Friction Rubbing.

Sometimes, when we injury a muscle, tendon, or a ligament, we can develop scar tissue around the injured structure.  When this soft tissue lesion heals, rough collagen is built-up; this build-up is known as an adhesion.  Adhesions are not a good development because they can impinge nerves, restrict muscle movement, and cause pain upon movement. In my Physical Medicine class, we learned how to 'break-up' adhesions as they develop after an injury. The technique we learned about is called Cross Fiber Friction Rubbing

How it works:
Friction rubbing reduces the bothersome adhesions from building-up, causing the body to form strong scar tissue instead. More specifically, the rubbing reduces the 'roughness' that forms with adhesions, making the resulting scar tissue smoother.

What is done:
A deep, non-sliding, pressured stroke is applied to the injury site (note: not during the acute stage of the injury, but in the sub-acute stage, such as several days after the initial injury). The movement is along the direction of the muscle fibers. . No oil is used topically and the 'stroke' doesn't slide; the skin doesn't move as the muscle is moved.  The doctor applies the stroke using their thumb and it is applied at right angles to the muscle fibers.

You've been warned! The treatment is quite painful, but it still safe and 'worth the pain'. No pain, no gain! The first treatment will be short, a couple of minutes only, then a day of rest, then another treatment. After a total of roughly 5 treatments, the adhesions will be fully broken-up, and thus the muscle/tendon/ligament will be back to its normal functioning state and will very likely be pain-free.

The RICE protocol is indicated (rest, ice, compression, elevation). Lots of ice in particular.

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