published 5/12/08, updated 11/18/09

[Clinical science update on the physiology of muscle knots or trigger points.]

Toxic Muscle Knots

New research confirms that muscle knots (myofascial trigger points) really are quagmires of toxic, irritating molecules

by Paul Ingraham, Vancouver, Canada MORE
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Credentials and qualifications

I am a writer and retired Registered Massage Therapist (unusually well-trained for a massage therapist, a 3000-hour program). I’m almost done with a Bachelor of Health Sciences degree. I am a peer reviewer for The Natural Standard, and a copyeditor for Science-Based Medicine. My most important qualification is more than a decade of workaholic post-graduate study, clinical experience, and constant conversations with readers from around the world, including many experts who have provided countless suggestions and criticisms.

For more information, see: Who Am I to Say? More information about my qualifications, credentials and professional experiences for my readers and customers.

EXCERPT This article is an excerpt from an extremely detailed tutorial, SaveYourself.ca’s advanced troubleshooting guide for muscle knots:
Advanced Tutorial: Save Yourself from Trigger Points & Myofascial Pain Syndrome!

I have some exciting new muscle knot science to report on. And this is a really a thrill for me, because my professional life revolves around muscle knots: they are both clinically important and full of mystery, yet their secrets are steadily yielding to scientific investigation right now. It’s wonderful to be alive for that, to learn things about myofascial trigger points that no one has ever known before.

Quick muscle knot review

Muscle knots, technically known as myofascial trigger points (MTPs), are a factor in almost all of the world’s aches and pains. A trigger point is a small patch of super-contracted and irritated muscle tissue, which can cause symptoms ranging from mild stiffness to extreme pain and a variety of odd side effects. They not only cause pain and problems directly, but also spring to life in response to almost all other painful problems, compounding and complicating them. Even though th existence and importance of trigger points is well known to medical specialists and researchers, most doctors and therapists knows almost nothing about them, so misdiagnosis and ineffective treatment are epidemic. For more information about how trigger points might be involved in your own medical history, see:

Save Yourself from Trigger Points & Myofascial Pain Syndrome!

Muscle knot chemistry

Today’s muscle knot science news concerns their chemistry, specifically the toxicity of the tissue fluids in and around them. The science of myofascial trigger points (MTPs) has been dominated since 1995 by the theory of a poisonous feedback loop, a vicious cycle. The idea is that knots generate a lot of tissue fluid pollution, waste products of muscle cells that are metabolically “revving” with intense contraction … and those “exhaust” molecules are then accumulating, causing pain and other symptoms, and irritating the MTP even more. This is called a metabolic energy crisis, and it’s why I’ve been informally calling trigger points “sick muscle” syndrome for several years now.

But this picture of a vicious cycle perpetuated by toxicity has always been just an educated scientific guess. “The feedback loop suggested in this hypothesis has a few weak links,” writes David Simons, the world’s leading trigger point researcher.

Fortunately, new research has really helped to firm up the theory.

Does your body feel like a toxic waste dump?

It may be more literally true than you realized. A muscle knot is a patch of surprisingly polluted tissue: a nasty little cesspool of waste metabolites. No wonder they hurt, and no wonder they cause so many strange sensations: it’s more like being poisoned than being injured.

The bleeding edge of muscle knot science

Starting with a simpler study in 2005, and then a more thorough one early this year, a group of scientists using “an unprecedented, most ingenious, and technically demanding technique” have confirmed that there really are irritating metabolic wastes floating around the neighbourhood of trigger points: “… not just 1 noxious stimulant but 11 of them,” Simons explains. “Instead of just a few noxious chemicals that stimulate nociceptors [pain sensors], nearly everything that has that effect was present in abundance.”

Basically, what the researchers did was analyze tissue samples from in and around trigger points and compared it with healthy muscle tissue. The differences were significant. The tissue of MTPs is rotten with irritating molecules: molecules associated with inflammation, with pain, and with immune function.

Trigger points are rotten with irritating molecules.

Feel the burn! Muscle knots are acidic …

Personally, I was particularly pleased to see evidence that trigger points are also strongly acidic.

I guessed that this might be the case several years ago. (The pioneer of trigger point research, Dr. Janet Travell, had already suggest the same thing, but I didn’t know that at the time.) I often told my patients that trigger points were “acidic,” because it seemed likely to be true and because … well, it just sounded good, I guess! In those days I was not as scientifically literate as I am today, and I hadn’t noticed that I was being intellectually dishonest, presenting a sketchy theory as though it were a meaningful fact.

Fortunately, the scientific evidence now supports my opinion! (And Dr. Travell’s.)

Trigger points really are strongly acidic which means that, for instance, it is actually plausible that deep breathing — which lowers blood acidity — could be relevant to treatment. One of the possible goals of massage therapy is to “flush” trigger points by pushing stagnant tissue fluids out. Perhaps if blood arriving in the area is significantly less acidic, the TrP will recover more easily? It’s certainly possible. But these days I know better how much I don’t know, so I’ll stop with just the suggestion.

Some great extra-curricular muscle knot reading

Professionals are strongly encouraged to read David Simons’ analysis of both the new evidence about the chemistry of energy crisis in trigger points, as well as another new scientific article on the use of magnetic resonance elastography (MRE) imaging — a very promising new way of taking pictures of muscle knots!

Simons writes that this technology “may open a whole new chapter in the centuries-old search for a convincing demonstration of the cause of MTP symptoms.”

Unfortunately, most casual readers will be stumped by Simons’ thick scientific jargon.

For much more information about muscle knots, see my tutorial for patients and professionals.

ADVANCED TUTORIAL

Save Yourself from Trigger Points & Myofascial Pain Syndrome!

Myofascial trigger points — muscle knots — are increasingly recognized by all health professionals as the cause of most of the world’s aches and pains. This detailed tutorial focuses on advanced troubleshooting for patients who have failed to get relief from basic tactics, but it’s also ideal for starting beginners on the right foot, and for pros who need to stay current. 199 sections grounded in the famous texts of Drs. Travell & Simons, as well as more recent science, this constantly updated tutorial is also offered as a free bonus (2-for-1) with the low back, neck, muscle, or iliotibial pain tutorials. Add it to your shopping cart now ($19.95) or read the first few sections for free!

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