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Massage in which superficial tissues are rubbed against deeper tissues is often termed friction massage. There has been considerable controversy among those experts who categorize massage techniques (the mind boggles!) as to whether friction is a type of effleurage or a type of petrissage. A great deal of the literature may refer to 'friction petrissage' or 'friction effleurage.' In the last five years or so, the majority of experts have characterized friction massage as its own category.

The Technique: How Friction is Done

Friction massage is not terribly different from the other major massage techniques. Typical friction massage is applied using the palm or margin of the hand or the knuckles. The therapist presses down on the tissues and rubs back and forth, either in a direction parallel to the underlying muscle, across the muscle or in a circular pattern. Sites which often benefit from friction massage are biceps, pectorals (upper chest muscles), shoulder and back muscles and the muscles of the calf and thigh.

The type of friction in which the strokes run perpendicular to the direction of the muscle is termed cross-fiber friction, transverse friction or cross-friction massage (CFM). This technique was popularized by Dr. James Cyriax, a British orthopedic physician and expert in musculoskeletal injury. CFM is considered to be among the best techniques for the rehabilitation of certain types of sports injuries and therapy on injuries to muscles and tendons.

Wringing, applied to the extremities, is sometimes classed as effleurage, but my own feeling is that it fits better into this category. Wringing is very simply grasping and lightly twisting the tissues (make absolutely sure to move only soft tissue and not bones and joints). On legs and arms, wringing may be done with both hands, gripping the tissue lightly and counter twisting, while on fingers and toes, wringing is a simple, light twist, applied slowly with the hand.

It is not necessary to use much (if any) massage cream, oil or other skin lubricant when performing friction massage. Since the very idea of these techniques is to get a strong friction, the creams, which reduce friction would be pointless. Sometimes, a very light massage cream (BioTone makes a massage lotion specifically formulated for deep tissue work, for example) might be used to reduce potential wear and tear on the therapist's skin.

What Friction is Good For

Friction is usually a deep tissue massage technique and, as such, it is very good for relieving very tired or sore muscles. This technique is often used in sports massage, particularly after strenuous competition or training (so called post-event sports massage).

Light friction may also be used on thin tissues and near joints in order to stretch out underlying tissues. Friction is capable of breaking up adhesions and draining excess fluid from the tissues–it increases blood flow to and from the area, thereby clearing out waste products and bringing oxygen and nutrients to the area.

Deep friction–called ASTM (augmented soft tissue manipulation) by those folks who have to have really technical terms for everything, is exceptionally good at treating tendinitis. It seems to help tendons heal faster by augmenting the body's production of the fibroblasts, cells which repair the tendons.

Friction, especially cross-fiber friction, is sometimes used in the place of steroid injections for reducing pain and inflammation in muscles and joints. It does not work as quickly as these injections, but some studies have found that it has fewer side effects and better long-term effectiveness. It is also a heck of a lot more fun than steroid injections!

As a massage therapist, I have worked with several clients who have lower back problems. One specific client was faced with the choice of the steroid injections vs. massage, and got in touch with me. I have worked with her (and her doctor) since then. Using a combination of slow effleurage and lots and lots of deep, cross-fiber friction, she has shown a terrific amount of progress and almost never suffers from pain in her lower back any longer. This is one of the best of the first-hand (har!) accounts of the effectiveness of cross-fiber friction that I have participated in–it is really amazing stuff!

Friction massage also shows a marked effectiveness at relieving pain. Part of this is certainly counter-irritation or gate control (wherein the pain carrying nerves are hyperstimulated and thus some of them slow down, this seems to be why you rub your head when you bump it). Certain researchers believe that there may also be some localized destruction of pain-modulation substances (such as Lewis' substances) at the site of friction.

Precautions and Contraindications

As this is a deep-tissue massage technique, there are parts of the body where friction should not be used: over organs such as kidneys, near areas such as the armpits or backs of knees, or any place where deep pressure could cause harm (for example, near the eyes, the front of the neck or near the solar plexus, to name but a few). Likewise, friction should never be used over any area where there is a problem with the skin such as infection, blistering, ulceration or recent open wound. Areas of hematoma should also be avoided. Friction should not be used in the case of rheumatoid tendinitis, bursitis or nerve disorders.

The person massaging should seek feedback, making sure not to use too much pressure. It is a pretty good idea to start with a light touch, increasing steadily until the right level is reached.

With a bit of practice, friction massage is a very easy technique to learn and very rewarding to practice. Your friends and loved ones will thank you!

My massage school notes, plus
Hammer, Warren, "Latest Information on Why Friction Massage Heals Tendinitis" Dynamic Chiropractic, August 25, 1997, Vol. 15, Issue 18, online at: http://www.chiroweb.com/archives/15/18/28.html
Dr. Joseph F. Smith Medical Library on-line: http://www.chclibrary.org/micromed/00056140.html
Syracuse Chargers running club therapy page: http://www.syracusechargers.org/therapy/chapt14.htm
Cyriax Orthopaedic medicine: http://www.ombregt.be/engels/friction.htm

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