Have you ever complained to your massage therapist about a knot, only to have them reply with words like adhesion or triggerpoint? Are all three words truly synonymous? Understanding such definitions can help us appreciate how these stuck spots are formed in the body, namely through muscular overload. Muscles can be overloaded through acute, sustained, and repetitive movements. After a primer on each, we’ll explore how massage therapy can provide relief, and invite you to experience tension release at our Portland school of massage’s student clinic.
Muscular Adhesions, Knots, and Trigger Points: Starting Definitions
Let’s begin with the simplest term, adhesion. Originally from the Latin word adhaesio meaning to stick to or to cling to, an adhesion occurs when muscles begin to stick together. Normally, muscle tissue glides smoothly against other tissues. Due to a variety of factors—injury, repetitive use, or sustained immobilization—the body forms scar tissue in the muscle fascia, leading to stiffness, decreased range of motion, and pain. Sometimes, muscle adhesions can worsen and become trigger points (John Hopkins Medicine, n.d.).
A trigger point is “a focus of hyperirritability in a tissue that, when compressed, is locally tender and, if sufficiently hypersensitive, gives rise to referred pain and tenderness” (Henderson, 1984, p. 6). It is a tender, spasming muscle that may feel knotty. It could be causing pain elsewhere in the body. For instance, if a person’s bicep is extremely tight, it may cause excess strain on the inner elbow joint, leading to referred pain in the inner elbow. (Bond, 2015).
For those taking classes at our Portland, Oregon school of massage, it’s worthwhile to study how sarcomeres (units of muscle fiber) contract repeatedly to transform knots into trigger points. For the average client, however, an analogy may prove more helpful. Imagine a one-foot rope being tied into multiple knots, shortening it into a length of just ten inches. Seeing this rope as a muscle, we can understand how trigger points can cause surrounding muscles to overstretch. The resulting structural imbalance can lead to trigger points and painful conditions such as sciatica.
With this more refined understanding of how adhesions (AKA knots) can eventually form trigger points, let’s review what types of movement can cause scar tissue formation in the first place.
3 types of Muscle Overload
Researchers agree that scar tissue and resulting trigger point formation can stem from two things: “muscle overuse” and “direct trauma” (Bron & Dommerholt, 2012, para. 1). It may be helpful to categorize the following three types of muscle overload: acute, sustained, and repetitive.
- Acute. Injuries and surgeries would fit into this category, alongside direct trauma. Acute muscle use can also look like lifting too much, often in an awkward position so that one muscle group must do all the work and becomes strained.
2. Sustained. Postural imbalances are often present in long-held postures, such as sitting at a desk. Over time, scar tissue can form around the muscles that must work harder to hold such positions.
3. Repetitive. Even small movements can cause adhesion if they are done repetitively.
How Massage Therapy Relieves Muscular Adhesions and Trigger Points
Massage therapists can help relieve adhesions and trigger points by understanding relationships between muscles. It’s key to identify which muscles must first be released in order to target connecting muscles. A LMT with a strong anatomy education can follow the pain through muscles, insertion points, and ligaments to ultimately find the trigger point.
Once there, the therapist can provide pressure to the spasming muscle until it softens. Different techniques such as deep tissue massage and myofascial massage can be helpful. After maintaining digital pressure on the trigger point from 30-90 seconds, the therapist should feel a change in the muscle tissue, and then release slowly. Last, the therapist can deliver integrating techniques such as petrissage and effleurage to further break down adhesed tissue, increase blood flow, and enhance relaxation.
Portland, Oregon School of Massage Student Clinic for Muscular Relief
Trigger points are involved in myriad painful conditions, including plantar fasciitis, frozen shoulder, and more. Even without a specific diagnosis, it is common to have trigger points and muscular adhesions. Such “knots” can be relieved through massage, movement, and stretching. We invite you to enjoy the benefits of regular treatment with affordable Portland massage at Our Massage Clinic. Make an appointment today to address any stiffness or pain you’ve been experiencing lately.
Resources:
https://www.amtamassage.org/publications/massage-therapy-journal/massage-and-trigger-points/
https://www.trifectatherapeutics.com/blog/knots-and-trigger-points-how-to-untie-the-knot-and-be-active-in-your-treatment https://www.fitelementsstudios.com/massage-therapy/what-is-the-difference-between-a-knot-and-a-trigger-point/ https://www.reddit.com/r/massage/comments/10t37m9/adhesions_vs_knots_vs_trigger_points/
https://pmc.ncbi.nlm.nih.gov/articles/PMC9599994/ (see background section)
https://merimartinmassage.com/2017/12/trigger-point-thereapy/
