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What Causes Knots Between Your Shoulder Blades And What Makes Them Go Away?

By Kathryn Merrow
Feb 10, 2009
Lots of us have pain between our shoulder blades and spine. We often call them "knots." That's just what that muscle spasm in our back feels like--a knot in the muscle.

What causes these spasms, or knots? What can you do to "knot" have them anymore? Wouldn't you like to know how to get rid of them?

People often write to me wondering if I can help them get rid of the knots near their shoulder blades. They tell me how much discomfort they have or how miserable they are. I understand; I used to have those knots, too.

I explain the causes of their back pain symptoms. I also tell them why the therapies they have tried did not work, or didn't work for very long.

"Gloria" wrote and told me she had "deep" massage and that it did not help get rid of her knot. Her doctor gave her shots in the knot that had not helped, either. Here is part of my response to Gloria.

The reason the hard massage and other treatments you have had didn't work for very long is probably because they did not address the cause of your pain. The massage therapist and doctor were working on the symptom (your pain) rather than the cause of your symptom. This is a common occurrence as therapists and doctors often do not understand why someone is having pain.

I am guessing that you are right-handed, since your pain symptoms are on the right side. Knots usually happen on the side of your most-used hand.

First, some background: All muscles attach to at least two bones. That is what allows us to move. If a muscle is pulling on one side of a bone (for instance, one side of your shoulder blade) then the muscles that attach on the other side of the bone will also be pulled on.

In other words, when a muscle contracts, or gets short and tight, it pulls on a bone. It moves the bone out of the bone's neutral (and best) position. The other muscles that attach to that bone then get stretched (simply because they are attached to the bone, which has moved.) Those muscles don't like to be stretched, so they go into their own special type of contraction--they get a spasm (they tighten and become taut.)

This spasm is a natural reaction from muscles when they are stretched for a long period of time. This is how your body keeps the overstretched muscles from tearing or being injured.

So, the shortened (pulling) muscles cause the problem (your symptom, or knot) but they don't usually complain. Instead their counterparts (opposite muscles) do complain. Loudly.

What you are feeling (your symptom) is pain caused from tautness in the overstretched muscles. Those are your "knots." Your overstretched muscle is not tight, rather it has become taut. There's a big difference.

If those painful spasms are massaged deeply, or injected with medicine to relax them, they may relax for a short time (or not.) The reason they can't stay relaxed is because the other muscles and bones that originally pulled on them are still pulling!

It is a natural law that taut muscles cannot relax until the pulling muscles are relaxed. The pulling muscles are the cause of your pain and they are what must be released, or relaxed, to give you relief.

It is okay to also massage the knots to help release them, after the pulling muscles are released. Your taut muscles can relax then. Then the knots can be released with pressure therapy.

What type of therapy applies pressure? Professional therapeutic massage can be very beneficial when the therapist understands how muscles work. You may have to guide him or her with this article. Encourage your massage therapist to "surround the dragon" rather than pounce on it all at once.

You can apply pressure yourself if you lie on a tennis ball on the floor. This doesn't get rid of the tight muscles pulling on the knotty area, unless you strategically use the tennis ball as pressure on those areas also. But, tennis ball therapy can be helpful.

Once you have the tennis ball under the most tender area of muscle (your knot,) then just lie there without moving. In about five minutes, you will notice that you can't feel the tennis ball much anymore. Your muscle is relaxing.

Move a bit to find the next tender area. Lie there and let gravity work. Then move to the next area.

A very important thing to prevent future knots is to get a strong back. That will keep your muscles from being overstretched and taut. It also benefits your whole body.
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