How refreshing to listen to someone with an intelligent, enquiring, independent mind! Thanks for this post Julian. I'm an Essentrics therapeutic fitness instructor. Understanding what's really going on in the body when things aren't right is hugely helpful to me.
Thanks for this. I have always struggled to understand exactly what these bumps and tender areas we, and clients call 'knots' are, knowing that logically the muscle can't actually be in a knot but not knowing what's actually happening. Just knowing that touch helps, and is really totally dependent on the individual client as to whether they need and respond to a deep or very light touch which can have the same outcome. Interesting to see what's actually happening under the skin.
Touch really does help, and movement in and around the area too. I agree that the pressure is probably just about a personal preference rather than any actual effect.
I have been a massage therapist for just under a year and I think you are close to correct but I don't think it is just fat. It's difficult for me to describe it in writing. I know that it's not the muscle that is tight. I used to do deep tissue massages with a lot of pressure. I figured out that in fact it's the facsia. It's the fascia that is tight. I do really deep tissue now with light pressure. The knots have legs and so instead of breaking down the knot, if you start from where it starts and then follow it to the knot, The knot will release. It's reallly hard for me to explain but I have been doing really deep tissue and hardly using pressure and the clients tell me it is not even painful and I am able to completely break down the muscle and relax it. I dont' know why massage is being taught the way it is either. I always start from the feet up because the muscles are all connected and the problem usually starts at the feet. If you start at the back you only band-aid the problem because it only loosens it a little. It will just become tight again from what is pulling it. I came here looking for answers. I was looking to see if anyone else had discovered how to get knots out easily and painlessly using light pressure but doing deep tissue and actually relaxing the muscle and fascia completely.
Thanks for the comment. I do know what you mean and it does feel that there is something deeper. But when you actually take the fat off the body (which I do during dissection) you can see how much fibre runs through this layer and feel the same structures that you would under your hands. The deeper layers of fascia and muscle just don't have that texture any more.
If you find an answer or solution please message me; I had a long term injury start healing and I never knew how painful muscle or facia dysfunction could be. I been getting trigger point injections in them at my sport doctor, and I try massaging but if I do too much I can hardly walk. I got zero drop shoes to help strengthen my feet and use pool, I can’t tolerate massages it’s torture. I also plan to do light weights to get blood flowing, no idea if this will help though. I asked my PT and she said stretch and strengthen the area idk 🤷♀️, I’ll give it a go.
@@LN-wt9ft I can't really describe how I do it because I do it by feel and it's slightly different on everyone. I know exactly what you mean about leg massages being torture, my legs get tight and it's torture when I have to get them massaged because no one else knows how to do it any other way than what we have been taught in school. Stretching may help but it doesn't help that much if the fascia is so tight that the muscle can't move. The method I use on my clients, I can only describe it as untangling the knots instead on pushing on the knots.
This is a great description of what I can feel and having attended dissections with you I have a good understanding of the textured fatty lumps you’re referring to. As a myofascial movement therapist I don’t find pushing knots around very useful and very often, for the client, it’s just painful, however working more globally with the tissues and bone movement has the affect of reducing or even magically releasing/removing said lumps in any case. Thank you for your humorous and insightful videos Julian 🙏🥰
I will never think of massage the same way! (Your comment below about how the lighter or deeper touch having to do with the nervous system makes perfect sense. How fast the sensory travels and what it effects is really interesting!)
Just found your channel and loving it. I remember looking at actin and myosin under a microscope when I was in Chiropractic College decades ago. They were either twisted up or laying straight. The theory was that those fibers got knotted up when there wasn't enough blood flow, O2 and ATP to keep it functioning with ease. I've been telling this story to my patients forever. Now what am I going to say? "Sorry, Dude, it's a bunch of fat cells? :))) I still work out those lumpy things either manually or with light, heat, BEMER, SCENAR or plain old massage....usually with lots of ironing pressure. At least it's getting the blood and lymph flowing again. I've once felt someone's huge 'fatty lump" in the shoulder that was hard as a rock. We thought it was a tumor and had it x-rayed first.....It was just "knotted" muscle fibers.....!!!
Thank you for your comment, it's really appreciated. As for what story now? I know what you mean, I have to keep going back to the drawing board regularly as what I thought I understood gets changed. I think the best advice is to hold on to your practice dearly and your theory lightly. What you do works, but the explanations are going to change. Regularly!
I would love to know more about your theory of using less pressure. Do you believe the lighter pressure communicates with the nerves in the superficial fascia and that we are actually working on the Nervous System rather than the Myofascia? Probably stated too simplistically but everything I am studying at the moment suggests light pressure communicating through the Nervous system is more beneficial.
I'd go as far as to say that ALL manual therapy is working with the nervous system rather than any mechanical outcomes. A very light touch will travel along slower, unmyelinated nerves to a different part of the brain, the insular cortex. The more physical and deeper touch will tend to travel faster and light up areas within the motor cortex. The differences are quite significant in terms of interpretation. But lighter or deeper probably doesn't make much difference except to expectation of the client.
It's not ever just fat, but is fibres that run in and between the fat cells that indeed are exactly the same as the fascia anywhere else in the body. Calcium deposits can occur, but these are less likely within superficial layers. The density of the fibres and how they conjoin give a huge nudge to this type of tissue being superficial.
