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Why Do These Muscle Knots Always Come Back After Getting Them Worked On?

Why Do These Muscle Knots Always Come Back After Getting Them Worked On? Barefoot Rehabilitation Clinic

15 Jan Why Do These Muscle Knots Always Come Back After Getting Them Worked On?

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One of the most common questions we get at Barefoot Rehab is:

Why do these muscle knots always come back after getting them worked on?

I’ll add, that “worked on” usually means one massage per week for months, if not years, or a daily bruising from your husband or wife when you say:

Honey, can you just, put your elbow right here into the crook of my neck? Oh, yes, right there. That feels so good. Don’t move …

Muscle knots are the bane of many neck sufferers’ existence. So much so, that one person (me) is calling it “The Great Spaghetti Phenomenon of the 21st Century.”

Let’s find out if pushing on muscle knots is worth your time.

Getting Your Muscle Knots Worked On is Not Worth Your Time

Let’s say that your significant other spends 15 minutes, 2x/week, pushing with his/her elbows or fingers into your neck.


30 minutes/week … 2 hours/month … 24 hours/year.

If you’re in the honeymoon period of your relationship (the first 1-2 years of seeing each other), you probably can’t get enough talking, touching, and being with your significant other. Your partner’s hands-on time may be double our projections, assuming 4 nights per week. On the other hand, if you have kids, it may be half that or 1 night per week due to the rugrats’ ability to launch spaghetti (actual pasta) all over your house, leaving you constantly cleaning up after them.

Any way you put it, the time your other is spending on your muscle knots is between:

12 – 48 hours/year.

Most people who have muscle knots in their neck have had it for years, only growing worse over time.

Let’s simplify our equation and assume that you’ve had your muscle knots and your neck pain for 10 years.

10 years of muscle knots + 10 years of a loving other’s elbow in your neck = 120 – 480 hours of well-intentioned, but unnecessary effort.

I don’t know how much money your other makes, but let’s say he/she makes $10/hour. At $10/hour, your significant other could have made $1,200 – $4,800 over the past 10 years instead of “loving” your neck.

While done in your best interest, there’s a better way to get rid of those muscle knots. First, you have to understand why muscle knots are the wrong suspect.

Muscle Knots are Like Cooked Spaghetti When You Forgot to Add Oil to the Pot

You see …

A muscle knot is a trigger point. Doctors like to used the word, “hypertonic” muscles (“hyper” = too much, “tonic” = muscular tone).

A muscle knot is a band of tissue that is acutely overloaded. Think of a muscle that has been working over-time, in the short term (days to weeks) and is doing it’s best to handle the workload you’ve put on it.

What does a muscle knot feel like?

A muscle knot is ropy. Everyday pain sufferers feel it like a small bundle of rope. The texture of a muscle knot is something any loving husband or wife can identify. It feels like a bundle of cooked spaghetti when you forgot to add oil to the pot. The person’s fingers on your neck will skip or jump over it, noticing very clear borders to the knot.

If you’re the one with the muscle knot, it will most often feel good to someone push on it.

The hallmark location of muscle knots is in the crook of the neck.

Many a patient have asked the doctors at Barefoot Rehab during exam while the doctor’s hands are feeling muscles:

You’re close, but that’s not the pain. Move your hand lower. Lower. Keep going. There! You feel that muscle knot?! That’s what’s causing my pain! It feels to good when you just push on it.

While it feels good to you, the muscle knot is not what’s causing your pain.

The muscle knot is the effect. Not the cause.

That’s why you can pummel them, needle them, or see doctors to directly treat them over and over again like the NY Times suggests with no permanent resolution.

Treating an effect means the effect will come back tomorrow because the cause was never removed.

And the Great Spaghetti Phenomenon of the 21st Century continues as loved ones continued to push on, massage, pulverize, and attempt to cook your neck’s spaghetti when really, you get rid of the spaghetti by not touching the spaghetti at all.

If not spaghetti (muscle knots), then what?

Treating Adhesions Is Worth Your Time

There’s an actual problem, that when treated, provides huge dividends (and causes the muscle knots and spaghetti to never come back).

It’s called a muscle adhesion.

What does a muscle adhesion feel like?

An adhesion is not ropy. Adhesions feel leathery and dense. Kind of like trying to push your thumb through a well-done steak (Note: A healthy muscle feels like a raw steak, which is precisely what a muscle is.) Adhesions do not have clear boundaries and are harder to perceive to ordinary humans.

If you’re the one with the muscle adhesion, it may feel like nothing is there, quite painful, or even pleasant as you feel the adhesion tearing under your fingers by someone who knows how to get rid of it.


If you really want to get rid of your muscle knots, adhesions, and pain in a permanent way, find an adhesion removal specialist to get rid of your muscle knots without ever touching them. Integrative Diagnosis Providers specialize in adhesions. If you live in North Jersey or New York City, call us at Barefoot Rehab.

Finding and fixing adhesion is our specialty.

As long as you don’t have significant structural damage to your neck (as evidenced by x-ray or MRI), then there’s no reason why you shouldn’t spend $1,270 over 8 weeks (assuming 15 treatments at $75/treatment and an exam of $145) getting rid of your muscle knots, once and for all.

And we’ll never have to talk about spaghetti again.

A Brief Note on Foam Rolling, Lacrosse Balls, and Other Self-Assisted Myofascial Treatments

Anything you’re going to do to yourself is helpful for recovery, not for removing a problem (or pathology).

Recovery means increasing blood flow, increasing oxygen, and neurologically relaxing all body parts in the area of your chosen weapon. This is good to do to make sure you can workout tomorrow.

Removing a problem (or pathology) takes something different. This is helpful to do to perform at a higher level, get pain relief, or prevent the wear-and-tear of degeneration as you age.

Imagine your muscles are a rubber band.

You can let quite a heavy elephant stand on a rubber band (compression forces) and nothing will happen to it.

Take the rubber band and pull it apart (tension forces) with your humble human hands and it may snap.

It takes 6 pounds per square inch of tension to tear adhesion. With thousands of pounds of compression, you are likely doing nothing to an actual problem in your body.

As Albert Einstein points out below, if you’ve been foam rolling your low back (or any other body part) without permanent (defined by less need to continue foam rolling to maintain results) for more than 3 months, stop the insanity.

speechbubblesHow much do you love your husband or wife for pushing on your muscle knots? How tired are you for pushing on his or her muscle knots? How happy is he or she going to be when you say “Eureka! We have a better solution!” Share in the comments below.

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Dr. Chris Stepien, DC, Full-Body ID Certified, ART Certified, CSCS, and CrossFit Level 1 Certified, is a Sports Therapy & Chronic Pain Resolution Specialist with Barefoot Rehab in Parsippany, NJ.  When you're in pain that hasn't gone away and you've been to at least 3 other doctors, Dr. Chris wants to help you. And when you're sad, depressed, or not enjoying life, Dr. Chris wants to hug you. He invites you to reach out, no matter what your concern is. Barefoot Rehab is here to serve you.
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  • Anita Hawkins
    Posted at 13:09h, 16 September Reply

    Could you recommend someone in North Carolina who could treat muscle adhesions, or tell me what I need to search for to find a good person to treat this condition?

    • Dr. Chris
      Posted at 20:42h, 16 September Reply

      Hi Anita, Unfortunately, I don’t know anyone trained to treat adhesions so successfully in North Carolina. Depending on your resources, there’s someone in Tampa who would be able to help. If not, you can try some “myofascial massage therapists” or search “active release technique”, but I haven’t found 100% of these providers to be excellent.

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