Are you feeling pain upon touching your calves? Do your muscles feel hard and rigid? You might have knots in your calf muscles. According to research, 85% of people have muscle knots and don't even know it. Let’s untangle the mystery of calf muscle knots.

1. What Are Muscle Knots (Myofascial Trigger Points)?

The medical term generally used for knots is myofascial trigger points. Knots happen when muscle fibers and fascia - tissues covering the muscles - become tense and inflexible. When you touch a knot, it feels like a small lump or a nodule. Knots can cause pain to radiate to other areas (where knots may not be present) in specific patterns through a phenomenon called referred pain.

2. What Are the Types of Muscle Knots?

According to medical experts, muscle knots can be active or latent. A latent myofascial trigger point (knot) is only painful when they are pressed or touched. On the other hand, active trigger points cause constant pain that can cause dull throbbing. Active knots make movements difficult and hurt a lot. 

3. Where Do Muscle Knots Develop?

Knots typically develop in all muscular regions that are regularly subjected to high levels of stress. These include:

• Lower legs
• Neck
• Shoulders
• Shins
• Lower back

4. Why Do Knots Exist in Calf Muscles?

Calf knots are tight, stiff muscles that are unable to relax and soften. They restrict mobility and lower the quality of life.

Though, it is more common to find muscle knots in the back, neck, and shoulder regions. Calf muscles are not free from this painful condition. In the human body, knots may appear in every place that has muscle and fascia, and calves have both. These knots appear because calf muscles are either subjected to a lot of physical strain or become shortened as you sit for long hours, your legs having little room to move.

5. Can Calf Knots Be Painless?

Latent knots can be considered painless till they lay dormant and you don’t press them. Yes, calf muscle knots can be present for a long time without being detected. But they can be activated for no reason and with no warning, causing severe pain.  

6. Is A Calf Knot Visible?

Hearing the word “knot” makes us imagine a hard bump or a protrusion on the surface of the skin. Calf muscle knots are not visible lumps, rather they are tight bands of muscles that cannot be observed through the naked eye.

7. How to Detect Calf Muscle Knots? (Symptoms)

We cannot see calf muscle knots. All we know about them is the pain they cause. The next question that naturally comes to mind is: how would I know that I have knots in my calf muscles?
Knots are identified through these symptoms:

1. Sore points in the muscles, you cannot see them but you can surely feel them.
2. When you touch these sore points, the surrounding muscles will feel like tight, over-stretched elastic bands.
3. You feel a nagging ache (sharp or dull) in the lower leg. Knots may be present on one side of the calf but you can feel the pain everywhere.
4. The pain is confined to the flesh (calf muscle), it does not engulf your shin bone or knee joint.
5. Tough exercise or exertion will exacerbate the pain.
6.  Muscles feel weak and tired. The smallest of movements feel exhausting.

8. Are Calf Muscle Knots and Lumps Similar?

There is a difference between a lump and a knot. Calf muscle knots will feel like hard lumps when you press deep into the connective tissues but they aren’t lumps.

Lumps in a muscle are soft tissue growths that can be benign or malignant and are visible on the skin.

9. What Causes Knots in Calf Muscles?

9.1. Sedentary Lifestyle

According to Dr. Adrian Chow DC,
“Muscle fibers are made to move - contract and relax - lengthen and shorten. However, when we sit at the computer desk all day with little or no movement in between, these muscle fibers begin to stick to each other forming a knot. Bad posture also puts stress on the muscles, and with enough time this stress can cause the formation of scar tissue.”

From the comments of Dr. Adrian Chow, it can be concluded that a sedentary lifestyle and little physical activity is the major cause of developing calf muscle knots.

9.2. Psychological Stress

The human body is well-equipped to handle stressful conditions. But sometimes the levels of stress surpass the human’s capacity to endure. This leads to adverse impacts on the mind and body. The formation of knots in the calves and other muscles is one such negative effect.

