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?

Share this!

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.

Share this!

Dr. Chris Stepien, DC, Full-Body ID Certified, ART Certified, CSCS, and CrossFit Level 1 Certified, fixes your annoying and frustrating pains, even when it's been over 6 months and you've seen 3-5 other doctors or therapists without lasting relief Barefoot Rehab in Denville, NJ. 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.
Gravatar Image
  • 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.

  • Trina Chapman
    Posted at 20:23h, 23 September Reply

    What the heck is somebody supposed to do if they don’t live in N.J? I am in chronic pain that has taken over my entire life. I have physical therapist having me roll all over balls and rollers. and it does nothing. I have massages. None of it helps.. I have had A.R.T. done and it helps temporarily. What questions should one ask when looking for a therapist that treats the problem properly? Please help.

    • Dr. Chris
      Posted at 01:37h, 25 September Reply

      Hi Trina – I know, this is not easy. This is a new style of healthcare that is innovation. Like any new treatment, it starts at experts popping up across the world, making awesome changes. Then, it spreads over the years and decades go by. It’s a question of resources to start.

      The biggest thing is that most people, even with chronic pain, should understand the 5 Visit Rule. I expect to give permanent relief in 5 treatments or less. You should too. And, the doctors or providers you see should have a diagnostic list of what they’re treating.. Do they have a track record of fixing hard cases?

      Where do you live?

  • Ashley White
    Posted at 00:06h, 13 November Reply

    Hi Chris, i’m 19 years old, I have trained in the gym for nearly three years now. for the last year I have been experiencing an uncomfy feeling in my left shoulder, this has led to me getting muscle knots in my left trap, left pec, left bicep, left delt and a painful feeling near the back of my left elbow. I have been to the physio who said that my jaw is the problem, then I went to a chairopractor that said otherwise, he took an xray which showed my c4-c5 vertebrae out of alignment along with slight scoliosis of my spine. I had about 5 treatments at £35 for about 20 minutes of him running between multiple clients at once. I am so confused with what to do. I just want to train pain free again. any advice would be amazingly helpful. thankyou!

    • Dr. Chris
      Posted at 01:23h, 13 November Reply

      Hi Ashley, sounds like you have a lower cervical disc issue. This could also be a degenerative issue of the facets. The location of all of your knots sounds like “sclerotogenous referral” on your lower neck. Were the 5 treatments adjustments of your spine or soft tissue work. I’d try to find a really good soft tissue specialist. I doubt there are any adhesion providers where you’re location. It’s also NOT your jaw, at least directly. You could have a separate jaw issue, but a jaw problem can’t cause all of those knots you’re having. LMK. I’m here for you.

      • Ashley White
        Posted at 00:45h, 05 December Reply

        Hi Chis, thankyou for your reply, I had tried another chairopractor and they did not give me any change. I have stopped going to the gym for now. what is the sclerotogenous referral? I had looked up on google but I didn’t find much information, if this is the problem what would you suggest the route I take? thankyou again for your reply, im 19 and don’t understand why all of these problems are happening, it is so disheartening.

        • Dr. Chris
          Posted at 12:22h, 05 December Reply

          Hi Ashley, I’m sorry for the problems. But, the more you can focus on figuring out the problem and pursuing a solution by taking action, the less you will suffer.

          If you do have “sclerotegenous referral” coming from a disc in your neck or a facet joint, then the answer is for someone to remove the adhesion, taking stress off of that damaged tissue (disc or joint).

          The problem is, we are hard to find and there aren’t many of us. You can try someone who does myofascial work, but if you don’t get some permanent relief in 3 visits or less, you’re wasting your time, then find another person.

  • Krista Stevenson
    Posted at 02:40h, 21 March Reply

    Please send me info on an adhesion removal specialist for the knots in my shoulders that won’t go away. I live in Roanoke, VA but can travel to NC if needed.

