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All Knotted Up


A knot is scar tissue created by chronic stress in the muscles which results in micro-tearing. If left untreated the muscle tissue will lose elasticity and can even cause postural stress that is difficult to reverse. A trigger point is fairly similar and is described as a hyperirritable nodule associated with dysfunctional contractile tissue that elicits a pain response when pressure is applied. Seventy percent of common trigger points are located in known acupuncture points and can be located in the skin, scars, ligaments, joint capsules, and fascia; however they are commonly found in a taut band of connective tissue. Trigger points can refer pain around that specific point. When pressure is applied (doesn’t even have to be very much pressure either) a sensation of pain, numbness, tingling, or some other sensation radiates from the point to another area of the body that is usually not associated by nerve or dermatomal segment.

What causes trigger points?

  • Repetitive overuse injuries (using the same body parts in the same way many times on a daily basis) from activities; such as typing, use of a mobile device, driving, gardening, etc.
  • Sustained loading as with heavy lifting, carrying babies, purses/bags, boxes etc.
  • Routinely poor posture due to a sedentary lifestyle, de-conditioning, and poorly designed furniture
  • Muscle clenching and tensing due to mental/emotional stress
  • Direct injury such as a blow, strain, break, twist or tear; examples: car accidents, sports injuries, falling, etc.
  • Can even develop due to inactivity such as prolonged bed rest or sitting.

What can be done to treat trigger points? Exercising regularly, hydration, and massage are all great ways to help with treatment. There are several different massage techniques that can be used to break down this scar tissue. Releasing the central trigger point usually results in release or reduction of the attachment trigger points. Ischemic compression or trigger point pressure release in conjunction of gentle passive stretching is just one way a massage therapist can deactivate a trigger point. Releasing the central trigger point usually results in release or reduction of the attachment trigger points. It is absolutely normal to experience discomfort when a trigger point is being deactivated during a massage session. The discomfort usually subsides after the release and the effected area (or area that was worked on) can be pretty sore and tender to the touch.

 There are other methods to deactivate a trigger point; however, they are out of the scope of practice for massage and should be discussed with your primary doctor (hint: it involves needles).



Jennifer Roldan, LMP Northwest WellnessFederal Way, WA