Massage and muscle knots

[iain]

Every now and again I enjoy a massage, purely for relaxation purposes.

However, the last couple of times I've had one, the masseurs has told me I've got muscle knots in my back and has proceeded to try to massage them out.

I don't know what a muscle knot is (something to do with stress?). What I do know is that having them massaged out is extremely painful and removes much of the enjoyment and relaxation from the massage (I'm half-sure that the first girl was actually trying to massage one of my ribs out of existence - that's what it felt like anyway). Of course, being English, I'm far too polite to mention any of this to them.

From my own experience, I have three observations :
1. I don't feel that removing these knots (whatever they are) makes me less stressed, or gives me any other mental benefit.
2. I don't feel any physical benefit : I'm not aware of having them normally, and if they are gone after the massage, it certainly doesn't make me feel any better.
3. It hurts like hell when they try to remove them.

Can anyone shed some light on what's going on here?

 

[Pantastic]

Muscle knots?! No such thing.
Next time they spot one, just say you're happy with your muscles being knotted and can they leave it alone.

 

[crimresearch]

'Knots' is a misleading choice of words, since the condition being addressed is supposedly a binding/friction within the bundle of muscles.

 

[Badly Shaved Monkey]

I think the worl of physiotherapy brings up interesting issues about diagnoses. So much of what they deal with is based on the patient's report of symptoms and what the physiotherapist subjectively claims to detect then the real basis of many of these diagnoses must always be in doubt.

This is particularly relevant to me as a vet, because the equine world has a centuries old history of 'back tweakers' all claiming almost mystical powers over ill-defined equine musculoskeletal problems. These days we are being asked to take seriously a raft of veterinary physiotherapists, many of whom have human physio qualifications, so are not complete charlatans, claiming to treat animal complaints. I have a big problem with this because a lot of what they say and do has no evidence to support it and at a fundamental level the diagnoses they work from are not 'falsifiable'. So, if I am told an animal is being treated for a stretched somethingissimus muscle leading to inflammation of the bursa of whatsit it's impossible to know what to say.

In the end, since the vast majority of musculoskeletal injuries get better with rest it's very hard to say whether these people do any good at all. I always remind my equine colleagues of this when they are telling me the results of some laborious lameness investigation that everything responds to Box Rest and Bute phenylbutazone, a NSAID), so why do they bother: it's always best to make sure I have worked out my escape route first!

 

[iain]

'Knots' is a misleading choice of words, since the condition being addressed is supposedly a binding/friction within the bundle of muscles.

Does that mean there is something real in my back which they are trying to fix?

 

[roger]

Does that mean there is something real in my back which they are trying to fix?

Well, when you are massaging a back you can definitely feel these little 'nodules' - hard points. When I used to massage my ex-girlfriend's back, her pain usually seemed to correspond to these places. I always assumed that it was a small muscle that was tensed up, or 'flexed'. Flex your bicep, and it becomes hard. I assumed it was like getting a charlie horse in your leg - the muscle ends up constantly contracted, which causes pain. I don't know if the musculature of the back actually supports my assumption, though.

I'd tell the SOBs to stop hurting you if you aren't getting any benefit from it.

 

[tamiO]

However, the last couple of times I've had one, the masseurs has told me I've got muscle knots in my back and has proceeded to try to massage them out.

Maybe you have fatty tumors?

edited to share this treat:
Frankly I'd be surprised if homeopathy could remove a lipoma of substantial size
- they can become massive and are not like warts etc
- but no doubt someone has a miracle story to tell.
I would repeat that minor surgical excision is relatively harmless, non invasive, and fast and effective as a treatment. (and I am a herbalist)

source

 

[Badly Shaved Monkey]

Does that mean there is something real in my back which they are trying to fix?

I assume it could be local muscle spasm. If its something that hurts when they press on it then that is a possible explanation. If they are claiming to palpate something and you feel no pain then it is unlikely to be muscular and if there are real lumps then letting a doctor look at them would be sensible.