Hallelujah, I get very frustrated at massage clients explaining that their problem is with 'knots' Not sure I want to explain that they have fatty lumps though. At least I was intuitively right. I also get fed up of clients thinking that deep tissue massage has to hurt to be effective
Yeah I know right? "Nah mate, it's yer fatty lumps". Not going to land quite right. Try "fibrous congestion of the superficial layer." There, fixed it! Thanks for the comment! :-)
@@julianbakeranatomy I studied Neuromuscular Therapy decades ago and i recall the concept of possible "incorrect" mapping on the somatosensory cortex for touch stimuli... So an area of nociception could be perceived as sensation in a different area than the place stimulated by pressure/touch. Any thoughts?
For sure, it's a well documented phenomena. Sensation, pain, restriction, even paralysis in some instances are all outputs FROM the brain rather than necessarily issues in the peripheral nervous system. Referred pain is a good example. Our gall bladder has sensory nerve endings but we don't really feel it consciously day to day. When we get pain, the brain doesn't recognise the region so interprets it incorrectly and it manifests as shoulder pain. Pain can be 'perceived' anywhere, it doesn't necessarily mean that's where the problem is and in many cases it really isn't!
Thank you for interesting videos. So the bumps I feel when I treat a body is fat? A lot of us have this lumpy knots between our shoulder blades, sometimes I can follow the lumpiness through a part o trapezius, it is like a hard string. This is fat? Does the lumpiness come from for example static movements, or why this lumpiness
It's not just fat, it's the fascia, the collagen that holds the fat in place. It's hard to know why the lumps and bumps arise, but probably due to changes in the way that fluid is moving through them or how fibres are being deposited.
I dry needle myself I suffer from extreme lower back pain, neck and shoulder pain. In my lower back the fascia I’m guessing it is well it feels like fibreglass. If you put a dry needle on fibreglass and push on it and it slides along it doesn’t penetrate it that’s the sensation I feel.
In my experience as a massage therapist, your lower back pain is most likely from you having tight and stiff muscles around the groin area. the groin area pulls on the muscles around the hip to the lower back. The lower back then pulls the neck and shoulder pain. Most of the people I see have lower back pain and they always just want their neck and back massaged. I don't know where you live but if you are coming by Reno, NV. I will fix you or at least be able to help you a great deal.
@Joleen I experienced this. Once I do mobility work for my hips my back loosens and actually feels much better. I do mobility and flexibility every day.
Well they still have the layer of fascial fibre in them, ready expand as and when needed. That is always there no matter how much fat you have and the fat cells are always there too. Same number. Just waiting to fatten up!
Great video. So what’s the solution to these specific fibrous bumps that feel tender to touch and relief after being massaged? Diet, exercise, massage, surgery etc?
I have an internal scar tissue injury in my wrists, forearms, elbows, and shoulders from repetitive injury and overuse and lifting heavy and playing very athletic sports like football. The pain started in my wrist in about mid way through April and has gotten worse slowly it is now in all the spots I listed and now it is almost October. The osteopath I’m going to is saying they have to break it all up been there 3 times see no difference the pain is not bad for a week then gets super bad for 3 days then when I wake up it feels good again it’s so weird, I get lots of pain in my tricep area and the tendons that connect to my elbow and in the spot you get tennis elbow and golfers elbow I am 15 and don’t know what to do I had to stop working and it is even hard to go to school have any tips or anything I just want anything advice. It’s in both Arms
If I am understanding your theory correctly, this does not explain why MFR is able to increase ROM and allow for smoother movements and muscle contractions. I still think MFR techniques do what the name implies: create motion between layers of tissue which are stuck together. Maybe I misunderstood this video?
I think you're assigning a specicifity to MFR, whereas any touch potentially can do the same. There is a degree of manually moving fluid around, but muscles don't knot. I mean they just can't. Also the layers that people keep referring to aren't there. Any hands on technique has the potential to change neural exchanges and increase fluid movement, but it's not releasing fascia and it's not breaking down muscle knots.
@@julianbakeranatomy ok, muscles can’t knot you say? Isn’t knot, in this case, more like the classic slipped disc? Most of us know that a slipped disc doesn’t mean the disc itself has moved at all. It’s a common misunderstanding of the condition but the name persists. Knot, I think to most people means a hard lump that is painful and restricts movement. Muscles can spasm, is that not what this is? Granted a whole muscle spasm is a different thing but couldn’t a ‘knot’ be a group of muscle fibres in spasm?
@@julianbakeranatomyfor example, right now I have a ‘knot’ in my calf, very low down, closer to the ankle than the knee. This is not an area with much adipose tissue at all, at least not on me. I think I can feel the skin, the layers underneath and then the knot, which follows on from the tendons I can feel going down towards the foot. Moving the knot moves the tendons, quite clearly. To me this is muscle tissue or are you suggesting that it’s not muscle tissue but the tissue very directly around the muscle that appears to form a solid mass right through the muscle to the bone? It must entirely encircle the muscle, in which case I presume you’d say that it’s restricting the muscle movement, eg lengthening, by some kind of strangulation?
