I get this question all the time in my practice as Rolfer. It usually prompts me to start trying to correct some misconceptions. Here's why.
1. Thinking about knots might increase threat
First and foremost, there is good reason to believe that the way we think about the state of our body can affect our sensations and pain levels. For worse or better.
As I’ve discussed before, pain is an output of the brain that can be modified by cognitive inputs. Before the brain decides how much pain to create in response to some perceived danger in the tissues, it will try to answer the question “how dangerous is this really?”
To do that, it will consider all the information relating to the condition of the tissue, including nociception, proprioception, and cognitive information such as memories, emotions, diagnoses, and mental images of the tissue. If you are constantly telling yourself that your muscles are tied into knots, this is one of the inputs into the system, and it doesn’t sound like good news.
Of course we know consciously that the muscles aren’t literally tied in a knot (actually I think some of my clients actually believe there is literally a knot.) But the parts of the brain that evaluate threat might not be quite so sophisticated as to understand the difference between metaphor and reality. And a picture is worth a thousand words. This is why many movement practices such as yoga, martial arts, and tai chi employ imagery as way to modulate muscle function.
And believe me, none of them ask you to imagine your muscles are tied in knots.
If you are constantly thinking of a knot whenever you sense the tightness in a particular muscle, you are probably increasing the chance that you will feel some unpleasantness associated with the tightness. So I ask my clients to consider this and conceive of their muscle tightness in less threatening terms. For example, how about just this: that area feels tight.
Oh, and that doesn’t mean the area actually is tight.
2. Most “knots” aren’t even tight!
Another problem I have with the “knot” idea is that the supposed knot is often no tighter than surrounding tissue.
Part of the reason for this is that the subjective feeling of tightness in a muscle is not the same as actual mechanical tension in the muscle. So you can have a feeling of tightness in areas that are actually pretty loose, and a feeling of looseness in areas that are mechanically tense.
For example, in this study it was found that the most painful trigger points in the upper traps (an area that is always described as being tight) were actually less mechanically tight (as measured by an algometer) than surrounding areas.
So just as pain is not an accurate measure of tissue damage, the feeling of unpleasant tightness is not a measure of actual mechanical tension. (Whether excess mechanical tension is a common cause of pain, or whether trigger points exist are separate issues that I won't get into here!)
3. Most knots are actually bones
This happens ALL the time. Ninety percent of the time when a client starts feeling around in their sore tissues and finds what they think is a knot, what they have actually found is a bone. So of course it feels hard, and of course it hurts to press on it.
For example, that knot in the upper traps? That’s often the superior tip of the scapula. The hard areas in between the scapulae are usually ribs. And that dense spot in the low back is often the transverse process of a lumbar vertebrae.
Although many clients are sometimes a little resistant to this idea, many are relieved to learn that their anatomy is not deformed in some pathological way. And several have told me that they are glad they don’t need to keep pressing on the knot - with foam rollers, lacrosse balls, or whatever other implements they can find - to "release" it.
Language matters. It affects threat and it directs treatment decisions. So share this post with someone who thinks they have a muscle knot!
And if you can think of any other language related thought viruses that can make us sick and send us down the wrong path, let me know know in the comment section.