From the Research
A myofascial trigger point, or muscle knot, is a localized contraction knot that develops after muscle overuse or an acute trauma, containing tense muscle fibers that have contracted and failed to release, with characteristics such as being smaller, stiffer, and deeper in the muscle tissue for patients with pain. The composition of a myofascial trigger point is complex, involving contracted muscle fibers that compress nearby blood vessels, reducing circulation and causing a buildup of metabolic waste products like lactic acid 1. This restricted blood flow creates a self-perpetuating cycle where reduced oxygen and nutrients prevent the muscle from relaxing properly. The knot also contains sensitized nerve endings that contribute to pain both at the site and potentially in other areas through referred pain patterns.
Some key characteristics of myofascial trigger points include:
- Being localized contraction knots that develop after muscle overuse or an acute trauma
- Containing tense muscle fibers that have contracted and failed to release
- Being smaller, stiffer, and deeper in the muscle tissue for patients with pain
- Compressing nearby blood vessels, reducing circulation and causing a buildup of metabolic waste products like lactic acid
- Containing sensitized nerve endings that contribute to pain both at the site and potentially in other areas through referred pain patterns
The most recent and highest quality study on this topic, published in 2024, provides evidence that myofascial trigger points can be characterized using ultrasound-based measurements, and that a combination of metrics (depth, thickness, and stiffness) can be used by clinicians to evaluate individual trigger points in combination with standard clinical assessments 1. This study highlights the importance of understanding the composition and characteristics of myofascial trigger points in order to develop effective treatment strategies.
In terms of treatment, options include massage therapy, stretching, heat application, and pressure release techniques that help restore normal blood flow and muscle function 2, 3, 4. For persistent or severe muscle knots, physical therapy, dry needling, or muscle relaxant medications like cyclobenzaprine (5-10mg) may be recommended 2, 3. Regular movement, proper hydration, and good posture can help prevent these painful contractions from forming in the first place.