What is a muscle knot?

What is a muscle knot?
We’ve all probably suffered from an area (oh so frequently in the shoulders or upper back) of what we think is muscle but is really painful and hard feeling.  This is what is described as a muscle “knot”: an area of muscle that is contracted and constricted and causing pain.  
These points of pain can also be called Myofascial Trigger Points and they can be referring pain to a distant part of the body in recognisable patterns (to those that know anyway).  These points only form in muscles but their impact can be felt elsewhere as they can pull on tendons and other connective tissue so that they pain they cause is felt remote to the actual site of the problem.

What causes the knots to form?
There are still a number of theories as to what is causing them but something triggers to the muscle to contract but then not switch off again so it remains contracted and this leads to muscle spasms.  Ideas about formation of trigger points include

• acute or chronic muscle overload.  Acute overload might be due to lifting or moving a heavy object leading to a spasm; chronic overload can be holding a phone between your ear and your shoulder, poor posture, raising your shoulders due to stress or badly positioned equipment.
• activation by other trigger points. The body is great at adapting and compensating so that it continues to function, so a pain in one muscle can cause problems in another as it is having to do more work than normal, or a task it really isn’t suited for.
• homeostatic imbalance. Homeostasis is the body’s control mechanism for temperature, glucose/salt/mineral blood levels, hydration levels etc.
• trauma. Either direct trauma to the muscle such as an impact or puncture or accidental, for example the impact of a car crash puts a lot of strain on the muscles.
• micro trauma caused during poor usage of the muscle damaging one or more fibre (a small component of the muscle) that then causes the surrounding fibres to work harder, which then quickly become fatigued and prone to damage so the issue spreads.

What can I do to treat them?
Massage is a great treatment for muscular knots and trigger points as there are a number of techniques that can be used by the massage therapist to get the muscle to relax.  These can be from direct pressure on the trigger point itself, which can be painful initially, to manipulation of the surrounding tissues to trigger a relaxation response in the muscle.  Massage also has the benefit in that it can help reduce any mental stresses that might be contributing to the formation of the trigger point.
Dry needling is also an option where an acupuncture needle is applied to the trigger point in the muscle itself.  This is different to acupuncture in that the underlying theory on the siting of needles does not follow meridians but is directly into the trigger point.