Thanks for the comment, We can for sure feel changes in soft tissues. I have a thigh strain at the moment and can feel a difference in the tissues where the pain is. Is this in the superficial tissue? Probably not. But there will be systemic changes in the ECM and the surrounding tissues that will cause inflammation, increase in fluid dispersion and so forth. I would say (without any imaging) that the actual muscle will still be composed of straight thin and thick filaments that are still lined up and that the changes I feel and the bumpy bits are changes to the surrounding tissues. How can I be sure? Because I can still stand up and I can still flex and extend my leg at the hip. If there was any material degree of change to the muscle or impingement on or through it, I wouldn't be able to do that. Is it a spasm? No I don't think that a knot is a muscle spasm, I think its a deposition of tissues in the area and possibly a lack of oxygen along with it. The slipped disc thought is interesting, I'll give it some thought!
I suspected that no-one would really do it and write about it, because it's not a thing. But did a quick literature search anyway and nope it's not really a research question which is quite revealing!
That's interesting! It would be interesting to see the process of this imaging and what a control would look like. For instance what was the function of the person being imaged in this area and if there was any pain.
I had a client get an MRI of her hip because she was still having pain 3 months after dislocating her hip. The doctors told her they couldn't find anything wrong with her. But they may not have been looking for knots.
If I had a pound for every adult man’s and woman’s right shoulder tension? Not sure just fat ? Lean muscle tension and contracture around systems.. neck shoulder pecs all upper right back layers… the emotional link to tension/emotion/responsibility. It would be a disservice to occlude the emotional link to tension and tight, shortening of muscle tissue. Surely? Why we should give ourselves permission to cry …. Acknowledge the burden and difficulties we place on ourselves in this life. Toughness, barriers, boundaries, versus tears, flow, softening….. find yourself a Bowen practitioner to get back into the much more than physical flow of YOU! Atleast in my experience. Always love your work Julian… 🌟
Great comment and thank you! I absolutely agree that an emotional component is hugely relevant in terms of tension and my explanation doesn't exclude this, but it's still coming from neural input. We 'feel' stressed or tense and contract our muscles or breath differently as a response. The work we then do in whatever aspect helps us to identify and change these tensions, but the underlying principle is that the 'knots' are unlikely to be muscle in origin.
I recommend any touch therapist that you can relate to and feel comfortable with. Don't be afraid to have a clear conversation about what you're looking for.
Hi Julian, Another very interesting video that challenges widely held beliefs OK, so in essence you’re saying that muscle “knots” - no, I never liked that term - trigger points are just lumpy fat? I get that the fat layer would be one of the things that we as therapists are feeling when we press & rub our magic into some unsuspecting victim, sorry, I meant client. But, we must also be feeling muscle in the mish-mash of tissues we have under our fingers. It stands to reason that if I can also feel bony landmarks then I am feeling that through all the skin layers, muscle, connective tissue etc. So on to lumpy fat. I ask myself why it is lumpy. Our friend Robert Schleip in his paper “Active contractile properties of fascia” proposes that fascia contains within its structure myofibroblasts that have the ability to alter the stiffness of the fascial matrix over an extended period. So, we have a contender. I’m going to say it. Mmmm, dare I? Yes, I can do this… Nooooo… Maybe… Ok. IT’S THE FASCIA!!! Ha ha ha, there you go, I said it. But really, what else could it be that causes this tightness in the fat layer? A localised hyper-tonic group of erector pili muscles maybe? But in any case, it still comes down to why? Now that we have a fascial contender, why would this be the case? Why would fascia “choose” to be tight in discreet areas, like in the upper traps or the calves or wherever, and not others. My ex is a kinesiologist, and she would say that it is a response to an underlying emotion and that the location is based on TCM meridian points that align with that particular emotion. Mmmm, that’s her view, but in any case, it’s an interesting question. And… if fascia - there, I said it again - can produce stiffness in fat layers, then why not in muscle tissue. I’m sure that it could. The next question then is how does rubbing, poking & prodding produce a fascial release - Jeez, I’m on a roll now - over time? When I’m massaging, I can feel tight spots loosen somewhat during the course of the massage. Well, I’m feeling something that certainly feels like that. Funnily enough, when I do Bowen, the tight spots can remain from treatment to treatment, but the associated pain is relieved. Another conundrum. OK, so I’ve had a bit of a poke around your favourite topic and as Mythbusters say - it’s a plausible explanation. What say you?
Well there are some good points here, but ultimately when you touch a dead body (as I am prone to do on many an occasion) there is no tension. Muscle has no inherent tension from fascia or itself. Its tension comes from energy provided by the motor unit. There is always a degree of tension even when you're relaxed, until that is you're dead, after which it's gone. All of it. Any changes in tension you feel after a session are because there is a difference in the frequencies being sent to that area. If you get tissue changes under your hands, the direct influence of a lump or a knot changing will be because of the way that the fibres wrap themselves through the superficial adipose layer. The underlying layers are totally smooth. Always. You can feel bony landmarks and you can feel muscle but that's not the same as touching them.
