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

It may seem like a stupid question. But why do we call them ‘knots’? We’ve all had them … that muscle tightness and tension as we hunch over a computer or smartphone or the weekend warriors who decide to play a sport we haven’t played for years. It can hit you pretty hard when you suddenly get that “knot” in your neck, back or shoulder.

Sometimes those knots seem to come when we aren’t doing much at ALL! Like Sleeping.

trigger points and referred pain when sleeping

Waking Up to Pain

We in the Pillow business like to call those muscle pains we wake up to as “Sleep Accidents” –caused by improper sleeping positions and postures. FACT: 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. Trigger points often “refer” pain to other parts of our bodies… sometimes quite far away. This referred pain is usually constant and can be mild to severe and usually a deep pain.

A common example is the headache you might have that is really coming from a trigger point from your neck.

One can never assume the pain we feel is where the problem lies. (Similar to that pain in your ass likely is referred from elsewhere).


headache referred pain enVy pillow

Headache and Referred Pain


Trigger Points Can Be Elusive

The knots / trigger points themselves 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 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.

Where are Trigger Points Found?

Considering that ‘muscle’ is the largest organ in the human body and accounts for 50% of our weight (Some of us maybe a little less than that). We have about 400 muscles, all of which we can get “knots’ or “trigger points”. Along with the pain and referred pain they cause, there is also significant fall out of body dysfunction with restriction of movement and improper posture.

How do you know you have a Trigger Point?

Just have someone press their thumb into that knot 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 .. see photo)

“You could have multiple trigger points in one muscle, maybe a few inches apart. Muscle often feels denser and tighter at a trigger point — more rope-like. When you push on it, pain spreads throughout the muscle area.”Dr. Leizman.

trigger point on trapezious muscle envy pillow

If muscle is healthy it will feel relaxed and soft to the touch and not dense… even if you are “muscular”. A trigger point is very tender to pressure. On a microscopic level part of the muscle fiber is contracted into a small thickness and the rest of the muscle fiber is actually stretched quite thin. This is what we feel when we feel a “Knot”. These contracted muscle fibers are in fact not available for use which is why we need to rest / treat it before we can get back to the activities we love…. Like turning our heads.

Untying the Knots

According to many pain Specialist, there are ways to relieve the pain and release the knots/ trigger points.

  • MASSAGE: Rubbing the trigger point to loosen and release the tense muscle.
  • ANTI-INFLAMMATORIES: Helps reduce the muscle pain.
  • HEAT AND COLD: Heating Pads and Ice Packs are always helpful.
  • KEEP ACTIVE: It’s true what they say “use it or lose it” and muscles need to stay moving to recover. Start with gentle stretches and work up to increasing the activity.
  • RESEARCH THE CAUSE: Try to figure out what is causing the problem. Perhaps it is a repetitive activity, a poor sleeping position or poor posture at your desk or computer. In fact some believe that emotional stress can cause trigger points/ muscle tension. Identify what’s “stressing out” your muscle.
  • PREVENTION: Make yourself aware of your body’s posture in all your activities including sleeping habits. If sleeping posture/ergonomics is a problem it may be time to invest in an ergonomic pillow that keeps the muscles properly supported while you sleep. The enVy pillow is one such pillow that is recommended by Physiotherapists, Chiropractors as well as Massage Therapists.

Take note of the headache, neck and jaw pain, tennis elbow, carpal tunnel syndrome, joint pain etc you feel. It may not be what it appears.

Do you have an unexplainable pain that could be tied to a “trigger point”?


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