Knots Are Not What You Think —

When people talk about “muscle knots,” they are usually describing a tender, tight, or painful spot in their muscles. This is one of the most common things massage therapists hear — and it is a real experience.

But the way muscle knots are commonly imagined is not quite how the body actually works. Muscles do not physically tie themselves into knots. Muscle fibers run in organized, parallel directions and do not tangle like a rope. What people feel is more accurately described as a sensitive or irritated area within muscle and connective tissue. In clinical and research settings, the term closest to what people call a knot is myofascial trigger point. A trigger point is described as a tender, sensitive spot in a muscle that may be part of a tight band of tissue and can sometimes refer pain to another area of the body, such as neck tension contributing to headaches. However, even trigger points are not fully understood or universally agreed upon in medical research. There is no single test or scan that clearly proves their physical structure.

What is widely agreed upon is that people experience real pain, sensitivity, and movement restriction in specific areas of muscle. So what may actually be happening?

Most current theories propose a combination of factors, including increased local muscle tension or incomplete relaxation, heightened nervous system sensitivity that maintains muscles in a protective state, reduced circulation in specific tissue areas, and fascial stiffness that restricts smooth movement between tissues. In other words, what feels like a “hard knot” is often a mix of muscle activity and nervous system signaling rather than a chunk of tissue that needs to be broken apart.

What can massage do for muscle knots? Massage can:

Reduce muscle guarding and excessive tension- Improve circulation and fluid movement in tissues- Calm the nervous system and reduce pain sensitivity- Improve mobility and comfort. These changes can make painful areas feel softer, less sensitive, and more functional — even though the tissue was not physically “untied."

What massage cannot do is crush or permanently remove knots, release toxins, or fix the underlying cause if the tension is coming from posture, repetitive movement, stress, or lack of recovery. If those factors remain, the same areas may become sensitive again over time. That is why massage works best as part of a bigger picture that includes movement, strength, rest, hydration, and stress management. Massage helps reset the system and support healing, but it is not meant to be a one-time mechanical fix.

Muscle knots are real sensations of pain and tightness, but they are not literal knots in your muscles. They are signals that your body is under strain and needs support. Skilled massage helps calm the tissues and nervous system, improve movement, and reduce discomfort — creating the conditions your body needs to feel and function better.