My friends were giving each other back massages the other day when I heard one of them say “Dang girl! You’ve got a lotta knots!” Intrigued, I walked over and asked her to show me. She took my hand and put it on my other friend’s back. I felt a hard little bump just to the right of her left should blade. Gross.

What exactly is a muscle knot? Most of us know what they feel like, according to the National Institute of Health over 44 million Americans suffer from them, but what are they? In all honesty, nobody really knows. There is not a solid medical definition for a “knot.” However, there are several theories about how they form and even more ways to treat them. Let’s take a deeper look:

How Muscle Knots Form

Most professionals agree that muscle knots are tightness in muscle tissue, usually in the fascia or tendons. They are formed because of stress or overuse of a muscle. Overdoing it at the gym or hitting a new level of intensity in your workout can certainly contribute to the formation of knots, but they’re found more often in people that do a lot of desk work.

When you sit at a computer for hours on end, the way you hold your head, shoulders, and arms can put your muscles in a situation that isn’t natural to them. This can put stress on your muscles and cause knots to form.

Another theory is that knots are a buildup of toxins in your muscle that come from stressful situations. If you are stressed out over something, you are more likely to have muscle knots. A possible explanation is that when you’re under stress your body gets tense and if this tension isn’t released properly, then it builds up in the form of knots.

Muscle knots are also thought to be related to scar tissue in some way. If you are an athlete then you will have a buildup of scar tissue in the muscle that you use the most. Example: a friend of mine through hammer for the track and field team all through college. She would get knots in her lower back from the way she had to throw the hammer. Those knots were most likely caused from overuse and deterioration of the scar tissue in her muscles.  Knots are thought to develop in muscles with scar tissue more frequently than regular muscle.

Whatever the reason your knots form, you’re really looking for a way to release them and continue on with your day. Just as there are many reasons for knots to form, there are many ways to treat them.

How to Treat your Knots

One of the first things you can try is hot or cold therapy. If you take a hot shower or put a heating pack on the afflicted muscle, it can help it to relax and possibly release the tightness that is characteristic of muscle knots. If hot doesn’t work, try cold. Placing a cold pack on your muscle can help reduce inflammation, which might be the reason your muscle can’t relax.

Massage therapy is also a very good way to release your knots. Heating the muscle with light pressure and then applying direct pressure to the knot (about a 7 on a 1-10 scale) until it releases is very effective. Applying direct pressure essentially cuts off the blood flow to your knot, which “starves” the knot from oxygen, forcing it to release. Typically the pain will get worse right before the muscle relaxes. You can do this for yourself, but if it is an especially hard knot then you might want to treat yourself to a massage by a licensed professional.

The best way to treat knots is to avoid getting them in the first place! Eating foods with lots of potassium and calcium can help reduce the likelihood of getting a knot. It’s also important to stay hydrated whenever possible. Because knots seem to form more often in people that do desk work, it’s a good idea to get up and walk around every hour or so in order to release the tension that comes from sitting in the same position for hours on end.

Muscle knots are still a bit of a mystery, but when they come a-knockin’, you can send them away by trying one of these methods. If the muscle pain doesn’t go away after a few days of home treatment, I highly recommend going to see your physician.

Penelope is a health and wellness enthusiast who writes regularly for First Medical Products, a retailer of fine medical supplies and equipment including TENS units which can be used for the treatment of muscle knots and other sports injuries discussed in this post.