Often times you’ll hear someone complain "I have such a huge knot in my shoulder" or "my back is full of knots". You may feel around your own shoulder and notice some crunchy lumpy spots. So what are "knots" exactly? Well I am so glad you asked! The simple explanation is that our muscles are layered and are oriented in many different directions. Their layers cross each other at various angles - think of some as parallel, like 14th Street and 23rd Streets in Manhattan, and others as perpendicular - 2nd Avenue as compared to 10th Street. To add complication, there are often several layers of muscles right on top of each other. You may find that at these crossings, from time to time, rather than gliding past each other nicely as usual, muscles may become adhered or "stuck" to their surrounding structures, resulting in a crunchy, lumpy, hard and painful spot that can feel stuck and uncomfortable. (Knot is a misnomer, as muscles aren't literally tangled up). An adhesion can start to limit your range of motion, making it harder to move or stretch in a certain direction, which is often uncomfortable and painful.
A common spot for someone to feel a bit stuck is Levator Scapulae because of its angular orientation (Think Broadway, how it runs along at an angle to all the other streets). Levator starts at a point high up in your neck, and runs at an angle to attach to your Scapula (or shoulder blade).
Why do we get knots? Muscles become adhered for all kinds of reasons, most commonly because of posture and sitting still (in front of a computer or at a desk) for too long. Sound familiar? When we don't move around, we don't allow proper blood flow - blood being important because it lubricates our muscles, bringing fresh oxygen and nutrients, all while speeding away the yucky stuff that accumulates over time. We aren't meant to be sedentary, our bodies need movement and action to stay healthy. (An extreme side of this is when muscles atrophy, or waste away, from lack of movement.) Another contributing factor to adhesions is dehydration. Coffee and alcohol are diuretics, and in order to stay well hydrated and it good shape, our bodies require water. Muscles are a pretty spongy tissue, and need to stay well hydrated to perform their best. Injuries can also contribute to adhesions, and they are commonly found at points of scar tissue.
How do you get rid of knots? There are a few things that you can do to treat adhesions, most notably stretching and massage therapy. Massage therapists will fully warm up an area before working on it, using long, gliding strokes and deeper kneading strokes (fancy terminology for these strokes is Effleurage and Pettrisage). Applying pressure to the area with their fingertips, fists, elbows and forearms, your therapist will sink in slowly into the painful area that is bothering you. A skilled therapist will at first work along the length of the muscle using long gliding strokes to feel the adhered areas, and then work across the points of adhesions using a technique called Cross Fiber Friction to help gently unadhere those stuck spots. This usually feels a little painful, but very very good. (What I like to call "Delicious Pain". The session should follow with gentle mobilization and stretches for maximum benefit. You can also give yourself a massage at home using a foam roller.
How can I prevent getting knots in the future? Take Breaks - don't stay in the same position for hours and hours, walk away from your desk or computer regularly, and use the most ergonomic posture that you can when doing repetitive work. Stretch regularly, it helps establish nice patterns of movement and increases your range of motion. Stay hydrated, skip excess caffeine and alcohol. Keep in touch with your body through activities that allow an understanding of how you're feeling, like meditation and yoga. You wouldn't wait for your car to break down before changing the oil - take a moment to listen to your body and notice where you have stress and tension, so that you can take preventative action before a condition worsens. Regular massage appointments can also help inform you and remind you of what is happening with your muscles, all while treating the pain and discomfort and increasing circulation.