In Defence of the Term 'Muscle Knot'

What do you think when you hear the term muscle knot? Do you get annoyed with the phrase because it isn’t anatomically correct? Or is it your go-to way of describing tender spots in your clients’ muscles? 

Some therapists don’t like it because the muscle hasn’t ‘tied itself in a knot’. Instead, they prefer to say “trigger point,” “hypertonicity,” or “myofascial dysfunction.” But the trouble is: most clients haven’t heard of those terms. Or if they have, they’re not entirely sure what they mean. 

But they have heard of muscle knots. 

When someone comes to see me and says, “I’ve got a knot in my shoulder”, I don’t stop them and offer a technical correction. I listen, I feel, and I work to release the area that’s causing discomfort. Because at the end of the day, communication matters more than terminology. 

We use all sorts of phrases in everyday client conversations—like “pulled a muscle,” “pins and needles,” “slipped disc,” or “frozen shoulder.” None of them are technically accurate, but they’ve become part of how we talk about pain and discomfort. If a client wants to understand more, of course we’ll explain. But most of the time, these familiar terms help us express what they’re feeling in a way that makes sense to them—and that’s what matters. 

So what is a muscle knot, technically? 

What we call a muscle knot is usually an area within the muscle that has become tight, contracted, or hypersensitive. Muscles are made up of fibres, and sometimes a few of those fibres remain contracted when the rest of the muscle has relaxed. That’s when you get that dull ache, reduced movement, or local and referred pain. 

These points can form due to overuse, poor posture, lack of movement, or even stress. The muscle isn’t literally tied in a knot—but it can certainly feel like one: tense, sore, and stubborn. 

Massage helps by releasing those tight fibres, restoring normal muscle function, and calming the nervous system. 

But the thing to remember is that clients don’t need a lecture in anatomy. They need help. And if they call it a muscle knot, absolutely fine. 

Of course, it’s important that we, as therapists, understand what’s really going on. But that doesn’t mean we have to replace every familiar word with clinical jargon. If anything, doing so can make things more confusing. 

A client might think, “Wait—do I have a trigger point? I thought it was a knot. Is that something different?” 

When we insist on only using “approved” terminology, we risk sounding distant or dismissive. Using everyday language is often more inclusive, more client-friendly, and ultimately more effective at building trust. 

Final Thought 

I don’t mind using the term muscle knot. It’s familiar, it’s descriptive, and it helps people explain what they’re feeling. Just because it isn’t an anatomically perfect label doesn’t mean we should abandon it. We have plenty of words in the English language that carry flexible meaning—and this is just one more. 

Let’s not be so quick to correct our clients. Let’s meet them where they are, speak their language, and focus on what really matters: helping them feel better.