What is a Muscle “Knot” or Adhesion?

Skeletal muscle, as its name implies, is the muscle attached to the skeleton. It is also called striated muscle. Skeletal muscle is made up of thousands of cylindrical muscle fibres bound together by connective tissue through which run blood vessels and nerves. Increased strength and muscle mass comes about through an increase in the thickness of these individual fibres and an increase in the amount of connective tissue.

A knot or trigger point is an irritated patch of muscle. The nerve that controls it is firing too quickly, or there has been some trauma to the muscle fibre and the tissue is full of junk molecules.

Once the initial injury has occurred, a cycle of repair and re-tear develops that leads ultimately to a large tender knot developing in the muscle, which comprises muscle fibres surrounded by scar tissue; “Scar tissue as being like chewing gum stuck and hardened to a wool carpet” – Gerard Hartman.

Within the muscle, the scar tissue is inflexible so when the muscle either contracts forcibly (shortens and broadens) or stretches (lengthens and narrows) the scar tissue re-tears and the cycle of repair and re-tear continues with increased irritation and more scar tissue being created. Excessive scar tissue formation at the site of tear inhibits normal contractibility and extensibility of muscle.