Motor Banding: a modern understanding of muscle knots and dry needling rationale
What is Motor Banding?
Muscles are made up of several motor units (sections of muscle that make up the larger muscle). A motor band is an area of muscle where a group of fibers supplied by the same nerve (a motor unit) becomes excessively active or sensitized. This creates a palpable taut band in the muscle that can feel tight or rope-like, restrict movement, alter muscle activation patterns, contribute to pain or dysfunction - even if it isn’t painful when pressed. Unlike a trigger point, a motor band does not require localized tenderness or referred pain to be clinically relevant. If we have pain, our body has protective guarding mechanisms and motor banding is likely occurring. Motor banding is a more modern, neurophysiology-based way of explaining what we are targeting during dry needling rather than trigger points.
Why Clinicians Are Moving Away From “Trigger Points”
The traditional trigger point model relies on:
A tender nodule
Reproducible pain with palpation
Often referred pain patterns
However, research has shown that:
Trigger points are difficult to define consistently
Palpation reliability is low between clinicians
Pain is not always the primary problem—movement dysfunction often is
Motor banding shifts the focus from pain spots to neuromuscular dysfunction.
When dry needling targets a motor band:
The needle stimulates the motor endplate region. This can produce a local twitch response (a brief involuntary muscle contraction). The twitch reflects a reset of abnormal motor unit firing.
Addressing motor banding helps to:
Restore normal muscle activation patterns
Improve strength and coordination
Reduce compensatory movement strategies
Decrease pain indirectly by improving the function of the motor unit
With electrical stimulation, repeated rhythmic contractions help:
Normalize motor unit behavior.
Reduce excessive tone.
Improve muscle coordination and timing.
Improve fast twitch and coordination muscle fiber recruitment.
Increase blood flow and clear metabolic waste.
Some e-stim settings can contribute to muscle hypertrophy.
This makes it especially useful for:
Athletic performance
Post-surgical rehab
Chronic pain conditions
Patients who don’t report focal tenderness
In Simple Terms
Instead of asking, “Where does it hurt?”
Motor banding asks, “Which muscle fibers aren’t working correctly?”
This perspective aligns better with modern physical therapy, rehabilitation, and pain science. Once we create those changes and restore normal muscle recruitment, then we challenge those muscles with progressive loading strategies to drive adaptation and increase tissue capacity.
