How do we get them, and how do therapist massage them out?
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Oh, I can answer this one. I’m a physiotherapist specialised in Dry Needling (using needles to relieve knots).
To start; muscles are made of bundles of microscopic fibres that can slide in and out of each other, which is how muscles relax and contract.
A knot, or a triggerpoint, are parts of those fibres that have contracted fully and don’t relax anymore.
Triggerpoints form due to various things, most common is (postural) overexertion of the muscle, and others are trauma (getting hit in the muscle), and after surgery.
Because knots/triggerpoints are fully contracted parts of the muscle, blood flow to that part is lessened and waste materials can’t get carried away, which is why knots hurt.
Massage therapist put pressure on the triggerpoints to basically reset the muscle to its normal relaxed state. Part of that is increasing blood flow to the area the knot is in.
However, triggerpoints are still subject to research and some of the inner workings are still unknown. As you can tell by some of the other responses, there are a few theories, so I stuck to the known parts.
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