The Definitive Guide to Getting Rid of Knots

Maybe you've been going a little too hard with the shoulder presses too frequently and now you're really feeling it. Or, you decided to skip your warm-up before your run (bad idea), and you're feeling some tightness in your calves.

It's not uncommon to wake up with some muscle tightness, or knots, every now and then.

On the other hand, you can also get knots from sitting at a desk all day, which can cause tension in your neck and shoulders, as well as tightness in the hips.

Over time, this stiff, fixed position can make the muscles of your core, back and butt weak, according to the International Sports Science Association. Not to mention, it can make knots worse, according to Piedmont Healthcare, and hinder blood circulation, especially if you sit with your legs crossed.

The good news is there are many budget-friendly, easy ways to alleviate knots, using equipment you might already have at home. Here's everything you need to know about treating and preventing knots.

Usually, knots feel like a tied-up ball of tension in a certain muscle. But most of us would call a "muscle knot" is technically a myofascial trigger point, according to Cameron Yuen, PT, DPT, physical therapist at Bespoke Treatments in New York City.

Let's unpack that: Fascia is connective tissue that overlays muscle and separates it from other tissue in your body. When muscle fascia gets irritated from overuse or poor posture, a myofascial trigger point is formed. This creates an isolated spasm of tightly contracted tissue, according to Tri-City Medical Center.

The isolated spasm — not to be confused with a whole-musle spasm or cramp — becomes a thick and tough knot, blocking blood flow to the muscle and causing more irritation.

Knots happen for different reasons in different people, but there are a few common lifestyle factors that may be the culprit behind your tense muscles.

• Muscle overuse. Overuse of certain muscles is one common reason you may develop trigger points, Yuen says. Muscle overuse can happen when you train the same muscle group too frequently, train it too hard too soon or train it with improper form, according to the Mayo Clinic. These same factors can also lead to muscle pain and tenderness, also known as delayed onset muscle soreness (DOMS). If left untreated, muscle overuse can develop into an injury over time.
• Poor posture. A less-than-optimal work setup is another common reason your muscles may be developing knots, Yuen says. Many people tend to sit with poor posture all day, which can tighten hip flexors, cause pain in the glutes and put stress on your back and shoulders.
  

The best treatment for muscle knots will look different for everyone, but a self-massage is a cost-effective, safe and convenient place to start. Also known as self-myofascial release (SMR), using a foam roller, tennis ball or lacrosse ball can help relieve knots. It also helps increase muscle length and range of motion while decreasing tightness.

According to the American Council on Exercise (ACE), there are two different hypotheses on how foam rolling and other forms of SMR work to relieve knots. One is that foam rolling makes muscles more pliable because it creates heat, which expands blood vessels to improve blood flow to the muscle tissue and relieve tightness.

The other is that SMR relieves knots through the principle of autogenic inhibition, which occurs when a muscle is under tension. Muscle fascia contains two key sensory organs: the Golgi tendon organ (GTO) and the muscle spindle. These muscle receptors determine when there is tension in the muscle tissue and a change in muscle length.

Muscle spindles are receptors in muscle fibers that respond to a change in muscle length, according to the National Academy of Sports Medicine (NASM), while the GTO senses when there is tension in the muscle fibers. When the GTO senses tension, it signals to the muscle spindles to relax and lengthen.

Foam rolling or using other forms of SMR creates tension on the muscle fibers, which stimulates the GTO and muscle spindles.

But before you choose the best SMR tool for your muscles, Yuen provides some general guidelines on how to properly massage knots:

1. Using your tool, start by rolling down the length of the muscle knot. Do not roll the area with so much pressure that it causes more pain.
2. Once the area has begun to relax, try to hold sustained pressure on the knot with your massage tool. This pressure should be intense but comfortable.
3. Get the muscle and joint moving through their full ranges of motion. Actively lengthen and shorten the muscle to help restore the nervous system's connection to the muscle.
4. Contract the muscle against resistance. Use your hand to gently block the joint from moving with your hand while you contract the muscle. Hold for a 10-second count then release and repeat. Do not push into pain.

The foam roller can be used for total-body tension relief, but it works especially well on your legs, glutes and back, Yuen says. Foam rolling is a great way to target larger muscle groups that are tight and knotted. Plus, foam rolling can encourage blood flow to your muscles and knots, which ultimately promotes recovery.

Foam rolling your legs and glutes is a similar process, Yuen explains. For your legs, place your quads directly on top of the roller and work down the length of the entire muscle, using your forearms to move your body. Pause for a few moments every time you hit a tight knot.

