2012-10-10

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.

Results:
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.

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

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