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zoogwah t1_iuricvq wrote

They are formally referred to as myofascial trigger points. The scientific evidence surrounding them is messy and controversial. It's generally accepted that a trigger point is simply a small area of contracted muscle, like a small cramp or spasm. There's also an hypothesis that sometimes a knot/trigger point might not feel hard or tight to the touch when palpating, and is instead a phenomenon related to sensory disturbance.

So to answer the question, it would probably just look like regular muscle, perhaps contracted.

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BebopFlow t1_iusjjot wrote

I'm a massage therapist. Knot is really a catch-all with no definition, which causes a lot of confusion. A person is often referring to the phenomena of trigger points, but the plain truth is that very few people who have "knots" have trigger points in my experience. There's a distinct texture to a trigger point and pattern of response, and the method to release a trigger point is different from what you'd use on generalized muscle tightness. In most cases people that come to me complaining of knots just have a generalized muscle tightness caused by poor posture exacerbated by either lack of movement or lack of movement variety. I see 2-3 dozen or so new clients a month, outside of my regulars, and I'd say that I encounter a proper trigger point maybe twice a month on average or less. My specialty is in myofascial massage utilizing structural integration techniques and philosphy, so it would stand to reason that I'd be more likely to encounter people with trigger points since they'd self select, right? (Structural integration is a somewhat broad subset of myofascial massage with the intent of balancing the relative tension between muscular groups in order to relieve pain or increase range of motion, usually through utilization of targeted stretching, active/passive mobilization, and targeted deep tissue work)

Personally, I think the word knot is overused, to the detriment of people's health. What is implied when a professional uses the word knot is that there's something wrong, some sort of physical thing that needs to be untangled by someone else (or even worse, something that just is an aspect of you, like the color of your skin or your height) instead of a temporary state of affairs that can be improved by yourself. Especially when it's actually just general muscle tightness. A professional can help short term, but generally targeted stretching and exercise, with some mild lifestyle changes, is the cure. A person sitting at a computer 6-8 hours a day doesn't need someone to hammer their upper back/shoulders with their elbow (though it will feel good and provide short term relief), they need to sit still for shorter periods, stretch their pec minor, and do some band pull aparts/face pulls/rows/lat pulldowns.

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Phoenyx_Rose t1_iuswwtv wrote

You. I like you. Thank you for putting this info in easy to understand terms. It’s helped confirm my idea that my restless and achy legs are at least partially cause by a lack of exercise

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EchoCyanide t1_iuswlln wrote

I like all your sciencey talk and cool words. I'd get a massage from you!

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blayd t1_iusxi26 wrote

Does this apply to tendons too? Does trigger point massage help tendinitis?

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[deleted] t1_iust715 wrote

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[deleted] t1_iusvsq9 wrote

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[deleted] t1_iusx6jb wrote

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TrespassersWilliamTW t1_iusyigk wrote

doctors don't have all the answers especially when it comes to our nervous system and muscles. It's something i've long since accepted. It's not their fault, the body is just super complex. I'm sorry you have pain, i hope you find some relief!

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[deleted] t1_iusckhi wrote

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THEpottedplant t1_iuseu9g wrote

I have a book on trigger point massage techniques. The general idea is that the trigger point is basically where the muscle is primed into action by the nervous system, and through over use can become inflamed and have poor circulation which makes it worse. So physically breaking it up helps a lot. Dependant on the muscle and inflammation, trigger points will feel different, but they normally feel crunchy, kinda like undercooked spaghetti

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[deleted] t1_iurjkhi wrote

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zoogwah t1_iurlmaj wrote

Unfortunately not an easy solution. Everyone seems to get trigger points but we don't fully understand the causes. Pain's pretty complex, so some things might work in some cases but not others.

A shortlist of stuff that could help includes exercise, massage (self-massage too), stretching, heat, dry needling or acupuncture. A portion of how much a particular therapy might help can be attributed to your interaction with the practitioner and your personal beliefs around that therapy (see biopsychosocial model of pain). Stress relief, adequate sleep, and improving general health (physical and psychological) can also contribute.

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Powerful_Artist t1_iurw3it wrote

I think this scishow video on youtube does a great job explaining and showing you the scientific perspective on muscle knots. I know they show at least one example of what it looks like in the video.

Spoiler, as another comment mentioned the real thing is that we dont fully understand them and dont really know how to always alleviate them. Which sucks for me, Ive had a knot in my back for like 6+years now that wont go away no matter who I go see and what I do. Its like a little bit of hell every day.

edit: thanks for all the suggestions! I definitely think I have tried literally anything and everything but Im sure someone has some suggestions I havent tried!

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[deleted] t1_ius14ru wrote

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[deleted] t1_ius41w4 wrote

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M0nsterjojo t1_iusk4kq wrote

SCI SHOW! I get their videos the odd time and most of them are a treat to watch/listen to. Plus the person doing this YT vid does a lot of great shorts.

