London School of Massage

Treating "Knots" - For Massage Therapists

From the many years of teaching and being involved in a clinical environment,  the recurring question which is commonly asked by practicing massage therapists is, "how do I treat knots in muscles?"

In answering this question it is best to first look at what these "knots" are and then some of the factors which cause them.

What are "Muscle Knots"?

Muscles knots, better known as Myofascial Trigger Points are the result of physiological changes that occur in muscular tissue resulting in tight painful spots with characteristic patterns of pain.

The term Myofasical Trigger Points was first coined by Dr Janet Travell & Dr David Simons and trigger point referral patterns have been well documented in the two volumes of work.

Common causes of Trigger Points 

Muscle Overload

The term muscle overload tends to conjure up an image of physical strain on muscular tissue, but in Trigger Point therapy, the term has a dual importance in relation to understanding the formation of a trigger point:

1. Physical overload imposed on the muscle 

2. Demand placed on the neuromuscular control mechanism 

The latter mechanism is responsible for taking the electrical impulse of a nerve and transforming it into a biomechanical signal that both controls and powers the muscular activity. The complex nature of this electrochemical process makes it the "weak link in the chain" of muscular functioning, and the failure of a muscles control mechanism is responsible for the activation of trigger points

Factors That Predispose a Muscle to Overload:

There are several factors that predispose to the formation of a trigger point and these should be considered when taking the case history.  These include:

• Muscle Tension - e.g. through emotional stress
• Structural Abnormalities - e.g. short leg, pelvic asymmetry etc.
• Nutritional Deficiencies - e.g. B1, B6, B12, C, and folic acid
• Metabolic Disorders - hypothyroidism, hypoglycaemia
• Chronic Bacterial & Viral Infections
 

Treatment of Trigger Points

In their works, Travell and Simons indicated multiple methods to the treatment of Trigger Points.  These methods range from injecting a trigger point with local anaesthetic, using physical modalities such as cold and heat to using manual techniques such as "stripping" massage.

From the standpoint of massage therapy, it is interesting to note that manual massage techniques formed an important aspect to the trigger point techniques and coupled with stretching, formed what they termed as the "workhorse" of the treatment method.

This is extremely good news for therapists as the treatment methods used make it very easy for massage practitioners to incorporate these  techniques into everyday practice.

                   

                      Trigger Point - "Spray"

Trigger Point - Stretch

If you are interested in the treatment of trigger points and want a variety of easy to use techniques which you can utilise within your clinic, why not join us on our next Trigger Point course or give the school a call for further details.