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The Overlooked Cause of Headaches and Migraines: Tight Muscles and Trigger Points

What’s a muscle knot?

A muscle knot is a spot in your muscle where the muscle fibers are contracted. While you could previously contract and relax that muscle, some of the muscle fibers are now outside your conscious control. It’s like the “on” button at the control center gets flipped and the controller goes out to lunch. This makes these muscles very difficult to relax, and they can stay contracted for years – even decades – if left untreated.

After you develop these muscle knots, the body will tend to guard this area and protect it from further damage. This causes a compensation pattern, which can lead to even more problems.

What causes muscle knots?

Muscle knots often develop as a result of a muscle being overused or unable to relax and forced to hold tension for a long time. Imagine holding a child in your arms for a few hours, or your arms out in front of you typing or driving. Once that muscle stays contracted for too long, part or all of the muscle simply decides: “Okay, I guess I'm supposed to stay contracted.” (And it does).

What are trigger points?

Trigger points are muscle knots that refer pain to a different spot. Referred pain from trigger points is often felt in multiple locations. There are two types of trigger points: latent and active.

What are latent trigger points?

A latent trigger point can be described as a tight area within the muscle tissue that is “hidden” beneath the surface. You don’t know it exists until it accidentally or purposefully gets pressed on. Because of this, it’s possible that one of these trigger points has existed in your body and has remained unaddressed for a long period of time.

Latent trigger points in the neck

Latent trigger points in the neck have been associated with tension headaches and migraine pain. When pressed on by a practitioner or muscle release tool, these points can feel extremely sensitive and refer pain to the sides of the head, temples, or jaw.

What are active trigger points?

Active trigger points cause localized and referred pain patterns without being pressed on. A latent trigger point can become an active trigger point if it’s rubbed, contracted, overstretched, or during periods of stress or dehydration. 

Active trigger points in the neck

You may have pain in your temples or other spots on your head caused by active trigger points in the muscles at the base of your skull (the suboccipital muscles). No outside stimulus needed; it hurts all on its own. But the cause of the pain is in a different location than where you’re feeling the pain. So even though it may feel good to rub your temples, for example, it doesn’t address the root cause.

What are common symptoms of trigger points? 

Common trigger point symptoms may include (but are not limited to):

  • Dull aching or muscle tenderness
  • Muscle stiffness and reduced range of motion
  • Muscle weakness or fatigue
  • Involuntary muscle contractions (or twitches)
  • Inability to get a muscle to relax
  • Affected area feels “warm” to the touch
  • Burning or tingling sensations

Because of latent and active myofascial trigger points, another tell-tale sign and common symptom of having a trigger point is experiencing local and/or referred pain patterns when having pressure applied to that area of your body. 

Trigger points may mimic other conditions

Due to possible referred pain patterns, trigger point symptoms may mimic the symptoms of other conditions, such as:

  • Temporomandibular joint (TMJ) pain
  • Neck pain and tension headaches
  • Arm pain (incl. numbness and tingling down the arm)
  • Shoulder pain
  • Shoulder blade (scapular) pain
  • Tooth pain
  • Eye pain

What happens if a muscle knot or trigger point goes untreated?

Over time, a muscle knot can begin squeezing all the blood vessels that go through the muscle. Like squeezing a hose to stop the flow, when you cut off the blood flow to a muscle, it prevents healthy circulation. When you cut off circulation, oxygen and nutrients can no longer effectively reach the tissue, preventing it from proper function and healing. 

Additionally, cutting off circulation doesn't allow for toxins to be carried away from the muscle. Then it becomes a kind of swamp, thick with no movement, and it just gets stuck. One thing that can accrue in the tissue is calcium. Too much calcium can cause a contracted muscle to contract even harder which solidifies the problem even further.

How do I get rid of muscle knots?

The best technique is to apply prolonged pressure to the muscle knot or trigger point. 

Simply rubbing or pushing on a knot for a few seconds is not enough. In fact, it can do damage: latent trigger points can become active and chronically painful trigger points if they are rubbed, pressed for less time than it takes for them to release, or overstretched. Sometimes trigger points may need prolonged pressure from anywhere between 3-5 mins. This amount of time will actually tell receptors on the muscle to relax and stop holding tension. 

