Chronic Glute Muscle Knots

[brent217]

I am 37 years old, 6'1" and 195 pounds. Had severe lower back pain, diagnosis seems to be refered pain from muscle knots in my glutes. After much money spent on physiotherapy, the pain has receeded to an ache. The aching and former pain all seems to be caused by muscle knots that will not go away.

I have muscle knots on either side of my tailbone in the Glute Maximus that make my lower back ache all the time, and cause what feels like a torquing pain when they are worked on by a strong massage therapist. I cannot currently locate these knots my myself with a tennis ball, they are too wide/deep, and the area just feels numb when I roll over it.

I have muscle knots in the glute Medius on both sides, that were causing severe pain in the lower back, and the pain has faded over the last few months with daily tennis ball rolling, along with massage and Graston.

I have muscle knots in the Glute Minimus on the left side, but I dont think this is causing me pain.

I have muscle knots down my outer hamstrings on both sides, the knots are in a line starting at the glutes and run down to the knee, but are mostly underneath the IT band, which makes it hard/painful to work on them. Massage is slowly, very slowly, loosening them.

I started the SS routine with an empty bar 2 months ago, and got my squat to 160 using 5 pound increases before I hit the wall the first time. Dropped to 145 and started again using 2.5 pound increases. Today i reached 160 again, but I am very slow coming out of the hole. I think having all the muscle knots in my glutes is interfering with my strength gains.

I am getting a massage 3 times a week, Graston 3 times a week, chiro back adjustments once every two weeks and IMS once a week; and I am spending 2 hours every day at the local public swimming pool in the sauna attempting to stretch my Glutes and Hams. It took 3 months of daily stretching to be able to touch my toes once the muscles are warm and lengthened, but now progress seems to have stalled. And the muscle knots are still there.

All of my various physiotherapists say I am the first person they have ever seen that does not seem to respond to treatment (the average person needs 8 to 10 sessions of IMS or Graston to get a muscle knot to let go, I am well over 150).

I have been doing good mornings with a broomstick (2 sets of 30 reps) and back extensions (3 sets of 20 reps) as accessory exercises to my SS routine. A month ago a tried to take a week off to see if that would help, and after 4 days my back was incredibly stiff and sore, which seemed to diminish when I returned to doing the GMs and Extensions.

So, what else can I do to get muscle knots to let go? I can only assume that these knots have been there since childhood and my body is accustomed to them being there, as I can think of no other reason that they do not release.

[Mark Rippetoe]

I have no idea what "muscle knots" are. Maybe Travis has heard of this.

[TravisRussellDC]

I'm assuming by "muscle knots" you are referring to trigger points, fascial adhesions, etc. I have to say that if you've been under treatment for that long utilizing chiropractic, soft tissue work, stretching and prescription exercise, and the problem still hasn't gone away, then somebody's missing the proper diagnosis. The symptoms are being treated but the cause is being overlooked. I find it very hard to believe that a primary muscle issue would take 150 treatments of Graston to "let go."

I would be curious as to what diagnosis your chiropractor, M.D. physiotherapist, and massage therapist have given you.

[brent217]

I have no idea what "muscle knots" are. Maybe Travis has heard of this.

Muscle knots, sometimes called trigger points, are muscles or parts of muscles that are contracted (shortened) and will not release on their own. Imagine if you contract your biceps to look at the peak, and when you stopped contracting, the biceps muscle stayed contracted. Attempting to curl weights with your biceps like this is pretty futile, as the muscle is already contracted, and has very little or no additional space to shorten, so you have no power in your arm.

This is the problem I have in my glutes.

When the muscle is chronically contracted, it is shortened, and puts strain on the surrounding tissue, and leads to inflammation, and creates "satellite muscle knots" or other semi-permanant shortening in other muscle tissue nearby. Once like this, the muscles cannot be released by any effort of the person the muslces belong to, they have to have an outside force of some type make them relax and lengthen.

In theory, massage, foam roller and ball therapy, and IMS (Intramuscular Stimulation) all do this by slightly different mechanisms. If the knots have been there for a long time, the body will have formed scar tissue around them, making them more difficult to release, which is where ART and Graston come in. I have tried both of those, and they seem to help a little bit but not much either. On a typical person with a muscle knot, 8 to 10 sessions of a given therapy with another person breaking the scar tissue and then forcing the muscles to lengthen are usually enough to to make the chronic shortening let go. On me, they do not seem to be working, which is why I am looking for advice.

[brent217]

I'm assuming by "muscle knots" you are referring to trigger points, fascial adhesions, etc. I have to say that if you've been under treatment for that long utilizing chiropractic, soft tissue work, stretching and prescription exercise, and the problem still hasn't gone away, then somebody's missing the proper diagnosis. The symptoms are being treated but the cause is being overlooked. I find it very hard to believe that a primary muscle issue would take 150 treatments of Graston to "let go."

I would be curious as to what diagnosis your chiropractor, M.D. physiotherapist, and massage therapist have given you.

My family MD sent me to a back specialist, who had me Xrayed and blood tested for various forms of arthritis and other things, and had an MRI done on my entire back. Those found nothing, so the diagnosis was soft tissue injury - just do rehab.

My massage therapist says the problems are all in my head (figuratively, not literally). She thinks that because I am a stubborn, type A personality, that my muscles act the same way. My physiotherapists, including the two Gratson practitioners, and my chiropractor all seem to focus on the fact that I am getting better, just slowly, when I ask them why it is taking so damn long.

In light of no other recommendations I am considering a meditation course to see if that can lower my stress levels, and thus make the muscle knots heal faster. Would really rather have a scientific explanation though.

[TravisRussellDC]

Well, the problem with looking for advice here is that you've already sought treatment from a variety of practitioners who have had the luxury of performing a physical exam on you. Nobody on an internet forum will be able to do more than to say, "try this," or "try that."

What is your diagnosis?

If you've been through this much treatment and haven't progressed the way you would like, how much are you going to go through before you decide that you need to look elsewhere? Graston is a great technique. But 150 treatments is beyond excessive. If the practitioner hadn't achieved noticeable results in 10 treatments, he/she should have tried something else.