What Is A ‘Muscle Knot’ And How To Treat It

by Candice Reimholz | 50 Comments

You probably hear this term all the time. People are constantly saying things like, “I have a huge knot in my back” or “I’m all knotted up!”  What does this actually mean? Can a muscle really get tied in a knot? Well, no, not really…

First of all, let me explain a little bit about muscle tissue. Muscle fibers run in all different directions in our body and muscles are layered on top of each other from our heads to our toes. This is a good thing and the reason why we can bend, twist, dance, and play sports. Our muscles are meant to be pliable, strong, and challenged. However, when we sit at a computer all day in the same position and if we injure ourselves, or if we are chronically dehydrated, we can lose our mobility and flexibility. The various muscle fibers start to stick to each other and become adhered. This new hard and lumpy feeling is a muscle ‘knot’.

Muscle ‘knots’ are incredibly common but common doesn’t mean they are normal or harmless. Chronic stress on our muscles creates micro-tearing of muscle tissue, which creates scar tissue. Unfortunately, if left untreated, the muscle tissue will continue to lose elasticity and cause postural stress that is hard to reverse.  It’s not all bad news and there are a lot of things you can do to treat and prevent muscle knots.

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Prevention – how to avoid getting muscle knots in the first place:

  • How much water/sports drink should I drink?Diet and hydration – Drink plenty of water and eat a healthy diet. Foods such as alcohol, sugary caffeinated drinks, processed and fast foods all play a part in dehydrating you. If you are careful about what goes into your body, you are less likely to get injured.
  • Take breaks – Most people spend a lot of their day sitting in front of a computer or staring down at a cell phone. Our bodies cannot handle being in those positions too long. Every hour at work, get up and walk around. Even when sitting at your desk, straighten out your back, turn your neck from side to side, uncross your legs, and move as much as you can.
  • Exercise – As previously stated, our muscles were designed to be challenged. We are built to perform. If we aren’t moving, stretching, and lifting then we are compromising our muscle health.
  • Massage – We are slowly starting to come around to the fact that massage is not just some occasional luxury saved for vacations and spa days. Massage Therapy can help keep your muscles healthy, pliable, and oxygenated.
  • Lifestyle – A life filled with stress and lack of sleep is a perfect pathway to injury. Slow down, get more sleep, and breathe. Even as little as 15 minutes a day of focused relaxation time can make a world of difference.

Treatment – what to do if you already have muscle knots:

  • Rest – If you’re in pain, it is your body’s way of saying it needs a break. Maybe, you take a few days away from the computer or a few days away from the spin bike. You need a break from whatever is causing the pain.
  • Massage Massage Therapy is not only great for prevention, but a good clinical Athletico Massage Therapy_Massagemassage therapist can help relieve that muscle pain, break up the adhesions, and recommend self-care that you can do on your own.
  • Physical Therapy – If you have been in pain for a while, physical therapy can really help. Not only will the treatment consist of manual therapy like massage and stretching, but the therapist can help identify the underlying causes, and give you a home exercise program to keep you healthy after therapy. Also, some PTs are trained in specific modalities that may help such as ART, Dry needling, and Graston.
  • Stretching – Gentle movements by going through your full range of motion can be very helpful. Do not push stretches too hard without discussing first with a Physical Therapist, Massage Therapist, or Athletic Trainer. You can over-stretch, and just because a muscle is hurting, doesn’t mean it needs to be elongated. Sometimes the opposite is true. However, gentle, full-body movement is usually a good idea as long as it is pain-free.

So, move around. Get a massage. Go to bed a little earlier. Drink more water. Your body will thank you!

If that doesn’t help, schedule a complimentary injury screen with your local Athletico to find out what’s causing your pain.

Click to Schedule a Complimentary Injury Screen

The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.

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50 Comments

  1. Jay G

    Very good article. It makes sense. Like the old saying goes, “if you dont use it, you will lose it”, so the key is to just stay mobile and avoid that oh-so-tempting sedentary lifestyle, while at the same time don’t over exercise. Sounds good to me. Now to actually implement it….that’s the hard part.

