub with Epsom salt- Reduces muscle soreness, relaxes muscle tightness, and draws toxin out of the body. Adding aromatherapy can be an extra benefit to aide muscle relaxation. Adding a few drops of Lavender, Tea Tree, and Rosemary oils into the bathwater enhances tension release and is also mentally and emotionally cleansing.
6. Try not to over use affected area- Switch things up! Example: If you carry a bag, purse, or backpack more on your right side, switch to the left every once in a while or vice versa. Be aware of your posture. How do you sit? Do you slouch? Do you lean more to one side than the other? These are all things that contribute to body tension and knots.
7. Ergonomics- Another aspect of life that is perhaps the number one reason people have knots is the work place. Most people work sitting at a computer. They spend hours staring at computer screen, with the head jutting out. This position puts a tremendous amount of stress on the neck, head, back, and shoulders. The average human head weighs between 8-10 lbs. and sits on a tiny vertebrae called the atlas. So remember this, and be kind to yourself! Look around your office or work station and see what changes can be made. Adjust your computer screen to where it can be viewed with your head in a neutral position. Can the keyboard on the computer be adjusted so that the wrists are also in a neutral position? What about the chair you sit in? If you suffer from low back issues due to sitting all day, a lumbar pillow gives this area support. Again, adjust the chair to where the thighs of your legs are even with your pelvis. If the chair cannot be moved, a foot still will accomplish the same effect. One other very important thing you can do is get up every half hour or so. The human body is designed to move, not sit in a cramped space all day. So get moving!
Unfortunately, as long as we breathe and move knots are something that will always have to be dealt with. It is the stress on the body that causes tension or tightness, tightness/tension keeps the muscle contracted, constant contraction of the muscle causes: KNOTS!
I hope that the readers of this article find some helpful advice on how to deal with these maladies that can at times make life uncomfortable. Keep in mind, your body rules! When it breaks down or is ill or hurt life gets hard or all but stops. Be good to yourself!