@@julianbakeranatomy You know what? I've wondered about whether tension was held after passing on for a long time, but have never found an answer - until just now. Thank you. I know it makes sense, but so did localised muscle hyper-tonicity until you introduced the fat layer curveball 🙂 So, the question returns as to why certain areas exhibit tension and others don't. Could it be something like the tensegrity model? You put tension into one area and the whole structure compensates, but some part of the tension is transferred to another area and that becomes the "knot"... Or is it the kinesiology model? Or something else entirely... In any case, it would seem that touch has the ability to soothe the savage beast and help remove tension over time. We seem to be programmed to give and accept touch, even down to the age-old picking fleas off each other in stone age times (don't know - I wasn't there). Another question arises of whether it is the specific touches we give, say as Bowen therapists or deep tissue masseurs or the gentle touches of ortho-bionomy that give a specific response in the body. Or it is just the touch. I know that as a Bowen therapist I have had people come to me and say that their previous session with someone else was far too light and how could that do anything? Didn't work for me!! So I give a firm but fair treatment and they are happy and suddenly it works. As a massage therapist, I have had people coming in telling me to hurt them. In their minds more pressure = better outcomes. I try to convince these people to have a different treatment such as positional muscle release, which works just as well. So given that fulfilling a person's expectation of sensation of touch seems to be as important of what we do as therapists, how much of what we do is placebo? There is placebo in many interactions, even with a doctor who is prepared to listen to their patient. In placebo trials red pills work better than blue pills, two pills works better than one. So is it when our treatments meet the expectations of the client that it works better? I think so. Even the embellishment in the telling what we do to the client makes what we do more potent. Add in formal assessments prior to treatments and you have gold standard in placebo. Give them muscle knots (they understand that), give them fascial release, give them mumbo jumbo. It all works. Just as long as we as therapists know what it is we are doing and that is giving healing touch.
So you need to look at my videos on how to explain Bowen and also my 'All medicine is placebo' video. We can tense anything if the signal to that area is telling it to tense and it will be for lots of reasons. Compensation for pain or injury for example. We can learn how to behave or move (or not move) in a certain way and not even realise we've changed it. Once we point it out through touch, the capacity to alter that output is realised. Whether we do it or not remains to be seen, but release or change of over tension is potentially a millisecond away.
I have had severe muscle knots in pec, shoulder and neck for almost 1.5 years now from bad posture and no treatment has helped. It’s really depressing me and it’s affecting my workouts
If you are in the Reno, NV. area, message me. I will totally help you. I am a massage therapist and I have seen guys who work out a lot have the same issue. If I can't fix your problem, then you don't have to pay me. But i am pretty sure i can fix your problem or greatly relieve the tightness. Cause I'm sure it's pulling your shoulders and your neck muscles forward which contributes even more to the bad posture.
This is misleading. What we call a knot is a muscle or part of a muscle that has contracted and will not relax voluntarily. Putting direct pressure helps the area relax by both physical and neurological means. Just because it is not exactly like a tangled headphone wire doesn’t mean it’s not muscle related.
I'd see that as a spasm rather than a knot. The concept of a constricted and continuously contracted muscle is valid of course, but it wouldn't feel like the knots that we can feel under our hands. I use the tangled headphones as an easy analogy, but the principle of the lumps we feel is, I am pretty certain, not muscle related.
@@julianbakeranatomy I agree with you. I don't think it is muscle related . It's the fascia. I have been finding lines in the body that completely release the fascia. And after it is released, the muscles drops and feels like jello.
@@julianbakeranatomybut you say that knots don’t exist, so isn’t a spasm what is commonly called a knot? You acknowledge that spasms exist so ok, let’s just call a knot a spasm.
@@stacer1962 you might see elsewhere I’ve likened ‘knot’ to the commonly used ‘slipped disc’. Many have no understanding of the true nature of a ‘slipped disc’ but the term still serves as a widely used name for the condition. I believe knot to be the same. The word knot is used in the same way, for the general population to describe what they feel, whether it’s accurate or not.
@@stacer1962 I guess the point is when someone says “knot” we know what they mean. What that actually is would be what we are really discussing. I don’t much care if someone says they’ve got a barnacle, what they mean is they have a hard lump that’s painful. So is it a spasm, is it trapped fluid or inflammation, is it bunched up muscle fibres in some way, is it some phenomenon involving fascia or muscle tissue, is it stretch reflex related, what’s the body protecting itself from and why, why does pressure relieve it, what about trigger points and muscle twitching? 🤔
How refreshing to listen to someone with an intelligent, enquiring, independent mind! Thanks for this post Julian. I'm an Essentrics therapeutic fitness instructor. Understanding what's really going on in the body when things aren't right is hugely helpful to me.
Thanks for this. I have always struggled to understand exactly what these bumps and tender areas we, and clients call 'knots' are, knowing that logically the muscle can't actually be in a knot but not knowing what's actually happening. Just knowing that touch helps, and is really totally dependent on the individual client as to whether they need and respond to a deep or very light touch which can have the same outcome. Interesting to see what's actually happening under the skin.
Touch really does help, and movement in and around the area too. I agree that the pressure is probably just about a personal preference rather than any actual effect.
I have been a massage therapist for just under a year and I think you are close to correct but I don't think it is just fat. It's difficult for me to describe it in writing. I know that it's not the muscle that is tight. I used to do deep tissue massages with a lot of pressure. I figured out that in fact it's the facsia. It's the fascia that is tight. I do really deep tissue now with light pressure. The knots have legs and so instead of breaking down the knot, if you start from where it starts and then follow it to the knot, The knot will release. It's reallly hard for me to explain but I have been doing really deep tissue and hardly using pressure and the clients tell me it is not even painful and I am able to completely break down the muscle and relax it. I dont' know why massage is being taught the way it is either. I always start from the feet up because the muscles are all connected and the problem usually starts at the feet. If you start at the back you only band-aid the problem because it only loosens it a little. It will just become tight again from what is pulling it. I came here looking for answers. I was looking to see if anyone else had discovered how to get knots out easily and painlessly using light pressure but doing deep tissue and actually relaxing the muscle and fascia completely.
