Lactic Acid Trip

Remember when the sun was good and wine was bad? If you’re like me, the constantly evolving research that alters our understanding of health and fitness can be daunting. The temptation is to believe what you want to believe because, eventually, research will come out to support that belief! Who would have thought, for instance, that there would be health benefits to eating dark chocolate? Well, besides chocoholics. But recent research has shown clearly that our old hackneyed beliefs about lactic acid—that it’s bad for you and must be removed from your muscles—is not only wrong, it’s really wrong. So what does lactic acid do?

As you probably know, increased levels of lactic acid in muscles have long been believed to play a role in muscle fatigue, cramping, and reduced performance. Such beliefs about lactic acid also led to the notion that if you reduce you exercise activity slowly—that is, cool down following a workout—you would give lactic acid a chance to leave your muscles. In fact, however, thirty years of research by George Brooks at the University of California at Berkeley have shown that lactic acid is one of the most important energy sources for high-intensity muscle activity. Before I get any further into discussion of this research, though, two other issues need sorting out.

First, “lactic acid” is a misnomer in any case. What the body actually produces is lactic acid minus one proton, or “lactate.” If “lactate” sounds like something a pregnant woman might do, that’s because, when the acid was first discovered by a Swedish chemist in 1789, he found it in some sour milk. Since “lactic” means “relating to milk,” Carl Whilhelm Steele named his newly discovered acid “lactic acid,” though in fact lactic acid is not confined to milk but can also be found in meat and blood. And again, it is not lactic acid that is produced in the body—it’s lactate. Lactate is the product of a side reaction to glycolysis, which is a process in which the energy stored in glucose is converted to a form the body can use.

The second issue I wanted to address is, if lactic acid (or lactate, as I’ll refer to it here on out) isn’t the culprit in muscle soreness, why have we all—including fitness professionals and educators—believed it was for all these many years? This prevailing understanding of the role of lactate came about because of incomplete observations of cell metabolism made by Nobel Prize–winning researchers Otto Meyerhoff and Archibald V. Hill in 1922. As noted exercise physiologist Robert A. Robergs puts it, the “research showed that lactic acid was produced during conditions of low oxygen content (hypoxia), and that muscle contraction also became impaired. This research led to the assumption that lactic acid production caused decreases in cellular and blood pH, which in turn caused the symptoms of muscle and body fatigue during intense exercise. This evidence was not cause-and-affect, but rather guilt by association [emphasis mine].” This incomplete description of acidosis—the low pH in body tissues and blood that arises when cells receive too little oxygen—then continued to appear in fitness and biochemistry textbooks, leading to our ongoing misconceptions about lactate and exercise.

That said, what actually does happen in the muscle during exercise? Without getting too technical, it has become clear that lactate production is not the cause of cellular acidosis but, rather, a consequence of it. But more than that, elevated levels of lactate—which occur when people exercise regularly and/or during high-intensity workouts—lead muscle cells to make adaptations that give them the ability to use lactate as an energy source rather than a mere waste product. It turns out that interval training, with its short bursts of intense activity, is particularly effective in causing spikes in lactate levels that increase the number of molecules in mitochondria that transport lactate. (The mitochondria, as you may recall from biology classes, is considered the “powerhouse” of the cells in your body because of its role in breaking down sugars into basic chemicals that the cell can then use for energy.)

So what does cause your muscles to be sore if not lactic acid? During high-energy exercise, our muscles use adenosine triphosphate, or ATP (a form of energy), which results in the release of hydrogen ions or protons that then accumulate and stimulate pain receptors. This is the “burn” we sometimes get during exercise. (In contrast, if you are doing low- or moderate-intensity exercise, you will seldom experience this burn because the protons are absorbed by other chemical reactions taking place.) This burning sensation generally disappears as soon as exercise is stopped or shortly thereafter. As for delayed onset muscle soreness, which generally occurs a day or two after a period of heavy exercise, it is partly caused by structural damage to muscle fibers, which causes an inflammatory response. This response factors into muscle soreness in two ways: (1) it produces a buildup of fluid (that is, swelling) that results in pressure being exerted on the muscle fibers and (2) the body’s defense system kicks in, producing white blood cells that “enter the muscle fibers and secrete chemicals that activate pain receptors,” according to fitness expert Deborah Riebe.