  2. Candice Reimholz

    @Jay- That’s the part we all get stuck on! Putting this into practice is the hardest and most important part! Good luck

  3. Christian

    well I get these plenty of times and I play soccer and football so I don’t think my muscles are still too often. Is this normal?

  4. Candice

    @Christian- great question! Yes, that is totally normal. People that are very active tend to stress their muscles too, just in a different way. They are also prone to over-use injuries. The same recommendations that I gave in the blog will apply to you as well.

  5. Angel

    I am having bad muscle spasms on my left side,under my rib cage. They started out like baby movements (not pregnant) and are getting worse. I will take the advice here and see how it works for me

  6. Nicholas

    Can muscle ” knots” in the neck and shoulder cause postural or dynamic headaches.
    I get brutal headaches when I walk run or exert.
    When I sit they stop.
    Been told muscle spasms in neck can be the cause.
    Any thoughts?

  7. Candice Reimholz

    @Nicholas- Thank you for reaching out and I appreciate you for seeking out clarity for your re-occurring symptoms. Muscle knots, or spasms, may be contributing to your symptoms, but without evaluating you, I would not feel comfortable dismissing your headaches. If you would like, I can assist you in scheduling a complimentary screen at one of our local Athletico facilities to assess your reported knots/spasms. The screen that we offer is usually 30-40 min in length and conducted by a Physical Therapist or Athletic Trainer. We can assess your symptoms and offer some direction/suggested next actions for you to help alleviate your chief complaint(s). Feel free to email me at candice.reimholz@athletico.com

  8. Dorie

    I get knots everywhere, including my thumbs and arches of my feet. I am fairly active, I don’t over do it. I sleep well, and have a fairly sound diet. I can try stretching more and drink a lot of water. I already get monthly massages but I am right back to knots the next day.

  9. Annette Kellly

    I GOT A KNOT IN MY Thigh on my left leg and it was very sore I could not walk drive the car or get in to the car , went to on phiso no could ,got pills from the doctor which were called antiamflamery which worked great.

  10. Sandra evand

    I have strained a muscle in my lowerback ..back in 2006. ..its always been a little sore..so i went to chiroprators….now back in 13/14 its been sore to sit too long …i was getting massages quite regularly…and now i get sore legs and my sciatica is playing up on both sides. ..left more the the right….i go to massage still and i cry with the pain and still sore afterwards. …what’s going on should i go back to chiropractor since massage is hurting??
    When i sleep sometimes it’s hard to move as im stiff….sick of being sore😢

  11. Candice Reimholz

    @Sandra- Since it has been going on that long, I would definitely go to either your primary care doctor or an orthopedic. Maybe they can prescribe Physical Therapy or do further testing to figure out the cause of your pain. Feel free to email me at Candice.reimholz@athletico.com and we can discuss further.

  12. Maree

    Had a lovely massage yest. Therapist told me my upper back was full of knots. Some of my massage was very sore. Today both sides of my upper back are very sore by my scapula, both sides. She said she could work on my back all afternoon it was so bad. I had no back pain at all before my massage, is it normal to have this pain so bad.

  13. Paul

    I engerd my leg I through my ankle nee and my hip out of place and every mussel in my right leg cramped for about10 to15 minute went to my.ciropractor he put me back in place and haven’t had a cramp since

  14. Elizabeth

    I have had an extremely large knot on the top of my shoulder leading up to my neck. It is so big it is visibly larger. If it has been over a year, and I have constently used stim therapy on it, and it has not gotten any better is there a chance it could be caused by a tear or any other underlying issue?

  15. Malaysha Castillo

    This article was a great reminder that taking care of our bodies is a day to day thing, and if we don’t the repercussions can be huge.

  16. Sandra Huard

    I have knots in my lower back and thighs! The pain is extremely painful and keeps me up at night. It extends around to my groin area and makes walking painful. My thighs are hard as a rock. I’ve tried heat, massage, yoga, stretching, walking. Nothing works…….it seems to make the pain worse. I can’t get in and out of a car. I also get spasms at times in my calfs and every night in my toes. This has been going on for a very long time. I’ve seen a PCP and Rhemmatogist.I would appreciate any information you could offer. I am a very tense type A person.

