“Trigger points, muscle knots, don’t exist”. That will kick a lot of masseurs and therapists against the shins. Although there are countless treatment methods for muscle knots, there is considerable criticism of the basis for these.
In this article, I will address the prevailing theory that forms the basis for current treatments as well as the criticism from researchers who argue that this theory is not proven. Are the existence and nature of trigger points, muscle knots, actually demonstrated? And if so, do practitioners actually know how to find them?
Pseudoscience
A simple example of pseudoscience are the graphs you see in some advertisements. Usually for whiter teeth or something similar. “Clinical research shows that in just three days blah, blah, blah”.
While watching an advertisement, we know that we should take such statements with a grain of salt. However, it’s different when researchers, doctors, masseurs, therapists, and pain clinics in hospitals tell you something. Then you assume that this is not just Bro-science. You assume that if they say muscle knots can lead to a large number of complaints, this has been investigated. For example, you assume that different practitioners could also find the same muscle knots in the same person. After all, how can you treat something you can’t find?
After all, we’re not talking about something vague like meridians and chi, are we? That depends on which story you read and that often depends on which story is most told. If you search for information about muscle knots, this is probably what you’ll find:
Muscle Knots, Trigger Points
“Neuromuscular Trigger Points”, or “muscle knots,” are contracted and thickened parts of a muscle that can lead to various complaints.
Usually, this refers to the following symptoms:
- A local, persistent painful and/or irritated point of a skeletal muscle or connective tissue
- The painful point can be felt as a thickening and stimulating this point (for example, pressing) can produce a kind of “twitch” sensation.
- Touching the point causes pain that can also radiate
- The pain is not caused by nerves
- Reduced range of motion
- Less strength in the affected muscle
Cause of Trigger Points
Trigger points can be caused by both acute trauma and the cumulative effect of multiple micro traumas. Especially in the latter case, you can think of the effect of strength training, but also of many repeated movements in daily life. Trigger points can also occur in the muscles that control body posture such as the neck and shoulders, which could lead to tension headaches among other things.
Muscles are consciously and unconsciously tense. To make this possible, blood is continuously supplied to and removed from the muscles. Under tension, waste products can accumulate locally, causing the tension to increase in a vicious circle. Trigger points are therefore sometimes said to be caused by a “metabolic energy crisis”.
The waste products stimulate nociceptors, or “pain receptors”. These are the nerve endings that send signals to indicate the presence of harmful substances. Signals that we experience as pain.
Finding Trigger Points
How do you find muscle knots? In practice, muscle knots are found by a practitioner who palpates for them. By using the fingers with light pressure along the muscle, they search for thickenings of a different consistency than the rest of the muscle. Once found, you may feel this because the point feels painful and irritated. The “twitch” sensation, the feeling of a jumping muscle fiber, is often experienced when crossing this point with the finger perpendicular to the direction of the muscle.
Trigger Points and Waste Products
Researchers from the National Institutes of Health looked at differences in the presence of various waste products between trigger points and non-affected muscle tissue. They found increased levels of bradykinin, serotonin, and prostaglandins in the tissue with trigger points. Interestingly, this concentration of waste products decreases when a “trigger point injection” is administered to a patient, which suggests that it may be the waste products that play a role in the formation of the trigger point.
Conclusion
So, muscle knots do exist. There is a physiological basis for it and several studies support their existence. But that doesn’t mean that the current treatment methods are always effective or that practitioners always find them. The debate continues, but the reality is that many people report relief from various symptoms after treatment for muscle knots.
