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How to release (treat) muscle knots yourself
Muscle knots are those tender lumps in your muscles, often associated with muscle tightness, pain and fatigue, and are usually involved in most cases of musculoskeletal pain such as back, neck or shoulder pain.
If you’ve had these for some time you will understand that there are a number of professional therapies including needles, lasers, massage techniques and various medications. However, long term these are expensive and usually just give temporary relief.
The good news is that there are therapies you can do yourself that work as well, if not better, We will show you these, plus some easy things we can do to prevent muscle knots.
What are muscle knots
The technical names you might read
The technical name for muscle knots is “(myofascial) trigger points”, or “trigger points” for short”. We will use the terms interchangeably, while all the technical papers we refer to will use the term trigger point. You might also read the term “myofascial pain syndrome”. This refers to a collection of pains caused by the muscles and their linings (fascia), but in practice it is a term used by doctors to give a name to something when they don’t know the actual cause.
What are the lumps
Of course there are no actual “knots” in your muscles. They are part of the muscle that have gone into spasm or cramp forming a lump. As you will see this causes a chain reaction known as a positive feedback loop that causes other issues and more importantly causes the lump to keep growing.
The feedback loop
As shown in this diagram:
- part of the muscle spasms forming a lump,
- this tightens the muscle restricting blood flow,
- The reduced blood flow causes a build up of waste products and a shortage of oxygen, making the area toxic.
- This toxicity causes the muscles to further spasm and tighten.
The symptoms of muscle knots
The the most obvious symptoms of muscle knots is referred pain. The first diagram below is an example of where scientists have mapped where common muscle knots (trigger points) refer pain to, while the second is a chart therapist use to show which muscles can cause pain in each area. As you can see most areas of the body are covered. Muscle knots can cause pain almost anywhere in your body, and are heavily involved in most cases of pain syndromes such as back, neck or shoulder pain.
I mentioned above that muscle knots also cause fatigue and muscle tightness. Even when not referring pain they actually cause a host of other symptoms. For more information please see our article Your Complete Guide To (Myofascial) Trigger Points .
The stages of muscle knot growth
You may read articles describing two types of muscle knots (trigger points): latent trigger points and active trigger points. These are really just the same trigger points. All this refers to is whether the trigger points are shooting pain or not.
- Latent: not shooting pain
- Active: shooting pain
Trigger points usually do not shoot pain when they are small and growing, but may do so later when they are larger and are aggravated. However, many trigger points will swap backwards and forwards between being “latent” and “active”. For example:
Muscle knots that hurt when you aggravate them
Many muscle knots only cause pain when you aggravate them by doing something such as over-exerting or even sitting at a desk for long periods. These will often settle down again when rested. Of course even when not hurting the muscle knots will still be there.
Muscle knots that are treated
Most treatments for muscle knots just stop them shooting pain. The pain goes away, but they are still there will eventually be re-aggravated and start shooting pain again. As we will discuss later this is a major problem with muscle knot or trigger point therapies.
The easy effective home therapies
Standard disclaimer: the is general information only, to be discussed with a professional familiar with your needs.
In this section we will first show you how to find the trigger points, then the following three effective therapies you may do at home.
How to find your muscle knots
You can use the following technique to find most of your muscle knots.
Start by using the pads of several fingers to generally examine your muscles looking for areas of tenderness and tightness.
When an area of tightness or tenderness is found use one or two fingers to examine more deeply. Looking for tightness, tenderness and lumps. Generally you will find tight bands of muscle, and if you explore along these bands you will find localized areas of tightness centred around lump. Those lumps are the muscle knots. When pressed upon these will be very tender and often cause pain elsewhere.
You’ll usually be able to find and identify a lot of the problems yourself. However, when starting it’s a good idea to get some professional help:
- to make sure you are using the correct techniques and identifying the correct problem, and
- to make sure you are finding all the muscle knots that need attention. In particular, there are parts of your back you will be able to do therapy on, but not be able to examine yourself.
