Scar Tissue vs Adhesions vs Fibrosis vs Trigger Points
The truth about what causes knots or what they are is still debated. Scar tissue, adhesion, fibrosis and even trigger points are all terms that are used interchangeably to label knots, but describe different phenomenon.
Fibrosis, commonly called scar tissue, is an increase formation of dense fibrous bands of connective tissue sometimes replacing primary (normal) tissue after injury. The sites where these fibrous bands form externally we know as scars. Scar tissue can form externally on the skin and internally within the tissues, often in areas of chronic inflammation. This chronic inflammation may be caused by medical intervention (surgery), or by chronically damaged or injured tissue. This dense, fibrous connective tissue lacks flexibility, restricting the extensibility of the primary tissue in areas where it forms.
Adhesions, or knots as they’re more commonly called, is defined as a discrete, focal, hyperirritable spot located in a taut band of skeletal muscle or connective tissue. Clients frequently report pain in another area of the body when a knot is touched. These types of knots are often called trigger points.
Today we will focus primarily on adhesions/knots.
The phenomenon that gives rise to knots and their perceived symptoms is still unknown and continues to debated by Practitioners and medical researchers. However, the industry is not short of services, products, techniques and individuals claiming to have the perfect remedy and solution. The primary issue is a lack of evidence and reproducible diagnostic criteria. It’s difficult to do science when most of the evidence is subjective or if two massage therapists can’t find the same knot or trigger point on the same individual. Attempts and studies to understand the causes of knots and how they are formed are inconclusive. Knots are often accompanied with nerve impingement, pain, numbness, limited range of motion, limited flexibility, postural misalignments, muscle atrophy, tissue hypoxia, and increased potential for re-injury.
Even though the research on what muscle knots are and how they formed are inconclusive, what remains true are the symptoms and effects that are perceived by clients.
So, what may cause muscle knots?
- Some studies have hypothesized that an increase in nerve output to the muscles can result in a muscle contraction that doesn’t stop.
- Another study believes that hypertonic muscles (tightly contracted) constricts blood flow and oxygen to the tissue, which results in sustained muscle contractions. Oxygen is required to produce the energy needed to stop muscular contraction.
So how can we address knots?
One research has discovered that applying pressure to a muscle at a point releases the muscle tensions, which releases the pain. The most common techniques used by our Studio Massage Practitioner are friction and acupressure, which help mobilize the superficial and deep layers of fascia, to promote localized blood flow and to release these restrictions.
Check out our Deep Tissue Massage services to book and schedule a session.