Why does this particular muscle always hurt? Why are my muscles tight and in "knots"? These are the big ones, and the answer is: It's different for every body. However, there are some generalities that apply to everyone.
The back, neck, and shoulders are usually the spots that most people have issues with. So, I'll start there, with the muscles of the upper trapezius.
Basically, the trapezius is a large superficial muscle on a person's back. It also happens to be the area of the body that I focus most of my attention on when I do bodywork.
This is what it looks like, and a brief description of its actions.
Because the fibers run in different directions, it has a variety of actions, including:
* scapular elevation (shrugging up or lifting the shoulders),
* scapular adduction (drawing the shoulder blades together)
* scapular depression (pulling the shoulder blades down)
Different fibers control different actions:
* The superior (upper) fibers elevate the scapula.
* the middle fibers retract it.
* The inferior (lower) fibers depress it.
* When the superior and inferior fibers act together they superiorly (upwardly)
rotate the scapula.
So...what is a "knot" exactly?
IN A NUTSHELL:
Simply put, a knot is a contraction of muscle tissue that is a cause of stiffness and pain in the affected area. The medical term for muscle knots is myofascial trigger points, and there is still much we don’t know about them.
Knots most typically appear after a prolonged period of tension or following an injury, and begins as a muscle spasm. The knots form because the spasm keeps the muscle continuously switched on (normally, muscles don’t work continuously without rest, but cycle on and off) so, the spasm makes the muscle work constantly, and muscles are not designed for this unremitting work.
Eventually, the muscle overloads and forms a knot.
A trigger point does not really cause a contraction, but rather a contracture, which is a sticking of the muscle fibers.
This sticking of the muscle fibers can result in a compression of capillaries, which has the effect of causing an increased local energy demand and loss of blood circulation to the area. This "energy crisis" causes the release of chemicals that augment pain activity. And, since an involved muscle is weakened by this sustained shortening, the muscles around a trigger point may also develop trigger points.
Here are the major trigger points of the body that seem to cause the most grief for the majority of people I treat. Click on the image for a larger view.
Amazingly, around 75% of pain clinic patients have a trigger point as the sole source of their pain, and the following conditions are often (incorrectly) diagnosed when trigger points are the true cause of pain. These conditions include, (but are not limited to): Carpal Tunnel Syndrome, Bursitis, Tendonitis, Angina Pectoris, Sciatic symptoms, and many other pain problems, especially a condition known as Fibromyalgia (more on that later).
However, the real culprit may be a trigger point, normally activated by a certain activity involving the muscles used in the motion, by chronically bad posture, bad mechanics, repetitive motion, structural deficiencies such as a lower limb length inequality, or nutritional deficiencies.
A client recently asked me if I thought she might have Fibromyalgia. Fibromyalgia Syndrome (FMS) is typically characterized by chronic, and often continual, pain in the muscles, joints, tendons, and fibrous tissues of the body. This pain is commonly located precisely in those localized trigger points shown in the picture above. The usual diagnosis consists of widespread pain that lasts for more than 3 months. Officially, a person must have 11 out of 18 trigger points to get a diagnosis of FMS, but I question this, because there is still alot we don't know about this condition.
UNTYING THE KNOTS:
I treat knots with a variety of massage techniques that I've refined over the years to deal, specifically, with the problem of pain and tension associated with shortened muscles.
First I identify the trigger points, and begin with efflueurage strokes to warm the muscles and increase blood circulation. I then utilize a combination of shiatsu and myofacial release strokes to release the tension of the trigger point and elongate the muscle fibers. Treating the fascia and surrounding muscles to elongate and resolve strain patterns is very important, otherwise muscles will simply be returned to positions where trigger points are likely to re-develop.
POST-TREATMENT MAINTENENCE:
Drinking water is essential, to flush out the toxins that are released into the blood stream after a massage session.
Head rolls and shoulder rolls should be performed often throughout the day, as soon as pain or stiffness is noticed.
A brisk 30-60 minute walk daily will promote efficient blood circulation and oxygenization of muscles, as well as release endorphins, which will help with relaxation.
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