Have you ever been working on a patient when you felt it creep in…the “knot” between your shoulder blades? It burns. It radiates. It spasms. It’s enough to take your breath away.
But what is it? Why did it suddenly pop up? Why does it hurt so much?
You’ve likely heard it called a muscle knot, an adhesion, or maybe even a trigger point. Let’s take a look at these names and figure out which one is correct.
What is Fascia?
First, let me just say that muscle fibers are incapable of getting “tied” in a knot. So take a big sigh of relief! 😅
So, what’s really happening?
What you’re feeling is an adhesion in the fascial tissue. Fascia is the connective tissue that covers every layer of your muscles—each individual fiber, each bundle, etc. It’s woven all throughout our muscles. (Fascia is everywhere in the body, but for the sake of this blog, we’re going to keep it to the muscles.)
Some fascia is sticky and can get “gunked up” when we’re not moving optimally—i.e. repetitive hygiene movements and static holds—and adhere to the muscle fibers, pulling them out of alignment (aka adhesion). And since fascia is interwoven throughout, the fascia can get tangled up and pull on the muscle fibers even more.
It does this as a protective measure to try to remodel to support us. So even though it seems like adhesions can come out of nowhere…they’ve been building slowly and “pop up” while we’re working because an area is weak from overuse.
Nerves run through fascia, too. Couple that with restricted blood flow, and it can be very painful.
If we don’t get rid of these fascial adhesions when they appear, they can become a chronic issue. This is why regular movement is so important to prevent adhesions in the first place.
What About Trigger Points?
According to Wikipedia, “Myofascial trigger points, also known as trigger points, are described as hyperirritable spots in the skeletal muscle. They are associated with palpable nodules in taut bands of muscle fibers.”
So, as we’ve already learned, the “taught bands of muscle fibers” are being held by fascia. And they’re “hyperirritable” because of the nerves running through the fascia. (And, trigger point is another way of saying fascial adhesion.)
You’ve probably heard the term trigger point release. If you haven’t, just know that it’s a form of myofascial release.
What is Myofascial Release?
Myofascial release (myo = muscle and fascial = fascia) refers to manipulating the fascia to “release” the muscle. Remember, the muscle fibers are being pulled by the sticky and interwoven fascia, causing them to adhere.
By pushing and pulling on the fascia, we can get it to remodel back to its healthy form—releasing the muscle from its “knotted” grip. This can be achieved through different tools and techniques, like cupping, foam rolling, Graston Technique®, FasciaBlasting®, and so many more.
What should you do if you feel an adhesion?
Let’s say you feel an adhesion on the side of your neck. Trigger point release can help. By pressing on the adhesion and adding movement, we can reduce its size and “stickiness” with increased blood flow:
- Press on the adhesion and move your neck to the opposite side
- Hold for 5-10 seconds
- Continue holding the adhesion as you return your head to the center
- Rub the area for a few seconds
- Repeat the above sequence 2 more times
- Do this a few times a day until the adhesion disappears (then continue with regular stretching and strength training to keep it from recurring)
- Follow up the session with 20 minutes of ice on the area
If it’s in an area you can’t reach (like between the shoulder blades), a tool like the Body Back Buddy can help.
In the example pictured above, you would raise the arm in front of you and lower it a few times to release the trigger point between the shoulder blades.
A few more tips to help remodel fascia…
Ideally, our fascia should be soft and pliable. This keeps us moving easier with less pain and ideal blood flow.
My favorite way to think about warming up the fascia for remodeling is to picture taffy. When you have taffy on a warm, summer day, it’s gooey and soft. But when you have it on a cold, winter day, it’s hard, brittle, and snaps easily. Fascial tissues are very similar.
Fascia loves to be hydrated and warm before a myofascial release session. So do some light cardio, hit it with a heating pad, or simply soak in a warm bath—all while taking in some fluids to stay hydrated.
The Takeaway
A career in dental hygiene causes us to move in ways that our bodies were not intended to move. We can’t always avoid this, but we can train our bodies to be more resilient.
So whether you call it a knot, adhesion, or trigger point…just rest easy knowing that you’re muscles aren’t all tangled up and you have options to release them. And remember, heated and hydrated fascia remodels best!
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