What Are Tender Points?


Tender points are localized areas that hurt with palpation. They are not always in the area where pain is felt. In fact, they are often on the opposite side of the body.

Tender points are the superficial representation of a deeper underlying restriction. These restrictions are located in the fascia, a fibrous covering that completely surrounds all structures in the body. This includes the muscles, organs, arteries, veins, lymphatic vessels, bone, tendons, ligaments and more. Each structure (every artery, vein, etc) has a tender point location on the surface. They may be in the muscle layer, on a bone, in a tendon or directly on a bursa. Sometimes the tender points are close to the structure they are connected with and sometimes very remote.

There are many nerve receptors in the fascial network that respond to  injury or threat of injury to the structure it surrounds. When these nerve receptors are activated, they send a message to the spinal cord and brain that the structure is in danger. The spinal cord and brain response is immediate and all musculature around that structure tightens to protect it. There are also smooth muscle cells in the fascia that will contract to protect the vessel or structure. This does not damage the vessel or mean the vessel will have disease. In other words, just because there is a restriction in the fascia layer around an artery, it does not mean the artery is in trouble. It only means the artery was in danger of being hurt and the body responded by shortening it to prevent damage. The remaining restriction may cause compensation somewhere else in the body.

The body will do all it can to protect the more vital organs and blood vessels of the body from injury. Tightness and pain within the muscles are the body’s automatic response and results from the fascia around the more vital structures tightening into their protective mode. These are the restrictions mentioned above.

Under ordinary circumstances, the body returns to normal operations after the threat of injury is gone and no lasting pain or dysfunction remains. It’s when these restrictions get “stuck” that dysfunction in the surrounding tissues occur.

Many times the body is able to compensate and work around the restrictions for months or even years. But as age and further injury compound the issue; pain, weakness, tightness, postural changes and difficulty performing every day activities results. This is when it’s necessary for these restrictions to be released.

Releasing is performed by gliding or positioning the restricted structure in a shortened position in order to take away all of the strain from the nerve receptors. Once the strain is removed, the restriction goes away and the receptors essentially “reboot.”

These releases are a permanent improvement in the body provided there are no underlying pathologies or continuous strain. In many cases, proper function can be returned to an area with several releases.


Avatar photo About Christine Wood

Christine Wood, PT, DPT lives in Augusta County in the heart of Virginia’s beautiful Shenandoah Valley with her husband and children. With over 20 years of experience as a Physical Therapist, her hands have brought healing and pain relief to thousands of clients.