Pressure release technique
This technique simply involves temporarily applying pressure to the muscle knots. These techniques are very commonly used, and vary from moderate pressure to therapists who use extremely painful pressure and hold until it fades. The good news is that clinical trials have shown the moderate pressure techniques to be very effective. For this guide I’ll show you two techniques: one you can use for muscles you can easily reach with your own hands, and another technique for where you need to use a mechanical tool to apply pressure.
Pressure with your hand
Use this technique for muscle knots you can easily reach and apply pressure with using your own hands. For this technique find the muscle knot, then apply moderate pressure until you feel the pain fade and the muscle relax, or to a maximum of 90 seconds.
Pressure with a tool
For muscle knots you cannot reach with your hands you can use a tool such as the trigger point cane shown to apply pressure. You are able to apply a lot more damaging pressure using a tool, so to keep you safe yet get great results we recommend you use a traditional Thai self massage technique. This has used very successfully in a clinical trial, giving great results . For each muscle knot use the tool to apply moderate pressure for 10 seconds then release. This is repeated five times.
Don’t use foam rollers or balls
For reasons discussed in our article Can foam roller be harmful we recommend you don’t apply this pressure with rollers or balls. In summary, it’s not very effective and potentially dangerous.
Pressure with massage
This technique is more effective because it adds massage which helps circulate fresh blood to help flush the wastes. However, you can only use it of parts of your body you can easily reach with your hands.
Applying the technique
- Start by lubricating the muscle with some form of oil. It doesn’t need to be special, just slippery.
- Using your thumb or fingers apply pressure and move slowly along the muscle as if you are squeezing out an old sponge. Because there are one way valves in your veins and lymphatic vessels do this towards your heart. Continue using a systematic pattern to cover the whole muscle, working gradually deeper each stroke.
- If you come to a tight spot or trigger point stop and maintain pressure for 5-10 seconds before slowly moving on. The stroking is an effective form of massage, whereas the stopping and holding pressure is an effective pressure technique.
Using a vibration massager (recommended)
Description and usage
This is by far the easiest, safest and most effective of the home techniques, but you need a proper vibration massager. We’ve got a separate article How to use a hand held massager that gives full details, but simply speaking all you need to do is sit the head of the massager over the trigger point and let the vibrations penetrate. Properly designed vibration massagers have ergonomically designed handles to allow you reach and apply this therapy anywhere on your body.
Why vibration massage works
Looking back at how trigger points form we see that it involves spasm, reduced blood flow and a build up of toxic wastes basically going around in circles feeding on each other. Scientists have found that vibrations help each of these issues, so the vibrations from the massager will gradually “dissolve” the trigger points.
You will need a proper vibration massager (not a massage gun)
To use this therapy you will need a proper therapeutic vibration massager. A lot of personal use massagers are not serious therapeutic devices, but rather are designed to look good on shop shelves and make good mothers day presents. Further, for the reasons below percussion massagers (massage guns) are totally unsuitable. For advice on how to get a device that will do a great job for you please see our article How to choose a massager .
Why massage guns are not suitable
Percussion massagers (massage guns) are hybrid devices that attempt to combine vibration and conventional massage. Looking at this diagram the machine on the left is a genuine vibration massager. As you van see it has a pad designed to send large amounts of therapeutic vibrations into your muscles. The tool on the right is a t-bar which therapists use to save their thumbs and apply deep (painful) pressure. Massage guns are basically t-bars fitted with a jack-hammer mechanism.
Rather than combine vibration and convention massage massage guns are just a marketing gimmick that deliver far less of the therapeutic vibrations needed to “dissolve” muscle knots, while increasing the risk of a conventional t-bar type tool doing damage.
We built our own
When looking for a suitable machine for our patients to use we were frustrated by only finding gimmick laden machines that were not serious therapeutic devices, so we built our own. These pack the effectiveness of a professional unit into an economical machine that is easily used by patients at home. For more information on these please see the links below.
General Purpose Massager
Ultimate Quad Head Massager
What professionals say about DrGraeme massagers
How to stop the pain coming back
The main reason pain keeps coming back after therapy or course of treatment is that all these usually do is temporarily stop them hurting. As well, most people keep doing the things that cause the knots to develop. In this section we will show you how to use therapy to eliminate the knots rather than just relieve the pain. In the next section we will discuss things you can do to stop them developing.
