What Physical Therapy Is

Those Knots Just Won’t Go Away – by Nathan Johnson, PT, OCS

Most of us have them now and all of us have had them at some point; sore tight areas in our neck muscles that we rub after spending a long day at work or an hour on facebook at night.  I will explain what they are, what the research says, and what you can do about it. 

Muscle trigger points (TrP) are defined as a tender point within a taut band of skeletal muscle that is painful upon compression, contraction, or stretch and usually responds with a referred pain pattern distant from the point.[1]  These points can either be active, meaning they hurt all the time, or latent, meaning they only hurt when you press on them.  TrPs have been shown to have concentrations of chemicals that are associated with inflammation and pain with the active TrP having much higher concentrations.[2]  The cause is thought come for a variety of factors including psychological stress and mechanical overload.  As with most things, they are not all or nothing.  TrP are on a spectrum from very mild latent ones (you would have to dig at it to elicit pain) to really active ones (when your friend puts his hand on your shoulder and you almost drop to the floor).

Sometimes these knots or TrP just go away on their own or they stay latent and you never know they are there until your annual massage, but other times they are a daily nuisance.  If you find yourself rubbing your neck often, making circles with your neck or shoulder blades because they don’t feel right, or constantly getting in the hot tub and letting the jets hit the area then you may need an expert to help you relieve the discomfort.  Researchers have found links between problems within the joints of the neck and these TrP.[3][4]  That may be why some people have to keep going back and getting massages which keeps the TrP at bay, but never truly solves the problem.  If there is joint irritation and stiffness between two vertebrae, then symptoms of muscle tension and pain will keep occurring. 

Physical therapists have various techniques in their arsenal that improve joint stiffness or hypomobility including but not limited to joint mobilization, manipulation, stretching, and muscle-energy techniques.  We are trained to isolate the involved segments and direct specific treatment to the area in need.  This is the most effective use of the patient’s time and healthcare dollars as the underlying problem must be solved before the patient has a full recovery.  Please visit a Spine & Sport location or give us a call to learn more or schedule a free consultation.