    • Dr. Chris
      Posted at 11:00h, 12 April Reply

      There’s no one in those locations. You can go down to Florida (Peak Soft Tissue) or come up to NJ and see me. : )

  • Brittnee P
    Posted at 21:31h, 24 April Reply

    Hello! I have been playing sports for 15 years. In high school and college I played basketball and I’m a go harder baller where I’m working almost every muscle. I’m very athletic. 3 years ago I started experiencing some stiffness in my shoulders over the years has gotten worst effecting my neck and also causing tension headaches. This has taken somewhat over my daily activities. I won’t allow it to stop me from still playing but it has allowed me to stop doing thing I usually do like enjoying being out with out tensing up. My ear hurts at night depending how I lay. I have several knots in my shoulders and my neck is super tensed. I live in buffalo NY. What’s the closes area or do you know of any doctors here?

  • Dr. Chris
    Posted at 08:43h, 25 April Reply

    You’re in much luck. There are 3 of my colleagues who practice Integrative DIagnosis in Buffalo. Go here and type “buffalo ny”

  • Charlotte Myers
    Posted at 05:40h, 07 June Reply

    I have a cluster of knots literally on my scalp area! This is the most strange part. It came after I was detoxing from opiates and my body went wacko! My pain management doc did a sudden cold turkey on me after 17 years and my muscles in my whole body went haywire! I am back on track again because I got help from another doctor, however my muscles are not too happy. Got to be one of the most odd phenomenas around! My muscles are still in “shock” so to speak. I promise u one thing, noone wants to experience what I and many people go thru after a sinister act like that. Im seeing a chiropractor and he said I had muscle clusters. Thats all he could give me. I dont believe he even knew how that is! Have you ever heard of this. Im still experiencing weird twitching and spasms here and there. If u can help, tell me.

    • Dr. Chris
      Posted at 09:55h, 07 June Reply

      Hi Charlotte, proud of you for going off opioids. Not easy. Unfortunately, I have ZERO experience with knots on the scalp. But I’d imagine that a proper diet, hydration, sleep, and really good muscle work will help. You might also want to see a functional medicine doctor to get your blood checked and make sure everything is OK on that front.

  • Ashley
    Posted at 11:47h, 25 June Reply

    Hi. I am 32 and I was in a car accident 12 years ago. All of my lower ligaments had been torn. I was seeing a chiropractor for a few weeks before finding out I was already a few months pregnant. I then no longer seen one until a year ago. The chiropractor had said I would have to be seen the rest of my life. My back pain is severe to the point I do not want to move. I can feel my muscle knots like they are bulging out of my back. Due to me not getting the treatment right after the accident the muscles constricted around my spine. So the chiropractor states. Would an adhesion specialist be able to cure this problem or am I really having to look forward to seeing a chiropractor the rest of my life?

    • Dr. Chris
      Posted at 22:02h, 25 June Reply

      Hi Ashley, I’m sorry for your troubles. This is difficult to say as we don’t have a prioritized diagnostic list. What exactly were you diagnosed with? If you “don’t want to move” and your “knots are bulging out of your back”, it’s safe to say you have moderate-severe spinal degeneration (likely disc). The next question is, how much adhesion do you have in your low back muscles, hip flexors, sciatic nerve, and other muscles that would correlate? Hard to say whether an adhesion specialist can cure your problem. For now, here are 25 video testimonials of people who had more than 6 months of pain and had NO PERMANENT relief with at least 3 doctors before finding us (https://www.youtube.com/playlist?list=PLnKFrpVz7iNARbHRTDHp6zKPUFT2xFWc-).

  • best clothing suppliers
    Posted at 21:27h, 01 July Reply

    Hi. I am 32 and I was in a car accident 12 years ago. All of my lower ligaments had been torn. I was seeing a chiropractor for a few weeks before finding out I was already a few months pregnant. I then no longer seen one until a year ago. The chiropractor had said I would have to be seen the rest of my life. My back pain is severe to the point I do not want to move. I can feel my muscle knots like they are bulging out of my back. Due to me not getting the treatment right after the accident the muscles constricted around my spine. So the chiropractor states. Would an adhesion specialist be able to cure this problem or am I really having to look forward to seeing a chiropractor the rest of my life

    • Dr. Chris
      Posted at 14:43h, 02 July Reply

      You’re definitely going to need to see a doctor/therapist if you want to stay as pain-free as possible til you die. That’s because you tore the lower ligaments. The question is, “How often will you see them?” Yes, an adhesion specialist would allow you to have permanently less pain and see a doctor/therapist less frequently.