The short and sweet of all this? The production of lactate during exercise actually provides the muscles with fuel and is not the bad seed we always thought it was.

If you’d like more detail on the science of all of this, here are some websites you can check out:

o http://www.unm.edu/~lkravitz/Article%20folder/lactate.html

o http://running.competitor.com/2010/01/training/the-lactic-acid-myths_7938

o http://findarticles.com/p/articles/mi_m0675/is_2_17/ai_54286949/

Lights! Camera! Massage!

As you might imagine, going from being an in-house manuscript editor for the University of Chicago Press to becoming a massage therapist involves quite a number of changes. One of the toughest adjustments for me, though, has been to promote myself to potential clients. At the Press, someone put work on my desk, I did it, and then I got more. But since no one is depositing clients on my doorstep, it’s up to me to find them. No one likes a pushy massage therapist—it’s anathema to our image of the nurturing, mellow, healing soul that is the massage therapist. But it’s also a fact of business that if no one knows you exist, no one can take advantage of your services.

I am, therefore, always on the lookout for creative ways to bring myself—or, more to the point, my special therapeutic abilities—to the public’s attention. In the growing field of massage therapy, which is becoming increasingly accepted as a therapy, it’s not always easy to stand out from the crowd. But when I decided to start using the bakfiets, or Dutch cargo bike, to deliver my services to clients, table and all, I knew I was doing something that set me apart and would give me the opportunity to show clients what really matters: my skill as a therapist.

After sending out a dozen or more press releases to local media, I was contacted by the Chicago TV show 190 North for inclusion in a segment they were doing on “bring-it-to-me services.” The host of the show, Janet Davies, had recently done an interview with my friend, the photographer Barbara Karant, about her book Small Dog, Big Dog for the 4 o’clock news on WLS TV (http://karantcanines.com/blog/?p=22). Barbara warned me that they were relatively low budget in that I’d be responsible for my own hair and makeup. This is not good news for someone who goes for what we’ll kindly call the natural look. Barbara strongly advised that I find someone to do makeup for me in order to avoid looking washed out on camera.

Having a shortage of cosmetology friends in my life, I decided to contact the Aveda Institute to see if someone there could do makeup for me. When I called for an appointment, the receptionist made a point of telling me they were low on their “seasonal colors” and suggested that if I had any makeup to which I was partial I bring it along. This compelled me to admit that I have no makeup: the last time I wore makeup was probably my sister’s wedding—some three decades ago! Aveda did a nice job of creating a very natural look, but despite their assurances that I would not sweat away the makeup during the two-mile bike ride—with massage table on board, of course—to where the 190 North segment would be shot, I’m not sure how much lip gloss and blush made it there with me.

The filming itself was a lesson in self-consciousness, which I actually already have a lot of experience in—feeling self-conscious, that is: I have very little experience being filmed. First, they had me ride around the corner and down the street on my bakfiets, all of which they filmed. They had given me the instruction not to look at the camera, which made me develop a sort of amnesia in which it was as though I had never ridden down a street where there was not a camera filming me! Where was I supposed to look, if not at the camera? I looked at the houses across the street, up into the trees, at the road underneath my wheels.

That extremely taxing activity completed, they next filmed me pushing my bike up the curb, parking it, taking off my helmet, unloading my massage table, carrying everything up the stairs, and setting everything up. I couldn’t imagine they would use much, if any, of that footage, riveting though it was to see me perform these mundane tasks.

