The Mystery of “Muscle Knots” Solved: Sensory Motor Amnesia

There is some confusion as to what “muscle knots” are and where they come from. This article from the New York Times posits: “How do they happen and how can they be prevented? Are they harmful and should they be treated?” Allow me to answer these questions in the simplest way possible:

“Muscle knots” are not mysterious; they are areas of Sensory Motor Amnesia (SMA)

Sensory Motor Amnesia is habituated muscle tension that develops when we become habituated to stress and/or certain ways of moving. These areas of accumulated, learned muscular tension are stuck at the level of the central nervous system and cannot, physiologically, release and relax.

If you’ve ever had back, neck or shoulder pain and gone to a massage therapist to work the knots out of your back, only to have the knots return, it seems that there is little that can be done. Not so. The reason these knots seem to stick around despite the best massage therapist’s effort, and why they don’t show up on scans and MRIs is because what is happening in the muscle is a neurological event in the brain – a functional problem of the sensory motor system. SMA is not a medical problem that can be diagnosed through conventional medical methods. It is a functional  problem of the sensory motor system that can be easily “unlearned” through Hanna Somatic Education.brain-side

Muscle knots can be prevented first and foremost by understanding how SMA develops in your brain due to repetitive stress responses and/or repetitive, habituated movement habits. Muscles have two functions: contract and relax. When muscles can no longer fully relax this is an indication that you have accumulated muscle tension that you are no longer fully aware of. The only way to fully release these “knots” is to make sure that the brain is fully in control of the muscles.

Muscles knots are only harmful when they get in the way of free, efficient movement.

Movement is medicine, movement is life, and painful muscle tension can cause you to move less efficiently and, for most people, minimize the amount of movement you do. In order to live a healthy, free life we need to be able to move strongly, vigorously, and with endurance for as long as we live. If you’re not planning on moving a lot then muscle knots won’t hurt you. The lack of movement will, however.

Treatment of tight muscles doesn’t work. Reeducation of tight muscles does.

If you want to untie a knot, you must look at the cord carefully then gently undo the tangle. Yanking on the cord will only make the knot tighter.

– Thomas Hanna

Muscle knots can’t really be “treated” successfully – for the long term.  Treatment is what bodyworkers and doctors do when they attempt to fix tight muscles (or postural imbalances) from the outside; there are therapists who can help provide short term relief, yet muscle tension Pandiculation demonstrated (1)develops from the inside out (Sensory Motor Amnesia) and, since humans are self-regulating, self-sensing beings, not cars or bicycles that need fixing, their muscles must be educated so they can contract and release fully in order to get rid of muscle knots.

Through active involvement of the brain – rather than through manual manipulation – people can more easily and safely learn to  eliminate muscle knots, restore full muscle function in all planes of gravity and prevent them from coming back by doing three simple things:

  • Become aware of your daily movement habits and reflexive responses to stress. Repetitive contraction of muscles without full relaxation creates muscle knots.
  • Learn to pandiculate instead of stretch. Animals pandiculate up to 40 times a day!
  • If you have chronic muscle tension, learn how to eliminate your patterns of Sensory Motor Amnesia with a daily routine of Somatic Exercises**

Muscle knots are not an inevitable part of life; they are a symptom of stress adaptation.

**You can also learn to eliminate your patterns of SMA through a series of hands-on clinical Somatics sessions with a skilled and certified practitioner.

6 thoughts on “The Mystery of “Muscle Knots” Solved: Sensory Motor Amnesia

  1. Martha, I really appreciate your work. This article rings true for me as I have been experiencing the transition from chronic muscle tension to awareness of that tension and noticing it resolving over the past several years through Somatics.

    I do want to mention that my husband and I started taking Astaxanthin 12 mg daily about 3 months ago and it has resolved residual chronic pain from my SI joint and shoulders. My hubby has not worn his back supporter or wrist brace in 2 months even while working outdoors. Now I do Somatics purely for pleasure and not because I am starting to hurt again. Maybe it would help your hip pain, worth a trial. It took us about 3 weeks to notice we were nearly pain free. We are both in our late 60s and have chronic pain from old injuries from car accidents and falls, pretty much normal life. We are both very active and do a lot of farm work.

    • Hi Bonnie, that’s great that you and your husband have been getting some relief, but corrective movements can sometimes take years or never see The full potential of relief without directly releasing the tension of the overfiring muscles and fascia. If your SI joint is still causing you pain it’s likely still out of place. I recommend you find a bodywork therapist that can release the soft tissues and relax/realign your hips so that your corrective exercises can function through good posture to confirm that new position, instead of tugging on joints that don’t seem to move from the movements.