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[deleted] t1_ius2slf wrote

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[deleted] t1_ius0iq2 wrote

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[deleted] t1_ius1l6r wrote

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SeePerspectives t1_iuseta1 wrote

If you’re not squeamish there’s a channel on YouTube called The Institute of Human Anatomy that is run by a cadaver lab for teaching medical students and they recently did a video on this subject. It’s a fascinating channel, no gore (all the cadavers have been preserved) but they are real cadavers, so if that gives you the ick then probably best to avoid.

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soleceismical t1_ius4mu4 wrote

It's believed to be a small segment of sarcomeres near where the nerve penetrates the muscle that are stuck in contraction, perhaps because there is inflammation impeding the flow of blood to the area to remove waste products and deliver oxygen to feed the Krebs cycle and provide the ATP needed to break the cross bridge between the actin and myosin. It can be due to sedentary lifestyle, muscle strain, poor posture, or a combo like being sedentary and then trying to do things you used to be able to do five years ago without working back up to it.

To treat them, you can massage them out with a theracane or yoga balls or a licensed masseuse trained in myofascial release. If you have greater problems/pain, you may want to see a physical therapist (especially one with FAAOMPT or similar credentials). You'll want to stretch and move the muscles through their entire range of motion. Increase physical activity and weight gradually instead of trying to lift a couch one weekend when you've done no lifting in a while. Get a computer setup that is ergonomically appropriate. Most people need to work out their mid and lower traps and glutes and abs.

Here's some photos and a drawing of what they are supposed to look like:

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More info:

>A Trigger Point (TrP) is a hyperirritable spot, a palpable nodule in the taut bands of the skeletal muscles' fascia. Direct compression or muscle contraction can elicit jump sign, local tenderness, local twitch response and referred pain which usually responds with a pain pattern distant from the spot[1][2][3][4].

[...]

>Anatomy and Etiology

>Trigger points develop in the myofascia, mainly in the center of a muscle belly where the motor endplate enters (primary or central TrPs)[5]. Those are palpable nodules within the tight muscle at the size of 2-10 mm and can demonstrate at different places in any skeletal muscles of the body. We all have TrPs in the body. Can be present even in babies and children, but their presence does not necessarily result in the formation of pain syndrome. When it happens, TrPs are directly associated with myofascial pain syndrome*, somatic dysfunction, psychological disturbance and restricted daily functioning[7].

[...]

>Causes - Usually, TrPs happen due to:

> *Ageing,

> *Injury sustained by a fall, by stress or birth trauma.

> *Lack of exercise - commonly in sedentary persons between 27,5-55 years, of which 45% are men[9],

> *Bad posture - upper and lower crossed pattern, swayback posture, telephone posture, cross-legged sitting,

> *Muscle overuse and respective micro-trauma - weightlifting,

> *Chronic stress condition - anxiety, depression, psychological stress trauma,

> *Vitamin deficiencies - vitamin C, D, B; folic acid; iron;

> *Sleep disturbance,

> *Joint problems and hypermobility.

>Pathogenesis and Theories

>Little is known about the formation of TrPs. There are some theories written in literature who try to explain the formation, sensitization, and manifestation of TrPs, but few of them have strong evidence[3][10][11].

>Under normal conditions, pain from TrPs is mediated by thin myelinated (Ad) fibers and unmyelinated (C) fibers. Various noxious and innocuous events, such as mechanical stimuli or chemical mediators, may excite and sensitize Ad fibers and C fibers and thereby play a role in the development of TrPs.

>Integrated Trigger Point Hypothesis (ITPH) is the present working hypothesis. When sarcomeres and motor endplate become overactive for a number of different reasons, pathological changes start at cellular levels. This turns on permanently sarcomeres leading to a local inflammatory response, loss of oxygen supply, loss of nutrient supply, endogenous (involuntary) shortening of muscle fibers, and increased metabolic demand on local tissues.

>Electrophysiological investigations of TrPs reveals phenomena which indicate that the electrical activity arises from dysfunctional extrafusal motor endplates rather than from muscle spindles[12].

>Polymodal theory explains the existence of polymodal receptors (PMRs) throughout the body which under certain constant, pathological stimuli turn into trigger points[13].

>Radiculopathic theory explains direct relationship between problems on nerve roots which lead to local and distant neurovascular signals and trigger points creation[14].

>Peripheral and Central Sensitization - Central sensitization is a phenomenon, together with peripheral sensitization, which helps in understanding chronic or amplified pain. There is central sensitization after an intense or repetitive stimulus of the nociceptor present in the periphery, leading to a reversible increase of excitability and of the synaptic efficacy of central nociceptive pathway neurons. Manifested as hypersensitivity to pain (called tactile allodynia and hyperalgesia secondary to puncture or pressure). These CNS changes may be detected by electrophysiological or imaging techniques[15][16].

https://www.physio-pedia.com/Trigger_Points

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