What is a muscle knot and why do they continue to occur? Is it where you hold your stress, or does it always happen with increased physical activity? Why do you get Charley horses in the calves at night? I was recently reading a NY Times article that discussed the idea of muscle knots and the many ways you can relieve them including Heat or Ice Stretching Massage Dry needling. Trigger point injections Massage gun. The same tired ideas of Posture or sustained postures Overuse Overloading muscles You can read the NY Times article below Muscles in Knots? Here’s How to Loosen Them Up. Why are your muscles knotted? To better understand why muscles knot up, we must understand you. Much of the research on muscle knots is vague and not very helpful because it is based on one-size-fits-all ideas that often fail We as physicians must understand why your muscles are knotted up. We are all different, built differently, adapted differently, and come in different shapes and sizes. Some of us sit for long periods, while others stand and constantly move. Others do both. It is important to note that the myofascial system has a lot to do with why you knot up and may be tight and that system encompasses how we move and controls how muscles respond. We all adapt and fascia forms according to the forces we place upon it. If we are built asymmetrically and go through growth spurts, the fascia will affect how we feel and function as it adapts there as well. If we fall and get injured, the fascial adapts and may tighten as we heal. While certain postures may aggravate poor function, is it the cause? If it is, why doesn’t everyone who does what you do for the hours you do it have the same problem? Muscle knots are caused by fascia and poor firing patterns. Tight fascia will change firing patterns. Firing patterns are how muscles coordinate to perform a function. Tight fascia affects firing patterns and makes them inefficient. When firing patterns are inefficient, we recruit other muscles and tissues in the surrounding area which causes more tight fascia worsening these firing patterns. This is why muscle work such as massage can relieve the knots, but they return. Heat feels good temporarily but the tightness returns. Stretching works on some tissues but fascia cannot stretch unless heated to a temperature most people cannot tolerate for a long enough time to be beneficial. I have no idea why they included try needling because it works on another theory called pain gate. When poor firing patterns persist in the shoulder, for example, the fascial system in the lower part of the body may be playing a part in making you knot up when you sit in the neck and shoulders. How can you figure this out on your own? We are bad at this because we work on where we hurt but may not understand why we hurt. This is one reason our protocols for foam rolling which loosens fascia and improves firing patterns generally can be more effective than any of the one-size-fits-all suggestions we commonly hear. Perhaps this is why a chiropractor who performs myofascial release, teaches you exercises to strengthen and retrain areas, and can help you move better using manipulation of the spine and extremities should be part of your healthcare team. Firing patterns are an important part of keeping you lose. When we recruit into other areas because of poor firing patterns from the tight fascia, the more we do, the tighter we get, the more we recruit, the tighter we get and so on. The idea is that we should do stuff to the knot when the mechanism behind the knot can be revealed during a patient visit with active tests. Improve the flexibility of the region by using myofascial release or other soft tissue treatments, Then we can retest the area and see if the firing pattern has improved, If it has, great. If not, reevaluate and understand why. Improve the firing pattern using treat-test-treat protocols and solve a knotty problem. Solving chronic knots requires a displined approach. First, test for the firing pattern to see why the area knots up. In the shoulder blade, it can either be the shoulder or something acting upon it such as the lower extremities. Often poor firing patterns in the left hip can affect either or both shoulders. Shoulder problems rarely develop by themselves and are rarely just bad posture. They are usually poor function that has yet to be understood. Many patients who are asymmetrical from the feet up benefit from foot orthotics which balance things out and reduce the torsion in the upper body. Many poor movement patterns or habits can also cause you to be knotted in the shoulder blades. A foot orthotic will level you out, and even reduce the stress in the upper body. This reduced stress will be felt both sitting or standing. Confused yet? You shouldn’t be. Function improves from the ground up. Tight fascia if improved with myofascial release, chiropractic adjustments, and exercises can resolve a lifetime problem of knotted shoulders. While I know some of you may reach for that massage gun you got over the holidays, maybe seeing the right healthcare provider can have you feeling better for years to come. Have knotted shoulders or crampy calves? Think chiropractic first. Need help today? Book online now.