Many a time have I heard clients referring to a specific painful spot in a muscle as the "knot". Although, more or less, every-one of us has experienced the pains caused by a "knot", or range of motion restrictions, or, have even felt the "knot" while self-palpating, we never really ponder on it much. "Oh, it's just another knot", we say, and continue our lives despite it getting more painful or more annoying by the day. We tend to ignore it as much as possible, because in the end. It will resolve itself, right?
True, but just like any other, untreated condition, which will eventually resolve itself, it will probably not recover to its full potential. To fully understand the long-term consequences of not treating sore and knotty muscles (and mind, we are not even talking about injured muscles), one needs to have an idea of what a "knot" is and how it forms.
Muscle fibres tend to stick together forming adhesions. This can be caused by micro-traumas, prolonged contraction or stretch, incorrect posture, overuse, under-use, incorrect use, sudden use etc. The blood flow to the area is restricted (therefore the oxygen and nutrient supply is also obscured), allowing the accumulation of metabolic waste. Painful spasms and restricted range of motion, happen more often than not. Now, this might make sense to a health professional or fitness fanatic, but to the average Joe, it's all Greek to them as far as they're concerned.
To simplify things, imagine, a muscle made up of bundles of elastic ropes, and each elastic rope is made up of shorter rubber bands attached to each other like the links of a chain (a bungee jump rope is a perfect example of the mechanic properties of a muscle fibre). A healthy muscle fibre has contractile and elastic properties, meaning it can contract and it can stretch, always to a certain point. For the reasons mentioned above, muscle fibres tend to stick together, resulting in an uneven application of force.
To visualise this better, imagine having 10 elastic bands in array, one end being the one you will tug on, the other end attached to a weight. By pulling onto your end, all 10 elastic bands will apply an even force onto the weight. Now, imagine tying a knot on a few of the elastic bands, therefore shortening the length of those few bands. When pulling onto your end now, not all 10 bands will be applying the same force onto the weight. Those, few knotted one's will pull stronger since they are shorter than the rest. Even at rest, those shorter bands will still be applying more force onto the attached weight. If this visualisation is helping, then try to imagine what it would be like to tie a few knots (say 3-4 knots) on those few elastic bands we chose to be knotted. Even further, imagine tying two different elastic bands together, while at the same time they are knotted. Ok, now mentally tug onto them. Will they all be applying an even, smooth force onto the attached weight?
Now, having a better idea of what "knots" are, let's go back to paragraph 2 and see how untreated "knots" can affect us in the long-term. As mentioned before, we are likely to ignore the pains and be patient till things sort themselves out. However, every untreated "knot" will heal to a certain point leaving an adhesive residue. This residue acts in an accumulative manner. And it is common that new adhesions will happen in the same, more or less, area that the previous ones exist, since those locations are already the weakest link in the muscle. This explains why people of an office-natured profession tend to get knots in their upper backs and necks, individuals with a large kyphotic curve get knots in their intra-scapular region, drivers get knots in their lower backs and so forth. This also explains why we tend to get chronic pains, but explaining the term "chronic" will be the issue of another blog.
A massage therapist will treat already existing "knots", prevent the accumulation of adhesions, and identify the reason(s) of why you have these "knots" in the first place. Keep in mind, that no therapist can "fix" you with a snap of their fingers. Recovery requires time and patience. Mostly on your end.