BASIC TECHNIQUES – Frictions

             Friction comes from the Latin word frictio, meaning “to rub”; Frictions are massage strokes intended to increase local blood circulation, and have a slightly more focused stretch effect in the treated tissue. Frictions are generally performed with fingertips, palms, fists, or elbows. It is important to minimize sliding on the skin (apart from V-frictions), and instead move the skin with the stroke to effectively treat the underlying tissue.

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• One hand is placed on top of the other as the fingertips are interlocked.
• The thumb is used as an anchor merely to determine the angle of the hands in relation to the athlete’s body. A more horizontal angle produces an added superficial stroke, and an increased vertical angle will generate a stroke reaching deeper into the tissue. For more depth, a 45-degree angle of the hands is needed.
• The elbows are kept to the side of the body as the hips and legs move the body and hands in a circular motion.
• Using the fingertips to actively push/pull the soft tissue will enhance the 8-finger frictions further. The distal phalanges are slightly flexed at the beginning of the stroke, pushing the muscle out further by straightening the fingertips during the first half of the circle. After being straightened, the phalanges are once again flexed during the second half of the circle, thus pulling the soft tissue into stretch from the other direction.

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Both hands are used separately to perform circular 4- finger frictions. This stroke is beneficial to use on muscles on rounder shapes like the arms, legs, and neck.

• The muscle is massaged with the fingertips in circular motions with each hand.
• The movement is generated from the hips, rhythmically rocking the body back and forth.
• The fingertips are used to push and pull the muscle fibers into stretch during the massage.
• The thumbs of each hand are used as an anchor. For added strength, each thumb is positioned on the opposite side of the treated body part, allowing the hands to squeeze together during the massage. The main force is thereby acquired from the leveraged hands and not the arms.

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• This type of friction is executed with a reinforced long finger and/or index finger. Placing the index finger or long finger of the same hand on top of the nail of the other finger reinforces the stroke One-finger circular frictions can be very effective when used for smaller, harder to reach areas.
• Thumb friction is another example of one-finger friction. Thumbs should normally not be used on larger areas but can serve as an excellent tool for focused work. It is important not to stress the thumbs extensively during massage treatments since they are vital for the normal function of the hands. For deep tissue work, the thumbs should always be braced.

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• The fists are kept loose and massage in a circular motion.
• Wrists are relaxed to ensure smooth motion. To achieve slightly more depth in the stroke, the therapist utilizes the bodyweight by leaning forward.

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Here the palms work in a circular motion. This stroke is less specific and can be used more briskly to generate increased blood circulation and temperature. To achieve more depth in the stroke, the pressure is focused on the palm heel.

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V-frictions are normally executed alternately with four fingers of each hand while the thumbs act as anchors. V-frictions are generally used in all directions, but particularly in a 45-degree angle across the soft tissue fibers. Some caution should be observed when executing against the venous flow in the extremities: in this case, the strokes are shortened to a maximum of 1–2 in to decrease potential stress on the veins.

Regular V-frictions

• The hands act as an extension of the hips and legs. The thumbs serve as anchors, and the wrists are relaxed.
• With the movement starting from the therapist’s hips, the four fingers are pushed at a 45-degree angle in relation to each other to enhance the stretch effect in the soft tissue.
• One hand alternately keeps the tension in the tissue as the other glides under the first hand to stretch the muscle in the other direction.
• The depth of this stroke, controlled by the thumbs, is determined by the angle of the hands in relation to the body.
• The fingers are slightly flexed to maintain depth in the stroke.

Reversed V-frictions

• This stroke massages the soft tissue by pulling it in semicircles toward the therapist’s midline.
• The fingertips are bent to hook into the massaged soft tissue.
• The other hand alternately massages in a mirrored fashion but overlaps the area of the stroke of the previous hand, which is keeping tension in the tissue.
• To increase the depth of this stroke, the therapist leans backward and alternately moves the body from side to side to utilize momentum effectively.

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[dt_sc_tab title=”Cross-fiber frictions”]

This stroke is perceived to effectively generate a local hyperemia and stretch effect in the treated muscle tissue.

• The thumb or other fingertip massages the muscle or tendon transverse to the fiber direction. It is important not to slide on the skin but instead move the skin to effectively treat the under lying tissue.
• The stroke is initially executed slowly to minimize activation of the myotatic/stretch reflex and increases in intensity as the tensed tissue softens. The more force that is applied to this stroke, the slower the pace of its execution.
• It is imperative that the therapist carefully monitors and adjusts to the changing state in the treated soft tissue to avoid unpleasant sensations for the athlete.

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The British orthopedic doctor, James Cyriax, empirically developed this technique as one of his many great contributions to manual medicine. Deep transverse frictions are specifically used for breaking up, stretching and/or restructuring connective tissue adhesions in muscles, tendons, and ligaments stemming from acute trauma and/or mechanical overload.

Deep transverse frictions:

• One or two fingers are placed directly over the adhesion or lesion. The muscle belly is kept relaxed.
• The soft tissue is gently pushed and pulled transverse to the direction of the treated muscle, tendon, or ligament fibers. It is important not to slide on the skin but instead move the skin to successfully treat the underlying tissue.
• For larger tendons, a broader contact surface is applied to effectively spread and stretch the tissue.
• Chronic adhesions are treated for 15–20 min/ treatment, whereas recent injuries start in 1 min intervals.
• Cryotherapy can be applied after each treatment to reduce an inflammatory response.

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Stripping utilizes a continual longitudinal pressure to the treated tissue, gliding from origin to insertion, or insertion to origin of the muscle. In the extremities, if using a broader contact point, like an elbow, the stroke is almost always applied in a direction towards the heart to avoid unnecessary stress on the venous valves and walls. Stripping is often executed using reinforced thumbs, fingertips, or an elbow.

• The therapist places both thumbs together beginning at one end of the treated muscle
• The therapist utilizes the body weight to lean forward, making the stroke slowly glide along the muscle, or between muscle bellies. This gives the stroke either a “milking” or separating character.
• The stroke is repeated along the muscle until tissue softening is noted. If the intent is to stimulate a hypotonic muscle, a faster pace is used.

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