By Chuck Hong, LMT · Bomb Bodywork, Las Vegas, NV
You know the spot. Right under your shoulder blade, or at the top of your shoulder, or that tender lump in your upper back you keep pressing into the corner of a door frame.
Most people call it a knot. And most people have had a massage where the therapist found it, pushed on it for a minute, and moved on, and it was right back the next morning.
This page is for people in Las Vegas who are tired of living with the same knots. Women who work at a desk and feel it between the shoulder blades by 3 p.m. Moms who carry kids on one side and feel the knot on that side. Lifters who have one spot in the upper back that always seems to grab. Anyone who keeps asking a partner to dig an elbow in.
I'm Chuck Hong, LMT, the only certified Sarga practitioner and instructor in Las Vegas. I work knots with Sarga barefoot bodywork, the only method I offer at Bomb Bodywork.
What a knot usually is
"Knot" isn't a medical term, but everyone knows what it means: a tight, tender spot in a muscle that you can often feel as a little lump or band. Therapists often call these trigger points, especially when pressing on one makes you feel it somewhere else too, like a spot in your upper back that you feel up into your neck.
Knots show up a lot in:
- The upper traps, between the neck and shoulder
- Under or along the inside edge of the shoulder blade
- The upper and mid back, between the shoulder blades
- The low back and glutes
They're common in people who sit for long periods, carry things on one side, or train hard. They're also common in people who are stressed, because tense shoulders don't take a day off.
How trigger point massage works
Trigger point massage is pretty simple in concept. The therapist finds the tender spot and holds focused pressure on it, usually with a thumb, knuckle, or elbow, until it starts to ease. Then they move to the next one.
Done well, that can feel really good. It's also a lot of focused effort on a small area. A couple of things can get in the way:
- It can feel sharp. A thumb or elbow concentrates pressure into a small point. Some people love that. Others clench up, and it's hard for a muscle to let go when you're bracing.
- It can get isolated. If the knot is part of a bigger tight area, working just the knot can leave the area around it still tight.
- Hands get tired. Holding real pressure on several knots, especially on someone with a lot of muscle, takes a toll on the therapist's thumbs.
None of that means trigger point work is bad. Plenty of good therapists do it well. It's just one way to get at a knot.
How deep barefoot Sarga work handles knots
Sarga takes a different route. I hold a silk anchored to the table so I can control my weight, and I work with my feet. Here's how that changes knot work:
- Broad first. I start by working the whole area around the knot with broad, heavy foot pressure. The tissue around a knot is often tight too, and softening it first tends to make the knot itself easier to work.
- Then specific. When the area is ready, I can get much more precise with the heel or the edge of my foot, right on the spot.
- Pressure that doesn't spike. Because the foot is broad and padded, deep pressure feels heavy instead of pointy, even on a tender spot.
- Slow traction. I use a high tack cream with very little oil so my foot can grip and slowly pull through the tissue around the knot, not just press on it.
- Time. My feet don't fatigue like thumbs, so I can stay with a stubborn spot as long as it needs within the session.
So instead of going straight to the knot, I work the area around it first, then come back to the knot when it's ready.
Read more about the method on why barefoot. If you're curious how that broad, slow approach connects to fascia, my myofascial massage article goes into it.
Knots between the shoulder blades and in the shoulders
This is where I hear about knots the most. Tight upper back, a spot along the shoulder blade, traps that never come down. It's usually tied up with how the whole neck and shoulder area is holding.
In a session, that means time on the upper back, traps, and shoulder blades, plus the chest and front of the shoulders, which can pull you forward and keep the upper back working. My neck and shoulder massage article covers that whole area in more detail.
What a session looks like
Every session is full body, with extra time on your knots.
- Short consult. New clients start by showing me where the knots are, how long they've been there, and what pressure you like.
- Broad work on the whole region around each knot.
- Specific work on the knot itself once the area is ready.
- The connected areas, like the chest for upper back knots or the glutes for low back knots.
You're in charge of the pressure. Some knots feel good with a lot of pressure. Some are tender and need a slower approach. Tell me what you're feeling and I'll adjust.
Sessions run 90 minutes or longer, so there's time to work knots properly without skipping the rest of your body.
When the same knot keeps coming back
If the same knot shows up every week, it's usually connected to something you do every day. Massage can help it ease. Getting up from your desk, switching which side you carry on, and moving more help too.
If you want to give it consistent attention, the Deep Reset is eight weekly sessions with a different focus each week, including the traps and neck, and the pecs and shoulders.
FAQ
Is massage good for knots?
For a lot of people, yes. Massage is one of the most common things people use for tight, tender spots, and many feel looser with less tenderness afterward. Knots can come back, especially if they're tied to daily habits, so how often you come in matters.
Is barefoot massage good for knots?
It can be a great fit, especially if you've found thumbs or elbows too sharp, or if you have a lot of muscle. The foot works the whole area broadly, then gets specific on the knot without the pressure feeling pointy.
What's the best massage for knots in the shoulders?
That depends on how you like to receive pressure. If you want deep, steady work across the upper back with specific attention on the knots, deep barefoot work is worth trying. If you prefer very pinpoint pressure, a trigger point focus might suit you. Ask your therapist how they approach it.
Should knot work hurt?
It can feel intense, and a tender spot can feel tender. It shouldn't feel sharp or make you hold your breath. If you're clenching, the pressure is too much for that moment.
Do you do trigger point therapy?
I don't offer a separate trigger point session. In a Sarga session, I work knots as part of the whole region, broad first and then specific.
Book a massage for knots in Las Vegas
If you've had the same knot under your shoulder blade for months, come in and let's work on it.
- Book online: bombbodywork.com/book
- Questions: text 702-929-9411
- Prefer home or the office? I offer private in-home and office sessions around Las Vegas. See in-home massage in Las Vegas.
Bomb Bodywork, Las Vegas, NV