The table now set up in Janet Davies’s living room—for it turns out we would be shooting in her home and I would be demonstrating my massage skills on the hostess herself—Ms. Davies proceeded to interview me while I perched on the edge of the blue-flowered sheets I’d put on the table. I wasn’t nervous about the interview because I knew all the answers to her questions, since they were about me, and I wasn’t worried about putting myself in jeopardy with the law as, say, a suspect to a crime might be. Perhaps I ought to have worried a little more than I did, though, since natural doesn’t always equal appealing. However, the only portion of the interview that actually made it to the air was my answer to a single question that highlighted my strong suit without making me seem totally self-aggrandizing, since I was quoting from my clients.

The interview was followed by the main attraction: a massage. But the massage was anything but typical. To begin with—and this may surprise you—I’m not usually under bright lights being filmed while I work. Ignoring that aberration, though, there was also the fact that Ms. Davies was nearly fully clothed under the sheet, allowing me access to about 4 or 5 inches of her back—which was akin to a pilot having a short runway for take off. My gliding strokes, consequently, were truncated, so I moved rather quickly from warm up to demonstrating my trigger point work. Finding trigger points, or knots, and releasing them is essentially my calling card, so showing off that part of my massage made some sense. But I’m pretty sure on camera it looks like I’m merely using Ms. Davies for a leaning post since the camera can’t capture either the knot or its release. Like a host of a cooking show, however, I will need to trust that viewers will be able to imagine how delicious the outcome is.

After some compressions, muscle stripping, and myofascial release work on her arms, I got to spend a short amount of time massaging her neck before the producer announced it was time for Ms. Davies to do the lead-in for the next segment of the show, which would be filmed elsewhere. First they tried a camera angle over her head as it lied cradled in my hands. (“Don’t just hold her head—do some massaging,” the producer directed. “I’m doing tractioning,” I objected, but that, of course, is about as visually interesting as watching Jello set, so I complied with something more active.)

After moving the sheet up closer Ms. Davies’s neck, having her turn her head to the side, and another variation or two, the producer decided this camera angle just wasn’t working. So they had Ms. Davies turn over. The cameraman toyed with shooting through the face cradle, but that was a short-lived idea. I didn’t get to see what the shot looked like, but I can imagine her face looked rather squashed and pruney, viewed from that angle. Probably not the sort of view of their star they wanted the audience to take away from the episode.

Finally, they decided she should fold her arms in front of her with her head propped on them. By the time we got that far, I knew her line by heart and could have said it myself, but they suggested I continue to massage her while she spoke, so I inanely kneaded her shoulders while she delivered the line. Inanely, I say, because it was a rather poor representation of how I would actually conduct a massage—beginning with the fact that Ms. Davies, in that position was far from relaxed, especially given that her neck was crooked so she could look up at the camera. I found myself hoping that any massage therapists viewing this would understand that what they were seeing was not how I would have staged the massage. But I wasn’t the director of this production, only a bit player.

After we packed everything up—me, my table and oils; the crew, their cameras, sound and lighting equipment—we went outside to shoot the lead-in to my segment. Ms. Davies was going to say a line or two, and then I was to ride onto the scene, into the camera’s view. Now, having taken to heart their earlier exhortation not to engage with the camera, when I pulled up on the bakfiets, I simply stopped at the curb next to Ms. Davies. “You could smile!” the producer said. “And maybe reply to the question.” So we did another take in which I grinned my way to the curb and gave a hearty “sure thing” to the question, “Hey, Knot Whisperer, can I get a massage?” Though they felt that was a good take, they decided to do another “just in case,” but this time I didn’t brake early enough and bumped my way onto the curb. We all laughed, and they said they’d use the earlier take, but on later viewing they must have spotted something amiss with it because they ended up airing my ungainly bumping into the curb.

I hoped this faux pas, like the inane shoulder kneading, would be overlooked by viewers. But when the segment aired, a client’s eleven-year-old son said to me, “I saw you on 190 Nor-orth. Way to bump into curb.” And then he acted out my wheel banging into the curb before he dashed off to another room. Can’t put anything over on an eleven-year-old!

