When It’s Not a Knot: Why Some Pain Isn’t What You Think It Is

One of the most common things we hear from clients is, “I’ve got this knot in my shoulder that won’t go away.” And sometimes? They’re right. But more often than not, it’s not actually a knot—it’s just tension. And yes, there’s a big difference.

At Stress Less Massage, we spend a lot of time educating clients about how pain really works. Because the way your body feels isn’t always a perfect representation of what’s actually going on.

So What Is a Knot, Really?

A true “knot” in a muscle happens when muscle fibers stick together, one at a time, over time. It’s similar to a tangled piece of thread—it shortens the muscle and restricts its ability to lengthen and contract properly. Left untreated, that shortened muscle becomes a ticking time bomb. You go to reach for something like you always do… and boom, sudden pain. That’s when people say, “But I didn’t even do anything I don’t normally do!” Yeah, except your muscle wasn’t in its normal state anymore. That’s why it snapped.

Knot = actual stuck muscle fibers. Painful. Restrictive. Needs to be worked out strategically.

But Sometimes… It’s Just Tension

Not all pain is from knots. A tight muscle is not the same thing. Want proof? Try this:

• Rest your hand on a table, relaxed. Use your other hand to massage your forearm.

• Now clench your fist hard. Try massaging the same spot again.

Notice the difference? That’s the impact of tension alone. No knots required. When your muscles are “on” all the time—because of stress, posture, or emotional overload—they become sore and stiff just from overuse and fatigue. That’s what your entire body starts to feel like when you’re overwhelmed: constantly flexed, harder to move, and more painful to touch.

Pain Is a Symptom—Not a Diagnosis

One of the most important things we teach is this: where you feel pain is rarely where the problem actually is. Pain is your body’s alert system, not a GPS. Often, smaller, weaker muscles end up doing work they weren’t designed for because the bigger, stronger muscles are dominating or compensating. The result? Fatigue, cramping, soreness… and you’re left thinking that’s where the issue is.

A lot of shoulder and neck pain? That’s likely from your back and glutes pulling downward—or from tension in the front of the body that no one talks about. (Let’s be honest, it’s not the most comfortable area to address, so most people skip it entirely.) But that front tension, combined with back tension, pulls everything down into a slouched, compressed posture. That leaves your upper traps and neck in a constant game of tug-of-war, straining to keep your head up.

So Where Do Knots Actually Form?

Knots usually show up in areas where muscles overlap and rub against each other—like your upper shoulders, between the shoulder blades, and around the hips. Long, straight muscle groups (like your hamstrings or quads) are less likely to form knots. They might still be tight, but they don’t “knot up” in the same way. They just get stiff and grumpy.

Our Approach at Stress Less Massage

We treat every session like detective work. We listen to your symptoms, sure—but then we look for the real cause. That might mean working on areas you didn’t even realize were involved. Because if you just chase the pain, you’re missing the bigger picture.

Sometimes it’s a knot. Sometimes it’s just tension. And sometimes it’s compensation from a totally different area. But whatever it is, we’ll figure it out—and we won’t just dig into it blindly and hope for the best.

The key to feeling better isn’t always where it hurts—it’s in understanding why it hurts in the first place.