News: September 2026

Muscle Knots Aren't What You Think

Most people have experienced muscle knots, aka trigger points. They are those tight, achy, sore spots commonly found in the upper back, neck, shoulders, or hips, but can be located almost anywhere in the body. You can usually point right to them. When you press on one, you sometimes feel pain in a different area of the body. Direct pressure on a muscle knot can both hurt and feel relieving.

So what are they? Trigger points are traditionally defined as small areas of contracted muscle that are stuck and need to be "released." It's a simple, satisfying explanation. But there's no clear scientific evidence to support it.

Despite decades of research, scientists have not been able to clearly identify trigger points as distinct physical structures in muscle tissue. Studies that attempt to locate them rely heavily on practitioner judgment, and when multiple clinicians examine the same person, they often don't agree on where a trigger point is - or whether it's there at all.

This is problematic for many conventional approaches to massage therapy, which claim to identify and treat muscle knots with precision. Even the physical description is inconsistent. We expect these spots to feel tight or hard, but that assumption is unreliable. Some tender areas feel firm, others feel soft, and some don't feel like anything in particular.

So we end up with a circular explanation. It hurts because there's a knot, and we know there's a knot because it hurts. That's not evidence. This doesn't mean the experience isn't real. People obviously feel these spots, and they can be quite painful. What's unclear is what they actually are.

Current evidence suggests these areas are not discrete lumps of contracted tissue, but part of a more complex process involving the nervous system. Local sensitivity, irritated nerve endings, and protective muscle activity are possible contributors. In other words, muscle knots may refer more to a sensation than a clearly defined physical structure.

Massage therapy has a strong reputation for "getting out the knots." You might wonder why it matters how they're defined, as long as the treatment works. It matters because the explanation shapes the treatment. If you believe you have a physical knot or adhesion that needs to be broken up, a logical approach is force. Teeth-grittingly deep pressure. Push through the discomfort until the muscle contraction releases.

From a pain science perspective, causing substantial pain during treatment is difficult to justify as a therapeutic approach. The nervous system doesn't interpret painful pressure as helpful. It's a threat. Pain is the nervous system's way of signaling danger. It's a protective response. When pressure becomes too intense, the nervous system usually responds defensively, increasing muscle guarding and sensitivity. If there was in fact a contracted muscle fiber - which current evidence does not support - this technique would only cause more tightening.

Massage can absolutely help with these sensitive areas. It can reduce pain, improve comfort, and restore a sense of ease in the body. But it makes little sense to cause more pain while trying to reduce it. Working within a person's comfort zone and creating a sense of safety aligns with current understanding of pain modulation and manual therapy. And it's a much more pleasant experience for the person receiving it.

But how do so many massage therapists seem to know exactly where to work? A few minutes into a session, I pressed into a spot on the back of my client's shoulder. "That's it," she cried. "How did you know?" Stories like this are a dime a dozen. Countless clients have been amazed at my ability to find their sore spots. "You are so intuitive!" Apart from what many believe, intuition has no place in manual therapy or in healthcare in general. What I do have is education and experience. I know where common tender points tend to show up. I also know how a body can respond to touch - subtle tightening, a shift in breathing, a muscle twitch. These are signs of sensitivity, not hidden structural defects.

Massage therapists don't have a sixth sense. Experienced practitioners develop pattern recognition built over years of repetition. That's how I locate and alleviate "muscle knots." With an understanding of current pain neuroscience, I now work to make treatment a pleasant, pain-free experience.

References: Quintner et al., 2015
Lucas et al., 2009

Quick Energy Boost: A 5-Minute Self-Massage Routine

Instead of pushing through fatigue, this simple sequence uses touch, movement, and breath to stimulate your system and bring you back online. You can do it anywhere, whenever your energy dips.

In this video, you'll learn how to:

• Wake up your brain with scalp stimulation
• Boost alertness with ear and face massage
• Release tension in your neck, shoulders, and arms
• Use breath to support energy and focus
• Reset your body in just a few minutes

Join me and give yourself a natural, feel-good energy boost.

What's new with me ...

We had the most wonderful time in London! Jesse, Sienna, and I spent five days exploring the beautiful city. Favorites included the Tate Britain, riding the London Eye, exploring Kew Gardens and the Treetop Walkway, Big Ben and parliament, The National Portrait Gallery, walking along the Thames, and strolling around Richmond. We even visited the house where Jesse's grandmother grew up, and the church where his grandparents were married.