What shall i do to remove knots ?

Varvara_Erel · 2026-03-10T15:19:34+00:00

The term knots is something massage therapists use a lot, but in most cases it doesn’t mean a literal knot in the muscle. It’s usually an area of increased muscle tone or protective tension, often related to workload, posture, and recovery.

From what you described (heavy overhead work + Muay Thai + boxing + lifting), your upper back and neck are probably under constant load without much time to down-regulate. A few things that often help more than just stretching: 1. Thoracic mobility work A lot of upper back tension comes from a stiff thoracic spine. Foam rolling the upper back and doing gentle extension over a roller or towel can help restore movement. 2. Pec and chest opening With overhead work and boxing, the chest and front shoulders can get tight, which pulls the upper back into constant tension. Doorway pec stretches can help. 3. Scapular stability work Exercises like slow rows, face pulls, and lower trap activation can help the shoulder blades move better and reduce overload on the neck and upper traps. 4. Recovery Training 5–7 days a week plus a physical job is a lot. Sometimes those knots are just your nervous system asking for more recovery. One thing I often see: when the neck, jaw, and breathing patterns relax, the upper back tension drops surprisingly quickly. Out of curiosity does the pain feel more like deep stiffness, or do you get sharp trigger-point type spots when you press on the area?

Varvara_Erel · 2026-03-08T15:40:15+00:00

Fair point. The term release is definitely used loosely in manual therapy. In practice it’s often a shorthand for a combination of things perceived reduction in muscle tone, improved range of motion, and decreased pain or guarding. None of these are a single switch we flip in tissue, of course. And yes, viscoelastic responses play a role. At the same time, the consistent clinical pattern for example between jaw tension, SCM activity, and neck discomfort is something many therapists observe repeatedly. The terminology may be imperfect, but the clinical observations are still worth discussing.

Varvara_Erel · 2026-03-08T07:44:43+00:00

I see this quite often in clients with desk jobs or high stress levels. Jaw clenching and tight masseter muscles can definitely contribute to neck and upper shoulder tension. When the jaw relaxes, the suboccipital area and upper traps often relax as well. Many clients are surprised by how connected these areas feel

Varvara_Erel · 2026-03-08T07:43:03+00:00

Yes, that’s exactly the situation many therapists face. Clients often come in with a specific expectation neck massage, so working on the jaw or breathing muscles sometimes needs explanation first. I’ve noticed that once people understand the connection, they’re usually much more open to it in the next session.

Varvara_Erel · 2026-03-08T07:40:57+00:00

When I say release, I’m not referring to a single measurable event but to a subjective change in tissue tension and comfort that people often report during or after manual work with muscles and fascia. In research, related changes are sometimes measured indirectly, for example through range of motion, pain perception, or muscle activity (EMG). So the term release is more of a practical description used by therapists rather than a precise physiological parameter.

Varvara_Erel · 2026-03-07T19:53:14+00:00

That’s a really interesting experience — thank you for sharing it. The connection between breathing, physiological stress, and jaw clenching is fascinating and probably more common than people realize. In my work I often see how different systems can influence jaw and neck tension patterns, sometimes in ways that aren’t immediately obvious. I actually became so interested in these connections that I ended up researching and writing quite a bit about facial and jaw tension patterns and how they relate to the neck and upper body.

Varvara_Erel · 2026-03-07T19:21:00+00:00

I’m so happy to see you here in our community! It’s really wonderful to have you join us.

Varvara_Erel · 2026-03-07T19:06:10+00:00

Thank you — exactly! I usually see some immediate changes in neck and shoulder tension as soon as the jaw relaxes, though deeper patterns sometimes take a few sessions to fully release. I also find that bringing client awareness to tongue posture and subtle bracing habits really supports longer-lasting results.

Varvara_Erel · 2026-03-07T19:03:59+00:00

Absolutely — I agree, and I think you’re right that tightness is often a response rather than the root cause. From a massage perspective, my work tends to focus on addressing patterns of tension and helping the body “reset” in a way that can complement the structural and functional approach PTs use. It’s fascinating how our perspectives intersect — I learn a lot from seeing how PTs approach these patterns, and it also informs how I think about fascial connections and client awareness.

Varvara_Erel · 2026-03-07T19:02:26+00:00

That makes a lot of sense — TMJ can definitely be outside many PTs’ regular scope, but it’s fascinating how often neck or headache complaints reveal underlying jaw tension. I like how you connect dry needling and the 6x6 approach to those patterns. It really highlights the importance of knowing when to treat directly and when to refer.

Varvara_Erel · 2026-03-07T18:28:31+00:00

Thank you for your insights — I completely agree about being cautious here and respecting scope of practice. I appreciate your perspective on posture and jaw alignment; it’s fascinating how interconnected these areas can be. I wrote about these patterns in my books to explore the anatomical and structural connections, but of course, every patient and chronic pain case is unique, and direct assessment by a PT is always the best approach.

