04/01/2026
AS THERAPIST
Those “knots” you feel under your hands aren’t chunks of muscle tissue that need to be broken apart.
They’re not scar tissue you have to smash. They’re not adhesions you need to overpower.
Scar tissue CAN be mechanically influenced with manual therapy.
It’s a structural change- collagen laid down after injury or surgery- and skilled, progressive loading and hands-on work can help improve its mobility.
But the most common “knots” people feel are trigger points, and trigger points are different.
Trigger points are areas of heightened sensitivity and increased tone that are held in place by the nervous system, not glued together by tissue that needs to be torn apart.
They’re part of a conversation happening between the brain, nerves, and muscles.
When the nervous system perceives threat, overload, fatigue, or repeated stress, it increases protective tone. Muscles stay guarded. Sensitivity increases. Pain signals amplify.
What you feel as a “knot” is often the body doing its job, creating stability and protection.
Massage doesn’t work because we’re stronger than the tissue. It works because touch changes how the nervous system interprets sensation.
Through mechanisms like:
• Gate Control Theory: where non-threatening touch competes with pain signals at the spinal cord
• Descending inhibition (DNIC): where the brain releases its own pain-relieving chemicals
• Parasympathetic activation: shifting the body out of defense and into safety
Skilled touch tells the nervous system:
“You’re okay. You don’t need to hold here anymore.”
And that is when tone changes.
That’s when trigger points soften.
That’s when relief spreads.
Massage isn’t about breaking people down.
It’s about helping the brain, nerves, and muscles work together again.
When therapists understand this, their work becomes more effective and their careers become more sustainable.
-CTTO
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