According to the American Psychological Association:
“Psychological stress causes the musculoskeletal system to react and the most common reflex action is the tightness of muscles. These tight muscles hold on to tension till the trigger of stress subsides. Chronic stress prevents this release of tension from the muscles. This leads to the development of knots in the muscles.”

As unlikely as it may seem, mental stress can take a toll on your calves, too.

9.3. Osteoarthritis (Joint Pain)

Osteoarthritis is a degenerative disease in the joints, where joint tissue begins to disintegrate. People suffering from this disease are vulnerable to the development of muscle knots.  

9.4. Sleep Disturbances

Research by the London Pain Clinic indicates that 60% of people suffer from sleep disorders. Oddly enough, sleep disorders are a major cause of knots or myofascial trigger point formation. Not sleeping enough leads to muscle fatigue. If this continues, knots begin to develop because muscles are unable to relax fully through quality sleep. On the other hand, exhausted muscles cause aches and pains that leave you restless and unable to sleep.

9.5. Poor Ergonomics

Prolonged sitting, working long hours, and stressful work conditions frequently give rise to muscle knots. The Senior Transplant Head for Hip and Knee Joint Replacement at the Center  for Knee and Hip Care addresses the effectsof poor ergonomics:

“Due to hectic schedule and stressful working hours, corporate and working professionals are highly vulnerable to develop muscle knots.”
(Dr. Akhilesh Yadav, Ghaziabad)

When your calves remain motionless and contracted, the fibers that make up your calf muscles stick together and shrink in length, leading to knot formation.

9.6. Bad Posture

Confined and compact workstations cause knots to form in the calves. Your legs get cramped in small spaces as there is little room to stretch your muscles. This results in calf muscle knots because your body posture is compromised, specific muscle groups are overworked, and some muscles lay contracted and inactive.

10. What Are the Risk Factors of Calf Knots?

10.1. Age

Even when exercising regularly, age leads to muscle inflexibility. As you get older, calf muscles become more rigid and are more prone to having knots.

10.2. Fibromyalgia

At times your body aches all over for no reason. Your blood test is clear and nothing seems to show up on your MRIs and CT scans. This unexplainable condition of chronic pain and hurting muscles is called fibromyalgia. The brains of patients suffering from fibromyalgia are more sensitive to pain signals. If muscles get pain signals constantly, they can develop myofascial trigger points or knots in response to the internal stimulus.

10.3. Chronic Stress & Anxiety

If you are leading a stressful life, then calf muscle knots will likely occur more often. Stress causes muscles to tense up as a guard reflex. If the muscles are still tense, myofascial trigger points or knots appear in the calf muscles. Try to reduce stress and anxiety levels. Meditate or take therapy sessions to help ease stress in your calf muscles.

11. How to Prevent Calf Muscle Knots?

Knots can be stubborn and nearly impossible to prevent. But you can start caring for your muscles by focusing on the following aspects:

11.1. Posture

As you sit at your desk, your mantra should be “slouching is prohibited.” Once a person becomes engrossed in work, it is easy to not pay attention to the body posture and the amount of stress on your muscles. Sit with your body relaxed and spine straight. Don’t cross your legs as it puts strain on the calves.

11.2. Exercise

If your job requires sitting for prolonged periods,  then you are already spending enough time in a chair. Try to incorporate more standing, walking, exercising, and resting sessions during your non-working hours.

11.3. Mineral Intake

Muscles need calcium, magnesium, and potassium ions to function properly. You should get yourself tested for deficiency, but if you are not deficient, keep up the intake of minerals in healthy, balanced amounts.

11.4. Gentle Self Massage

A massage is a good way to release calf muscle knots. You should massage the trigger points in your calves every day for a maximum of 10 minutes. Massaging a spot more than necessary can increase muscle irritability.

12. Will Calf Muscle Knots Go Away?

Calf muscle knots often go away with proper treatment. To remove these knots, it is important to break the knob present between taut muscle bands. Once that happens, the calf muscles get proper blood supply, their range of motion increases, and persisting pain also subsides.

13. How to Get Rid of Calf Muscle Knots? (Treatment)

If an active lifestyle, light exercise, gentle stretching, and massages are not enough to heal your knots, adopt more aggressive treatment methods to get rid of calf muscle knots.