At first, the pressure may cause increased pain where you're pressing. But if you have genuinely found the trigger point, that pain will start to manifest in the area that is causing you problems. Trigger points can also refer pain to several places; there are certain patterns that practitioners typically see, and we’re able to predict or make an educated guess about the source of the pain. For example, a knot in the trap muscle causing a headache or a pain down into the arm.

Prolonged pressure sends a signal to the brain to relax the knot and stop holding tension or protecting the area. Whatever the cause of the tension, prolonged pressure is the key to releasing it. If you don't change that pattern of tension, the pain can’t improve.

Muscle knots and migraines

If you suffer from migraines, it can be helpful to apply ice to the back of the neck for 5-10 minutes after releasing trigger points. Apply ice, a cold pack, or cool cloth for 5-10 min at the base of the skull and around the jaw after applying pressure to trigger points. 

Direct, prolonged pressure to release the trigger points responsible for migraine pain creates muscular relaxation which allows for increased circulation to the area. It also creates a biochemical effect that causes vasodilation systemically. This vasodilation enhances blood flow to areas of the body that are lacking oxygen and/or nutrients.

It’s important to know that direct pressure on these trigger points may temporarily increase the symptoms of migraines. However, over the long run, these muscle knots release and provide long term relief. One of the best practices is to release these muscles regularly, when you’re not experiencing symptoms, to change the pattern of the muscles and prevent future headaches.

Neck trigger points make you vulnerable to headaches and migraines

If you experience migraines, you likely know some of the behavioral culprits: wine, lack of sleep, high altitude, etc. If you have muscle knots at the base of your skull, it is much more likely you will experience symptoms when you add any of your known instigators. You may find that after releasing these muscles, you are no longer negatively affected by an occasional glass of wine or hike up the mountain.

Muscle knots and tension headaches

There have been clinical studies associating muscle knots in the suboccipital muscles (at the base of the skull) with tension headaches. When releasing muscle knots in this area, it is extremely important to continue pressure on the muscle until it releases. If you stop pressure before the muscle relaxes, it can increase the headache.

It’s also important to stay on one spot in the muscle until it releases. Don’t rub back and forth, or rub over the knot: this can activate trigger points and increase pain. Keep continuous pressure in one spot to relax the muscle; then, move on to any other sore areas of the muscle and repeat. 

Be patient: stay on one spot and breathe

Remember that these muscle knots may have been building in your body for years. They may not release on the 3rd or the 30th pressure session. Stick with it; we’re aiming to correct the root cause of the problem and finally discover long term, natural relief. It’s so worth it.

Keep your suboccipitals relaxed, improve your posture, and move more

For long-term relief and improvement with headaches or migraines, consider using the NUCKLE as part of your weekly routine to help you continue to make progress in releasing tension in your suboccipitals, especially if you are someone who sits down a lot and works on a computer.

The NUCKLE can also be used to release tension around your chest and shoulders, targeting the pecs and upper traps. Releasing all of these areas can help you use the proper muscles to improve your posture and reduce the stress that builds up in your upper traps and neck.

Ensuring that all 3 of these muscles remain happy and free of tension will keep your Secondary Core functioning at its best. To make it easy for you, here's a simple 3-step sequence we recommend you follow:

  1. Release the suboccipital muscles at the base of your skull.
  2. Release the pec minor muscles in your chest.
  3. Release the upper trap muscles between your neck and shoulders.

Spend at least 90-120 seconds on each muscle and feel free to explore a couple of different tighter spots within the same muscle.

Lastly, get up and move your body more. Even when sitting at your desk in “perfect posture” for 8+ hours, your muscles can still become tight. Your suboccipitals are working hard all day long to stabilize your head.

Take some breaks throughout the work day to move your body, stretch, and get some motion into your head, neck, and shoulders. This should help reduce the frequency that you experience knots and pain in your neck that lead to headaches or migraines.

Secondary Core

This blog post is part of the Secondary Core education where we teach you how to release tension in the muscles around the head, neck, chest, and shoulders. To learn more about our upcoming courses and certification programs, please reach out to us at for more information.

By Christine Koth . Wed Dec 08

Author Bio

Uncovering the cause of your pain is my mission. As a bestselling author and holistic physical therapist with decades of experience, I have helped countless people, just like you, recover from long-standing issues. I've discovered a major cause of pain hidden in the hip and this has lead to my "Iliacus Queen" and hip expert status. I'm here to help you discover causes like this. It doesn't have to be complicated to live a pain-free life. We can do this. I look forward to supporting you on your healing journey.