In muscular, tendinous or ligamentous lesions, a few minutes of massage on the suspected spot results in diminished pain on testing immediately thereafter, so confirming the diagnosis as accurately as an infiltration with local anaesthesia. Preparation for mobilisations and manipulation Transverse massage is often applied prior to and in conjunction with other mobilizing techniques. In muscular lesions, friction is given before active or electrical contractions on an unloaded muscle. Deep en thorough friction also proceeds manipulation of the elbow in case of a refractory type 2 tennis elbow. The technique is used for its desentizing and softening effect which makes the manipulation more tolerable Therapy Muscle bellies.
Friction is given to a healing muscle belly after contusion or in minor muscular tears.
In minor muscular tears the friction is often part of a combined treatment as it is usually applied after an infiltration with local anaesthesia. The aim of treatment in muscular tears is to allow the torn fibres to heal in such a way that normal enlargement during contraction remains possible. A muscle belly normally increases in breadth on contraction, a characteristic that can be disturbed by abnormal adhesion formation. It is obvious that, to break down crosslinks in a chronic stage the friction can be given forcefully and for a duration of 15-20 minutes, whereas in more recent lesions the technique will be applied more gently and for a shorter duration. Friction to a muscle belly is always given with the muscle well relaxed.