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Knots In Muscles vs. Fascial Adhesions

Knots in muscles vs. fascial adhesions ~ Dr. Angela Walk

Muscle pain is one of the most common sources of pain in the body. When your muscles and other soft tissues become overused or strained from a repetitive activity or an injury, microtrauma occurs within the soft tissues.

The result can be in the form of "knots", also called trigger points or fascial adhesions. These are both soft tissue lesions that can cause pain, tightness, and weakness of a muscle.

Are trigger points the same as fascial adhesions? Close, but not quite. They typically occur for the same reasons such as overuse, stress, or injury. But, while trigger points often refer pain to other arears of the body, fascial adhesions typically do not. However, there is some overlap here.

In this article, I will differentiate trigger points and fascial adhesions and share the most effective soft tissue therapy to resolve common muscle and fascia conditions.

I believe the best way to resolve any muscular pain syndrome—hands down—is to use Instrument Assisted Soft Tissue Mobilization (IASTM), also called muscle scraping, with a fascial release tool.

I instruct my patients how to use this technique on themselves, and I will guide you through that in this post.

Dr. Angela Walk

Sports Chiropractor

The Plantar Fasciitis Doc

What are Muscle knots?

Muscle “knots” are sensitive areas of muscles that feel like hard, tender bumps in a tight muscle. A muscle “knot” isn’t a knot at all, but it can certainly feel like it.

The medical term for a knot in a muscle is a trigger point. Research shows that trigger points are areas of metabolic waste products that form when a muscle is overused or injured.

Trigger points can be the source of tremendous pain and tenderness. They frequently manifest as neck pain, headaches, jaw pain, arm and finger tingling, lower back pain, and even sciatica.

Trigger points can also cause referred pain when you press on them. This means that the pain spreads to nearby areas, or along the length of the muscle when pinpoint pressure is applied.

For example, one of the most common sites of a muscle knot is in the trapezius muscle, which is located across the top of your shoulder.

A knot in this muscle can refer pain to the neck, lower back, jaw, and may even cause discomfort or ringing in the ears or a tension headache.

What Causes Knots In Your Muscles?

The most common causes for developing muscle knots or trigger points includes poor posture, poor workstation ergonomics, a sedentary lifestyle, having biomechanical or muscle imbalances, poor sleeping posture (stomach sleeping), and physically demanding exercise routines (running, weight training).

Trigger points can cause many common symptoms:

  • Headaches & Neck Pain

  • Shoulder Pain

  • Elbow Disorders: Tendonitis, Carpal Tunnel Syndrome

  • Plantar Fasciitis, Achilles & Calf Muscle Pain

The second type of soft tissue condition that I will cover in this post is fascial adhesion. Before we describe fascial adhesions, we must first define fascia.

What Is Fascia?

What is fascia? Dr. Angela Walk

Fascia is the vast network of connective tissue that runs through your whole body and it surrounds every single thing inside of our body. It resembles saran wrap that surrounds all of your muscles, nerves, bones, joints and organs.

It turns out that most injuries and loss of flexibility involve the fascia. When a repetitive strain or injury occurs, adhesion form in the fascia and it causes restrictions with movement, aching muscles, and even weakness.

Now that we have defined fascia, let's take a look at what causes adhesions to form in the fascia.

What Causes Fascial Adhesions?

What causes fascial adhesions? Dr. Angela Walk

Fascial adhesions are one of the most common causes of pain in the body. The formation of adhesions is the body’s response to injury or trauma.

Any time muscles or fascia is overused, a breakdown of the tissue occurs. These strained/overworked areas form adhesions or fibrous clumps made of collagen.

These collagen fibers bind together into an unnatural "sticky" state. The fascia begins to “stick” to other tissues, which creates tension.

You can think of fascia like cling wrap. It clings and sticks to itself and other tissues until you can remove the adhesions.

Fascial adhesions are also referred to as fascial restrictions or scar tissue. As these adhesions form, they start to affect the normal function of the muscles and fascia.

In fact, they will often lead to pain, tightness, lack of flexibility, muscle weakness, compromised muscle endurance, restricted joint motion, and diminished blood flow.

Adhesions remain until they are removed. Rest, ice, stretching, and ibuprofen will not make them go away! You may get some temporary relief, but in order to remove these adhesion, you must receive some type of soft tissue therapy.

