Those Nasty Knots!
Skeletal muscle, the largest single organ of the human body accounts for 40% of our body weight. Each one of us has over 400 muscles, allowing us to move through the world, but unfortunately and any one those muscles can develop “knots”. The technical term for a knot is myofascial trigger point. We’ve all experienced them. If you are feeling one of these knots, it is not your imagination. It is not so much a physical knot as it is a localized area within the muscle that has tightened up. As massage therapists, we can actually feel these spots as a lump or bump under the skin in the soft tissue.
Interestingly enough, trigger points do not appear randomly in our bodies, but rather occur in predictable locations. These locations appear on trigger point maps or charts such as the one pictured here. Symptoms of trigger points can include dull ache, localized tenderness, burning feeling, reduced range of motion, or even sharp, point-specific pain. Trigger points can also refer pain is to another location on the body. A classic example of this is the all too common tension headache. Our instinctive response to this type of pain, to press on trigger points to relieve pain, is a healthy and proper one. Pressing on the area typically causes desensitization of the area and also usually lessens the physical size of the trigger point.
While the Chinese mapped these spots as acupressure points, they were not taken seriously by western medicine until Dr. Janet Travel, John F. Kennedy’s personal physician, did a detailed study on this topic. Her 1983 book Myofascial Pain and Dysfunction: The Trigger Point Manual, co-authored with David Simons, still stands today as the definitive work on this topic. Their work was thorough and detailed.
So, what is the origin of a trigger point? Well, to begin with, if you look at the trigger point map above you will see that trigger points happen in predictable locations, so you could say that some areas of our body are predisposed to getting “knots”. What can make trigger points rise to the surface and increase in size are such things as trauma, overuse, strain, poor posture, bad ergonomics, structural imbalances, improper body mechanics, or even such things as poor nutrition and psycho-emotional stress or exposure to cold temperatures.
The good news is that trigger points respond well to treatment, and you can oft times treat yourself. Trigger points respond best to four things; heat, pressure, massage, and stretching. If you want to treat a nagging trigger point, one way is to heat up a grain (magic) bag in the microwave and then place it on the area. Another way is to press directly onto the tender spot and hold pressure for a minute or two. You will know when you are on the spot because you will feel what we call “exquisite pain” (i.e. hurts so good). The third way is to massage the area. To do this, put a little lotion or oil on the area and rub it until the sensitivity in the area decreases. The fourth method involves taking the area into a gentle stretch. This is best done after you have heated the area first. The final suggestion that I can offer is for you to visit a massage therapist. We specialize in this kind of work and we have several other techniques for reducing trigger point pain. As well, admittedly many trigger points are hard to reach on our own bodies. As massage therapists we can get at all of these spots as well as find other trigger points that are contributing to your pain.
If you are experiencing any soft tissue pain, do not hesitate to give us a call. This is our area of specialty. In most cases we can quickly assess your situation and begin treating your pain, getting you back into the game of life with reduced pain and increased pain-free movement in a few short sessions. Either way, don’t just suffer in silence. Treat these spots yourself or have someone else work on them. Trigger point pain is very treatable. This is not a pain that you have to live with.