Freese, Clark and Storrar - physiotherapists

Is it a "knot" or not?

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One of the most common causes of muscular pain is what is commonly termed “knots”. Another, more scientific term for “knots” is trigger points. They can be defined as an irritable spot within a taut band of muscle. They are often felt as tender, hard “pea-like” nodules within the muscles. It is thought that the taut band within the muscle affects its own blood supply which causes irritation and pain. Trigger points can occur in various areas of the body however the most common areas are in the neck, shoulders and back muscles.

After forming trigger points have two phases, namely an active trigger point and a latent trigger point. An active trigger point leads to pain, this pain could occur locally as well as it could refer to distant areas. For example, the muscle of the top of your shoulder called trapezius could develop a trigger point which refers pain up the side of your neck and face; it may also result in headache-like symptoms. Typical symptoms of a trigger point are pain, which is often described as a dull, achey and deep pain, stiffness and tension. Latent trigger points are very common and generally do not cause pain unless they are compressed or pushed on.

There are several factors which could predispose you to developing trigger points such as poor posture, repetitive mechanical stress e.g. typing for long periods of time, joint disorders and sustained loading of muscles e.g. carrying a briefcase or laptop bag.

Identifying and eliminating the predisposing factor for the development of trigger points is most important in the management of them for example, elevating your shoulder whilst working on the computer. A thorough assessment by your physiotherapist is very helpful in identifying these predisposing factors. Physiotherapist may also use several modalities to relieve your symptoms such as massage, ultrasound, heat or ice, transcutaneous nerve stimulation (TENS), dry needling and stretching.

Please contact your physiotherapist for an assessment and treatment.

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