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Muscle knot is the collective term for a condition called myofascial trigger points; a specific area of a muscle that causes pain or twitching. Touching the area results in pain, often radiating from the problem area. Sometimes a palpable lump, or “knot,” can be felt in the tissue. Mobility can decrease in muscles with a knot. There may be a painful tightness in the area and a slight warmth to the skin. 

Identifying these problem areas rely on the patient describing their pain and a doctor or specialised physiotherapist using their hands to locate the problem.  Always discuss matters with your doctor or physiotherapist. They will be able to recommend a treatment plan based on you and your issues.

What causes a muscle knot?

Why these knots form is not known, but stress, poor posture, and repetitive, hard body use is consistent with the formation of them. Tight connective tissue and fascia can also create inadequate blood supply to the muscles, resulting in the tightness and pain.  

You probably already know that trigger points in the neck and shoulders feel like small nodules and hurt when pressure is applied. Similarly, one can have muscle knots elsewhere in the body, like in the pelvic floor.

Muscle knot self management

Muscle knots can often be softened and massaged away, but you also need to find the root of their existence. It can be hard to find the knots and loosen them, however in severe cases of trigger points; a doctor can inject a numbing agent into the knot.

Ask your doctor if these guides in your case will be safe and helpful.    

Choose a body area per day. Dedicate time to inspect your thighs, stomach, back (you might need help for that), buttocks, pelvis/labia/perineum, and vagina systematically for knots. The goal is to learn the state of your body.

Sometimes it can help one area of the body if you work in a different area.   



  • Swipe the area to warm it up a little. Feel for tender points.
  • Roll your skin and tissue systematically between thumb and index finger, alternatively, tap into the tissue smoothly.
  • Swipe over the area again to attract blood circulation.
  • When you find a knot, hold it with constant light pressure for about 30 seconds. It isn’t supposed to hurt, but discomfort is to be expected. Be aware that the pain diminishes. If it doesn’t, the pressure is probably too hard. Use let-go exhalation
  • Slowly let go of the pressure to allow the blood in.

Repeat exercise a couple of times. You are the one to judge how many times are beneficial for you. 

The aim of pressing down on the knot and stroking the area is to force the tissue and muscle to loosen and to promote good blood circulation.  


The Heskiers OneTool is a massage and acupressure tool for pain and tension release.

A Heskiers one tool is first used to increase the fluid flow in the tissue. It may assist in the softening of muscle and connective tissue. A Heskiers one tool can also be used to press down on trigger points and allow for their release. Use it with ease; it is more effect full than you would think.


It can be a difficult experience carrying out a self-examination of the vagina. Some find it easier to use a tool such as a dilator or a thin vibrator (Props & Pearls recommends). Do not use force. Talk the steps through with your doctor or let a physiotherapist do the job for you.

It is essential for women to take pride in themselves, also for the little signs of progress they make. Small steps count. Remember to praise yourself.


  • Lie on your back with bent legs
  • Imagine your vagina as a clock. The clitoris is at 12 o’clock, and the rectum is at 6 o’clock
  • Use a handheld mirror to look between your legs
  • Avoid the area from 11.30 to 12.30 o’clock, as the bladder and urethra are located here
  • Insert your tool (finger, dilator, or vibrator). Place the tool in the vagina, inserting only 1-2 cm
  • Consider this the first of three “zones” of the vagina, just up one-third in length
  • Start at 6 o’clock. Move the equipment softly and slowly counterclockwise to 12.30 o’clock
  • Imagine that there are three layers of tissue and you gradually increase light pressure to get to all three layers
  • Then carry out the same exercise from 6 to 11.30 o’clock
  • Subsequently, you examine the area further up into the vagina – equivalent to two-third, which we will call zone 2. Repeat the process in zone 3, corresponding to three-third inside the vagina, and in the remainder of the vagina, if there is still space left.    


Note where you experience your vaginal pain:

  • Length axis: 1st Zone (shallow), 2nd Zone (middle), 3rd Zone (deep)
  • Horizontal axis: Clock position of the pain (12.30 to 11.30 o’clock)
  • Depth: superficial, light press, slightly harder 
  • Pain Grade: from 0 to 5 (0 being no pain and 5 being very painful)  


  • If you feel, there is a knot inside the vagina, focus on it. Note where it is: zone, clock position and approximate depth
  • Apply light, constant pressure. Enough to feel it subside gradually (approx 50% in 30 seconds) and not so much that the pain level keeps its intensity. If the pain stays, then you may have to ease the pressure. Or maybe this is not beneficial for you
  • Concentrate on letting go and not buckle up. Use letting go breath. Read Breathing
  • Take breaks between different pressures
  • Swipe across the area to promote blood circulation
  • The goal is to stretch the muscle fibres and increase blood circulation

Pain source

This method can alleviate a muscle knot, but the knot can reappear if you do not change your habits. The body acts by experience and tends to return to the inappropriate habits you have if you don’t do something active to introduce a change.  

A crooked house

Is your body (including fascia, bones and muscles) in balance and aligned? Is your pelvis balanced?

Imbalance and misalignment may occur due to

  • Uneven legs or feet
  • Crooked spine or pelvis
  • Uneven tightness of connective tissue on either side of a muscle (common in the psoas muscle in the pelvis) or muscle pairs

It may be a good idea to perform a whole body examination to mark if some muscles are tighter than others.  Talk to your doctor about your options.

Are your muscles in shock?

If you experience a trauma, your muscles may freeze. They can tense up to protect you. Sometimes you have to work with them to get them in order and let go. Afterwards, we can react by physically shaking to loosen the tension. The pelvic floor is an area that is harder to get to and work with. Therefore, we tend to forget to shake off the experiences of the pelvic floor. If you do not work with the muscles, they may continue to be tight, ‘thinking’ that they need to protect you. You then need to teach your body that the danger is over and that it must let go.  

Read Frozen in the moment

Chronic muscle tension

The muscles in the shoulders and neck are often tense when we are experiencing chronic pain. The pelvic floor works the same way – muscles tighten. Constant muscle tension provides reduced blood flow and right conditions for muscle knots. Read When Pelvic Muscles cause sexual pain

Try to use controlled breathing to relax and let go.   Read Breathing

A mystery

Some people do not know why their muscles tense up. Perhaps they experienced a trauma, but they cannot remember it. Maybe they have chronically experienced this tension, but they really do not know why. Many people, unfortunately, do not have an answer as to why their muscles are tense. It is possible that the explanation is simply not available. Whatever the reason, focus on getting the connection with your pelvic floor and increase its flexibility. Which implies good nerve contact to the muscles and that they are both responsive and durable, with proper blood circulation.  

A GYN/OB physiotherapist is a very good professional to work with when it comes to pelvic muscles. Find one you trust who has experience in your field.