Muscle contractures, sometimes called "knots", can form in the shoulders of athletes, as well as in those of sedentary people. Repetitive movements (such as throwing a ball) can cause muscle fibers to stiffen, which feel like thumb-sized knots under the skin. The shoulder muscles, especially those that connect to the neck (such as the trapezius), are particularly susceptible to this disorder, which is triggered by a slumped posture maintained for too long (for example in front of a computer) or by excessive stress. Regardless of the cause, a contracture in the shoulder muscles can be treated with specific home care or with the help of an orthopedist.
Steps
Part 1 of 2: Treating the Shoulder Knots at Home
Step 1. Do some light stretching exercises
Muscle contractures are, in practice, the result of chronic fatigue caused by repetitive movements or postures that contract the muscle fibers for too long. Muscles are meant to contract for a short time and then relax completely. However, if you continuously perform the same movements (during sports, weight lifting, house cleaning, and so on) or if you maintain certain positions at work, you will tire the muscle fibers that remain contracted. For this reason, the "knots" respond well to light stretching exercises that relieve tension, improve blood circulation and increase flexibility. As a general rule, hold the stretch position for 30 seconds without bouncing and stretch at least three times a day, until the contracture disappears.
- While standing or sitting with your back straight, bring one arm in front of your body and grab your elbow with the opposite hand. Apply gentle elbow traction towards your chest until you feel a pleasant stretch at the corresponding shoulder. Remember to take your shoulder away from your ear (don't lift it). This exercise is perfect for the outer and back muscles of the joint.
- Stand or sit upright, bring one arm behind your back and grab the wrist of the other hand (corresponding to the shoulder with the contracture). Gently pull your wrist down until you feel some stretch in the sore shoulder. This exercise is very useful for stretching the muscles that connect to the neck. To increase the stretch, tilt your head in the opposite direction.
Step 2. Use a hand massager
It is not difficult to feel knots in large muscles such as those in the shoulder. Contractures feel like hard areas surrounded by soft tissue and are painful under pressure. Unlike severe muscle injuries, they show no obvious signs of inflammation, swelling or redness. For this reason, he feels the shoulder and identifies the contracture, which is the point that triggers the pain. Once you feel the knot, you can use a manual vibrating massager for 10 minutes to see if it loosens the contracted fibers. To get noticeable results, you may need to apply more pressure for longer.
In the pharmacy you can find these manual devices at an affordable price; however, you can also use a wooden massager to loosen the knots. This tool typically takes a little more work, but costs less
Step 3. Use a tennis ball
If the knot is not near the shoulder blade and you are having difficulty reaching it, then you can use a tennis ball to roll over. Place it right on the knot and lie down on it for about five minutes. This position may be uncomfortable at first, but you should feel that the contracture slowly fades.
Step 4. Apply moist heat
As previously stated, contractures are a type of chronic injury that does not generate an inflammatory process and acute pain, as is the case with muscle injuries. For this reason, cold packs are not suitable for muscle knots, as these need a higher blood supply. Instead, try applying moist heat to the affected shoulder. This type of treatment warms the soft tissues (muscles, tendons and ligaments) by increasing the flow of blood, which is very useful for treating knots and muscles contracted in a chronic way. For this purpose, bags of cereals (rice or wheat) that can be heated in the microwave or those with herbs and essential oils are very useful. Heat the bag in the machine for about two minutes and then place it on your shoulder for 15 minutes at least three times a day.
- Do this treatment before doing exercises to reduce muscle tension and pain, as well as to improve tissue flexibility.
- You can also take a warm bath to enjoy the same benefits. Add some Epsom salt (which is rich in magnesium) to the bath water to increase the relaxing effect.
- Avoid applying the dry heat released by regular electric warmers, as it dehydrates soft tissue and increases the risk of further injury.
- If you have a steam room in your gym, spend some time in this room to relax, as it is another effective way to expose your muscles to moist heat.
Step 5. Take over-the-counter medications
Muscle relaxants (such as cyclobenzaprine) are very useful against muscle spasms and contractures, because they release tension. However, when taking medications by mouth (i.e. by mouth) remember that the effects are not localized only to the problem area. For this reason, muscle relaxants can generate strange sensations in some patients, because they prevent the muscles of the whole body from contracting. If the knot is particularly sore, you can take non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen or aspirin, which are more effective and have fewer side effects.
- Some of these medicines are quite aggressive on the stomach, liver and kidneys, so it is best not to take them for more than two weeks. Whichever medication you choose, remember to always take it on a full stomach.
- Always follow the instructions on the leaflet or ask your doctor which dosage is most appropriate for your situation.
- Try applying pain relief creams directly to your shoulder, such as those with menthol, camphor, and methyl salicylate.
