Synopsis of; Chamberlaine, G., 1982. Cyriax’s friction massage: A review. Journal of orthopaedic and sports physical therapy, 82, 16-22.
Clinically outstanding results are often seen with the use of frictions. Frequently within just over ten minutes movements become pain free and range of motion improves. They are a key treatment in orthopaedic medicine. Where the core treatment is often cortisone injection or frictions to the injured site. When administering deep transverse frictions (DTFs) clients often ask, “what does this actually do?”. This is an excellent question.
Chamberlaine ‘s article written back in 1982 provides some answers.
She states the rationale for DTFs in chronic injury is primarily to move the tissue and create traumatic hyperaemia (Chamberlaine 1982). The transverse movement mimics the natural movement of fibres and is theorised to reduce scar formation. Traumatic hyperaemia or therapist induced increased blood at the site, improves blood supply to the area. Hyperaemia decreases pain by accelerating the rate of breakdown of substance P. This is believed to be due to the release of histamine. Interestingly substance P produces ischemia when it accumulates. In the acute situation she suggests the friction creates movement but is not sufficient to stretch or tear the healing fibres.
Interestingly she talks about using two minutes in acute situations and ten to fifteen minutes in chronic situations. This is now prescribed as six sweeps posts numbness in acute injury and ten minutes post numbness in chronic injury.
Chamberlaine states five basic principles in effective application of DTF.
- Proper location must be found with application of selective tension and palpation.
- Friction must be applied transversely across the orientation of fibres.
- The therapist’s fingers and skin must move as one.
- The friction must have sufficient sweep and depth.
- The patient must be comfortable.
These principles hold as true now as they did in 1982. We may understand the theory in more detail than we did then but Chamberlaine’s review remains a key reference in orthopaedic medicine.
Chamberlaine, G., 1982. Cyriax’s friction massage: A review. Journal of orthopaedic and sports physical therap, 82, 16-22.