Thanks for the comment. I do know what you mean and it does feel that there is something deeper. But when you actually take the fat off the body (which I do during dissection) you can see how much fibre runs through this layer and feel the same structures that you would under your hands. The deeper layers of fascia and muscle just don't have that texture any more.
If you find an answer or solution please message me; I had a long term injury start healing and I never knew how painful muscle or facia dysfunction could be. I been getting trigger point injections in them at my sport doctor, and I try massaging but if I do too much I can hardly walk. I got zero drop shoes to help strengthen my feet and use pool, I can’t tolerate massages it’s torture.
I also plan to do light weights to get blood flowing, no idea if this will help though.
I asked my PT and she said stretch and strengthen the area idk 🤷♀️, I’ll give it a go.
@@LN-wt9ft I can't really describe how I do it because I do it by feel and it's slightly different on everyone. I know exactly what you mean about leg massages being torture, my legs get tight and it's torture when I have to get them massaged because no one else knows how to do it any other way than what we have been taught in school. Stretching may help but it doesn't help that much if the fascia is so tight that the muscle can't move. The method I use on my clients, I can only describe it as untangling the knots instead on pushing on the knots.
This is a great description of what I can feel and having attended dissections with you I have a good understanding of the textured fatty lumps you’re referring to. As a myofascial movement therapist I don’t find pushing knots around very useful and very often, for the client, it’s just painful, however working more globally with the tissues and bone movement has the affect of reducing or even magically releasing/removing said lumps in any case. Thank you for your humorous and insightful videos Julian 🙏🥰
@@stacer1962 I do know about compartment syndrome but that is not what I am talking about.
I will never think of massage the same way! (Your comment below about how the lighter or deeper touch having to do with the nervous system makes perfect sense. How fast the sensory travels and what it effects is really interesting!)
Thanks, it's a really interesting subject and one that we need to think about in much more detail
Just found your channel and loving it. I remember looking at actin and myosin under a microscope when I was in Chiropractic College decades ago. They were either twisted up or laying straight. The theory was that those fibers got knotted up when there wasn't enough blood flow, O2 and ATP to keep it functioning with ease. I've been telling this story to my patients forever. Now what am I going to say? "Sorry, Dude, it's a bunch of fat cells? :))) I still work out those lumpy things either manually or with light, heat, BEMER, SCENAR or plain old massage....usually with lots of ironing pressure. At least it's getting the blood and lymph flowing again. I've once felt someone's huge 'fatty lump" in the shoulder that was hard as a rock. We thought it was a tumor and had it x-rayed first.....It was just "knotted" muscle fibers.....!!!
Thank you for your comment, it's really appreciated. As for what story now? I know what you mean, I have to keep going back to the drawing board regularly as what I thought I understood gets changed.
I think the best advice is to hold on to your practice dearly and your theory lightly. What you do works, but the explanations are going to change. Regularly!
I would love to know more about your theory of using less pressure. Do you believe the lighter pressure communicates with the nerves in the superficial fascia and that we are actually working on the Nervous System rather than the Myofascia? Probably stated too simplistically but everything I am studying at the moment suggests light pressure communicating through the Nervous system is more beneficial.
I think you are right. Research into what we are doing with touch seems to point to communication via the Nervous System
I'd go as far as to say that ALL manual therapy is working with the nervous system rather than any mechanical outcomes. A very light touch will travel along slower, unmyelinated nerves to a different part of the brain, the insular cortex. The more physical and deeper touch will tend to travel faster and light up areas within the motor cortex. The differences are quite significant in terms of interpretation. But lighter or deeper probably doesn't make much difference except to expectation of the client.
@@julianbakeranatomy please can you do a video on this subject
Great content !!!! super interesting. Thank you !!!
Thanks for the comment, glad you liked it.
Calcium deposits can also cause lumps and bumps creating ‘ blockages in fascia ; it’s not just fat surely ?
It's not ever just fat, but is fibres that run in and between the fat cells that indeed are exactly the same as the fascia anywhere else in the body. Calcium deposits can occur, but these are less likely within superficial layers. The density of the fibres and how they conjoin give a huge nudge to this type of tissue being superficial.
Thank you Julian for a clear explanation!
You are welcome!
Great chat as usual, nice length too!!
Glad you enjoyed it
Hallelujah, I get very frustrated at massage clients explaining that their problem is with 'knots' Not sure I want to explain that they have fatty lumps though. At least I was intuitively right. I also get fed up of clients thinking that deep tissue massage has to hurt to be effective
Yeah I know right? "Nah mate, it's yer fatty lumps". Not going to land quite right. Try "fibrous congestion of the superficial layer." There, fixed it! Thanks for the comment! :-)
Can't wait for the next mind blowing video "turns out you never actually had bones"
Well funny you should mention that because... :-)
Are you saying that if you burn the fat with exercise you would not get knots or on people who have no fat they do not have knots
What about trigger points? Twitch respond?
