Rethinking Trigger Points- Muscle Knots or Neural Hotspots?

I’ll never forget the day a client pointed to their shoulder and said,

“Right there — that knot has been ruining my life.”

They were convinced it was a ball of muscle that needed to be kneaded, pummeled, or “broken up.”

So, like most of us were trained, I did exactly that.

They felt a bit better for a day — but by the next week, the “knot” was back, angrier than ever.

That was the moment I started to wonder -if we’re actually fixing the muscle, why does the pain keep returning?

That question led us down a rabbit hole — one that changed everything we thought we knew about pain, tension, and those so-called “muscle knots.”

We’ve all spent years chasing them — pressing, scraping, and stretching them in search of relief. But what if we’ve been chasing the wrong thing?

Modern neuroscience and biomechanics suggest trigger points aren’t muscle problems at all — they’re neural events.And that realization changes everything about how we approach pain, and better yet -offers us new solutions to treat it. 

The Motor Endplate Connection

Each muscle fiber is controlled by a motor nerve at a specific entry point — the neuromuscular junction.When that junction becomes overactive, it floods the muscle with acetylcholine, creating a localized contraction, reduced blood flow, and a chemical soup that irritates pain receptors.

The result? A tender, stiff, painful “knot” that isn’t really a lump of tissue… it’s a neural control point stuck in overdrive. 

The Cohen Connection — What if “Trigger Points” Are Actually Neural?

Back in 1994, Drs. Milton Cohen and John Quintner rocked the pain science world by suggesting that trigger points were not lesions in muscle at all, but zones of peripheral nerve sensitization.

“Maybe what we’re feeling isn’t a lump of tight muscle — maybe it’s a neural phenomenon.”— Cohen & Quintner, 1994

Their model explained how small nerve fibers and nociceptors become sensitized after injury or inflammation.The nervous system responds by turning up its local protective tone, and the nearby muscles contract reflexively — creating that familiar taut, painful spot.

Sound familiar? It should — because this neural model is the foundation of what RAPID NeuroFascial Reset has been doing all along. 

Why Trigger Point Maps and Nerve Charts Overlap

Ever notice how trigger point charts and dermatome maps look almost identical?That’s not a coincidence.

Trigger point referral pain follows neural pathways, not muscle fibers.When a nerve or its receptors are irritated, the pain travels along predictable sensory routes — the same ones shown in nerve maps.

So the next time a glute trigger point refers pain down the leg, remember:It’s not fascia magic — it’s the sciatic nerve’s sensory territory lighting up. 

How RAPID Fits In

This is exactly why RAPID NeuroFascial Reset gets results so quickly.

We don’t break up tissue or chase muscle tightness — we communicate with the nervous system itself.Through precise movement and neurological input, RAPID helps-✅ Desensitize irritated nociceptors✅ Normalize tone in overactive motor endplates✅ Calm the body’s protective reflexes

When the nervous system resets, the “knot” disappears — because it was never about the muscle.It was about the message.

“Trigger points aren’t muscle problems — they’re protective neural outputs.” 

The Takeaway

Pain isn’t purely mechanical — it’s neurological.And when we treat it that way, we stop fighting the body and start working with it.

Stop chasing tissue. Start resetting signals.That’s what RAPID is all about.So till next week keep resetting,Rob and SherryRAPID NeuroFascial Reset 

ps...Learn How to Treat Pain at the Source

Join a RAPID NeuroFascial Reset course near you and discover how to treat pain by working with — not against the nervous system.

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References

1. Cohen, M.L. & Quintner, J.L. (1994). Fibromyalgia syndrome, a problem of tautology. Rheumatology, 33(10), 986–999.

2. Simons, D.G., Travell, J.G., & Simons, L.S. (1999). Myofascial Pain and Dysfunction: The Trigger Point Manual. Williams & Wilkins.

3. Hong, C.Z. (2000). Pathophysiology of myofascial trigger points. Arch Phys Med Rehabil, 81(7), 917–922.

4. Shah, J.P. et al. (2008). Biochemicals associated with pain and inflammation are elevated near active myofascial trigger points. Arch Phys Med Rehabil, 89(1), 16–23.

5. Quintner, J.L., Bove, G.M., & Cohen, M.L. (2015). A critical evaluation of the trigger point phenomenon. Rheumatology, 54(3), 392–399.

6. Schleip, R. (2003). Fascial plasticity – a new neurobiological explanation. J Bodyw Mov Ther, 7(1), 11–19.

7. RAPID NeuroFascial Reset Training Manual (2025 Edition). Internal publication