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  • Reuben Hall

What is a Knot?

Updated: Jul 29

This is one of the most common questions that Massage Therapists are asked and one of the most difficult to answer.


At some point you’ve probably had what felt like a lump, ball or knot in your shoulder or back. You might feel stiff or restricted and squeezing or massaging it hurts but probably feels kind of good as well.


But what exactly are you feeling?


For something that happens so often, very little is understood about exactly what causes knots or the best way to treat or prevent them. In fact, very little is known about what a “knot” even is.


But before I talk about what knots probably are and the best ways to deal with them, I’d like to dispel a few common myths or misunderstandings.



What a Knot is NOT

No, you do not have a literal knot in your shoulder. There is absolutely no way that your muscles have tied themselves into an actual knot. Many people envision a tangled mess like a pile of twisted string has appeared and needs “straightening” or “untwisting”. This is not the case.


A knot is not a separate entity. It’s not a blob of tissue or a hard ball that’s appeared or settled into a part of your body. And it can’t move around. If you have a knot in your right shoulder and then it goes away and you get one in your left, it’s not the same knot that’s moving around your body.


With that said there are many other types of lumps and bumps that you should watch out for. From swollen lymph nodes to lipomas (clusters of fat cells) to tumors, if you’ve found anything resembling a lump in your body go to your doctor and have it looked at right away.


What a Knot Probably Is

The knot that you might get in your shoulder is most certainly a tight muscle or at least part of a muscle that is “stuck” in a contracted or shortened position. If you hold your arm out to your side and then bend you elbow while flexing your biceps (the big bulgy arm muscle people like to show off) what you’re doing is contracting and shortening that muscle.


When you get a knot, the muscle can’t let go of that contraction. If the entire muscle seizes up into full contraction you have a spasm, which is almost always extremely painful. Sleeping funny and then waking up with a stiff neck that won’t turn is caused by a spasm.


Most of the time what knots appear to be are either a lesser version of a spasm, where the muscle will let go of the contraction a bit while still causing you pain and stiffness, or a full-blown spasm in only part of the muscle. Some people refer to this as a Trigger Point and it is the most likely culprit when you can feel a painful lump or knot in your muscle.


What Causes Knots

There are endless theories about what causes spasm, knots or trigger points. And it’s understandable when you’re experiencing one to ask the question:

“What Have I Done to Deserve This”!


Unfortunately, there are so many possibilities that honing in on a single specific cause can be difficult. They can be caused by repetitive strain, muscle strain, cold exposure, dehydration or simply being in one position for too long.


How To Fix a Knot

If you understand that a knot is muscle that doesn’t want to stop contracting, the way to get rid of the knot is to get your muscle to relax. But that’s easier said than done.


Treating the symptoms can be quite simple. Pain killers and other medications can mask the pain, reduce inflammation and relax the muscle; as can applying a hot or cold pack.


Visiting a Registered Massage Therapist for treatment is obviously my preference, as well as considering other treatments such as chiropractic adjustments, acupuncture, osteopathy or physiotherapy. This approach can offer long term relief as well as a way to address the underlying causes of your specific problems.


Depending on where the knot is, how long you’ve had it and how persistent it is, the knot may resolve in a day, or it may take much longer. The harder part is figuring out how to prevent it from happening again.


How to Prevent Knots in the Future

So now that you know what a knot probably is, what seems to cause them and how to fix them, you'd like to know how to prevent them from happening in the first place.


There are 5 simple although not necessarily easy ways to avoid getting knots.


1. Make sure you’re getting up and stretching throughout your day. Set a timer on your phone if you have to. Get up and move at least once an hour.

2. Drink water that hasn’t been through a coffee maker.

3. Put on a sweater or a scarf if you’re somewhere cool.

4. Find some time for regular exercise.

5. Consider your work space. Is your chair supportive? Is your computer monitor at a proper height and distance? If you can, request an “Ergonomic Assessment” from your HR department. And stop staring down at your phone all the time.


As with most things in life, prevention is the best medicine. So stay warm, stay hydrated and stay active. And please, find time to move, time to relax and time to take care of yourself.

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