Though inquiries have been slow to come in, following the segment’s airing, I’m fairly certain it’s not because of my less-than-balletic bike riding. People will continue to see the 190 North segment online and I’m definitely on people’s radar: visits to my Knot Whisperer Facebook page were up more than 200 from the previous week. So now, when viewers do need a massage, the Knot Whisperer will ride again in their minds’ eyes and up to their doorsteps—which I will take care not to run into with the bakfiets!

If you’d like to see the finished product, you can find it at http://dig.abclocal.go.com/wls/podcast/101010190northvodcast.m4v. The Knot Whisperer starts her “star” turn at the 6:33 minute mark.

Starring in the Role of Client: You

Getting a massage seems straightforward enough—you lie on a table and let a qualified therapist employ massage techniques to soothe your body—but a surprising number of people aren’t entirely sure what is expected of them during a massage. No doubt, differences exist depending on the therapist, the venue, the type of massage, and so on, but there are some general tips that would probably apply to many massage situations. Below are a number of things to keep in mind for your next massage, in order of importance—in terms of resulting a session that you will find effective and enjoyable—rather than in the chronological order of a given massage.

1. Undress to whatever level you feel comfortable. There is no right or wrong; you just want to do whatever is going to allow you to rest most easily. A few things to consider when deciding how much clothing to remove, however, are that (a) by Illinois state law and the training of any reputable therapist, you will be completely covered during the massage except for whatever isolated area is being worked; (b) if women leave their bras on, it is next to impossible for the therapist to do any long flowing strokes; (c) if shorts are worn, the therapist may be impeded from doing effective work in the glutes and/or hamstrings, for instance; and (d) absolutely none of this applies if you are getting a chair massage or a massage in an open space!
2. This is your time to relax! Try not to worry about anticipating what the therapist wants you to do—mostly, what the therapist wants you to do is let your muscles go slack. If the therapist needs your head or a limb to be in a different position, she will move it for you. There may be times when the therapist will want your assistance—for example, when it’s time to turn over—and at those times, she will explain what she needs you to do. Otherwise, just try to be. Forget about thinking, forget about moving: just feel. Of course, we are not all equally skilled at letting go, but that’s the goal.
3. Communicate. As with any good relationship, clear and honest communication is a key component. Before the massage, take time to speak with your therapist about what you are looking for in terms of outcome and about what you want your massage experience to be. In general, talking during the massage is not expected—and can actually detract from your being able to fully relax—but if the massage is not proceeding the way you had hoped or if anything gives you pain or otherwise makes you feel uncomfortable about the massage, let your therapist know. Massage therapists are knowledgeable about a variety of techniques, but each of us experiences them differently. Because everyone’s level of sensitivity is different and because our preferences are unique to each of us, it is difficult for the therapist to know what feels good and/or effective for you and what doesn’t—unless you tell him. This also applies to temperature: if you feel too warm or too cold during the massage, let your therapist know so he can take steps to make you better able to enjoy your massage.
4. Following the massage, ask the therapist for self-care tips if she doesn’t provide them. Are there stretches that would be helpful for relieving or preventing particular muscles issues? Are there things you can do at home to alleviate remaining muscle pain? What tools are effective for addressing recurring muscle pain?
5. While not required, a clean “work surface” is much appreciated by the therapist. It’s not always possible, of course, to arrive at your massage appointment sweat- and odor-free (I’m thinking, for instance, of Chicago’s notoriously hot and humid summers), but whatever efforts you make along those lines will be beneficial to the therapist and, therefore, ultimately to your massage.
6. If you have long hair, consider putting it up in some way that will keep it out of the way. Doing so not only keeps your hair from getting oily, but it also allows the therapist to focus on the work at hand rather than on repeatedly trying to move your hair aside.

In sum, your main responsibility as a client is to help make it possible for your therapist to give you the best massage of which she is capable. In the unlikely event that you find yourself in an unredeemingly unpleasant massage situation, remember that you always have the option to end a massage early if it seems you and the therapist are just not on the same wavelength. However, when you keep in mind the above points, you are giving both yourself and your therapist a fair chance at achieving a satisfying outcome.