The little lumps you may have felt under the skin of someone else are unlikely to be 'muscle kots' and more likely just to be irregular fatty deposits. Remember that you 'back muscles' are a long way in and only very deep palpation is going to be able to detect som variation in texture between one side and the other. I doubt that a superficial rub would do this. Partially hence the universal doubt over equine back tweakers: "See the size of a horse. See the size of my hand. Now is it really likely I could palpate anything significant 6 inches beneath the surface of a 500kg lump of horsemeat?"

 

[roger]

So, if I am reading you correctly, you are saying that you don't believe we can feel muscle spasms in a human back?

It's a bit difficult to test, due to my flexibility, but from what I can tell of the parts of the back I can reach and voluntarily flex, I can feel the difference between a relaxed and contracted muscle. This is rather easier to do on my deltoids, and I would say that my flexed (I forget the name, the middle one, though) middle deltoid muscle feels the same as the lumps I felt in other's backs.

I can also feel my own ribs through my back, so how deep are the back muscles, really? There's skin, fat, muscle, then bone, right? (you can tell I'm not medically trained ) If I can feel the bone, doesn't that mean I can also feel the muscle?

 

[Capsid]

I was referred to a sports injury clinic by my doctor to treat a neck injury acquired from playing tennis. The physiotherapist at the clinic warned me before he got started that he would hurt me! Anyway he certainly found plenty of "knots" in my back which he pressed out with a lot of force. And yes it did hurt a lot. However, it did cure my neck problem! I'm not sure whether the knots are indicative of anything but he certainly concentrated on them.

If you just want a massage for relaxation then I would ask not to have these knots touched.

 

[crimresearch]

Originally posted by iain
"Does that mean there is something real in my back which they are trying to fix? "

Hmm..I'm probably going to screw this up, as it has been a while since I paid much attention to massage therapy's theories.

Many of your body's muscles are 'bundled' inside sheets of fascia. If a muscle develops a spasm/tension, it will be less able to relax itself alongside the other muscles in the bundle, leading to the impression that the therapist is pressing on a hard or 'knotty' point on the muscle.
Some therapists say that pressing 'trigger points' will 'unlock the knot', others say that stretching the fascia will allow the 'knotted' muscle to relax.

So yes, it would seem that there is 'something' there, and that a little painful digging can ease the symptom.

How many therapists grab at 'knots' on every client they see, or how useful such manipulations are, I wouldn't really know.

 

[iain]

Sounds like something real which could potentially be a problem but, as I experience no problems other than the pain during the massage I should indeed probably overcome my English reticence and ask them to leave the knots (or whatever they are) alone.

 

[Badly Shaved Monkey]

So, if I am reading you correctly, you are saying that you don't believe we can feel muscle spasms in a human back?

It's a bit difficult to test, due to my flexibility, but from what I can tell of the parts of the back I can reach and voluntarily flex, I can feel the difference between a relaxed and contracted muscle. This is rather easier to do on my deltoids, and I would say that my flexed (I forget the name, the middle one, though) middle deltoid muscle feels the same as the lumps I felt in other's backs.

I can also feel my own ribs through my back, so how deep are the back muscles, really? There's skin, fat, muscle, then bone, right? (you can tell I'm not medically trained ) If I can feel the bone, doesn't that mean I can also feel the muscle?

I don't doubt that the manipulations can help human patients, what I doubt is the 'diagnoses' that go along with them. The problem is that the responses of patients are effectively used to confirm the reality of the daignoses. My point is that this is logically incorrect. This is not to say that all such diagnoses are wrong, but to maintain a highly sceptical approach to them.

In animals the situation is worse, so I am much more doubtful about the majority of claimed diagnoses.

This is an important issue, because if we can't maintain an appropriately sceptical attitude to conventional medicine then we have no right to beat up the homeopaths and other woos for using weak-minded reasoning in support of their nonsense.

 

[Eos of the Eons]

Go see a doctor and see what he says. If it is harmless then the masseuse can play, or you can tell them to leave it alone.

