Last reviewed: September 2026
What Is Adhesion?
Adhesion is restricted connective tissue that can reduce normal movement between tissue layers. Muscle, tendon, and fascia should slide against each other. When they don’t, movement can become stiff or painful.
Connective tissue itself is normal. It holds muscle together and carries force. Related terms overlap but are not interchangeable:
- Fibrosis — excess, disorganized collagen within a tissue.
- Scar tissue — repair tissue that forms after a wound or tear.
- Restricted glide — lost sliding between neighboring layers, with or without obvious scar.
- Adhesion — Novo’s clinical term for an area where layers do not slide normally and motion is limited. It may involve fibrosis or scar, but not always.
Routine imaging may not show adhesion clearly, so we look for it with hands-on and movement testing.
Adhesion is one possible finding, not the explanation for every tight or painful muscle. Stiffness can also come from a joint, tendon, nerve or other source, and the exam looks at those as well. Adhesion is also not the same as a trigger point, although one tender spot can involve both (Trigger Point or Fibrous Adhesion?).
In the animation, healthy fibers glide past each other until an adhesion binds them and limits stretch and contraction.
How Adhesion Can Contribute to Pain
Adhesion can be one contributor in the conditions we see most:
- Low back pain — restricted tissue can add to stiffness, muscle guarding, and altered loading of the lumbar spine.
- Neck pain and headaches — restricted tissue in the neck and upper back can add to stiffness and tension headaches.
- Joint pain — it can add to tightness around the knee, hip, ankle, shoulder, elbow, and wrist.
Musculoskeletal Fibroaging
Fibroaging is Dr. King’s term for a pattern he sees in practice. It is a clinical framework, not a formal medical diagnosis.
Fibrosis and cellular senescence are established areas of aging research. Dr. King’s observation is that some stiffness people write off as "just getting older" may involve adhesion built up over years, and may respond to treatment. That link is his hypothesis, not a proven cause.
What Is Musculoskeletal Fibroaging? →
What Patients Say
Some patients raise the adhesion question themselves. "I had a suspicion that adhesions were part of my problem," one patient told us. Another described Dr. King’s "adhesion release technique" as "a rare talent."
How We Treat Adhesion
We examine first. If we find adhesion, the tool depends on the tissue:
- Focused shockwave — energy focused at a chosen depth, for a tendon insertion or deep fibrotic band.
- Radial shockwave — a broader, shallower field for fascia and muscle bellies.
- EMTT — a high-intensity magnetic field for degenerative joint and enthesis tissue.
- Manual adhesion release & IASTM — hands-on and instrument-assisted work on the restricted tissue.
See how each treatment works →