The Heated Debate: Hot? Or Cold?

Among massage therapists, physical therapists, trainers, and medical professionals of all stripes, one of the most contested topics is whether sites of soreness or injury should be treated with heat or cold. It turns out that at least some of the divergence can be resolved based on what the cause of pain is and how long the area has been painful—although as the Merck Online Medical Manual points out, “Whether to use heat or cold therapy is often a personal choice.” Consequently, the decision of which to use may always be open to question.

The first thing to consider, though, is what each type of treatment does to tissue. According to the University of Chicago Medical Center, for instance, the application of heat brings more blood to the area, reduces joint stiffness and muscle spasm, and helps resolve inflammation. Merck adds to this the fact that heat makes connective tissue more flexible and reduces the buildup of fluid in tissues. Cold, in contrast, relieves pain by numbing the affected area, reduces swelling and inflammation, and reduces bleeding. Already you can see that the issue gets a little muddy in that both cold and heat help reduce inflammation.

So when do you use which? The August issue of the Mayo Clinic Health Letter advises cold first, to soothe inflamed muscles, and heat later, per Medical News Today. So if you have injured a muscle or ligament, having sustained a sprain, strain, or pull, the application of a cold pack or cold compress will act like a local anesthetic, numbing the area, thus relieving the pain. Cold will also slow the flow of blood to the area, which helps reduce bruising. Because of this reduction of blood flow, though, cold should not be applied to areas where the supply of blood is already compromised, such as where arteries are narrowed by peripheral arterial disease. Cryotherapy (treatment using cold) should also be avoided for areas with trigger points (tight bands or knots in a muscle) since chilling activates them owing to decreased circulation.

In contrast, heat therapy is in order once the pain and swelling of an injury have decreased or for chronic pain, such as when muscles are simply tight or sore but haven’t sustained an injury, per se, or for arthritis. The increased blood flow brought about by the application of heat helps soften the connective tissue. If you imagine connective tissue to be like taffy, think about how rigid and inflexible it becomes when cold versus how pliable it is when warm. Furthermore, since blood helps eliminate the chemical by-products produced during exercise that make muscles tight and compressed, the increase in its flow will aid in this elimination.

If all else fails, use your head. Not as a compress! But, rather, to think about this: you already know that cold makes your muscles stiff, right? So why would you treat stiff muscles with cold? Certainly cold will numb the pain of, say, a tight back or shoulder. But unless an area was just injured, the use of cryotherapy won’t promote the relaxing of the tissue to which it’s applied. So for stiff, chronically achy muscles, I recommend heat. That’s a “personal choice,” certainly, but it’s one I’ve come to after careful examination of research and based on logical extrapolation of the findings of that research.

Gimmicks, Gimcrackery, and Goodness

The most important consideration about a massage is whether it is good. But what constitutes a “good” massage? The short answer is that it does what you, the client, want/need. The longer answer requires answering in the affirmative to questions such as the following. Were the techniques, modalities, and level of pressure appropriate for what you hoped the massage would accomplish? Did you feel like the therapist had really listened to you and did what you’d asked? Did you feel better (more relaxed, experiencing less discomfort) not only immediately after the massage but in the day or two following? Did your therapist do everything she could to make you comfortable?

Beyond such considerations, there are a variety of extras that may enhance the massage for you, everything from the overall environment of the massage space to the kind of linens used. Such so-called extras can even be therapeutic in the hands of someone professionally trained to, for instance, use essential oils for aromatherapy. The trick is to distinguish between tools that are used with professionalism and knowledge and those that are mere gimcrackery—for instance, the application of tuning forks by someone not trained in sound therapy.

