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QUESTION: hey, thanks for all this advice you give to people. i hope my question is not too vague, i recently got married (we are both twenty). my wife really likes when i massage her, and i like that i get to make her feel good,particularly because she often complains of back pain,even though i keep giving her massages. i think she is still in pain because i do not take out her knots, how do i recognize a know and how do i get rid of it? i watched videos on youtube and read some articles on massages so i could massage her, but as you can see I'm no expert. any advice would be great. thanks!

ANSWER: Hi Charles,

Very kind of you to massage your wife!

There is always a reason for knots.  Usually, the cause of the knot isn't where the knot is.  Knots can be caused by short and tight muscles somewhere else that are pulling on the muscle that gets the knot.  Knots are just symptoms.

If your wife is complaining of her upper back, the problem can be caused by her posture and the short tight muscles in the front of her body.  Yup, I said in the front.  The muscles of the upper chest and fronts of the arms can pull on the upper back muscles.  They get unhappy and create knots.

You can find lots of articles that I wrote about this at

You might feel a knot or tight muscle as a bunchy or hard area.  Or you might be gliding your hands and feel as though the muscles are kind of stopping your movement.

Massage, rub, warm and gently stretch the muscles around your wife's ribs, upper chest, abdomen.  Also, massage the muscles on the outer sides of your wife's shoulder blades, under the arm pits.  

Let her guide you as to pressure and don't get discouraged.  She should tell you, "Yes. That's a good spot."  Or, "It hurts but don't stop.  It feels useful."  Or, she may say that is too much pressure or please use more pressure.  Tell her you need her help so you can do a good job; you need her input.

I commend you for trying to help your wife.  I believe massage would keep more marriages and families together.  :)

Thank you for writing and you are welcome,


---------- FOLLOW-UP ----------

QUESTION: Hey, im not sure if you remember me, you had helped me regarding treating my wife's knots.If you don't mind I just wanted for some instructions, you had told me to massage her front. But what area? ( where is the muscle?) Is there a good oil you can recomend? And Im sorry if this question is awkward, is it all right to have sex after a massage?

ANSWER: Hi Charles,

Good questions!  Look online for a picture of the pectoral muscles.  There is pectoral major which is larger and covers the smaller pectoralis minor.  If your wife has large breasts it's harder to get to the muscles than if she has smaller breasts.  

The pec muscles are the ones you want to find.  They will most likely be tender so start with light pressure.  The chest can be extremely (!) tender so let your wife be your guide.  If she says, "too deep", use less pressure.  She is the expert on how it feels so let your wife be the pressure guide.  If she says, "no," then it's no.  If it starts to feel to her as though you are not pressing as deeply, that means the muscles are starting to relax.  That's a good thing!

Below the collar bones, to the breastbone, into the armpits pulling the muscle forward.  Compress the upper chest wherever you can access the muscle.  If your wife is full figured, you may find it easier to find the muscles on the outer side of her chest when she lays on her side.  That allows the breast tissue to drop toward the floor or bed.

Any massage oil will work.  So will baby oil or cooking oil.  Some hand lotions have a nice glide.  That's the idea:  a nice glide so you don't rug-burn your wife.

The answer to your last question is yes, it's fine.  But that will depend on how your wife feels.  

In fact, a good way to find the muscles would be to look at the pictures of the pec muscles and find them on yourself.  As you explore with your fingers, you will feel muscle and bones.  Flex or tighten your chest muscles.  See how they feel.  Now you have more information.

Also by rotating her arms and giving them gentle tugs, you will be stretching the chest muscles and helping them relax without any discomfort.  She can also pretend she is a butterfly and let her arm drop gracefully off the side of the bed.  She will feel the stretch in her chest muscles.

I hope this helps.  Thank you for writing again.


---------- FOLLOW-UP ----------

QUESTION: Her breasts are, i guess small ish? She is quite thin. Oh i didnt realize the breast area can be massaged. ( non sexually) so i was wondering where there is muscle.thank u so much for the quick and detailed response. I really appreciate it

Hi Charles,

That's good she's a small woman; that will make it easier on the one hand.  On the other hand, small women usually also have small muscles.  If you find your own chest/pectoral muscles and look at pictures of the pectoralis major and minor muscles online, you will have a better idea of where her chest muscles will be even if you have trouble feeling them.

Since she is thin, you will be able to feel her ribs.  The chest muscle covers the ribs.  It's there whether or not you can actually feel it.  With practice, you may be able to feel the muscle better.

It won't take much pressure.  Remember, you don't want to cause a lot of discomfort; it's just about warming and relaxing the muscles because they are the muscles that cause knots in your back.

You're welcome!



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Kathryn Merrow


I can respond to questions about migraines and headaches, carpal tunnel syndrome, hand-wrist-arm pain, upper back pain, and other assorted and miscellaneous pain symptoms. I can also respond to general questions about massage and how to select a massage therapist.


I have been a massage therapist since 1992 specializing primarily in pain relief techniques. I utilize the St. John Method of Neuromuscular Massage Therapy (NMT) and other bodywork modalities. I'm The Pain Relief Coach online.

Professional Member of American Massage Therapy Association (AMTA) Nationally Certified in Therapeutic Massage & Bodywork (NCTMB)


My initial training in massage was at Health Enrichment Center in Lapeer, Michigan. I have had advanced training or workshops with Kurashova Institute for Studies in Physical Medicine, St. John Neuromuscular Institute of Pain Relief, Center for Self-Healing and many others. I now share my education and experience as a Massage Instructor and Pain Relief Coach.

Awards and Honors
The highest honor I receive is when someone tells me that they finally understand why they had pain, that they took action and that their pain is either less or is totally gone.

Past/Present Clients
I have done well over 20,000 therapeutic massage sessions, primarily with clients with various types of pain or painful syndromes.

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