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Updated: Apr 26

Muscle Knots in Neck & Shoulder? Learn their causes, some easy self-relief tips for neck & upper back pain, & why massage therapy can truly help with this!

Woke up feeling a bit out of shape? Oh no, there may be some muscle knots hiding in one of your muscles! Come on then, let's get it out of there.

As a massage therapist, I hear the word 'muscle knots' so often that I'm considering to dub myself a muscle knots therapist. May be more fun, but the problem with muscle knots is that they exist but they don't. I know, I know. Something clients refer to as muscle knots and therapists are trying to be smarter than thou by saying: ooooooh you mean adhesions, can actually be a million different things. Nonetheless, they feel like knots and we call them knots, and there is nothing wrong with that.

back pain, muscle knots

So in order to try and explain muscle knots, I must make it clear that there are four stressors that can induce pathology (knots!) in the muscle and surrounding connective tissue: it includes adhesions, scar tissue formation, trigger points, inflammation, stiffness, atrophy and ischemia.

The four stressors that can cause muscle knots in neck & shoulders are these:


Simply, movement. Our posture is influenced by the shoes we wear, a mattress we sleep on, the chair at work, being left-handed or right-handed, a heavy shoulder bag, and so on. Due to these postural imbalances, we overuse some groups of muscles and under-use others. Under-used muscles can develop a degree of atrophy, fascia stiffening, ischemia, while overused muscles can develop inflammation, hypertonicity, spasms, trigger points, or scar tissue.

TIP: Keep active! Stretch stretch stretch, aaaaaand streeetch! Try different sports or types of exercise to introduce new movement patterns to your body. Do yoga. Get a Deep tissue or Thai Yoga massage, obviously. Make your body "think" out of the box!


What we put into our system, including water, food, supplements, medication.

What we put into our stomach is what goes into our system, muscles include:

- nutrients and oxygen supply muscles with energy,

- potassium and magnesium determinate the secretion of the muscle-moving chemical, acetylcholine,

- body-unfriendly substances that aren't being flushed out of the muscles by blood or lymph, cause a build-up of pathogenic tissue in the form of phlegm, crystals, oedema.

TIP: Keep hydrated (and you may want to check the acidity levels in your tap and bottled water - keep in on the alkaline side!) Eat your greens! Boost your absorption by detoxing and cleansing your digestive system periodically with a lymphatic drainage massage. Test yourself for food intolerance and sensitivity. Keep away from fast sugars and processed foods. Support your belly by friendly bacteria cultures.


Forgive me if I sound too holistic, but our body does react to our every thought and emotion. Why? Because the mind is directly connected to the body by the nervous system (afferent and efferent nerve endings, heh) and the history of any emotional trauma is going to result in tension in the body. Sometimes it's the whole muscle group, sometimes is the single sarcomere within the muscle strand within the muscle bundle that won't relax. Body language is the best way to picture how thoughts and emotions affect our movement or posture. Cultural factors, such as how we are being seen due to being male or female, our age and social status also often dictate how we should be sitting, standing or moving. It can result in developing dysfunctional movement patterns which are going to affect the state of our muscles.

TIP: Talking therapy, journaling, yoga, meditation, deep relaxation techniques, Alexander technique, NLP, hypnotherapy. Find a therapy that works for you.

 journaling, tea, relax


My least favourite, because it indicates something can't be changed. But what if someone told you it can be? The rule here is being familiar and honest with yourself as to what your flaws, strengths and cognitive/behavioural tendencies are, and employ them in the most effective ways. Choosing the type of sport that challenges your weaknesses is very VERY difficult and tough work, but the results are so sweet that once you've tasted them, you won't ever want to go back.

TIP: Know thy self. Read. Watch. Try. Fail. Try again. Zen Master Seung Sahn said: "Try, try, try. 10,000 times."

Best of luck!


If you enjoyed this post I’d be very grateful if you’d help it spread by emailing it to a friend or sharing it on your favourite social. Thank you!

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We hope you now have a better idea of what are muscle knots.. make sure to experiment our self-care tips next time those muscle knots appear in your neck and shoulder!

monica pineider massage therapist in london

Hi, Thanks for reading our blog! I'm Monica: founder of A to Zen therapies! I love being a massage therapist and   I strive to support you guys feeling looser, stronger & more positive day after day! I am here to share all my best tips to help you get even better results from your massages with maintenance, natural health and wellbeing advice. 

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