Massage techniques: friction

Friction massage is a valuable tool for every massage therapist. Due to their deeper nature, they are best reserved for after the client’s body has been properly warmed up with effleurage and petrissage.

​Friction is a massage technique of applying deep pressure with the balls of the fingers and/or thumb and gently rubbing back and forth or in a circular motion. It is applied transversely or across the muscle fibres rather than along their length like in effleurage. Hence, it is often called Transverse Friction Massage (TFM) or Cross Fibre Frictions (CFF).
 
It is often stated that it was developed by James Cyriax in the 1980s but in reality, friction is described and used in textbooks on massage even from the beginning of the 20th century. Although considered by some people archaic, there is a lot of wisdom and deep knowledge in such older sources. Some of these sources, for example, recommend to always follow and by and repeatedly alternate friction with effleurage to avoid overstimulation of the nervous system and promote re-absorption of the by-products of local inflammation.
 
Purpose
 
The general purpose of frictions is to maintain soft tissue mobility, including muscles, tendons, and ligaments, by preventing or reducing the formation of scar tissue. Working perpendicularly to the actin and myosin filaments of the muscle breaks down adhesions.
 
Frictions also facilitate the proliferation of fibroblasts in the area, which help maintain the integrity of the tissue by secreting extracellular proteins. Where trauma has occurred, frictions support the development of more mobile and better-quality scar tissue.
 
It can also reduce pain by promoting the evacuation of Lewis’ P factor, an irritative metabolite. It is believed that this effect is most likely due to a localised release of histamine.
 
Tissue fibres are also lengthened and realigned in proportion to the applied pressure.
 
Application
 
It is important to diagnose through palpation and single out the exact location to be worked on. To avoid skin injury and irritation, the therapist’s fingers and the client’s skin must move simultaneously. Friction is applied to the underlying tissue, not to the skin. The only exception is when working to relieve superficial scarring or wrinkles.
 
It is worth emphasising again that frictions are applied perpendicular to the tissue’s fibres to smooth down the scarring. This motion mimics the normal mobility of the structure by broadening the healing fibres.
 
It is recommended to apply with sufficient sweep in order to treat the whole scar. Although it is advisable to apply deep pressure, it must be within the client’s pain tolerance. With gradual and progressive application and sufficient time for the client’s nervous system to adapt, pain diminishes.
 
The general rule is to stretch tendons and ligaments for better contact during fractioning. On the other hand, when working on a muscle, a shortened position is advantageous as it aid in the separation and realignment of fibres.
 
Contraindications
 
Frictions are not to be applied in cases of skin disease, rheumatoid arthritis, local sepsis, bacterial infection, calcification of the soft tissue, bursitis and tunnel syndrome.
 
Frequency and duration
 
How often and for how long to apply frictions would depend on the client and the problem that they present. Daily sessions may be recommended in some cases and if circumstance permit. This would lead to rapid improvements but also requires the client’s cooperation. They must support their body in this rapid healing process with plenty of rest and fluids to promote disposal of toxins. A lower frequency of 2-3 times a week is more realistic and can continue until symptoms dissipate.
 
With regard to duration, a gradual progression is the best approach. A therapist can start with 1-2 minutes at a spot, follow up with some effleurage and repeat this a few times for a total of 10-12 minutes. In subsequent sessions, this can be increased up to 15-20 minutes or even longer depending on how the client responds.
 
Evidence
 
There is no definitive research proving the benefits of friction massage. The practical experience of thousands of massage therapists, however, speaks of the efficacy of this technique. Ideally carefully designed RCT studies in the future would bridge that gap.
 
So, the next time you want to get rid of that tight knotty bit in your muscle consider applying some frictions. Better yet, go to a massage therapist that can do that for you in a safe and efficient manner. 

Related articles:
Massage techniques: effleurage and petrissage
Massage techniques: tapotement