Is That ‘Knot’ in Your Neck Really a ‘Knotted’ Muscle?

Waking Up to Pain

We have been in the Pillow business for over a decade after inventing our Class 1 Medical device for neck support and TMJ support. We like to call those muscle pains we wake up to , often in our neck or upper back as “Sleep Accidents” –caused by improper sleeping positions and postures. Spinal experts will tell you that our sleep posture should closely mimic our proper standing posture.  Meaning that when we are lying on your back you should be able to draw an imaginary straight line running from your forehead, chin and chest which is close to parallel to your mattress.  This can be accomplished using a pillow with the neck support. See photo below.

These "knots" are technically called 'Trigger Points'

Unlike a “muscle spasm” which is a very active contraction of the entire muscle, trigger points are a more specific small part of a muscle. And to make things more difficult, these Trigger points often “refer” pain to other parts of our bodies --sometimes quite far away. We may think the injury is in our shoulder blade but it actually may be in our C-Spine (neck). This referred pain is usually constant and can be mild to severe and usually a deep pain. This is confusing as we are unaware that the criminal is no where near the crime!

Common Example: That headache you wake up to might actually be coming from a trigger point in your neck, of all places! 

One can never assume the pain we feel is where the problem originates from.  Similarly, we have all experienced the pain-in-our-ass that is generally “referred” from elsewhere.

Trigger Points Can Be as Elusive as Unicorns

These Knots in our muscles and/or Trigger points often do not hurt AND it is interesting to note that we often don’t even notice them UNTIL someone pushes on the them.  The patient is  often surprised when a very tender tight spot is located (which they were unaware of) and is nowhere near where they are actually experiencing the pain.  A very common experience for RMTs during their treatment sessions.

Where are Trigger Points Found?

‘Muscle’ is the largest organ in the human body and accounts for an average of 50% of our weight -- that's a lot of real estate to find trigger points.  We have about 400 muscles, all of which we can get “knots’ or “trigger points”.  Even worse than the pain and referred pain they cause, there is also significant fall out of body dysfunction with restriction of movement and improper posture.  Unable to turn your head to one side, or down or up. This is a common ailment for many healthcare workers who have to look down for hours while doing surgery or cleaning your teeth. Dr. Sheila Nazarian is a Plastic Surgeon who talks about her inability to lift her head the morning after performing surgery.  This is life changing for many of us.

How do you know you have a Trigger Point?

Simply have someone press their thumb into that knot (the one you know is there)  and you will quickly diagnose a trigger point. According to specialists in Cleveland Clinic’s Department of Pain Management, trigger points are commonly found in our trapezius muscles (those muscles that run from the base of our skull, neck down to middle of back and shoulder..

If muscle is healthy it will feel relaxed and soft to the touch and not dense, even if you are “muscular”. On the other hand, a knotted muscle or trigger point is very tender to pressure. On a microscopic level part of the muscle fibre is contracted into a small thickness and the rest of the muscle fibre is actually stretched quite thin. This is what we feel when we feel a “Muscle Knot”. These contracted muscle fibres are in fact not available for use which is why we need to rest and treat it before we can get back to the activities we love. Even if that is simply being able to turn our heads to check our blind spot!