“So is that a knot?”

“So is that a knot?”

As massage therapists, we hear that question a lot. Let’s say I have my forearm in between your spine and shoulder blade, and start to sink deeper into your rhomboids. The tissue feels firmer and denser, not as supple as the surrounding muscle. You might feel a dull ache with the compression, or it could even reproduce the pain you notice after sitting at the computer for a while. “That’s it,” you say. “You found the spot. So is that a knot?” 

Sure, let’s call it a knot. We can both feel it’s different from the rest of the muscle, and it can certainly give the sensation that your upper back twisted like a kindergartener’s shoe string. But what is a knot, really? 

Let’s start with what a knot isn’t. It’s not your muscles somehow tied or stuck together - don’t worry, that’s not a thing. A muscle knot also isn’t visible in any kind of imaging - wild, right? To the best of our knowledge, these hyperirritable spots in a muscle are myofascial trigger points. Trigger points are thought to be caused by both overuse and muscle weakness (yes, sitting at the computer all day does fatigue your muscles!). 

Trigger points can be active, meaning they’re hurting right now and probably why you’re getting a massage, or latent - those tender spots you didn’t know were there until your therapist started pressing on them. Either way, you should feel relief during and after your massage. Keep in mind, though, if a knot has been bothering you for a while it may take more than one session to notice longer lasting benefits. 

Trigger points can be found in just about any skeletal muscle, not just the upper back. Other common spots are the neck, glutes, IT band, and calves. A massage ball or foam roller can help, along with varying your posture and activities throughout the day (sometimes easier said than done, I know). But if your DIY treatments on that knot just aren’t doing the trick - finding and treating trigger points is what we do.