  2. Martha-

    I am an avid follower of your blog and fully value the role of movement awareness in health. But in response to this particular article, I question the assertion that muscle knots are centrally maintained by inarticulate signals descending from the motor cortex.

    It may be that muscle knots arise in the first place due to habitual patterns of unnecessary muscle firing. But there are two other models that have been proposed to account for their persistence.

    One competing model of muscle knots is that chemical cross-bridges (“adhesions”) arise between various layers of connective tissue wrapping the muscle. This implies that manual therapy degrades these cross-bridges, improving the mechanics of muscle function.

    A second competing model of muscle knots is based on the concept that shortening of the muscle’s contractile elements (actin and myosin) requires only the energy already stored in the muscle, yet the muscle requires an external energy source (glucose in the blood) in order to release the contraction. As a consequence local ares of “contraction” can persist in areas of poor blood supply or prior injury, or due to dysfunctional joints, hormonal or nutritional factors, or other reasons. This phenomenon is illustrated by the presence of “rigor mortis” in a corpse – the muscles stiffen when no longer being supplied with energy by the bloodstream. These “contracted” areas are no longer reacting to a neural signal to maintain their shortening. This model implies that manual therapy improves blood (and hence energy) supply, or mechanically disrupts the actin-myosin linkages.

    In addition to the possible relevance of these two models to the phenomenon of muscle knots, there’s yet another important component: manual therapy in and of itself refreshes the feedback from the muscles to the brain and can reinforce the effect of other interventions that attempt to improve sensorimotor awareness.

    All this being said, I appreciate your efforts to continue bringing the fundamental message of sensorimotor awareness to your readers.

    • Hi Ronald,

      Thanks for your input – and I’m so glad you’re enjoying my blog.

      There is definitely a place for manual therapy and, in certain circumstances, a complementary approach is an excellent idea.

      When it comes right down to it, without the brain (all parts of it) and the electrical messages to the muscles, the muscles would be mere slabs of meat. How we experience ourselves, whether involuntary/unconscious or voluntary/conscious, it all happens within the brain. The kinds of muscle knots people are talking about are the ones that are so common to anyone with sensory motor amnesia.

      I’ve just seen so many people learn to “iron out” their own muscles without even understanding a bit of the science behind it. Much of muscle pain is vastly simpler than it is made out to be. The beauty of somatic education (whether Alexander, Feldenkrais, or Hanna’s work) is that they were looking not at “bodies” that needed to be fixed, but living, breathing processes Hanna called “Somas,” that can be educated and thereby changed and improved.

      If you ever have the chance to have a hands-on clinical session with a certified somatic educator, I highly recommend it! I think you would really appreciate it.


  3. I agreed with this article until it seemed to completely disregard true therapeutic bodywork. Without it you are trying to piece together an incomplete puzzle. I like the quote from Thomas Hanna, but what it means to me is first release the tension area and then reeducate the area through proper movement sequences.

    • Hi Smilie,

      I was a massage therapist for 25 (specialized in a long list of modalities) and I worked with some terrific doctors and therapists. Unfortunately I saw patients return for sometimes 20 sessions and still had no long term relief or understanding of how the problem started in the first place! They had no ownership of their experience. Hanna Somatics is education, which teaches one to recognize how stress reflexes (universal to all humans) and habituated movement patterns cause muscle pain. It’s a different paradigm. And, in many cases (like a car accident or post surgery) doesn’t take the place of a good PT or MD. It’s complementary.

      This post comes from my own clinical experience as well as years of struggling with hip pain myself. An understanding of SMA, habituation of stress reflexes and pandiculation was a game changer for me; it flew in the face of everything I ever learned, as a professional dancer and a manual therapist.

      My clients, many of whom who have “tried everything” (PTs, dry needling, trigger points, neurokinetic therapy, shots, surgery, NMT…) say that what was missing for them was the active, first person engagement of their brains, through movement. There are those for whom a combination of methods can work (I mainly see a combo of EMDR/trauma work and Hanna Somatics, or Yoga and Hanna Somatics), yet the bodywork (third person) perspective and somatic (first person) perspectives are different.

      Yes, you’re spot on about Hanna’s quote. If you read his book, Somatics (which the quote comes from), you will see that he is talking about pandiculation as the method for “untying the knot.” Pandiculate the muscle groups (and its synergists), then re-educate the pattern. If you are a manual therapist I think you might really appreciate his book. I’d love to discuss it with you!

      Thanks so much for your comment.

      Best to you,

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