Gimmicks should also be viewed with caution. All too often, the word “gimmick” bears greatest resemblance to the part of its definition delineating it as “a concealed, usually devious aspect” of a deal—for instance, “massage” parlors that offer 24-hour service. But a gimmick doesn’t necessarily have to be a bellwether for something subpar. A gimmick that is “an ingenious or novel device, scheme, or stratagem” used to increase the genuine appeal of a service or product or that incidentally draws attention to something of real value doesn’t warrant the same sort of caution as its less respectable counterpart. In other words, a gimmick can also be an honest means to a good end.

For example, my recent venture of delivering massage to clients in their homes via bicycle could at first glance be construed as a gimmick. And in the sense that transporting a massage table via bicycle is a novel way to do so, it is, in fact, a gimmick. But the motivation for buying a Dutch WorkCycles bike so that I could haul a massage table was not to bring attention to my massage business—though doing so would without a doubt be a happy by-product. Further, it is the quality of my massage—not the fact that I ride a crazy-cool massage-table-carrying bicycle—that persuades people to schedule with me.

So if not primarily for the publicity, why have I embarked on this enterprise? In the main, I have done so because (1) I love bicycling, (2) I hated having to burn fossil fuels in order to go just a few miles to a client’s home, and (3) I work with a lot of athletes and so I feel using my own power to move about adds to my credibility with them. As it turns out, the bakfiets (pronounced bahk-feets and translated as “box bike”) is also incredibly fun to ride!

On the bakfiets, you sit much lower than on a “regular” bike, similar to someone riding a chopper. It is a position that makes me feel relaxed and incapable of hurry, as though I were piloting a ship. And though I’ve not carried as much as the 300-pound load limit, for the most part, I haven’t felt especially burdened by whatever I’ve carried in the box so far. (I’ve taken my five-year-old nephew for rides and used it to carry nearly a hundred pounds of groceries, as well as having transported my massage table.)

In addition to the physical pleasure of the ride, there is the added pleasure of reaping oodles of positive attention and admiration. The day after my partner Kathy and I purchased the bakfiets, I rode it about five miles to the Trader Joe’s grocery in Park Ridge, IL, with Kathy accompanying me on her own bicycle. Though I wasn’t aware of it, Kathy tells me I “turned a lot of heads.” I couldn’t help but notice, however, the things people called out as we passed by. “That is the best bike ever!” “Awesome bike!” “Where did you get that bike? Did you have it specially made?” “Did you build that bike yourself?” I even drew amused chuckles from an elderly woman waiting for her bus. At stoplights, I was engaged in lengthier conversations with nearby motorists. At Central Avenue and Northwest Highway, a Vietnamese man told me the bike reminded him of a kind of bike used in his homeland, and at Raven Avenue, a pale man with dreadlocks quizzed me about where to purchase such a vehicle. There were also questions about what I used the box to carry. The latter sort of question has mostly ceased since I mounted my banners on it, with my logo and the declaration “Pedaling massage to you,” but passersby are no less amazed by the vehicle itself or by its purpose.

When I first used the bike for its intended purpose, I received surprisingly little notice. First, it was near rush hour on a weekday, and not on the weekend as when I’d ridden it otherwise, and so people were more in hurry (hence the rush in “rush hour”!) and less inclined to stop and marvel. Second, I took more residential streets to get to my client’s home so there were simply fewer people out and about. When I arrived at my destination, though, the eleven-year-old boy who lives there was rendered nearly speechless by how “cool” my mode of transport was.

Since that first trip, and since affixing the banners, in addition to the comments about the bike itself, I’ve gotten many comments from strangers on the street and in parking lots about what a neat thing I’m doing and what a great way to advertise. The banners have even generated some networking. In the parking lot of the Trader Joe’s in Wrigleyville, a musician who composes music for massage and relaxation, Michael Strening Jr. (www.msj-music.com), approached me to pass along his business card and ask for mine. Now he’s spreading the word about me and I am buying his CD of piano compositions to use in my massages and to sell.