  • ac market
    Posted at 08:41h, 03 August Reply

    You’re definitely going to need to see a doctor/therapist if you want to stay as pain-free as possible til you die. That’s because you tore the lower ligaments. The question is, “How often will you see them?” Yes, an adhesion specialist would allow you to have permanently less pain and see a doctor/therapist less frequently.

  • Bethany D
    Posted at 05:32h, 19 August Reply

    Hi! I have epilepsy so I’ve had a lot of experience with falling, I had an incident when i was a child and fell out of a three story window that messed up the lower part of my spine also and i worked as a CNA for years until my seizures got so bad that i couldn’t work anymore. My doctor told me that i have I have damage to cyatic nerve bc my hips hurt all the time and i lose feeling in my legs a lot of the time. I was in physical therapy for a while they tried many different things and nothing would help. Everytime they would do a massage i would go back the day after and the knots and the tention would be back just as if it never left so they requested that i just start getting shots but i refused bc i figured that would be even more painful. Just want to know your thoughts after reading some of the replies to others.

    • Dr. Chris
      Posted at 16:01h, 17 March Reply

      Hi Bethany! Sorry for very long delay. Yeah, it sounds like there is damage to the sciatic nerves or lumbar nerve roots. Now, the question is, how much of your symptoms is degeneration vs. stuck with adhesion? If you can ever find an Integrative Diagnosis doctor to diagnose you, you’d be able to find out how much permanent relief you can get.

  • Jason Chiumento
    Posted at 00:03h, 30 October Reply

    I live near Memphis, TN. I’ve worked out for about 22 yrs, mostly weight related. 5 months ago I had an aching in my right shoulder blade, mostly around the blades edge. I’ve tried months at a chiropractor and after no luck, I’m now at an orthopedic (Ortho One) that has PT, even the PTs are stumped. The doc took x-rays and say no anomaly’s beyond some slight disc degen around c6 vertebrae (which he says was normal for a 42 yr old). The area seems to continualy knot up, along with the right trap at times. I’ve stopped doing any upper body workouts now, I’ve tried using a lacrosse ball around that shoulder blade ridge, and can feel it flare right up as if it’s the “hot spot”. PT says they do feel that the right side is tight “angry”, compared to my left as a comparison. Please help, any idea, suggestions, remedies..?

    • Dr. Chris
      Posted at 16:03h, 17 March Reply

      Hi Jason, sorry for delay. Depends what your diagnosis is. The “upper trap spot” is often either levator scapula adhesion or a lower cervical disc derangement. The best thing you can do is minimize stress to your neck, making sure you’re sitting with full back support, and not texting or reading with your head down. If you can ever make your way to an Integrative Diagnosis doctor, I hiighly recommend it. We all specialize in permanent relief for chronic pain patients, non-surgically. Hope that helps.

  • Why Myofascial Release Doesn't Work for Chronic Pain
    Posted at 17:13h, 15 January Reply

    […] already wrote about trigger points, or muscle knots and the Great Spaghetti Phenomenon of the 21st […]

  • Melissa McCann
    Posted at 23:59h, 21 March Reply

    Hello. I have chronic neck and upper traps pain. I was in a car accident years ago that we believe caused my “military neck”. I also played the flute with poor posture for years which seems to have led to my neck actually growing crooked – my whole neck bends to the right a bit. I have constant knots in my neck and on top of my shoulders. I see a chiro and massage therapist every two weeks, but I could go every week it’s so bad sometimes. I was told to use a posture pump to help put the curve back in my cervical spine. Does this actually work? And is there anything I can do to correct the right sided bend of my neck?

    • Dr. Chris
      Posted at 11:39h, 22 March Reply

      Hi Melissa – I’m sorry for what you’ve been dealing with. Your symptoms are likely coming from a cervical disc problem. No, a posture pump is a waste of time. Even if it feels good during, your symptoms will come back after a few minutes or hours. Make sure you’re respecting the sit slide lean rule. You can google it on our website. At some point, you’ll need to get the adhesion removed to get chronic pain relief in a permanent way. Ideally sooner than later so the arthritis (disc issue) doesn’t get worse. HOpe that’s helpful.

