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  • Jana Wheeler

Trigger Points and Muscle Knots

If you’re a regular to massage, the concept of a muscle knot is probably something you’re well aware of, but what are they exactly? And what’s the relationship between a muscle knot and a trigger point?

Knowing what they are helps to deal with them

What’s a trigger/tender point?

A tender point is exactly what it sounds like – a painful spot in a muscle. These tender spots are common and many of us have them, but for some people they can become really troublesome. They are common in hot-spots like the shoulders and neck, but they can crop up just about anywhere and, in some people, they can cause a lot of pain.

Trigger points, on the other hand, are simply tender points on your body that ‘trigger’ or cause discomfort in a different location. For example, if a therapist presses on a spot on your back, you might feel pain radiating up into your head or down the arm – that’s a trigger point.

(And the only way a therapist can know the difference between a tender and a trigger point is if the owner of the body lets them know – so please always communicate such things; we can feel tightness, but we cannot feel radiating pain 😊 )

A trigger point is like a ‘knot’ in your muscle, or the fascia (the thin wrapping around each muscle, more on that later) which is why they are often referred to as a muscle knot. Of course it’s not a real knot; what you feel is usually muscle fibers that are stuck together. To a massage therapist it feels like a hard contraction on the muscle fibers connected to it, like a tight band around the muscle. Trigger points in muscles are ‘myofascial trigger points’ – and there are other types of trigger point that can occur around the body, on your skin, ligaments and tendons, and on scar tissue.

How can you tell if you have a muscle knot or trigger point?

You’ll be able to tell where your own tender points are; if you touch them with any kind of pressure, you’ll notice they start to hurt, or hurt more. They are often situated close to problem areas for you as well, so if you have back issues, your tender points are likely to be around your back, neck and shoulders, although this isn’t always the case. You can feel trigger points too, although that’s a little trickier and requires knowing your body really well. The range of sensations you might feel from a trigger point can be quite wide, too; anything from intense pain to a dull, throbbing ache. Some people feel ‘pins and needles’ or numbness.

So, what causes trigger points to flare up? To be honest, science has just started on researching that field, and we don’t really know much, especially what causes those specific pain patterns that come from one muscle knot. One theory is that they are down to some sort of muscular overload - if you’ve been working out too hard or overdoing it, or just not been taking care of your posture.

In general, repeating the same movement over and over, or staying in the same position for too long at a time (hello, desk jobs and long commutes) will cause muscles to tense up. Add things like sleeping on a not ideal pillow or mattress, carrying a heavy purse, dehydration and not doing enough exercise to counter all of that, and those painful trigger points can form.

On some people, that occurs more than on others, and like most other chronic issues, there are a ton of variables, which is why two people can have (seemingly) the same lifestyle, and one has no issues and the other one does.

How are Trigger Points treated?

If you notice a sore spot and want to see a massage therapist for advice, we’d advise having a word with your medical adviser first just to make sure that any swelling or soreness is just down to muscular stress and nothing more serious. Also, you should be sure it's actually a muscle (or several) that hurts, not the joints etc.

Once you’ve been checked over, we can start to look at the problem and help you to heal it with massage.

A good massage therapist will be able to work on your trigger points and muscle knots, gently but firmly releasing them. They can also help you with in-between treatment massage techniques and stretches to try at home that will ease any discomfort and help to prevent the muscle knots building up again (see an article for self-care here).

Generally avoiding long times of sitting in the same position (or even getting up every 30 minutes or hour to move and stretch), exercising and stretching, avoiding bad posture, maybe get your spine checked at a chiropractor, and drinking enough water will help your muscles to stay healthy and get back to normal after being contracted.

Trigger points and tender spots can cause a huge amount of pain and discomfort, often restricting your movement and your ability to do the activities you want to. You don't have to put up with this pain though, with some action on your part you can be pain free!

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