Even at this early stage of my latest endeavor, it’s clear that the “gimmick” of this strange cargo bike is generating a little buzz for me. And that’s nice. But in the end, what will really matter is whether I give the people what they want: a darn good massage.

Massage and Weight Loss

It may seem too good to be true that massage can help you with a weight-loss program. There are many ways, however, in which massage therapy will indeed support your exercise and weight-loss goals. Massage is unlikely to have a direct impact on weight loss, such as physically bursting fat capsules as some have claimed. This doesn’t mean, however, that the benefits are not real.

To begin with, massage will improve your flexibility by loosening tight muscles. Muscles that are therapeutically manipulated will experience an increase in blood flow, which helps lubricate muscle fibers that are sticking together. And an added benefit of loosening tight muscles is that you will be less stiff and sore, making it easier for you to stay on track as you work toward achieving your objectives. In short, because massage increases oxygenation of muscle tissue, it can shorten recovery times and prolong endurance.

Massage can also help reduce your risk of injury, especially as you increase your level of activity, putting greater stress on muscles that have been less active. By stretching and manipulating the connective tissue that enwraps all muscle tissue, massage can help reduce adhesions, or scar tissues, which are common with muscle injury.

Further, research has shown that massage will increase metabolic rate, thereby allowing your muscles to burn more calories. This improved metabolic rate is a result of the endorphins released during massage. Endorphins, as you probably know, make you feel better, too, and will help you remain motivated and active.

Another frequent factor in weight gain is the production of cortisol, a hormone that is released in response to stress and has been shown to increase appetite and cause fat to be deposited in the abdominal area. Exercise is the best way to reduce cortisol levels, but massage can reduce it as well by lessening your stress level.

Digestive health is another critical factor if you are going to achieve your target weight, since the digestive tract supplies your body with the fuel it needs for energy and eliminates waste products. Abdominal massage not only promotes digestion, it also reduces constipation, bloating, and flatulence, all of which are factors in belly size. Abdominal massage should therefore be given serious consideration if you are intent on decreasing your body size.

Finally, although losing weight and regular exercise are rewards in themselves—improving your health, your self-esteem, and so on—the results are not instant and it can be easy to feel discouraged. Therefore, if you are working hard, it’s important to find healthy ways to reward yourself regularly to maintain your motivation. Massage is an excellent way to do that because not only does it feel great but it can also be an important adjunct to any exercise and diet plan.

Exactly What Is a Knot in Your Muscle?

Clients often come to me with a “knot” in their back or their necks. And occasionally, one of them will ask me the question I’ve just posed above: “Exactly what is a knot?” I swear that they’re picturing a nice little half hitch or slipknot in their muscle fibers. But a knot, in this context, is less like something you learn in Boy Scouts, with loops and twists, and more like what you find in a piece of wood: a hard place.

In reality, a knot in the muscle occurs when a section of the muscle becomes constricted (or compressed). The scientific term for this state is a myofascial trigger point, with myo meaning muscle and fascial referring to the connective tissue surrounding the muscle. Knots can form when some event generates a reaction in which the muscle never relaxes, which leads to a muscle spasm. The spasm creates a sense of chronic tightness—a.k.a. “a knot.” The word spasm might seem to suggest a sudden series of muscle contractions and relaxations—a jumpiness in the muscle—but a spasm can also be a single prolonged involuntary muscle contraction, or abnormal tightness.

Muscle constriction can also occur as a result of small amounts of scar tissue developing through an injury or even just repetitive motion, from microscopic damage to muscle fibers. Scar tissue is an inflexible collagen fibrous material that, once created, can adhere to muscle fibers, preventing them from sliding back and forth over one another as they should, as well as to connective tissue, reducing muscle flexibility. Muscle fibers can also adhere to one another as a result of, for example, dehydration.

One of the reasons that massage is so effective at treating knots is that it helps loosen such adhesions, allowing the muscle fibers to slide over each other again, and it also helps reintegrate the scar tissue into the muscle, reducing its inelasticity and thereby restoring the muscle to a more flexible state.