No-one really knows what a trigger point is physiologically either. Probably an area of lower oxygen uptake but other than that...?
@@julianbakeranatomy I studied Neuromuscular Therapy decades ago and i recall the concept of possible "incorrect" mapping on the somatosensory cortex for touch stimuli... So an area of nociception could be perceived as sensation in a different area than the place stimulated by pressure/touch. Any thoughts?
@@bhaktima108interesting. I’m sad there’s no reply to this.
Missed it. On to it!
For sure, it's a well documented phenomena. Sensation, pain, restriction, even paralysis in some instances are all outputs FROM the brain rather than necessarily issues in the peripheral nervous system. Referred pain is a good example. Our gall bladder has sensory nerve endings but we don't really feel it consciously day to day. When we get pain, the brain doesn't recognise the region so interprets it incorrectly and it manifests as shoulder pain. Pain can be 'perceived' anywhere, it doesn't necessarily mean that's where the problem is and in many cases it really isn't!
Yes that sounds more like it to me .
Thank you for interesting videos. So the bumps I feel when I treat a body is fat? A lot of us have this lumpy knots between our shoulder blades, sometimes I can follow the lumpiness through a part o trapezius, it is like a hard string. This is fat? Does the lumpiness come from for example static movements, or why this lumpiness
It's not just fat, it's the fascia, the collagen that holds the fat in place. It's hard to know why the lumps and bumps arise, but probably due to changes in the way that fluid is moving through them or how fibres are being deposited.
We all get the knot thingy translation obstacle you’re having but im gonna continue to say ‘my muscle is knotting up right here’
I dry needle myself I suffer from extreme lower back pain, neck and shoulder pain. In my lower back the fascia I’m guessing it is well it feels like fibreglass. If you put a dry needle on fibreglass and push on it and it slides along it doesn’t penetrate it that’s the sensation I feel.
Interesting! Bet that feels weird!
In my experience as a massage therapist, your lower back pain is most likely from you having tight and stiff muscles around the groin area. the groin area pulls on the muscles around the hip to the lower back. The lower back then pulls the neck and shoulder pain. Most of the people I see have lower back pain and they always just want their neck and back massaged. I don't know where you live but if you are coming by Reno, NV. I will fix you or at least be able to help you a great deal.
@Joleen I experienced this. Once I do mobility work for my hips my back loosens and actually feels much better. I do mobility and flexibility every day.
Very interesting and makes sense! Thank you..... oh and love the shirt! 🙂
Thank you! The bees have it! :-()
I love it! What about body builders who have virtually no fat all all? Love all your content btw ! Amazing stuff.
Well they still have the layer of fascial fibre in them, ready expand as and when needed. That is always there no matter how much fat you have and the fat cells are always there too. Same number. Just waiting to fatten up!
Great video. So what’s the solution to these specific fibrous bumps that feel tender to touch and relief after being massaged?
Diet, exercise, massage, surgery etc?
Can they be permanently fixed? I’ve had a single, specific, recurring “knot” for years. With this better understanding, is there a long term fix?
Can they be permanently fixed? I’ve had a single, specific, recurring “knot” for years. With this better understanding, is there a long term fix?
I have an internal scar tissue injury in my wrists, forearms, elbows, and shoulders from repetitive injury and overuse and lifting heavy and playing very athletic sports like football. The pain started in my wrist in about mid way through April and has gotten worse slowly it is now in all the spots I listed and now it is almost October. The osteopath I’m going to is saying they have to break it all up been there 3 times see no difference the pain is not bad for a week then gets super bad for 3 days then when I wake up it feels good again it’s so weird, I get lots of pain in my tricep area and the tendons that connect to my elbow and in the spot you get tennis elbow and golfers elbow I am 15 and don’t know what to do I had to stop working and it is even hard to go to school have any tips or anything I just want anything advice. It’s in both Arms
If I am understanding your theory correctly, this does not explain why MFR is able to increase ROM and allow for smoother movements and muscle contractions. I still think MFR techniques do what the name implies: create motion between layers of tissue which are stuck together. Maybe I misunderstood this video?
I think you're assigning a specicifity to MFR, whereas any touch potentially can do the same. There is a degree of manually moving fluid around, but muscles don't knot. I mean they just can't. Also the layers that people keep referring to aren't there. Any hands on technique has the potential to change neural exchanges and increase fluid movement, but it's not releasing fascia and it's not breaking down muscle knots.
@@julianbakeranatomy ok, muscles can’t knot you say? Isn’t knot, in this case, more like the classic slipped disc? Most of us know that a slipped disc doesn’t mean the disc itself has moved at all. It’s a common misunderstanding of the condition but the name persists. Knot, I think to most people means a hard lump that is painful and restricts movement. Muscles can spasm, is that not what this is? Granted a whole muscle spasm is a different thing but couldn’t a ‘knot’ be a group of muscle fibres in spasm?
@@julianbakeranatomyfor example, right now I have a ‘knot’ in my calf, very low down, closer to the ankle than the knee. This is not an area with much adipose tissue at all, at least not on me. I think I can feel the skin, the layers underneath and then the knot, which follows on from the tendons I can feel going down towards the foot. Moving the knot moves the tendons, quite clearly. To me this is muscle tissue or are you suggesting that it’s not muscle tissue but the tissue very directly around the muscle that appears to form a solid mass right through the muscle to the bone? It must entirely encircle the muscle, in which case I presume you’d say that it’s restricting the muscle movement, eg lengthening, by some kind of strangulation?