How To Remove Knots In Muscles & Fascial Adhesions

How to get rid of fascial adhesions and scar tissue ~ Dr. Angela Walk

When it comes to knots in the muscles and fascial adhesions, the most effective way to release both, is with a specific soft tissue therapy called Instrument Assisted Soft Tissue Mobilization )IASTM), also called muscle scraping.

I have used muscle scraping in my practice for many years with great success.

I have extensive training in these techniques including Graston Technique and Gua Sha. It involves the use of a stainless steel instrument or stone to "scrape" away scar tissue adhesions.

These tools greatly assist in soft tissue mobilization and improve blood flow to the affected area and in turn, release adhesions in the muscle tissue and create healing.

What Conditions Benefit From IASTM?

Trigger points and fascial adhesions respond well to IASTM. I have found this release technique to be effective for numerous conditions including:

  • Neck, Shoulders, and Arms ~ Effective for headaches, neck tension, "knots" across your shoulders, rotator cuff issues, and elbow and wrist disorders ( elbow tendonitis, carpal tunnel syndrome).

  • Hips, Low Back, and Knees ~ Get relief from hip soreness, low back pain & sciatica, IT band and knee conditions.

  • Foot, Calves, and Achilles ~ Use the fascial tool to treat Plantar Fasciitis, Achilles Tendonitis, Shin Splints, and other foot and lower leg aches and pains.

Why Use Muscle Scraping/IASTM?

How to break up fascial adhesions at home ~ Dr. Angela Walk

Muscle scraping is an easy, non-invasive technique that helps promote the healing and recovery of stressed tissue. In general, scraping therapy reverses these processes to help you quickly regain pain-free mobility, and it also promotes pain suppression.

Whether you've suffered from a repetitive strain or have chronic muscle soreness from an active lifestyle, muscle scraping can help you.

This technique involves the use of a stainless steel instrument or stone to "scrape" away scar tissue adhesions. These tools greatly assist in soft tissue mobilization and improve blood flow to the affected area and in turn, release adhesions in the muscle tissue and create healing.

  • Start by applying an emollient such as lotion, coconut oil, or essential oils to each of the soft tissues/muscles you are releasing.

  • Apply light pressure with the massage tool to the soft tissues and determine if they are tender, hardened, or feel restricted.

  • Now, begin to scrape along the direction of the muscle fiber with unidirectional strokes.

  • When you locate an area of tenderness, continue for 10-15 seconds then move to the next tender area.

  • Once you feel the muscles and tendons you are working getting warmer and pinkish that is an indication that you have increased blood flow and circulation.

  • Don’t aim to resolve all the fascial adhesions in one session.

  • At the end of each session, your muscles should feel lighter, looser, and warm from the increased blood flow. You may also see redness or red dots.

This is evidence of scar tissue that has been released or broken up. It's a good sign, however, wait until the redness has resolved to start another session.

How Often Do I Repeat Treatment?

If everything went well the first time, you can do this every 2-3 days. That would be around 2-3 times per week for 4-6 weeks until your pain goes away.

It's very important to NOT overtreat the area. You must allow time for tissues to heal before you scrape again! Expect to feel sore in the treatment area in the following days.

It almost feels like a bruise. Again, this is normal and is an indication that your treatment was a success.

Attention: Important Treatment Recommendations

1. Use only light to moderate pressure. Deeper pressure isn't anymore effective and can lead to deeper soreness and will prolong the time before you can scrape again.

2. Expect the tissues that you have treated to be sore and tender to touch for a couple of days following treatment. Wait until the soreness resolves to treat again.

3. You may see redness, red bumps, or mild bruising. This is normal and expected, however, you must allow the tissues to heal before treating again. If you continue to see bruising, your pressure is too deep.


Dealing with muscle and fascial pain can be so frustrating, but applying this knowledge and using this soft tissue release technique can keep your soft tissues flexible and healthy.

I have found that most of my patients were able to find and release their trigger points and fascial adhesions using these tools at home to achieve quick relief and improved flexibility.

Best of Health,

Dr. Angela

Hi, I'm Dr. Angela Walk

I have been involved in the health and wellness industry for over 25 years as a sports chiropractor and foot health coach.

I have written extensively for health publications and I am keenly aware of trends and new developments in natural health.

I embrace an active lifestyle combining diet, exercise and healthy choices. My goal is to inform my readers of natural options available to them in hopes of improving their health and quality of life.

GET FREE ACCESS! I am on a mission to provide you and your family with the highest quality natural tips and organic products...Join me on my Facebook Page or Instagram Page.


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