To massage your glutes, you can sit directly on your foam roller and cross one ankle over the opposite knee. This position will help you get deeper into each glute. Roll side to side, pausing at particularly tender spots, like the outside of your butt.

You can also foam roll your upper back. Lay the foam roller horizonally on the ground so it's parallel with your upper back. Lie on the ground with your shoulder blades on top of the foam roller. Wrap your arms around your body tightly. From here, roll up and down the muscles between your shoulder blades.

Although these tools are a little less common than the foam roller, lacrosse and tennis balls are excellent ways to target smaller, harder-to-reach knots. Much like a foam roller, you'll want to use the ball to apply gentle pressure as your muscles begin to release tightness.

While the idea is generally the same, massaging with a ball is a little different than with a roller. Smaller muscle groups, like your traps, can be tricky, but you can use a doorframe to help target these knots, Yuen says.

For instance, if you're dealing with tight traps, you can place the ball on the edge of a doorframe, aligning your muscle directly on top of the ball. With your head and neck through the doorway, press into the ball to apply pressure.

Or, if you're feeling some knots in your core or mid-back, lie on the ground with the ball directly on the muscles along the sides of your spine. Wrap your arms around your body as if you're giving yourself a hug. Then, roll up the length of your back to your shoulder blades, pausing as needed.

To massage your chest, place a ball against a wall. Lean against the ball in the area where your pec meets your shoulder. The more you lean into the ball, the more pressure you'll apply to the knot. Roll side to side across your chest.

A manual, full-body massage can be pricey but it's an excellent knot-reliever. As with self-massage tools, getting a manual massage can increase blood flow to tight muscles. Plus, you can ask your massage therapist to pause on your knots to give them a little extra attention.

"As long as it's is not overly aggressive, a massage can work wonders," Yuen says. "Like with a foam roller, you will want to try various techniques including working the length of the muscle and sustained pressure on the trigger point. However, a massage is generally superior to foam rolling because a massage therapist can be more specific with their hands and knows how much pressure to use."

Some physical therapy practices also offer injury-specific massage services. However, these can be expensive and may require health insurance. Be sure to do some research on specialists in your area and see if your insurance can cover the majority of the costs before you decide to book an appointment. You can also consult your doctor for a referral.

Despite the age-long debate, choosing whether to use ice or heat actually just depends on your symptoms. Generally, ice is used on acute injuries, like ankle sprains, according to the American Academy of Pediatrics. Applying ice to an injury will decrease circulation, which helps bring down swelling and inflammation.

But if you're dealing with muscle tension and knots, heat is probably the best way to go. Heat relieves muscle tightness by expanding blood vessels to increase circulation and reduce swelling.

"Since the knot consists of irritated contracted muscle, you will want to choose heat or ice based on which one will help you relax more," Yuen says. "Heat generally works better, but there's no harm in trying both. A good rule of thumb is 15 minutes."

In addition to treating muscle tightness, you'll want to take every precaution possible to prevent future knots from forming. A great place to start is your pre- and post-workout ritual.

As mentioned above, knots can occur through overuse or training with improper form. So, start each workout with a dynamic warm-up (as opposed to static stretches) to make sure your muscles and joints are ready to train. When you launch into your workout without a proper warm-up session, you're more likely to practice your exercises with faulty form.

Before you hit the shower, make time for a full cooldown routine, too. Foam rolling, or other forms of SMR, is a great start, but you can also incorporate some brief dynamic stretching. However, you don't want to stretch beyond your body's natural range of motion, Yuen says.

"Gentle stretching can be helpful, but aggressive stretching generally makes this worse," he explains. "Dynamic stretching encourages more blood flow and actively takes the muscle through its range of motion."

Space out your workouts appropriately, making sure to avoid training the same muscle group on back-to-back days. This will help with preventing muscle fatigue as well as overuse. Limit any exercises that cause pain or pinching in the knotted muscle.

But you don't want to stop working out completely, Yuen says. In fact, try to move or walk more frequently throughout the day. "Muscles feel best when they're contracted, stretched and able to get increased blood flow," he says.

Adjusting your day-to-day posture is another way to promote healthy muscle function and prevent future tension, Yuen says.

Rearrange your workplace as needed, aligning your computer screen to eye level and adjusting your chair so you can sit comfortably with a 90-degree bend in your knees.

Get up and walk as often as possible, and even add a few dynamic stretches to your work day. Increasing your daily movement can help increase circulation, dramatically improving muscle pain and soreness.