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Trigger Points vs Fascial Adhesions: Are They The SAME Thing?

By August 7, 2019Fascia, Pain

What’s the difference between a trigger point and a fascial adhesion? Are they the same thing? 

This is another question I get asked all the time. What do you think? Share your thoughts in the comments below!

My understanding (as someone who hasn’t been trained in trigger point therapy) is that a trigger point REFERS pain to a different area of your body when pressed. 

There’s going to be fascia there of course, because there’s fascia everywhere! It may or may not be in “adhesion” form, though. It could just be dense or restricted fascia causing some referral pain. 

Yet, not every fascial adhesion causes referred pain when “triggered” by compression. So I would argue that no, trigger points are not the same thing as a fascial adhesion. However, there is some overlap here. 

My opinion, based on working with thousands of people in pain since 2008 using fascia release, is that you do not need to locate trigger points to get out of pain.

I also wonder whether trigger points behave the way they do because of the compression itself (rather than indicating anything about your pain). 

Dense unhealthy fascia, when compressed, can cut off blood supply and nerve communication, which might trigger a sensation response in your body that you label “pain.” Usually, these sensations are very different from, say, knee pain or back pain. 

For example, you’ll notice that in all my videos on scalenes (a muscle group in your neck) I talk about a potential numb referral pain down your arm or into your back…there are not necessarily adhesions there, but when really “tight” and compressed, this area causes a referred pain in myself and many of my clients. However, after some consistent efforts to release the fascia here, the referral pain goes away. 

I believe that any area referring pain when compressed merely indicates VERY restricted fascia (which may or may not be related to your pain). 

As you can see, there’s some nuance and grey area here. These are my opinions, but I don’t claim to know everything. Please share your thoughts below so we can create a discussion about this topic! I’ll see you there 🙂

Blog post/video: Is pain always related to fascia? https://mobilitymastery.com/is-pain-always-related-to-fascia/

Blog post/video on the “clunk” – muscle belly or fascial adhesion?
https://mobilitymastery.com/fascia-release-clunks-muscle-belly-or-fascial-adhesion/

6 Comments

  • Dave says:

    Cool I’m watching this via my TV just figured out how to study YouTube videos especially like yours will without using my smarter than me phone aka forward head posture extrapolation tool

  • Matt Joseph says:

    About 3 years ago I began experiencing some pain amd stifness in the neck. I was also experiencing muscle tension in my right trapezius. Other weird problems were jaw tension, ear tickling, tension headaches with tension around the sinus area and above the eyebrow. All on the right side. Hospitals and doctors couldn’t figure it out or had different opinions, none of which fixed my problem. I bought the Trigger Point Therapy Workbook by Claire and Amber Davies. I’ve worked through the SCM, traps and romboids and I can’t “palpate” anything that feels like a trigger point. Occasionally, I might get a tickle in my ear if I squeeze my right trap close to my neck. The technique mentioned in the book involves a stroking as opposed to a pressure but I found “milking” my SCM muscles scary. There are definitely knots in my traps and mid back but these seem too big to be trigger points so I started investigating fascia instead using some techniques you’ve mentioned and also some covered in Supple Leopard. I have no experience of massage but I can feel a clunky knot but have no hope finding a small pea sized trigger point. Maybe it’s hidden within the knot. I continue to investigate my ongoing problems.

  • Bill Hooper says:

    I played around with trigger points and it just seemed to flare my pain up in a big way. I think the trigger point model is a good step on the way, but your model seems more accurate. If I remember right, the books I read on it didn’t really talk about fascia, was more about muscle — as if they weren’t really aware of fascia.

    🙂

    • Hey Bill, thanks for sharing your experience and thoughts. I remember the same thing when I learned about trigger points in massage school. Fascia, as a system, has so much to teach us about ALL the other systems, including muscle tissue and the nervous system.

  • Maurice Loridans says:

    I am Valerie Loridans’ husband Maurice. About a decade ago I had a severe range of motion impairment of my left shoulder. Valerie remembered a story in a book she’d ordered several years earlier (Clair Davies cited in the second comment) and I read it. He had suffered the same disability and developed the therapy and concept of Triggerpoint therapy based on the results he got from a singular massage therapist.
    It has been years so my recall is somewhat vague. The concept is that a muscle has gotten stuck in contraction and the nerve signal in the middle of it’s length forms a small knot. The pain is transferred to the joint that the muscle is involved in controlling.
    The therapy that worked for me was to locate the triggerpoint (assisted by his diagrams with dots showing probable sites) and apply direct pressure with gentle strokes in my case with a “theracane” but small rubber balls work too. You know if you are on the right spot if you experience “exquisite pain” to let you know you have a trigger point. A small knot that does not give the nerve pain on palpation is probably a lymph node which you should leave alone.
    The routine is six strokes about six times a day to coax the nerve and muscle to relax. My trigger point was in the supraspinatous muscle behind the ridge of my shoulder about halfway from the neck to the shoulder. Mashing the trigger point does not send a transferred pain signal to the affected joint. That is the symptom that sends you looking for the trigger point in the first place. The “exquisite pain” from the therapeutic pressure is felt at the site of the pressure.

  • Moneeka Lynne O'Sullivan says:

    As a massage therapist and with what little I know about triggers points (after very recent training) and fascia I believe trigger points are both muscle & fascia related. Fascia covers, encases muscle fibers entire muscles and layers exist every where in the body including the nervous system with our pain sensors. I believe a tight or injured small groups of fibers/entire muscles could produce a “knot” or small fascial adhesion then layers of muscles and any muscle compensation/s cause the referred pain.
    I see, know this to be like an onion or ripple effect.

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