We've all heard, and most of us have even said things like, “I have a huge knot in my back” or “I’m all knotted up!" But what exactly is a "knot"? First, it is important to know a little bit about the muscles themselves. The muscular system is comprised of 650+ muscles layered on top of each other and running in all different directions. This enables us to have the range of motion, precise movement, and balance that we do. However, if we get injured or do not properly maintain our muscles, the muscle fibers can start to stick together and become adhered. The hard lump that results in the muscle is the knot or myofascial trigger point. The Fascial Distortion Model describes another form of dysfunction called a herniated trigger point that produces the sensation of a knot. This is when underlying tissue protrudes through the surface of the fascial tissue.
Trigger points are extremely common, but common doesn’t mean they are normal or harmless. Not only are they painful but, if left untreated, they can cause local and possibly referring dysfunction that will gradually lead to a chain reaction of pain and dysfunction throughout the structure of the body. A few trigger points here and there is annoying, but having too many is the cause of myofascial pain syndrome. They are the primary cause of most aches and pains, they form like wildfire around injuries and surgery sites, and they worsen anything the isn't directly caused by them.
So what do you do about it? Many Chiropractors and Physical Therapists seem to be preoccupied to a fault with joint function and exercise therapy. These components are very important and often necessary, but they should not be emphasized at the expense of understanding muscle pain as a sensory disorder which can easily afflict people with apparently perfect bodies, posture and fitness. A lot of patient time and money gets wasted trying to “straighten” patients, when all along just a little work on a key trigger point or distortion in the fascia might have provided relief. Massage Therapists differ so widely in their techniques, skill level, education, career purpose, and even what they consider effective and ineffective treatment. When dealing with pain, it is important to find a therapist who understands the source of the pain and has a consistent record of success in unraveling the dysfunction that it caused.
What about prevention? We all get trigger points but a good way to keep them under control is to stay hydrated (with water), exercise often and with impeccable form, stretch often, avoid alcohol/ smoking/ and inflammatory foods, foam roll, and stress management. Avoid sitting for hours at a time without getting up to move and stretch. Set a timer for every 90 minutes if you have to. Lastly-- and I know it's impossible to do perfectly unless you're lucky enough to be ambidextrous-- try to avoid getting into a pattern of using one side or the other for all things repetitive.
Hopefully this information has been useful to you and thank you for reading!
Alan Nicely, LMT