Knots and Spurs
Repeated pressurization or constant tension on tissue can often result in problems. In some way, shape, or form our tissues require nutrition which arrives in the form of blood flow. Should we shunt that, things can get rather uncomfortable. Soft tissue knots and bone spurs are the first things that come to mind.
Manual therapy and/or massage often reveals knots in areas where patients have pain, and this is typically considered the source of symptoms. However, that may simply be an outcome of a movement strategy. If I place high pressure or tension in the same place time and time again blood flow may eventually be reduced. That reduction leads to a build of by-products that cells produce with the limited resources they now have available. As resources continue to decline, tissue types morph and adapt to the local environment. The result may in fact be a knot, or collection of cells that have changed the way they do business. They are not the cause, but a result of their environment placing new demands on their capabilities.
Bone spurs occur very similarly. Bones are very dynamic structures; they adapt to stresses like any other tissue type. They grow when forces are beyond their capacity, and they shrink when they are not needed. In the case of the latter, think of the astronauts who spend a good deal of time in space. A heel spur is a common occurrence most people are familiar with. If a person were to stand toward their forefoot, as if peering over the edge of the Grand Canyon, focal tension tends to develop along the bottom of the heel. Over time the heel grows to deal with the tension and a spur develops to respond to this continued tension. Osteoarthritis is another condition where frequent compressive loads on joints, causes bones to grow in localized places, resulting in bones touching and pain/loss of movement.
Soft tissue knots and bone spurs occur often and are no cause for alarm, many people have them without issues. Their development follows the same rules that all other forms of biology must abide by. If they do become problematic, determining the cause or the movement producing them may be useful in managing symptoms at their origin.
Austin Ulrich, Physical Therapist