  17. Candice Reimholz

    @Elizabeth- That is definitely a long time to have symptoms for the same problem. I would definitely recommend going to an orthopedic doctor to rule out a more serious injury. Once you get an official diagnosis, it is easier to decide on a plan of action.

  18. Candice Reimholz

    @Sandra- have you tried seeing an Orthopedic Doctor? I would hate to speculate since I have not assessed you personally. That would be my next step if it were me. I am not sure where you are located, but if you are any where near an Athletico office, we would be more than happy to asses your pain and symptoms, and make an appropriate referral. Let me know if you need help finding us. We do have locations listed on our website http://www.athletico.com

  19. Liz Greene

    I have had muscle knots in my calves for about 30 years. I walk fast. I thought it was restless leg syndrome. If I do not take klonopin at night I am up taking about 5 hot baths a night to relieve the pain. I would like to get off this medicine. I also take mirapex. Please help me. I can press on my calves and the pain is unbearable. I would like to be able to get rid of this once and for all. I have never injured my leg muscles that I know of. Cutting the grass with a self propelled lawnmower actually makes my legs feel better. I have had massages etc. which is a temp relief. I use to lay awake four or five nights and finally go to the ER and get a shot the pain was so bad. I want to get rid of it. Help me.

  20. Candice

    @Liz- I am sorry you are having such long term difficulty with your leg muscles. It sounds like ‘cramps’ or ‘spasms’ vs. a muscle knot. Let me start by saying- I am not a doctor. So, anything I would recommend should be ran past your doctor. Usually with spasms that are this chronic, there is an underlying, systemic cause. Therefore, yes- massage would likely be temporary. I would check with your doctor, check your blood work, etc. and see if there is another recommendation (i.e. supplementation, aqua therapy, etc.). If you are around any Athletico office, I am sure a Physical Therapist could give you their opinion as well. We offer free screening at our locations. Feel free to email me and I could help facilitate. Thanks! Keep us posted. Candice.reimholz@athletico.com

  21. Lachlan

    I play cricket and I’ve been hit in my left thigh more than 10 times with the ball on the exact same spot every time, now there is a lump there that hurts when I put a lot of pressure on it. My leg only hurts in the spot that the lump is. Is it a muscle knot or something else

  22. lex

    Hi Lachlan
    That sounds familiar.I do jiu jitsu and always have bruises on the thighs,but now my left thigh has a kind of lump or hard scar tissue.Surely it’s sport related and not cancerous!!
    Can you let us know how yours is progressing?
    Thanks
    Lex

  23. Candice

    @Lachlan and @lex- Sometimes when there is repeated trauma to one specific spot, the body can lay down scar tissue, collagen, or even ‘fatty’ tissue as the body heals. It is a protective mechanism but it can also lead to pain and dysfunction. I would recommend getting evaluated by a Physical Therapist or Orthopedic doctor. There are treatments that could help with ‘knots’ like those. Massage Therapy would be helpful too, but I -personally- would want you cleared by an MD before I performed body work on you. If you are close to any Athletico locations, you can come in for a free injury screen. Check out athletico.com for more info.

  24. Angelica

    It’s been about a month since My arm,neck and close to my spine that hurts. My friend says that I have a lot of knots. She has given me 3 massages and my fatigue has improved but my I haven’t been able to recover from soreness and mild shocks to my upper back and lower neck area. I have been through a lot of stress. I’m trying to correct my posture. I hope that it changes because I enjoy avid hiking and backpacking. Where should I get checked or do?

  25. Debra Roesser

    I had a injury to my whole arm I feel straight out like I was flying,and I had a pace maker so of course no mri’s. I did therepy but still in consist pain,no relief ever.I had injections for the swelling,but no relief.Seen a surgyen says the is a old way of putting needles in the top of my shoulder to put dye threw to see what damage is there,this pain has been going on since jan. 2016 I need help what can I do?

