Trigger Point Therapy Explained: What a "Knot" Actually Is
By Josh Kennedy, RMT, July 11, 2026
A "knot" is usually tissue that has become overworked and irritated because it is compensating for a weaker muscle nearby. Pressing on it can release it temporarily, but it comes back until the weak muscle it covers for starts working again. That cause-first approach is how trigger point work is used at LYKE Massage, in mobile, in-home RMT sessions across Durham Region, Ontario.
What is a "knot" actually?
When you press on a knot, you are usually feeling tissue that has become ropey, firm, and tender, a muscle or a spot within a muscle that has been worked past its capacity. Here is the part most people have backwards: an overworked muscle is not a strong muscle. In many cases the tissue in and around a knot is weak and fatigued, forced to keep working because something nearby stopped doing its share. The tenderness is real. It is just not a sign of strength, and it is rarely the whole story.
Why does pressing on one spot cause pain somewhere else?
This is a referral pattern. An overloaded structure can send pain, aching, burning, or even numbness into areas well away from the spot itself. The tendon of the latissimus dorsi, near the shoulder, is a good example: when it becomes heavily overused it can enlarge, firm up, and send pain down the arm to the elbow, wrist, or fingers, and can make areas of the arm and hand feel numb. Plenty of stubborn arm and hand symptoms trace back to a structure like that rather than to where they are felt.
Why does the knot keep coming back?
Because releasing the spot does not change why it was overworked. If the weaker muscle it has been covering for still is not firing, the same load lands on the same tissue the moment you go back to your day. When the correct muscle is activated instead, the tenderness reduces, the tension subsides, and the result lasts longer. That is the difference between chasing a knot and treating one. For more on this pattern, see Where It Hurts Usually Isn't Where the Problem Is.
How is trigger point work used in a session?
As one tool, not the whole treatment. Focused, sustained pressure is used to release overworked tissue, and sometimes to help you become aware of a muscle that has gone quiet, since feeling a muscle is often the first step to using it again. Myofascial release works more broadly on the connective tissue around muscles, and the two are often used in the same session. What matters most is the assessment around them: finding which muscle stopped doing its job, so the release actually holds.
A technique, not a standalone fix.
Trigger point work is used within Chronic Pain Massage and Functional Massage sessions, applied alongside work on the underlying cause.
Frequently asked questions
What is a muscle knot?
A knot is usually tissue that has become ropey, firm, and tender because it is overworked, compensating for a weaker muscle nearby that has stopped doing its share. An overworked muscle is not a strong muscle; in many cases the tissue in a knot is weak and fatigued.
Why does pressing on my shoulder make my arm hurt?
This is a referral pattern. An overloaded structure can send pain or numbness well away from the spot itself. The tendon of the latissimus dorsi near the shoulder, for example, can refer pain down the arm to the elbow, wrist, or fingers when it becomes overused.
Why do my knots always come back?
Because releasing the spot does not change why it was overworked. If the weaker muscle it covers for still is not firing, the same load returns the moment you go back to your day. Activating the correct muscle is what reduces the tenderness and makes the release last.
How is trigger point therapy different from myofascial release?
Trigger point therapy applies focused, sustained pressure to a specific overworked spot. Myofascial release works more broadly on the connective tissue around muscles. Both are tools used within the same session where the assessment shows they are needed.
Questions about your condition?
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