Never go up against a muscle...
Updated: Aug 7, 2019
Muscles do NOT get knots! There, I have said it.
In fairness, this is something I often say, particularly when doing a sports massage. I often have patients who tell me they have lots of knots in their shoulders or calf muscles, but really? Think about how a knot would actually get into a muscle. They do not have loose ends that can get entangled with each other and the long fibres of a muscle all run the same way.
What is commonly referred to as a knot is more likely an adhesion or fibrous tissue within the muscle. For a muscle to contract properly the muscle fibres need to glide smoothly along each other but sometimes they get stuck together in an area which prevents normal function and over time these areas may get 'matted' together into a palpable lump within the muscle.
We have all experienced muscle soreness the day after overdoing things; when you wake up achy and find walking uncomfortable. This is a result of micro tears, blood pooling and waste products in the muscle.
Having started my Osteopathic career as a Sports Massage Therapist many years ago, I would have found the area of adhesion and used friction (deep massage) to disperse the 'knot'. I was taught to break down the adhesion and was told that the immune system (phagocytes) would remove the debris from the muscle post massage.
Then I began my training as an Osteopath.
Now, having learned about the fascia covering the muscles, entwining groups of muscles together in long chains and learning the physiology of muscles and more specifically about the Golgi tendon organs which are muscle stretch receptors located in muscle tendons, my approach to muscles has completely changed.
Now when I am trying to reduce the tension in a muscle I have the idea I am gently lengthening the muscle into a stretch. I am usually gentle with the techniques I use but this does not make my treatments less effective than painful sports massages. I would argue that if a muscle can be stretched, as opposed to areas of adhesion broken down, there will be less trauma to it and therefore the treatment more effective.
Another thing I commonly come across is patients who try to stretch muscles through the pain barrier - as if holding the stretch through the pain will make it better. This is often not the case. If a muscle is painful whilst it is being stretched it is more likely contracting against the stretch. It is called the stretch reflex and is the body's way of protecting muscles from being overstretched. When you stretch it should be comfortable and only to the point of tension.
If muscles are extremely tight, I often advise patients to try proprioceptive neuromuscular fascilitation (PNF) stretching. There are two types of PNF stretching, one style is to isometrically contract the muscle, relax and then stretch it; the other is to contract the antagonist muscle to relax the muscle, relax and then stretch. The contractions are for 5 seconds and stretch period is 20 seconds and these are usually repeated 3 times.
So to summarise.... stretching is for anyone with tight muscles and not just for athletes. A deep sports massage does not have to be painful to be effective. Muscles need to be gently encouraged to reduce in tension and more importantly there is no such thing as a 'knot' in a muscle!