Thanks for the comment, We can for sure feel changes in soft tissues. I have a thigh strain at the moment and can feel a difference in the tissues where the pain is. Is this in the superficial tissue? Probably not. But there will be systemic changes in the ECM and the surrounding tissues that will cause inflammation, increase in fluid dispersion and so forth. I would say (without any imaging) that the actual muscle will still be composed of straight thin and thick filaments that are still lined up and that the changes I feel and the bumpy bits are changes to the surrounding tissues. How can I be sure? Because I can still stand up and I can still flex and extend my leg at the hip. If there was any material degree of change to the muscle or impingement on or through it, I wouldn't be able to do that.
Is it a spasm? No I don't think that a knot is a muscle spasm, I think its a deposition of tissues in the area and possibly a lack of oxygen along with it.
The slipped disc thought is interesting, I'll give it some thought!
MRI of a knot? What does it show?
I suspected that no-one would really do it and write about it, because it's not a thing. But did a quick literature search anyway and nope it's not really a research question which is quite revealing!
I’ve seen one, just today. It shows the muscle fibres bunched together in a abnormal way compared to a relaxed muscle.
That's interesting! It would be interesting to see the process of this imaging and what a control would look like. For instance what was the function of the person being imaged in this area and if there was any pain.
I had a client get an MRI of her hip because she was still having pain 3 months after dislocating her hip. The doctors told her they couldn't find anything wrong with her. But they may not have been looking for knots.
@@lynnewbrown356 ruclips.net/user/shortsa4oYhDF5O0M?feature=shared
If I had a pound for every adult man’s and woman’s right shoulder tension? Not sure just fat ? Lean muscle tension and contracture around systems.. neck shoulder pecs all upper right back layers… the emotional link to tension/emotion/responsibility. It would be a disservice to occlude the emotional link to tension and tight, shortening of muscle tissue. Surely? Why we should give ourselves permission to cry …. Acknowledge the burden and difficulties we place on ourselves in this life. Toughness, barriers, boundaries, versus tears, flow, softening….. find yourself a Bowen practitioner to get back into the much more than physical flow of YOU! Atleast in my experience. Always love your work Julian… 🌟
Great comment and thank you! I absolutely agree that an emotional component is hugely relevant in terms of tension and my explanation doesn't exclude this, but it's still coming from neural input. We 'feel' stressed or tense and contract our muscles or breath differently as a response. The work we then do in whatever aspect helps us to identify and change these tensions, but the underlying principle is that the 'knots' are unlikely to be muscle in origin.
Hey man, there's no Bowen technique practicioner near where I live , anything else you may suggest? Thanks
I recommend any touch therapist that you can relate to and feel comfortable with. Don't be afraid to have a clear conversation about what you're looking for.
Hi Julian,
Another very interesting video that challenges widely held beliefs
OK, so in essence you’re saying that muscle “knots” - no, I never liked that term - trigger points are just lumpy fat? I get that the fat layer would be one of the things that we as therapists are feeling when we press & rub our magic into some unsuspecting victim, sorry, I meant client. But, we must also be feeling muscle in the mish-mash of tissues we have under our fingers. It stands to reason that if I can also feel bony landmarks then I am feeling that through all the skin layers, muscle, connective tissue etc.
So on to lumpy fat. I ask myself why it is lumpy. Our friend Robert Schleip in his paper “Active contractile properties of fascia” proposes that fascia contains within its structure myofibroblasts that have the ability to alter the stiffness of the fascial matrix over an extended period. So, we have a contender. I’m going to say it. Mmmm, dare I? Yes, I can do this… Nooooo… Maybe… Ok. IT’S THE FASCIA!!! Ha ha ha, there you go, I said it. But really, what else could it be that causes this tightness in the fat layer? A localised hyper-tonic group of erector pili muscles maybe? But in any case, it still comes down to why?
Now that we have a fascial contender, why would this be the case? Why would fascia “choose” to be tight in discreet areas, like in the upper traps or the calves or wherever, and not others. My ex is a kinesiologist, and she would say that it is a response to an underlying emotion and that the location is based on TCM meridian points that align with that particular emotion. Mmmm, that’s her view, but in any case, it’s an interesting question. And… if fascia - there, I said it again - can produce stiffness in fat layers, then why not in muscle tissue. I’m sure that it could.
The next question then is how does rubbing, poking & prodding produce a fascial release - Jeez, I’m on a roll now - over time? When I’m massaging, I can feel tight spots loosen somewhat during the course of the massage. Well, I’m feeling something that certainly feels like that. Funnily enough, when I do Bowen, the tight spots can remain from treatment to treatment, but the associated pain is relieved. Another conundrum.
OK, so I’ve had a bit of a poke around your favourite topic and as Mythbusters say - it’s a plausible explanation. What say you?
Well there are some good points here, but ultimately when you touch a dead body (as I am prone to do on many an occasion) there is no tension. Muscle has no inherent tension from fascia or itself. Its tension comes from energy provided by the motor unit. There is always a degree of tension even when you're relaxed, until that is you're dead, after which it's gone. All of it.
