What Are Knots – And Can Massage Really Help?

"Knots"

What Are Knots and Why Do They Hurt So Much?

People ask me this all the time. What exactly are knots? Are they real? Are they dangerous? And can massage actually do anything about them?

You’ve probably felt one at some point. A small lump in your shoulder that refuses to behave. A tight band near your jaw. That familiar pinch near your shoulder blade. Knots are almost universal, but most people are not quite sure what they are.

What You Are Really Feeling When You Say “I Have a Knot”

The word “knot” is not a medical term, but the sensation is very real. When people tell me they feel a knot, they are usually talking about a myofascial trigger point. These are irritated spots within a muscle where the fibres have become tight, shortened and stuck.

Experts estimate that up to 85 percent of the general population will develop myofascial pain syndrome at some point in their lives.Dr David Simons described trigger points as areas that “cause significant pain and limitation even though they do not show up on scans.” (Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual)

These trigger points restrict blood flow, reduce oxygen supply and can send pain to other areas of the body. This is called referred pain and it often confuses people because the site of pain is not the source of the problem.

How Knots Feel Under My Hands During Massage

When I am working, knots often feel like small, solid nodules or tight bands beneath the skin. They show up most often in places that carry strain or emotional load. Common sites include:

• the neck

• the shoulders

• the jaw

• the upper back

• the glutes

  
  

During your Deep Tissue Massage I use slow, deliberate pressure to work into the fibres. The goal is simple:

• release the contracted tissue

• restore healthy blood flow

• free up restricted movement

• reduce pain and irritation

People often assume a therapist needs to choose between strength and relaxation. I don’t. I work slowly enough that your nervous system stays calm while still using enough pressure to create real change. You will feel the difference.

The Medical Definition of a Knot

Medically, a knot is described as a myofascial trigger point. The Journal of Orthopaedic & Sports Physical Therapy defines it as:

“A discrete, focal, hyperirritable spot located in a taut band of muscle which produces local or referred pain.”

There are two main types:

• Active trigger points: painful even when nothing touches them

• Latent trigger points: only painful when pressed

Left untreated, they can feed into persistent tension, reduced movement, poor posture and in some cases central sensitisation, where the nervous system becomes overly reactive to pain signals.

Do Knots Go Away By Themselves?

Sometimes.

Not always.

A 2022 systematic review and meta-analysis found that manual therapy, including myofascial release and trigger point massage, helped reduce pain and muscle tension in people with myofascial pain syndrome (https://chiromt.biomedcentral.com/articles/10.1186/s12998-022-00441-5)

If the habits that created the knots are still there – poor desk posture, long sitting hours, dehydration, disrupted sleep – then the knots tend to return. My approach is always whole-body and person-specific. I pay close attention to what your body is doing on the day and adapt as we go.

My Deep Tissue Massage includes trigger point work and myofascial release because both are proven to help.

Did You Know Trigger points can alter how a muscle fires which can reduce strength in nearby areas. A knot in a shoulder muscle can affect how your neck stabilises even if it feels like a separate issue.

Does Massage Actually Help Knots?

Yes.When it is done properly.

Massage interrupts the pain-tension cycle, increases circulation and helps your body shift out of defensive holding patterns.

A 2024 systematic review in JAMA Network Open found that massage therapy reduces muscle soreness, reduces stiffness and increases range of motion, which supports recovery from trigger points. (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821154)

There is no single technique that works for everyone. That is why my treatments are fully tailored. Some bodies need pressure. Some need slow sustained work. Some need space to calm the nervous system first. You get what your body needs on the day.

Self-Massage Tips You Can Use At Home

These are safe, simple techniques you can try between sessions. They are grounded in research and in what I see helping clients every day.

1. The Two-Minute Ball Technique

Use a massage ball against a wall.Find a tender spot.Hold gentle pressure for up to two minutes. You should feel the sensation soften. Self myofascial release has been shown to improve mobility and reduce stiffness.

2. Warm the Area First

A warm shower or heat pack increases blood flow and helps the muscle respond better to massage.

3. Slow Neck Stretches

Move slowly and never push into sharp pain. Hold each position for 15 to 20 seconds.

4. Small Upper Back Release

Place a rolled towel horizontally across your upper back while lying down. Let your chest open and breathe deeply for one minute.This encourages the thoracic spine to move, which reduces strain further up in the neck.

5. Breathe It Out

Slow breathing reduces muscle guarding.Inhale for four seconds.Exhale for six seconds.Repeat ten times.

These techniques support your treatments but do not replace targeted work. If something feels wrong, stop immediately.

Did you know Nervous System Response Your nervous system can “learn” a knotTrigger points do not just live in the muscle. Research shows that the nervous system can start reinforcing these pain patterns over time. This is why the same knot keeps returning in the same spot, especially if you sit or move in ways that load the area every day.A well targeted treatment helps retrain both the muscle and the nervous system.

A Final Thought

Your body whispers long before it shouts.Knots are often the first whisper.

If you catch them early, you save yourself a lot of unnecessary pain.

If you want help understanding what your body is doing, you can book:

• Deep Tissue Massage

• Signature Head Neck and Shoulders

• TMJ Intra Oral Therapy

  
  

I work from a quiet residential studio near Victoria Park and every session is adapted to your body on the day.

References

1. Bodine N. An overview of myofascial pain syndrome with a focus on trigger point injection. The Nurse Practitioner. 2023;48(11):18-25.Journal link: DOI: https://doi.org/10.1097/01.NPR.0000000000000110

2. Fleckenstein J, Zaps D, Rüger LJ, Lehmeyer L, Freiberg F, Lang PM, Irnich D. Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: results of a cross-sectional survey. BMC Musculoskeletal Disorders. 2010;11:32.Journal link: DOI: https://doi.org/10.1186/1471-2474-11-32

3. Lu W, Li J, Tian Y, Lu X. Effect of ischemic compression on myofascial pain syndrome: a systematic review and meta-analysis. Chiropractic & Manual Therapies. 2022;30:34.Journal link: DOI: https://doi.org/10.1186/s12998-022-00441-5

4. Mak S, Allen J, Begashaw M, Miake-Lye I, Beroes-Severin J, De Vries G, Lawson E, Shekelle PG. Use of massage therapy for pain, 2018–2023: Evidence map of systematic reviews. JAMA Network Open. 2024;7(7):e2422259.Journal link: DOI: https://doi.org/10.1001/jamanetworkopen.2024.22259