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  • Writer's pictureAnne-Marie Rose

Help! I have knots in my shoulders!

Updated: May 27, 2020

As a massage therapist I have a lot of clients come to me suffering from tightness and soreness, particularly in the upper back/shoulder area. Massage tends to relieve the discomfort but what are these knots and why do you have them in the first place?

I will do my best to explain here.

Physiology of a Muscle

Muscles are made up of layers of tissue with lots of little fibres wrapped up in fascia. These muscle fibres group together and one muscle unit is built, for example, the bicep. Muscles are involved in movement, lifting, bending etc and we have 650 muscles in our bodies to support movement, maintain posture, circulate blood among many other functions. These muscles can be broken down into 3 types: skeletal, smooth and cardiac. In this article we are concerned mostly with skeletal muscle, which is involved in voluntary movement of the body.

The build up of a muscle knot

Muscle knots are created when muscle fibres become compressed and adhere to each other, becoming tight and leading to a muscle spasm. The muscle spasm may be a series of small contractions or a prolonged muscle contraction, both having the same outcome which is that tense, "knotted" feeling in the shoulder area . During this time the blood flow and movement is restricted and there is a general feeling of soreness. There can be various reasons for the build up of a knot - it could be due to stress or exertion to name but a few.

How to prevent the build up of muscle knots

  • Diet and hydration - It is important to stay hydrated and eat a healthy diet.

  • Movement - If working at a desk take regular breaks rather than sitting in the same position all day.

  • Regular exercise - to include a warm up and cool down to allow muscles to stretch and be flexible.

  • Regular massage therapy to keep muscles healthy and increase blood flow/nutrients to the muscles.

  • Lifestyle - ensure regular sleep patterns and relaxation is part of your daily routine.

  • Good posture is important especially when sitting at a desk all day.

  • Regularly practice relaxation techniques and stretches.

I already have knots - what should I do?

  • Rest if necessary and allow your body to recover as much as possible.

  • Massage therapy - this can help loosen and separate the muscle fibres, allowing them to slide over each other again and removing restrictions.

  • Massage also increases blood flow to the area introducing nutrients into the tissue and making the previously tense area more relaxed and reducing any pain.

  • Physiotherapist - if the muscle tension is particularly bad then a visit to a physiotherapist may help.

  • Regular yoga/pilates classes - Such classes are ideal as includes plenty of gentle stretching.


Muscle soreness and knots are very common but as you can see there are measures to take to either prevent their occurrence or to manage the symptoms. I can help with massage therapy, with sessions starting from only £20 for 30 minutes which can focus on areas of tension. If you need support with healthy eating or exercise or referral to a physiotherapist I can also provide referrals to local professionals who are trained in this area and can work with you to promote your well-being.

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