Any changes in tension you feel after a session are because there is a difference in the frequencies being sent to that area. If you get tissue changes under your hands, the direct influence of a lump or a knot changing will be because of the way that the fibres wrap themselves through the superficial adipose layer. The underlying layers are totally smooth. Always. You can feel bony landmarks and you can feel muscle but that's not the same as touching them.
@@julianbakeranatomy You know what? I've wondered about whether tension was held after passing on for a long time, but have never found an answer - until just now. Thank you. I know it makes sense, but so did localised muscle hyper-tonicity until you introduced the fat layer curveball 🙂
So, the question returns as to why certain areas exhibit tension and others don't. Could it be something like the tensegrity model? You put tension into one area and the whole structure compensates, but some part of the tension is transferred to another area and that becomes the "knot"... Or is it the kinesiology model? Or something else entirely...
In any case, it would seem that touch has the ability to soothe the savage beast and help remove tension over time. We seem to be programmed to give and accept touch, even down to the age-old picking fleas off each other in stone age times (don't know - I wasn't there). Another question arises of whether it is the specific touches we give, say as Bowen therapists or deep tissue masseurs or the gentle touches of ortho-bionomy that give a specific response in the body. Or it is just the touch. I know that as a Bowen therapist I have had people come to me and say that their previous session with someone else was far too light and how could that do anything? Didn't work for me!! So I give a firm but fair treatment and they are happy and suddenly it works. As a massage therapist, I have had people coming in telling me to hurt them. In their minds more pressure = better outcomes. I try to convince these people to have a different treatment such as positional muscle release, which works just as well. So given that fulfilling a person's expectation of sensation of touch seems to be as important of what we do as therapists, how much of what we do is placebo?
There is placebo in many interactions, even with a doctor who is prepared to listen to their patient. In placebo trials red pills work better than blue pills, two pills works better than one. So is it when our treatments meet the expectations of the client that it works better? I think so. Even the embellishment in the telling what we do to the client makes what we do more potent. Add in formal assessments prior to treatments and you have gold standard in placebo. Give them muscle knots (they understand that), give them fascial release, give them mumbo jumbo. It all works. Just as long as we as therapists know what it is we are doing and that is giving healing touch.
So you need to look at my videos on how to explain Bowen and also my 'All medicine is placebo' video. We can tense anything if the signal to that area is telling it to tense and it will be for lots of reasons. Compensation for pain or injury for example. We can learn how to behave or move (or not move) in a certain way and not even realise we've changed it. Once we point it out through touch, the capacity to alter that output is realised. Whether we do it or not remains to be seen, but release or change of over tension is potentially a millisecond away.
I have had severe muscle knots in pec, shoulder and neck for almost 1.5 years now from bad posture and no treatment has helped. It’s really depressing me and it’s affecting my workouts
I would always suggest trying Bowen if all else has failed. Find out more and if there is a practitioner near you at www.thebowentechnique.com
If you are in the Reno, NV. area, message me. I will totally help you. I am a massage therapist and I have seen guys who work out a lot have the same issue. If I can't fix your problem, then you don't have to pay me. But i am pretty sure i can fix your problem or greatly relieve the tightness. Cause I'm sure it's pulling your shoulders and your neck muscles forward which contributes even more to the bad posture.
@@UTubeSporaticUser I live in the Midwest so that won’t be easy. Do you have any recommendations going forward?
@@buckast3907 You could also try cupping or acupuncture to release the knot if you haven't tried those options yet
@@stacer1962 I don't claim efficacy with acu or cupping as I do neither, so I don't know what you are talking about.
I have fatty lumps everywhere. Literally everywhere.
This is misleading. What we call a knot is a muscle or part of a muscle that has contracted and will not relax voluntarily. Putting direct pressure helps the area relax by both physical and neurological means. Just because it is not exactly like a tangled headphone wire doesn’t mean it’s not muscle related.
I'd see that as a spasm rather than a knot. The concept of a constricted and continuously contracted muscle is valid of course, but it wouldn't feel like the knots that we can feel under our hands. I use the tangled headphones as an easy analogy, but the principle of the lumps we feel is, I am pretty certain, not muscle related.
@@julianbakeranatomy I agree with you. I don't think it is muscle related . It's the fascia. I have been finding lines in the body that completely release the fascia. And after it is released, the muscles drops and feels like jello.
@@julianbakeranatomybut you say that knots don’t exist, so isn’t a spasm what is commonly called a knot? You acknowledge that spasms exist so ok, let’s just call a knot a spasm.
@@stacer1962 you might see elsewhere I’ve likened ‘knot’ to the commonly used ‘slipped disc’. Many have no understanding of the true nature of a ‘slipped disc’ but the term still serves as a widely used name for the condition. I believe knot to be the same. The word knot is used in the same way, for the general population to describe what they feel, whether it’s accurate or not.
@@stacer1962 I guess the point is when someone says “knot” we know what they mean. What that actually is would be what we are really discussing. I don’t much care if someone says they’ve got a barnacle, what they mean is they have a hard lump that’s painful. So is it a spasm, is it trapped fluid or inflammation, is it bunched up muscle fibres in some way, is it some phenomenon involving fascia or muscle tissue, is it stretch reflex related, what’s the body protecting itself from and why, why does pressure relieve it, what about trigger points and muscle twitching? 🤔
Lost me with the butter.