Most people have experienced a muscle knot at one time or another.
Muscle knots can occur in virtually any muscle or fascia tissue in the body but are particularly common in the calves, the trapezius in the upper back, lower back muscles, and shoulders.
But what is a muscle knot? What causes muscle knots? And what does a muscle knot look like?
This article will discuss what causes those dreaded muscle knots and what’s the best way to treat them.
More specifically, we will cover:
- What Is a Muscle Knot?
- Symptoms of Muscle Knots
- What Does A Muscle Knot Look Like?
- Causes of Muscle Knots
- Treating Muscle Knots
Let’s jump in!
What Is a Muscle Knot?
So what are muscle knots, exactly?
A muscle knot is a common term used to describe a myofascial trigger point, which is essentially defined as an irritable nodule of muscle tissue that can cause direct pain, movement dysfunction, decreased range of motion, and other issues, depending on the location and severity.
Muscle knots can theoretically develop anywhere in the body where muscle or fascia, a fibrous connective tissue, exist, but muscle knots and myofascial trigger points are most commonly found in the calf muscles, shoulders, back, neck, and along the front of the shins in the tibialis anterior muscle.
Trigger points can be considered active or latent.
If you’re aware of your muscle knot when there is no pressure on the area, it’s defined as active because it’s currently causing you pain and discomfort, often even when you’re not touching the area.
Latent trigger points are only painful when touched or activated but otherwise tend to be asymptomatic.
For example, you might feel fine after a long run and decide to foam roll your calves after the workout.
When doing so, you might hit a latent trigger point or muscle knot you didn’t even know was there, but you’ll experience pain and may even feel a nodule or bump in the flesh or belly of the muscle.
Muscle knots can often be palpated and may feel like hardened or dense lumps or bumps in the muscle, but it will depend on your body composition, the location of the muscle knot, and the size of the muscle knot.
Deep muscle knots may not be palpable, especially if you have a lot of overlying skin or fat tissue, but that doesn’t necessarily mean that you won’t feel pain from them.
Symptoms of Muscle Knots
The primary symptom of any active myofascial trigger point or muscle knot is pain.
The pain may be chronic or acute, sharp or dull, stabbing and persistent, or achy and only noticed when you use the muscle or touch the tender area.
Trigger points can also cause referred pain, especially when you press on them. This means that the pain spreads to nearby areas or along the length of the muscle or tissue.
For example, studies suggest that one of the most common sites of a muscle knot is in the trapezius muscle, which is located in your upper back between your shoulders.
A knot on this muscle can refer to pain to the neck, lower back, and jaw and may even cause discomfort or ringing in the ears or tension headaches.
The presence of referred pain is typically what is used to differentiate a real trigger point from a tender point, which is usually a sore area of muscle tissue or fascia that isn’t as knotted and doesn’t elicit radiating pain.
In addition to pain, muscle knots can cause numbness or tingling, depending on where they are located and if they are pressing on any neighboring nerves.
There can also be decreased range of motion, either due to stiffness or poor mobility in the muscle fibers of the fascia itself or due to the pain caused by the muscle knot.
What Does A Muscle Knot Look Like?
Many people ask also ask, “What do muscle knots look like?”
In many cases, muscle knots are not necessarily visible through the skin unless they are very superficial or if you have very little body fat in the area.
For example, if you have a muscle knot deep in your glutes, you likely won’t see anything because the nodule will be covered by overlying muscle and fat.
However, if you have a muscle knot in the tibialis anterior muscle along your shin, you might be able to visualize the knot as a small bump or node along the muscle that juts out from the surrounding tissue.
Causes of Muscle Knots
There are a variety of common causes of muscle knots, such as overexertion or muscle injury during exercise, physical trauma to the area, poor posture for ergonomics, stress, tension, prolonged sitting or standing in one position without moving or stretching, and certain conditions such as fibromyalgia.
Interestingly, other muscle knots are very common in athletes who participate in repetitive activities such as running, cycling, rowing, or even habitual weightlifting.
Another risk factor for muscle knots is actually being overly sedentary, as an activity can decrease the blood flow to your muscles. Muscle knots can develop if your muscles are not being stretched and mobilized regularly.
Evidence suggests that the primary risk factors for developing muscle knots include poor posture, a sedentary lifestyle, being overweight or obese, having biomechanical or muscle imbalances, having a history of prior musculoskeletal injuries or joint problems, insomnia or poor sleep quality, and abnormal breathing mechanics.
Studies suggest that poor posture during prolonged sitting or sleeping can lead to muscle knots. For example, many people slouch or hunch forward to use their phones or mobile devices for long periods of time, causing an overstretching of the trapezius and muscles in the upper back and shoulders and a tightening of the anterior muscles of the body.
This type of poor postural alignment can particularly contribute to the development of muscle knots in the upper back, shoulders, and neck muscles.
Treating Muscle Knots
There isn’t an instantaneous treatment for muscle knots.
In most cases, treating muscle knots has to begin with identifying the likely cause that contributed to developing the trigger point or muscle knot in the first place.
If you try to address and manage the symptoms of your muscle knot without getting to the root cause, any type of muscle knot treatment you implement will likely be futile because even if you are improving it on one end, you are still simultaneously continuing to encourage the development.
For example, if you are getting muscle knots in your upper back or neck due to poor posture, it’s critical to take steps to be more mindful of maintaining proper postural alignment as you work through managing the symptoms of the muscle knots you already have.
Treating the symptoms of muscle knots typically involves a multifaceted approach with home remedies such as alternating heat and ice to the affected area.
You can use an ice pack, cold gel pack, or pack of frozen vegetables on the sore area. Apply the ice for about 10 to 12 minutes at a time, depending on the location of the muscle knot.
You always want to ensure that there is some interface between your skin and the ice to prevent frostbite.
Muscle knots that are deeper or located in fleshier parts of the body, such as the calf muscles, can typically take icing for a longer period of time.
In contrast, if you have a muscle knot on sensitive areas with superficial blood vessels and nerves, such as in your neck muscles or along your shins, you should limit your ice application to 10 minutes or less if you start to feel a loss of sensation or changes in skin temperature that seems concerning.
Heat can be applied with a heating pad, a warm wet compress, or soak in a warm bath.
Self-myofascial release is another effective way to help treat trigger points and release muscle knots.
Modalities like foam rolling, massage guns, and applying static compression by pressing the knotted tissue against something like a lacrosse ball have been shown to help treat muscle knots.
Stretching, staying well hydrated, getting enough rest, yoga, and consuming anti-inflammatory foods may also potentially be able to help prevent and ease muscle knots.
Anti-inflammatory medications may be implicated for pain relief and to reduce swelling for acute trigger points.
If home remedies for muscle knots don’t work for you, you might need to work with a physical therapist, depending on the severity and persistence of the muscle knot.
A physical therapist can employ specialized techniques like dry needling, pulsed ultrasound, electromyostimulation, and transcutaneous electrical nerve stimulation (TENS).
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