Muscle Knots: Your Guide to Getting Relief

When you feel a crick in your neck after a long workday or an ache in your lower back after a big yard clean-up, it may be a muscle knot causing your pain. “Despite the name, when you have a muscle knot, your muscle is not actually tied in a knot,” says Samantha Stewart, PT, DPT, a physical therapist at Hinge Health. “Your muscles aren’t like a rope you can tie and untie. Muscle knots are simply another way your body communicates with you, and you can take the feedback and adjust, so you can still do all the things you enjoy.”

Muscle knots aren’t harmful, but they can cause problems like pain and limited range of motion if ignored. You can avoid this by taking some simple, at-home steps to ease muscle knots and prevent them from returning.

Read on to learn more about muscle knots: what they are, their causes, and how to treat them, including recommended exercises from Hinge Health physical therapists.

What Are Muscle Knots?

Muscle knots, sometimes called myofascial trigger points, are hard, lumpy spots in muscles. Unlike muscle cramps or spasms that affect the entire muscle, muscle knots are localized.

“Muscles are made up of fibers that contract and relax as you move your body,” says Dr. Stewart. “Nerves tell those muscle fibers when to contract and when to relax. Muscle knots usually occur when there's some kind of miscommunication, and some muscle fibers get stuck halfway in between contraction and relaxation. That's when you can feel a muscle knot.”

Muscle knots often occur in the neck, upper back, glute, hip, and calf muscles. “You rely on these muscles for many different activities, and they often kick in and do the job of other parts of the body when needed,” says Dr. Stewart. As a result, they are more susceptible to forming muscle knots. 

Muscle knots can be active, hurting even when you don’t touch them, or latent, only sensitive when you press on them.

Symptoms of Muscle Knots 

Common symptoms of muscle knots include:

• A hard lump in a muscle

• Tender or painful to the touch

• Sensations of achiness or dull pain

• Stiffness

• Reduced range of motion

• Referred pain, feeling pain in other parts of the muscle or body as a result

Causes of Muscle Knots

Muscle knots can develop for various reasons but are often related to function or positioning. Here are some common causes of muscle knots.

• Doing too much, too soon. Sometimes you may engage in activities that are more than your body is ready for, like a spontaneous weekend of yard work when you spend most days at a desk. Or maybe you went on an intense, all-day hike when you haven’t been exercising regularly in months. While your body is capable of doing these and many more activities, doing more than your muscles are prepared for can cause them to form muscle knots. “When your muscles have had enough, they aren’t sure whether to contract or relax,” says Dr. Stewart. A regular exercise routine can help prepare your body for all sorts of activities. 

• Staying in one position for too long. If you find yourself hunched over a computer at work, seated in a cramped spot on a flight or road trip, or stuck wearing high heels for a long time, your muscles can fatigue. “If you're in one position for too long, muscles become tight,” says Dr. Stewart. “They’re not able to fully lengthen or contract, and, as a result, muscle fibers get stuck in between, creating a knot.” Setting a reminder to move a little during these types of situations can help to prevent knots.

• Engaging in repetitive tasks. Using muscles over and over again in the same way for hours, like when you’re painting your house, crocheting, or hammering nails, can leave them overworked and susceptible to muscle knots. 

• Not using proper form during certain activities. Not only can it undermine your performance for sports and recreational activities, but improper technique can also leave you with muscle knots. The same goes for everyday tasks like lifting heavy objects, shoveling, raking, and bending. When your body mechanics are off, more stress is placed on some muscles, which can lead to the formation of knots. 

• Having muscle imbalances. Muscle imbalances result in some muscles becoming too weak to perform effectively, so other muscles need to pitch in and help. Over time, those helpful muscles become fatigued to the point of developing knots. This can happen due to an injury, like the traps in the upper back stepping up to assist injured rotator cuff muscles in the shoulders. A physical therapist can help you identify and address imbalances that can lead to muscle knots and other injuries. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

Treatment Options

“The best treatment for muscle knots is prevention and preparing your body through exercise and movement to better tolerate the things that can trigger a muscle knot,” says Dr. Stewart. But when you do get muscle knots, these strategies can help get rid of them.

• Listen to your body. “Just like pain, muscle knots are a way the body communicates that something needs to be addressed,” says Dr. Stewart. That may mean taking up strength training so your body is better able to tolerate certain activities for longer. Or getting up from your desk periodically during your workday to stretch muscles instead of sitting for many hours straight. Pay attention to what may be triggering muscle tension and take steps to adjust what you’re doing or how you’re doing it.

• Stretch. Gentle stretches lengthen muscles and increase blood flow to help release knots.

• Heat. “Heat brings blood flow to the affected area and will naturally relax muscles,” says Dr. Stewart. A heating pad, hot shower, or hot bath all work. Some people find alternating heat and ice to be helpful, but choose what feels best to you. 

• Take movement breaks. Moving through a full range of motion can help reset a muscle with a knot. Movement also increases blood flow to the area, which can help a muscle relax. Incorporate movement snacks — small bursts of activity — into your day to break up staying in one position for too long.

• Massage. The rubbing and pressure of a massage can help loosen muscle knots. You can do self-massage for on-the-spot relief or get professional massages to help avoid muscle knots from forming by reducing overall muscle tension and stress that can build up and increase your risk of knots. Trigger point massage specifically targets sore spots.

The above exercises help muscles to reset when their fibers are stuck in a knot. “When a muscle is confused and stuck between contracted and relaxed, working through these movements can reset what the muscles should be doing,” says Dr. Stewart. The exercises also help to prevent future knots by lengthening and strengthening muscles so they are better prepared to tolerate activities.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Apply Pressure

“Direct pressure on a muscle knot can give you the most immediate, short-term relief,” says Dr. Stewart. “When muscle fibers are confused and partially contracted, applying pressure gives a different input signal to help reset them.”

You can do this with a tennis or lacrosse ball, or your thumb. If the knot is in your glutes, for example, sit on the ball to target the affected area. For a knot in your back, put a ball in a pillowcase, throw it over your shoulder, and lean against a wall to apply pressure. You can use your thumb for knots in your neck, arms, or legs that are easy to reach. Foam rolling can also provide relief, according to one study. Any discomfort or pain as you press should not exceed a level that’s acceptable for you. You can repeat this as frequently as you like based on your symptoms and the relief it provides.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Gillen, Z. (2022, August 4). What are muscle knots? An exercise physiologist explains what those tight little lumps are and how to get rid of them. The Conversation. https://theconversation.com/what-are-muscle-knots-an-exercise-physiologist-explains-what-those-tight-little-lumps-are-and-how-to-get-rid-of-them-184917 

2. Ingraham, P. (2019, November 12). The Complete Guide to Trigger Points & Myofascial Pain. Pain Science. https://www.painscience.com/tutorials/trigger-points.php 

3. Knots in Your Neck? How to Try a Trigger Point Massage to Release Them. (n.d.). Cleveland Clinic. Retrieved from https://health.clevelandclinic.org/knots-in-your-neck-how-to-try-a-trigger-point-massage-to-release-them 

4. Knots in Your Neck? How to Try a Trigger Point Massage to Release Them. (2019, April 3). Cleveland Clinic. https://health.clevelandclinic.org/knots-in-your-neck-how-to-try-a-trigger-point-massage-to-release-them 

5. Wilke, J., Vogt, L., & Banzer, W. (2018). Immediate effects of self-myofascial release on latent trigger point sensitivity: a randomized, placebo-controlled trial. Biology of Sport, 35(4), 349–354. doi:10.5114/biolsport.2018.78055