How to use therapy to eliminate the knots
In this section:
- What most people (including professionals) do wrong
- What you can do different
What most people (including professionals) do wrong
Muscle knot therapies, including professional ones such as needles and laser, are just designed to stop the the points causing pain, but not eliminate the points themselves. To disguise this fact proponents of these therapies use the term “de-activate”, such as claiming that their therapy is “proven to de-activate trigger points”. This sounds like they are doing something to the trigger point won’t work like disarming a bomb or pulling the fangs out of a snake, but from the information above you now understand that all this means is to (temporarily stop them shooting pain). In other words “de-activate” is more like re-setting a circuit breaker but leaving the elctrical fault.
Professional like to base their treatments on evidence, so look to the results of clinical trials. However, the scientists who do trials on therapies such and needles and laser generally (very conveniently) only measure symptoms such as pain, and only for a short time after. By doing this they can conclude that the treatments were effective. This is exactly the same techniques that drug companies use to get doctors to prescribe their drugs that relieve pain but do not fix the problem.
What you can do different
We do have one trial where the scientists checked for muscle knots (trigger points) afterwards. In this trial patients were given a a 12 week course of multiple therapies. Rather than testing a therapy these scientists were trying very hard to eliminate the points. This chart from the trial report shows that about 2/3 of the trigger points (muscle knots) were still there.
If most of the trigger points were still there after 12 weeks of the best trigger point scientists in the world trying their best you can be sure that neither a home release technique from YouTube or a typical course of therapies will make much of an impression long term. However, there is one positive we can take from these results.
Keep going with the therapy after the pain has gone
Although most of the trigger points were still there they had all diminished and about 1/3 were gone. Instead of stopping therapy you need to continue, further diminishing them and eliminating more. Continue until you not longer find any muscle knots when you examine, then do some form of regular maintenance to keep them at bay. This would be a serious imposition if you were getting for example professional dry needling, but not if you are using as simple home therapy without any ongoing cost.
How to prevent muscle knots
What causes muscle knots
There are many causes of muscle knots including injury, muscle overload and emotional stress. However, the biggest cause is where muscle tightness restricts blood blood flow creating an environment of accumulated wastes and reduced nutrients in your muscles. This is why muscle knots are so common where postural issues (eg. sitting at a computer) or repetitive activities cause muscle tightness. It is also important to note that psychological and emotional issues can cause your muscle to tense, restricting blood flow and causing muscle knots to develop. Here are some basic ways you can help stop muscle knots from forming.
Avoid postures or activities that tighten your muscles
We have used the common example of sitting at a desk. However, there are may other activities that could cause issues. Our government worksafe has this excellent practical reference that covers most situations, including how to set up your chair and desk.
If you are in a situation such as sitting at a desk where your muscles may tighten take regular breaks, doing some light stretches or exercises.
Likely you will be able to reduce the amount of muscle knots that form but not stop them completely. Regular massages or the regular use of any of the the techniques above will help find muscle knots and take care of them while they are small.
Psychological and emotional stresses
Is these issues are causing you to tighten your muscles a lot seek some professional help on how to deal with them.
BONUS: Trigger point release (therapy) for various parts of your body
You should be able to use the basic examination and therapy techniques shown for most muscles of your body. To help further we’ve done articles showing specific techniques for many areas of your body. Remember: (myofascial) trigger points is the technical name for muscle knots.
Self massage and trigger point therapy for headaches and migraines
Massage and trigger point therapy for low back pains with self help options
Massage and trigger point therapy for calf pain, with self help options
Massage and trigger point therapy for shoulder pain with self help options
Self massage and trigger point therapy for tennis elbow
Does massage help with fibromyalgia, with self help advice
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About Dr Graeme
Several years ago Dr Graeme, a Chiropractor practicing in Victoria, Australia was looking for a serious hand held massager his patients could use at home to get the extra quality massage they needed. The ones he found in the shops and on-line for home use looked nice but were not serious, and... read more