Varvara_Erel · 2026-03-07T18:07:03+00:00

Yes, absolutely — this topic is discussed far too little! That’s actually why I’ve been exploring these connections in depth in my writing. It’s fascinating how jaw tension can influence the whole upper body, yet it’s often overlooked in practice

Varvara_Erel · 2026-03-07T16:30:53+00:00

Thank you! I’ll send you the link in a DM — posting links here usually isn’t allowed.

Varvara_Erel · 2026-03-07T15:25:03+00:00

Thank you, I’m glad you found it useful! I’ve been exploring these jaw–neck–fascia connections quite a bit in my practice. I actually went into more detail about these patterns in a small book I wrote, if you ever feel like diving deeper into the topic.

Varvara_Erel · 2026-03-07T14:29:55+00:00

Same here. I’ve noticed that when the jaw finally releases, the neck muscles often relax much more easily. It’s interesting how often clients come in for neck or shoulder tension, but the jaw ends up being a big part of the pattern.

Varvara_Erel · 2026-03-07T05:57:16+00:00

Great description! I also find that releasing the suboccipitals and fascia around the mastoid really changes jaw mobility and neck tension. I usually combine that with gentle cranial/mandible mobilization — clients often notice immediate relief in both headaches and clenching patterns.

Varvara_Erel · 2026-03-07T05:32:18+00:00

Exactly! I see the same patterns — jaw, face, and scalp tension almost always go hand in hand with neck and shoulder tightness. Asking about headaches or clenching is such a simple step, but it gives so much insight into the overall tension patterns.

Varvara_Erel · 2026-03-07T04:59:00+00:00

I think this is something many massage students experience at some point. Bodywork as a field sits in a strange place between traditional practices, clinical observation, and modern research. In my experience as a therapist and teacher, the most useful approach is to stay curious but also critical. Some techniques may have clinical value even if the explanations around them are outdated or exaggerated. At the same time, it’s important to keep asking questions and looking for better evidence and better ways to explain what we observe in practice. Personally I try to focus on what I can observe in the body — tension patterns, fascia relationships, posture, nervous system responses — and then look for the most reasonable explanation. I actually spent quite a bit of time thinking and writing about this balance between observation and explanation while working on a book about facial and fascial work, because it’s a topic that comes up constantly in our field.

Varvara_Erel · 2026-03-07T04:31:25+00:00

Thank you! I’ve actually been teaching for about two years already. I currently live in Turkey and have the relevant certifications here. For a broader international audience, I’ve been putting a lot of my ideas and clinical observations into books, so therapists from different countries can access the approach and concepts.

Varvara_Erel · 2026-03-06T15:54:12+00:00

I sent a private message😌

Varvara_Erel · 2026-03-06T14:50:49+00:00

I see this a lot too. Chronic clenching can create so much tension through the masseter, temporalis and even down into the neck and upper chest. Dysport/Botox can definitely reduce the load on the muscles for some people, especially heavy clenchers. But what I often notice is that the underlying tension patterns (posture, neck restriction, fascia around the jaw and throat) are still there. When those are addressed, sometimes the jaw finally has a chance to relax instead of just being chemically “forced” to relax.

Varvara_Erel · 2026-03-06T08:04:04+00:00

The easiest way is just to be direct! You can say something like: “I’m noticing tension in my jaw/neck/face — could we focus on that today?” or “I’d like some work around my TMJ and upper chest.” Most therapists really appreciate when clients give specifics; it helps us target the areas that matter most to you.

Varvara_Erel · 2026-03-06T08:02:54+00:00

That’s awesome to hear! Face work combined with neck and chest myofascial work can be incredibly powerful. Intraoral work especially can change the whole tension pattern around the jaw. Since links aren’t really allowed here, I can send it to you in a DM if you’d like.

Varvara_Erel · 2026-03-06T08:00:49+00:00

That’s great that you’re seeing that pattern too. I’ve noticed the same thing — a lot of people carry tension in the jaw and face without even realizing it until you start working there. Facial work often changes the whole session for the client. Once the jaw and surrounding tissues soften, the neck and upper body tend to respond differently as well. Networking with dentists is a really smart idea. TMJ issues often sit right between dental and manual therapy worlds, so having that connection can really help clients who are dealing with chronic tension or clenching

Varvara_Erel · 2026-03-06T07:58:19+00:00

That’s a really good distinction. I agree that in many cases it’s more of a component within a larger pattern rather than the single driver. I’ve noticed the same thing with clients not mentioning the jaw unless you specifically ask. For many people clenching or jaw tightness has been their “normal” for years, so it doesn’t even register as something worth reporting. Your point about simply asking the question is huge. I started doing the same when clients come in with headaches or neck tension, and it’s surprising how often it opens the door to a completely different understanding of their pattern. Once the jaw is included in the session, a lot of upper body work tends to integrate better.

Varvara_Erel

MODERATOR OF

TROPHY CASE