  • Jack Prasad
    Posted at 19:47h, 12 April Reply

    Hey there – Last year I started running a ton after no exercise for years, wearing basic unsupportive shoes. Arch of my right foot started hurting but I kept running on it until it became too painful (thought I was being too soft!) – it’s been about a year and finally saw a DPM. Ultrasound looked totally fine, but you can FEEL the adhesions in my arch / that tendon connected to the big toe, which is wear the pain is. Any advice? Just started with chiro using graston, hasn’t helped yet but only been a few sessions. Thank you!

  • Travis Hayward
    Posted at 11:46h, 05 April Reply

    .Hey Im 32 and about three years ago i had a breathing problem, no one could figure it out. Started out seeing a gi, lung sp. every doc you could imagine…. I found a dentist up in Indianoplois hes a Lvi dentist he found it on his ex ray.. Which was my madible was to far back causing me to breathe through like a straw. fast foward he has got my madible and max widened and pulled out with no surgery hes awesome. Ive had tongue release, So i run a pressure washing buisiness and for 2 years i went through this truama where i couldnt breathe, fast forward to now i cant run a pressure washer cause all the neck pain that comes with it. My dentist also found my atlas was out of line I see a nucca chiro every month with the dentist. So i see a massage therapist who takes the knots out twice a week…which is deep tissue…. I also see a cranio who does soft tissue and I have felt good when they do it, but as soon as i go bacj out and pressure wash my body shuts down and i get knotted up real bad again.. Well about a month ago i was on a neck group who i met a functinal movement sp. he acess me my glutes dont fire my hips are tight have ankle problems….. So now i am doing foam roller trigger ball massage and release on my own self, ive lost all strenght but slowly building my body back up again… I have been through this crazy journey the last 3 years and im not gonna give up.. So last week i got diagnosed with crohns, and i saw on your page something about crohns…. I have abdomal cramping and dir. all the time, right now about to be on budesonide and start humara wednesday but i dont want to do shot injections for the rest of my life.. Their has to be a solution, I have had sinus trouble all my life, inclduing two surgerys…… so my biggest thing here do you think i have adhesions doing all this pain. My upper traps work way to much my lower traps or rhomb dont work at all but with the functinal th. hes working on that with me… Do you have a solution for my problem i want to stop pressure washing but then again thats what put food on my table.. Thanks

    • Dr. Chris
      Posted at 13:53h, 10 April Reply

      Hi Travis, wow, you’ve been through a lot. I’m sorry for your struggles. I love all the learning you’re doing. When it comes to chronic issues like this, it’s all about accumulating all the puzzle pieces. It DEF sounds like you Have adhesion. One of our colleagues, Dr. Ryan Pribble, is in Indiana. I don’t think he does jaw issues, but he is a master of the neck. Dealing with the sinus issues ( and diet), any anxiety, etc. is how you get all of this stuff better. If you need to get the jaw structures treated, we just had a patient fly out from California last week for the 4th time. Hes 70% better. We are here for you.

  • Katie
    Posted at 20:50h, 23 March Reply

    Hello! I have been dealing with chronic trap pain and upper cervical/occipital pain for almost 8 years with no hope with any treatment that I have tried. Injections, acupuncture, etc. I am not located in NJ but I have seen posts about someone you can refer to in Tampa area? please share if you can who that is please! I am desperate for help.

    • Dr. Chris
      Posted at 13:49h, 24 March Reply

      So sorry to hear Katie. Veracity Soft Tissue – Dr. Andy Wengert! He’s not too far from you

  • Lisa
    Posted at 04:36h, 07 March Reply

    For 6 months, I have chronic shoulder spasms that happen when i lift my arms and even when I change sleep positions. They never go away. And when I put my arms fully down, my shoulders and upper back feel heavy, so I’m forced to keep my hands in my pockets so I can feel comfortable. I’ve tried everything (except pharmaceuticals) like self-massage and stretches and heat therapy, but they are just temporary fixes. The heaviness in my shoulders always comes back, and the shoulder spasms are always present for 6 months straight. How do I get rid of these problems for good?

    • Dr. Chris
      Posted at 15:26h, 07 March Reply

      Hi Lisa, it sounds like you either have a cervical disc issue and/or nerve roots at scalene entrapments (when you put your arms fully down). I recommend you see an ARM specialist.


      Hope that helps

Post A Comment