"All this stress has my muscles in knots!" If you have ever uttered a phrase like this, you were probably right. What causes muscle knots, and how can you relieve them? Read on for advice from Tim Charleston, PT, DPT, a Piedmont physical therapist.

What are muscle knots?

Knots are comprised of tense muscle fibers.

"Muscle knots are actually hyperirritable spots in muscle or fascial tissue [bands or sheets of connective tissue] known as myofascial trigger points," Charleston says.

Trigger points typically fall into one of two categories:

• Active. These active trigger points produce intense pain in the body.

• Latent/hidden. You don't feel pain from these latent/dormant trigger points unless you press on them, resulting in tenderness or a dull, aching sensation.

Where do muscle knots develop?

Myofascial trigger points can develop anywhere in the body where there is muscle or fascia. Some common areas include:

• Neck and shoulders

• Lower back

• IT band area, which runs along the outside of the leg from the hip to the knee

• Calves

• Shins

Causes of myofascial trigger points

Charleston says there are several factors that can lead to painful trigger points, including:

• Injuries from overuse, heavy lifting or repetitive motions

• Poor posture, which often results from a sedentary lifestyle and lack of exercise

• Tension from mental and emotional stress

• Direct injury, such as a break, strain, tear, twist or strain  

• Prolonged sitting or bed rest

If you sit for long periods throughout the day, try this quick chair yoga routine or 15-minute exercise "happy hour" to get moving.

Are myofascial trigger points dangerous?

"Generally, trigger points are not harmful or dangerous," he says. "However, they are often called 'The Great Mimickers,' as they may actually be causing painful symptoms attributed to other conditions."  

These conditions include:

• Back pain

• Headaches

• Neck pain

• Rotator cuff (shoulder) pain

• Tennis elbow

• Carpal tunnel syndrome

• Hand and arm pain

How to get rid of muscle knots

At home, you can try massage or stretches. If the pain continues, see a physician who may refer you to a physical therapist. Physical therapists have a range of pain-relieving techniques, including:

• Therapeutic massage

• Therapeutic stretching techniques

• Dry-needling

• Low-level laser therapy

• Electrostimulation

• Pulsed ultrasound

• Mechanical vibration

• Ischemic compression

• "Spray-and-stretch" cooling spray

To prevent myofascial trigger points, take time to relax, increase your physical activity, take stretch breaks and walk as much as possible.

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