  26. Olga Ormsby

    Question. I during PT for piriformis syndrome in my left hip my therapist identified several knots in the hip area and showed me how to massage them. Now I’m on my own and thought I had found one in that hip just at the top of what I think is the femur. But I’ve since found an equally tender spot at exactly the same location in the other hip (which I’ve never had problems with). Should I treat both as knots or is it something else, maybe normal?

  27. Candice Reimholz

    @Debra- sounds like you exhausted a lot of your options. I would try to listen to your orthopedic doctor at this point. You can always get a second opinion, maybe someone else would be able to give you different options. Not sure where you are located, but we could always help you find a doctor if you are close to any of our locations. Sorry I am not more helpful but it sounds like you have done all of the things that I would recommend already. Keep us posted!

  28. Candice Reimholz

    @Olga- The good thing about massage is that it is 99.999% safe. If you have a ‘knot’ or a sore spot, by all means rub it. Having sore spots in the area you are describing is very common. We humans beat up our hips and glutes. We sit too much and don’t use and stretch enough. The only time I would say to be careful about self-massage is if you are right on top of a bony prominence. Make sure you are over a muscle and/or soft tissue.

  29. Connie Doyle

    I have had knots in my shoulders upper back and neck for over a year now.I am in so much pain all the time. Can I get cortisone shots in the muscles or maybe botox. I just need the muscles to relax. I can’t take the pain any more.

  30. rosie selth

    i have got a knotted muscle right on my shoulder and i have tried massaging but am still in pressured pain. what should i do, i already drink 2L a day and sleep- i try my best 😬

  31. Candice

    @connie- Have you tried Massage Therapy? Or Physical Therapy? A good therapist might be able to give you some relief. If you have already tried that, I would ask your doctor about what the next step may be. Are you any where near an Athletico? We could help with a referral if needed.

  32. Candice

    @rosie- Have you seen a massage therapist or are you trying to massage it yourself? I would definitely seek out a clinical massage therapist and see if they can provide some relief. Also, a good therapist will make an appropriate referral if they think the problem is bigger than muscle tension.

  33. Jeff

    I get a massage about once a month. I mentioned yesterday that I wake up a lot with a dull headache and my neck hurting. My massage therapist focused on my neck and said I did have a lump in my neck. I’m a 57 year old male. I workout 3 times a week but have a desk job. The word “lump” scared me. I am a high-strung person so I asked if it could be a stress knot. I may have read too much into her facial expression. I don’t get headaches or neck pain often during the day, I mainly notice in the morning and when I get up during the night. Should I worry. Thoughts?

  34. Brandon

    I’ve had a lump in my quad since last year when I pulled my quadricep. Water and stretching helps but I want to LITERALLY get rid of it. Any remedies you know of?

  35. Del

    I have knots between my shoulder blade and upper back but I figured out why I got them. It’s summer and I like to make crafts so I watch videos everyday on my computer ,turns out I sit in the same position every time. One day I was crafting and felt a sharp pain so I looked everywhere for a cure. So I’m going to take at least a week off,stretch and drink water

  36. Michele

    I am a distance runner and got a knot n my hip. I have gotten rid of the knot, but the soreness and inability to walk or run without pain has yet to come. Can anyone tell me how long the pain should last? i can see my doctor, but i was hoping this would all go away soon. Thank you!

  37. Saga

    Nice article to read but following is important. I do martial arts and play cricket. My right hand shoulder is stiff compare to left hand shoulder. Got couple of knots near trigger points between shoulder blade, deltoid muscle and one under my armpit. Armpit knot has gone over time, as i do massage it myself. But knots between shoulder blade (right hand) is bit hard to get rid of. Also knot in my deltoid muscle gives me most hard time, during my push ups or during raising hand in specific angle.
    Is there any medical way to get rid or get muscles relaxed so they do not come or grow again?

