If you've got a lump on top of your shoulder muscle, there's a good chance it's a trapezius knot. In fact, according to a study published in June 2017 by Medicine, these lumps in the trapezius muscle — called myofascial trigger points — are among the most common causes of musculoskeletal shoulder pain.
Anyone familiar with this particular tension and pain is probably wondering how to release trapezius knots. Luckily, home remedies can help.
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What Are Muscle Knots?
Myofascial trigger points or muscle knots are tight balls of clenched muscle fibers under the skin in areas we typically stress and strain a lot during the day, like our neck, shoulders and back, according to the Cleveland Clinic.
Causes of Muscle Knots in Your Traps
Your trapezius muscle spans from the back of your neck to your lower back, according to a February 2015 article in BioMed Research International. Because it attaches to your vertebrae and shoulder blades, it has many functions: shrugging your shoulders, rotating your shoulder blades to allow you arms to move overhead and pulling your shoulder blades down and together.
Knots most often occur in the upper trapezius, or the part that runs on either side of your neck and along the tops of your shoulders. These swollen trapezius lumps are typically painful to the touch and can cause pain to spread to other areas in your shoulder and back.
Common causes of upper trapezius muscle knots include poor posture and psychological factors that increase stressors, such as high pressure at work and low job satisfaction, according to the Medicine study.
You could also develop tension in your trapezius muscle, knots or even spasms if other surrounding muscles are weak or fatigued, causing the upper trap to work overtime to help support your arm.
Trapezius Knot Release Techniques
There are a number of different approaches that deliver trapezius muscle tension relief, either at home or under the guidance of a physical therapist.
Even if the muscle knot on top of your shoulder isn't particularly painful, it indicates that your muscle is inflamed. Trigger points in the upper trapezius muscle can negatively affect movement of your shoulder, increasing risk of injury. This is especially true if you perform a lot of overhead activity.
According to a very small September 2018 study in the Journal of Human Kinetics, stiffness in the upper trap can decrease shoulder range of motion, increasing the risk of rotator cuff injuries. However, this study also showed ischemic compression — trigger point release — was effective in treating muscle knots on the top of the shoulder for 12 professional basketball players.
1. Release Your Trigger Point
While trigger point release is often performed by physical therapists and massage therapists, you can try this technique on yourself with a massage ball, tennis ball or lacrosse ball. Try it both standing and while lying on your back.
- Stand with your back against a wall.
- Place a ball behind your upper trap directly on the lump, and lean against the ball. Press hard enough to cause tolerable pain.
- Hold until the pain subsides by 50 percent, then press harder.
- Continue to hold this pressure until the pain subsides, typically between 30 seconds and several minutes.
2. Stretch It Out
Stretching for trapezius knots can reduce tightness on top of your shoulders. Hold each stretch for 20 to 30 seconds, and repeat three times on both sides.
- Sit up straight and tip your ear toward your shoulder on the unaffected side.
- Rest your hand on top of your head to gently increase the amount of stretch.
- Rotate your head slightly and repeat to target different fibers in your trapezius muscle.
3. Apply Cold or Heat
Trapezius pain that occurs immediately after activity or pain that is sharp is a sign of inflammation, according to Summit Orthopedics. For this type of pain, apply ice to your affected muscle for 10 to 15 minutes to decrease blood flow and inflammation.
If you have a knot in your trapezius that just won't go away, and it is achy and annoying, apply heat for 15 to 20 minutes to increase blood flow and help the muscle relax.
4. Squeeze Your Scapula
Strengthening a muscle that has a trigger point puts more strain on the already aggravated muscle, potentially making it worse, according to the National Association of Myofascial Trigger Point Therapists.
But you don't have to avoid exercise altogether. Strengthening exercises for your upper back can help improve posture and reduce risk of overuse of your upper trapezius muscle. You can perform scapular squeezes without even leaving your desk.
- Sit up straight on a firm surface.
- With your arms relaxed by your sides, squeeze your shoulder blades together as if you are trying to hold a pencil between them.
- Hold for two to three seconds, then relax.
- Repeat 10 times, working up to three sets in a row.
Be sure your upper trap muscles are relaxed during this exercise. Try it in front of a mirror to help keep your shoulders from shrugging.
5. Get a Massage
If self-myofascial release don't help, you could enlist the help of a professional massage therapist for muscle relaxation (or even try a massage gun), according to the Cleveland Clinic. They'll use a variety of massage techniques to help break up the knotty ball of muscle fibers.
6. Perfect Your Posture
Poor posture, especially while sitting at a desk, can contribute to trapezius trigger points, per the Cleveland Clinic. Make sure you're set up properly by following these tips from the Mayo Clinic:
- Adjust your chair so your feet can rest flat on the floor (use a footrest if needed) and your thighs are parallel to the floor.
- Position your keyboard and mouse so your wrists and forearms are aligned and your shoulders are relaxed.
- Place your computer monitor about an arm's length away from your face, at eye level.
When to See a Doctor
While most lumps on the top of the shoulder muscles are likely to be trigger points, there are other medical conditions — such as cancer — that can cause lumps. Cancerous lumps often appear out of nowhere and grow steadily in size. See a doctor for an accurate diagnosis if you have any concerns about a lump in your trap muscle (or anywhere else, for that matter).
You should also talk to a doctor about trap pressure points if the lump gets red, feels hot to the touch or is draining any fluid or blood, per the Cleveland Clinic.
- Medicine: "Predictors of Upper Trapezius Pain With Myofascial Trigger Points in Food Service Workers the STROBE Study"
- Journal of Human Kinetics: "Changes in Muscle Stiffness of the Trapezius Muscle After Application of Ischemic Compression into Myofascial Trigger Points in Professional Basketball Players"
- PhysioMed: "Correct Sitting Posture: Office"
- Summit Orthopedics: "Treatments You Can Try at Home for Trigger Points"
- National Association of Myofascial Trigger Point Therapists: "Myofascial Trigger Point Therapy - What Is It?"
- Cleveland Clinic: "Loosen Up Those Muscle Knots: Here’s How To Get Rid of Them"
- BioMed Research International: "Trigger Points: An Anatomical Substratum"
- Mayo Clinic: "Office ergonomics: Your how-to guide"