Step 6. Review your work station
If the contracture is clearly not caused by your sport or training, then you need to consider how your desk or workstation may be contributing to the problem. For example, if your computer, chair or desk is not positioned correctly for your height, your posture may cause fatigue in your shoulders, neck, and mid-back (between the shoulder blades). When sitting at your desk and looking straight ahead, your eyes should line up with the top of the computer monitor, about 1/3 of the way up; your forearms should be almost parallel to the floor as you type on the keyboard, supported by stable armrests; your elbows should be a few inches from your hips and your feet should rest on the ground.
- If the arm is too high or low because the desk or chair is not well positioned, the shoulder problem could get worse.
- To avoid fatigue, minimize the occasions when you have to lift loads over your head by using a higher ladder or by getting closer to the place where you need to perform the task.
- Do not hold the phone between your ear and shoulder, use a pair of headphones or a hands-free system.
- If you spend a lot of time driving to and from work, remember that this contributes to shoulder pain. Try to keep your hands at the bottom of the steering wheel, palms towards the floor.
Part 2 of 2: Seeking Professional Help for Shoulder Knots
Step 1. Get a professional massage
If the vibrating device or tennis ball does not bring the desired results against the muscle knot, you can consider getting a massage at a physical therapist. A deep connective tissue massage is very useful against chronic contractures and knots, because it reduces spasms, tension, stimulates blood circulation and at the same time promotes relaxation. Start with 30-minute sessions by asking the physiotherapist to focus on the painful shoulder and surrounding areas (cervical and central back). Let the professional go as deep as you can handle.
- The therapist may also stimulate special points by pressing them with the thumb or the tip of an elbow to force the contracted fibers to relax. This is a painful but effective procedure, so trust the experience of the massage therapist.
- Immediately after a massage, always drink plenty of water to eliminate any by-products of inflammation and lactic acid; otherwise, you will suffer from a slight headache and some soreness the next day.
Step 2. Evaluate acupuncture
It is an ancient healing technique that involves inserting fine needles into specific points of the skin and muscles, with the aim of reducing pain and promoting healing. It is not a particularly painful procedure because it stimulates the release of natural painkillers (called endorphins); for most musculoskeletal problems, a session lasts about 15-45 minutes. Acupuncture for shoulder injuries is very effective, especially if it is done as soon as symptoms are noticed.
- One session isn't enough to get rid of contracture, so consider scheduling at least three sessions before evaluating their effectiveness.
- Remember that the points stimulated by acupuncture to loosen the knot in the shoulder are not all located in the shoulder itself, in some cases they are also found in other areas of the body.
- Acupuncture is practiced by many professionals in the health sector, such as doctors, chiropractors, naturopaths and physiotherapists. Rely on a qualified and respected professional.
Step 3. Make an appointment with a chiropractor
It is a musculoskeletal system specialist, whose work focuses more on restoring the motility of muscles, spinal joints and related areas, just like the shoulders. If the shoulder knot is located near the shoulder blade or neck, there are several chances that the cervical or central part of the spine is involved in the pain process. The chiropractor will use manipulation techniques to stretch tense muscles, loosen knots, and align affected joints. You may feel clicking or creaking when manipulating the joints, but you shouldn't feel pain. One of the most interesting effects of joint alignment is the almost immediate relaxation of the muscles involved.
- While just one chiropractic treatment is enough to completely untie a knot in the shoulder, it is likely that it takes a few sessions to notice results.
- The other health professionals who practice joint manipulation are osteopaths, physiotherapists and orthopedists.
- The NHS does not cover all chiropractic treatments and a referral from a specialist doctor is typically required. For this reason, it is very likely that you will have to pay for the sessions out of your own pocket.
Step 4. Go to a physical therapist
If the knot in the shoulder is not resolved either with home treatments, or with therapeutic massage or chiropractic treatments, then you must think about relying on some form of physical rehabilitation under the guidance of a specialist. Your family doctor will be able to recommend a good physiotherapist who will teach you specific stretching and strengthening exercises to rehabilitate the muscles involved. In some cases, machines, free weights or Swiss balls may be useful to strengthen the shoulders and thus withstand the strain required by your sport or job duties.
- If necessary, the physiotherapist is able to treat muscle knots with therapeutic ultrasound or muscle electrostimulation.
- This kind of rehabilitation requires 2-3 weekly sessions for 4-8 weeks to effectively reduce chronic shoulder problems.
- The activities that can make the shoulder muscles stronger are swimming, push-ups, pull-ups and rowing exercises.
Advice
- To avoid shoulder problems, do not carry bags that distribute weight unevenly. Try to use a regular daypack with well padded shoulder straps.
- If your shoulder problem gets worse and causes severe pain, make an appointment with your doctor.
- Yoga can prove helpful in stretching and relaxing contracted muscles.