13.1. Acupuncture

The acupuncture method utilizes a thin, tiny needle to release the trigger point. The acupuncturist will locate the pain-exuding trigger point. Then he will insert the needle into the affected calf muscle to release the trigger point. The muscle will now become elongated and relaxed.

This method is by far the safest and less painful as the penetrating needle does not cause any muscle tears that take may take longer to heal.

13.2. Dry-Needling

Dry needling is a modern method to treat calf muscle knots. The practitioner will insert several small, fine, stainless steel needles called filiform needles into the trigger spots. The method is called “dry needling” because the needles do not inject any fluid into the muscles. 

Are Acupuncture and Dry Needling the Same?

Acupuncture and dry needling have much in common, yet they are very different. Acupuncture penetrates the trigger points to release and relax the muscles, improving the flow of blood and nutrients. It is an old method and is called “oriental medicine.”

Dry needling aims to stimulate muscles and relieve pain, being considered a modern method.

13.3. Electrostimulation

Transcutaneous electrical nerve stimulation units (TENS) are used to relieve calf muscle knots and any pain associated with them. A TENS machine controls pain signals; this relieves pain and triggers the release of endorphins. When the pain recedes, tight muscles begin to relax.

The electrode pads of the TENS unit are applied over the affected area. The machine will stimulate an automatic response in the calf muscles. They will start relaxing on their own and the knots will loosen up.

13.4. Chiropractic Treatment

Calf muscle knots may appear due to joint dysfunction and restrictions. The chiropractor alleviates these restrictions with hands-on chiropractic manipulation of the muscles. Once the restrictions are removed successfully, knots are removed next.

13.5. Ultrasound Therapy

The findings of Turkish investigators, published in the American Journal of Physical Medicine and Rehabilitation claim that,

“The ultrasound therapy to treat the muscle knots known as myofascial trigger points is as effective as other invasive methods involving penetration of needles directly into the trigger points.”

The therapy is similar to having a normal ultrasound. The transducer probe of the machine is placed on the affected calf area. The cool, medicated gel is also applied depending on the condition of the patient. The probe sends vibrations into the body through the skin. The tight knots in the connective tissues vibrate under the ultrasound waves and loosen up. 

13.6. Laser Therapy

Low and high-power laser therapy is the fastest way of treating muscle knots and alleviating the pain associated with them. Laser therapy stimulates the production and release of pain-relieving chemicals in the “knotted” regions. Moreover, laser therapy transmits photon energy into the cells. There is no heat damage involved as the skin and tissues absorb this energy through a photochemical effect. 

Dr. Bruce Coren, DVM, MS commented on the benefits of treating muscle trigger points (knots) and said:

“Laser is particularly effective in extinguishing painful trigger points. It is also effective in stimulating acupuncture points without the discomfort associated with needling.”

14. Why Do Muscle Knots Linger?

Muscle knots may take longer than normal to go away. If your muscle knots are here to stay because you may be suffering from a disorder called myofascial pain syndrome. Myofascial pain syndrome is a serious disease in the muscles and soft tissues that impairs muscle strength.

To distinguish between a common calf muscle knot and myofascial pain syndrome, consider the following tell-tale signs:

1. Deep lingering pain in calves
2. Sore spot in the calf muscles that won’t go away.
3. Difficulty sleeping due to pain

If simple treatments fail to loosen up the knots in calf muscles, then you should consult your doctor for proper treatment.

15. Takeaway

Calf muscle knots are frustratingly painful. They appear when muscles have to bear repetitive stress. Calf muscles can be active trigger points that cause continuous pain or they can be latent - painful only when you press them.

The fact that it is difficult to identify the exact area in the calf muscles where knots are formed leads to frustration. However, though calf muscle knots are common, the cause of the occurrence, degree of pain, and treatment methods may vary from person to person. The methods that work for others might not work for you, and vice versa.

In case nothing helps your discomfort and the calf muscle knots persist, seek medical attention without delay.