How do we get them, and how do therapist massage them out?
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I edited and combined my comments on this top level for clarity. This topic is dear to my heart as a yoga teacher (fascia is a big factor in yoga) and as my PhD is related to fascia as well.
Muscle knots are also known as sites of myofascial pain. We have something called fascia running between and inside every muscle all through the body. It is all connected in lines spanning the whole body. When fascia sticks together it creates knots. The reason fascia will stick together is due to the muscles not moving enough (in the right ways), giving the proteins in each layer the chance to entangle with one another. (eventually this will make muscles actually stick together and reduce your mobility!) This in turn reduces the fluid flow between the layers, lessening the exchange of waste products of the muscle (toxins) to the blood.
Grab a handful of your shirt and twist it. Notice how there is now tension on the whole shirt? Similarly, that twist happens in the fascia. This happens naturally and accelerates with dehydration, bad posture, and incorrect movements. This tension will hinder the mobility and strength in the whole line.
When a muscle uses energy required to contract it creates waste products, we can call them toxins. The toxins (reactive oxygen species and others) build up which causes an inflammation reaction which causes pain. The mechanism is quite complex. Other explanations here are more focused on the muscle itself which I believe plays a big part in this as well.
By placing pressure and stretch on the knots you are moving the muscle and layers of fascia apart, breaking the tangles of the “knot”. Now fluid can flow, and toxins will release. This is why you need to drink lots of water after a deep tissue massage to reduce the concentration of toxins as you process them out of the body. Else you will get headaches and the toxins will not wash out of the muscle. When massage therapist talk about toxins they are correct. But they can sound a bit woowoo because they do not know this explanation.
Unfortunately, fascia is not as known as it should be due to it not being given any attention on during cadaver prosection during medical school. It is deemed to be in the way of the interesting muscle and organs. Partly this is due to the preserving agents used to conserve cadavers changing the texture of the fascia.
Please allow me to include an excellent reference:
Jafri,M. S. (2014). Mechanisms of Myofascial Pain. International Scholarly ResearchNotices, 2014, 1–16.[https://doi.org/10.1155/2014/523924 ](https://doi.org/10.1155/2014/523924 )
I have been summoned. I’m an LMT
So the smallest unit of a muscle cell is a sarcomere. Its made up of actin and myocin. A muscle contracts by sucking calcium into the sarcomere which makes the actin and myocin slide past each other. If they over-contract, and stay that way, due to developing a high level of tonus, or resting tension in the muscle, they basically get stuck together and jumbled up. Kinda like a knot of sarcomeres. Tho the similarities probably aren’t as literal as that.
This limits the blood delivered to the area, and as a result, potassium can’t get in to take the place of calcium and tell the muscle to relax. This causes a trigger point.
The way we get rid of them is basically rubbing and irritating it enough to create inflammation. It swells with blood and washes the area out and hopefully solves the issue. We can use cupping to physically suck blood to the area, we can stretch the Fascia (connective tissue) to make room for the muscle to relax.
The only other problem is the Fascia will go back to its original constricting shape in about 4 hours. So you need to stretch alot after a massage and drink lots of water. But most spa therapists who don’t train deeper into trigger point therapy wouldn’t necessarily know to tell you that.
One thing I would add is it is moderate massaging over days or weeks that bests releases the knots, not heavy massage once in a while.
Just throwing this in there as a supplement to what everyone else is saying. Your muscles use sodium for the “contract” signal and potassium for the “release” signal. If you find you’re getting a lot of muscle knots, you could theoretically be low on potassium. I always eat a banana when I’m dealing with stiff shoulders. It’s not some kind of miracle cure that’ll replace massaging the knot out, but hey, bananas are delicious, so what have you got to lose really?
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