Q. Could you explain what muscle knots are and what you can do to alleviate them? I have one in my neck, due to repetitive movement, and stretching only helps if I do a lot of it. —K. Strand, San Francisco
A. Muscles are designed for work. In fact, they are healthiest when regularly stimulated and challenged. But no muscle in the body is designed to operate continuously without a break (Even the heart muscle rests between beats.). When overstimulated by exercise, repetitive motion, poor posture or injury, skeletal muscles can spasm. The pain and discomfort send most of us to a certified massage therapist to work on the spot until it feels better. If the spasm remains untreated, the muscle is left in the "on" position, and a very specific "knot" develops.
The medical community refers to a muscle knot as a "myofascial trigger point." It can be as small as a grain of sand or large enough to be mistaken for a golf ball. "Trigger" is the appropriate adjective, because when the knot is massaged, you feel like you will shoot right off of the table! There are a number of ways to treat the pain of muscle knots (myofascial pain syndrome, or MPS), the most popular being massage therapy.
Most licensed and certified massage therapists spend a great deal of time staying abreast on the treatment and consequences of MPS, because it is believed that aches and pains, even toothaches, can actually refer from these trigger points. Registered massage therapist Paul Ingraham, of Vancouver, Canada (
www.vancouvermassage.ca), says, "MPS often causes unusual symptoms that may be mistaken for more serious problems." He suggests that diseases such as carpal tunnel syndrome, earaches, sinusitis, tinnitus (ringing in the ears), dizziness, sore throats, sciatica and even some cases of fibromyalgia are often misdiagnosed, when the real cause is referred pain from a muscle knot.
An experienced deep-tissue massage therapist may be a great way to go if current treatments or programs are not working for you. Other trained medical professionals who treat MPS are physical therapists, chiropractors and acupuncturists. While massage seems to be the most effective for the majority, the use of heat, cold, ultrasound and electrical stimulation have also proven helpful. The flipside of this is to investigate and observe what sets off your chronic pain. This sort of analysis is best accomplished with the help of a physical therapist to see if some adjustments can be made to the way you move your body at work and play.
Another method is "myotherapy," the offspring of myofascial trigger point therapy, developed in the 1940s by JFK's physician, Dr. Janet Travell, and her research partner, Dr. David G. Simons. Treatments involved injecting the spot with saline and a mild anesthetic. Trigger-point massage therapy, on which so many rely for pain relief, is due primarily to Travell's research.
In 1976, Bonnie Prudden, a nationally known fitness and wellness proponent since the 1950s, accidentally stumbled upon a pressure technique, now called "Bonnie Prudden Myotherapy®." Prudden found that when pressure was systematically applied over a wide area, followed by therapeutic exercises to re-educate the muscles back to their relaxed state, the reoccurrence of the muscle knot was prevented.
Resources• "Myofascial Pain and Dysfunction: The Trigger Point Manual," by David Simmons, Janet Travell and Lois Simons (Lippincott Williams and Wilkins, 1999), $102 per volume
• "Pain Erasure: The Bonnie Prudden Way," Bonnie Prudden (Random House, 1985), $14;
www.bonnieprudden.com or (800) 221-4634
Linda Buch is a fitness trainer in Denver, Colo., and Lancaster County native. Her book, "The Commercial Break Workout" (Crown/Random House), is available in bookstores. Please send your questions to: Linda@LJBalance.com or c/o "Body Language," Lancaster New Era, P.O. Box 1328, Lancaster, PA 17608.
