06/09/2026
What most people call a “knot” is almost certainly a trigger point, & a trigger point is not a physical tangle of tissue. It is a neurological event.
Every muscle fiber is controlled by a nerve. Where that nerve meets the muscle fiber is called the motor endplate. When everything is working normally, the nerve fires, the muscle contracts then releases. But sometimes the motor endplate gets stuck in the ON position, so it keeps releasing acetylcholine, the chemical signal that tells the muscle to contract.
The sarcomeres (the tiny contractile units inside the muscle fiber that actually do the shortening) cannot complete their cycle. So they stay locked. Sustained contraction compresses local blood vessels, cutting off the ATP supply the sarcomeres need to release. No ATP means the actin and myosin filaments cannot detach from each other. They stay stuck.
Imagine a fist. A clenched fist is not a structural deformity. You cannot fix it by forcing the fingers open. You fix it by giving the nervous system a reason to let go.
So the trigger point is not a knot. It is the neurological consequence of sarcomeres that cannot let go. Which means you cannot mechanically break it up, because there is nothing structurally broken to break.
We are talking to the nervous system. Through gate control, through descending modulation, through conditioned pain modulation & more.
Actual fascial adhesions & scar tissue? yes, structure matters there BUT even those mechanisms are not what most therapists think. For fascial adhesions, sustained mechanical load signals fibroblasts to remodel collagen over time, a process called mechanotransduction. For scar tissue, techniques like cross friction create a controlled stimulus that encourages collagen to reorient along lines of tension. BOTH are slow & cumulative. Not a one-session fix.
