So your massage therapist told you that you have knots, or maybe the most knots Ive ever felt! What is a knot, and what can you do to get rid of them? Well, Ive got good news: There is no medical phenomenon known as a muscle knot. Your muscles dont get knotted up or clumped together when you get stressed, and there are no balls of messed up tissue within your muscle.\r
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So. what is your massage therapist talking about? As I say in the video (0:55), theyre probably just talking about tight postural muscles, usually in trapezius, rhomboids, and the spinal erectors. These are naturally very lumpy muscles—in high-tension situations, they can feel quite bumpy, especially where they overlap. If you dont know your anatomy (your massage therapist should, by the way), it could be easy to mistake this for a problem.\r
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Another likely not-knot are the many bits of your anatomy that are difficult to identify (4:24), such as the tendon of levator scapulae, the inferolateral border of trapezius, and the many ridges and folds of perfectly healthy muscle. If youve been told that you have knots in your upper back, its very likely that your massage therapist was just unaware of what they were feeling under their hands.\r
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Its possible that your massage therapist was talking about myofascial trigger points (3:00), a phenomenon with mixed scientific evidence. Heres the theory: Youve got taut bands in your muscles that tend to have isolated areas of contrion within them. These can refer pain elsewhere, following predictable patterns. While the referral of pain from one area to another seems to be reliable (if poorly understood), the palpability of trigger points is in question. See this study for an example: , and this article by Paul Ingraham for a comprehensive write-up: \r
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If your massage therapist told you that you have knots, its likely that theyre just using the language and interion style modeled for them by teachers and colleagues. Those people were mistaken too. Please feel free to let those knots go. If youve got muscle tension thats giving you trouble, that can and will change over time, especially if you make some changes.\r
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To the massage therapists in the crowd, Id love to hear your thoughts. If you used to tell clients about their knots (I know I did), what made you change your mind? Have you found other language thats more useful, and that creates less stigma? Lets talk about it!\r
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What does your massage therapist mean by knots? \r
0:55 1. Tight posture muscles.\r
3:00 2. Trigger points\r
4:24 3. Mistaken anatomical identity\r
4:57 What should you do about your knots?\r
The not-knots:\r
5:27 The superior angle of the scapula\r
7:00 Inferolateral trapezius\r
7:53 Aponeurosis medial to the spine of the scapula\r
8:30 Infraspinatus\r
8:58 The back mouse\r
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