It's a phrase I've heard countless times while working on someone - "Is that a knot?" - and my response is almost always the same, "No, it's just a tight muscle." There is an impression on all of us that there are certain muscular points responsible for the majority of our muscular pain. I'm here to tell you that that's not the case. Most of us actually have our entire muscles bound up, from end, to end.
I've come across only one true case of muscular knotting, and it was working with an amputee. He lost most of his lower leg in a motor vehicle accident some years ago and his hamstring function had became abnormal in adapting to it's new role. It was coupled by the fact that he now had a permanent metal plate screwed into to his femur. The result: his hamstring would get constantly knotted up in a particular spot due to the abnormal stress and demand on his muscle.
And that just isn't the case for most people. Let's take a look at the shoulder where we see the biggest example of this. You know that big lump in your shoulder? The one about half-way between your shoulder blade and neck? Is it a knot? Well, as it turns out, no, it's not! It's simply a tight muscle under incredible stress.
If It's Not a Knot..
Let's take a look at this diagram from Grey's Anatomy. It shows us our Levator Scapulae muscle highlighted in red. If you're not familiar with this muscle, it's job is to raise up your shoulder blade during many daily activities. Levator -> elevator, get it? Now imagine how many times a day we use this type of motion, and for how long. Today, we spend countless hours texting, driving, on the phone, using the computer, etc. All with this muscle taking a beating. The cause of the lump in our shoulder is actually this specific muscle succumbing to extreme pressure. It gets stressed, shortens and then feels as if it's all 'balled-up' in our shoulder.
So what can we do about it?
The answer is we need to release the stress that has accumulated and restore normal function to the muscle. Most of us might think that a massage is perfect for this. It's great, but the stress may come back rather quickly. This is because of a thin membrane of strong fiber that encompasses your muscles called myofascial tissue. It's like a thin, flat tendon that wraps around the fibers of your muscle, keeping them together in a bundle.
So, if you release the tension in your muscle through massage, it will almost definitely come back because you're bound to do the same things that got it tight in the first place. And with the myofacial tissue still tight, your muscle will have an easier time conforming back to the same pattern of tightness. The best thing you can do, along with getting soft-tissue work like a massage, is find a practitioner that can also assist you with stretching.
Stretching will help open up your myofascial tissue along with your muscle fibers and solidify flexibility to prevent further muscular tension, pain and discomfort. Overall, it smooths out your muscle fibers for longer periods of time and relieves the feeling of having 'knots' in your neck, shoulder or other areas.
We practice primarily using a gentle form of stretching called Active Isolated Stretching. It consists of gently easing into a stretch, holding it for no longer than 2-seconds in the 'stretch-zone', and then gently releasing, just as slowly as you went into it. In this way, it drastically reduces your risk of injury, prevents micro scar-tissue from forming, and the best part is, it hurts way less than traditional stretching.
You can also stretch on your own, just be mindful. There are plenty of materials online to learn more about how to gently lengthen your muscle and myofacial tissue. For now, take your time in opening up your muscles. Focus on lengthening your entire muscle and opening your range of motion rather than just doing soft-tissue work. It does take patience and dedication, but like all good things in life, it pays off.
So, good luck, be gentle and enjoy! Happy Stretching.