  38. Jenny F

    When I sit in my office chair it feels as if there is a golf ball under my thigh. Its only in the right thigh. This is a constant pain and the pain extends to my feet. When I stand up from sitting I get “shooting” pains down to my foot. I have been to physical therapy and it seemed to help….that day…by the afternoon the pain is back. I used to be a very physical person but since this pain has started I really have to pick and choose my activities. Any suggestions? Oh and I work in a prison so I walk on concrete most of the day

  39. Jackie

    I have a knot in my left side of my head leading to my neck. This has caused me to have severe neck pain feeling like whiplash. I can’t turn my head side to side without it hurting real bad. Went to the doctor and he prescribed naprosyn for pain and a muscle relaxer as well. I’m reading all these stories of people dealing with their pain for years and I’m wondering if mine is gonna be one of those scenarios? I just started with my pain like a week ago and I can’t wait for it to go away. How long does this take to heal?

  40. Marisa

    After I was finished with a 2 mile race on Saturday, I tried to walk right after the run and both my calves have huge knots that hurt like there is no tomorrow. I have tried messaging them out and even ” pain relieving lotions, I am lost because I have ran since June training for a marathon and I am in good shape. I need to get back to training but my calves hurt too bad.

  41. patricia silvia

    I had a total shoulder replacement for not being able to lift my arm for more than 5 years. Nobody wanted to operate. A few months back i had the surgery, which i am now in therapy. They just noticed i have a huge knot on my left side and even goes up my neck it hurts a lot. The therapist told me to rub it at home its been about 10 wks now. Please let me know if you have any other suggestions.

  42. Lauren

    I always have knots on my right side. They have been there for about a year. I sleep ok my stomach and play soccer about 4 out of 7 days. It is always on my right side and is now very painful. I roll out and that seems to help. Any advice???

  43. James

    Great article. As a man, I was diagnosed with Non Bacterial Prostatitis for years. Constant pain like a urinary tract infection that never went away. Guess what…….muscle knots in my pelvic floor, prostate was fine. Specifically the levator ani muscles and gluts. I found a PT therapist who is able to work the muscles internally. I spent thousands and thousands of dollars on various treatments, snake oil, Urologists etc. But it was muscle knots in my pelvic floor causing me the chronic pain and transferring the pain throughout my pelvic region.

    Pelvic floor pain affects men and women equally. Never discount pelvic muscle pain related to knots as it will mask itself as another diagnosis (UTI, Prostate, PID).

    Point being, If your DR. has not been able to treat your pelvic pain, seek an internal Physical Therapist ASAP. The second they touch your knotted pelvic floor, you and the therapist will know the source of your pain……then treat it. Its like pulling out a bad tooth. Dont suffer another day.

  44. Cindy

    I started getting severe stiffness and knots all over body that got gradually worse over 4 years. Also, cavities for first time, tired eyes, tonsil stones, loss of heat sensation in lower legs, plus constant urinary tract infections. Tested for rheumatoid arthritis, lupus, ect, and went to all kinds of specialist with no hope or remedy.
    A massage therapist said to look into candida. After doing a yeast treatment i am convinced thats what is was. Now, when knots and muscle problems come back i know candida is getting unbalanced again.

  45. Jimmy Bland

    I have had pain in my calves for the last 20 years, can the knot be picked up with an ultrasound and what is the difference between the muscle knot and a blood clot (DVT) ? If I think its a muscle knot could it possibly be a blood clot?

  46. Christina A Davis

    My 3 year old daughter has knots in her shoulders and lower back. I noticed them for the first time when she was just a year and a half. Her right shoulder is worse than her left (she is right handed). When I asked the doctor about it, without even feeling the knots, she said it’s fine. I massage her every night and she takes Epsom salt baths every few days. She doesn’t drink as much water as she should, but she doesn’t show signs of dehydration and doesn’t drink sugary drinks. Do all kids get knots so young? Is it normal? Or is this rare and maybe I need to seek more medical advice?

  47. Jonathan castle

    I am currently in physical therapy at an athletico. I have 2 bulging discs in my back which are made much worse by the knots in my upper back. On my X-rays my back doctor pointed out where I was having spasms during the X-ray. The massage helps dramatically in reducing the pain. Athletico is a great place for for therapy and I do recommend it to everyone.

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