I've had a sore neck ever since I got my first massage ever a few weeks ago. Its sore on the right side, the back of neck, and extends down to my should a bit. I'm rather annoyed that I feel worse now than when I went into the massage with no soreness problems.

I'm sticking to my hot baths from now on!

 

[Badger]

I'd say get yourself a better masseuse/masseur. There's no need for a massage to hurt, other than the impatience or lack of skill of the massager.

I give the odd massage, and am familiar with the "lumps" you refer to. They're just tense muscles. One of my wife's friends was in a car accident and ever since has had pains in her back/neck. When I massage her, I can feel muscles tensed up. Not only are they fatigued from constant tension, they seem to be throwing her out of alignment.

I find a lot of people start kneading on the lumps themselves, rather agressively, and of course that hurts. What I do is I start a ways from the lumps, and work the muscles to relax them, and as things relax, I gradually move along the muscle, until everything's relaxed.

Of course in a week or so, she's back out of alignment, presumably from habit, or from being used to compensating for whatever injuries she incurred with that car accident.

I'm not trained in this stuff at all, and I know it's just anecdotal, but I know that when I start, there are lumps, and when I finish, there aren't. So, for whatever it's worth, there ya go!


edited for spelling....there may be more mistakes. I'm soft of head today.

 

[JSFolk]

My fiancee has a chronic "knot" in her back. It's just below and slightly in from her right shoulder blade, and feels like a hard lump in the muscle.. kind of like a golf ball covered in a piece of flank steak. (Now isn't that a nice image.) When I massage her back, I can place virtually any amount of pressure on this particular spot without hurting her, and she says she feels a definite release of tension when I concentrate on this one spot. I don't know what the physiological aspects of this are, but just wanted to throw in my .02.

 

[Mercutio]

Well, when you are massaging a back you can definitely feel these little 'nodules' - hard points. When I used to massage my ex-girlfriend's back, her pain usually seemed to correspond to these places. I always assumed that it was a small muscle that was tensed up, or 'flexed'. Flex your bicep, and it becomes hard. I assumed it was like getting a charlie horse in your leg - the muscle ends up constantly contracted, which causes pain. I don't know if the musculature of the back actually supports my assumption, though.

I'd tell the SOBs to stop hurting you if you aren't getting any benefit from it.

This is my experience as well...

I'd suggest that, at TAM3, we double-blind test massage, as well as chocolate. I volunteer as both giver and receiver of massages.....

 

[roger]

I don't doubt that the manipulations can help human patients, what I doubt is the 'diagnoses' that go along with them. The problem is that the responses of patients are effectively used to confirm the reality of the daignoses. My point is that this is logically incorrect. This is not to say that all such diagnoses are wrong, but to maintain a highly sceptical approach to them.

Okay, I see your point, and agree, for what my opinion is worth.

 

[roger]

I'd suggest that, at TAM3, we double-blind test massage, as well as chocolate. I volunteer as both giver and receiver of massages.....

Mercutio, you are a genius.

 

[Zep]

Muscle "knots" are, as people above have described accurately, tensed muscles that are, or are about to, cramp up. The pain and tenseness is from the usual symptoms of cramp - lack of blood flow, lactic acid buildup, muscle strain, etc, etc.

Now for those who have had a cramp in the leg or calf (is that what a "charlie horse" is, btw?), imagine if someone then tried to pound the cramped muscle. Sure, it's gonna hurt! The cure for back muscles, as with any cramp, is the promotion of adequate blood flow and the easing of muscle tension. With your calf or leg, you usually have to stretch the muscle very hard (they are BIG muscles in your leg). For the back, don't hit the muscles or try to push the knot down, instead they should be stretched. A regular stretch/push-release type motion also promotes blood flow to the area (the area should go quite pink if done properly). It should also be quite relaxing after a while - if it hurts too much then you are doing it wrong.

Of course, this same method can be accompanied by close company, a big warm bath, fragrant oils, subdued music, candlelight, a little wine...