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Multidirectional Friction and Eccentric Contraction
Most sprains and strains can be treated effectively with a combination of multidirectional friction and eccentric contraction. The multidirectional friction is an improvement over the older and established practice of cross fiber friction.
Cross Fiber Friction
Although cross fiber friction can assist injury healing, there are now better approaches that can be used. Cross fiber friction is deep friction done across the grain of a muscle to break up scar tissue.
It was believed that cross fiber friction worked by breaking up scar tissue that crossed the grain of muscle fibers and left the scar tissue that was parallel with the grain. This would leave all the scar tissue aligned with the muscle fibers, which would allow for better muscle function.
It is now known that the friction serves to break up the scar tissue but does nothing to realign it.
Since the scar tissue is laid down in random directions it makes more sense to friction in multiple directions to soften the scar tissue. This takes only about 30 seconds of friction. Once the scar tissue is softened we can help the fibers realign in the direction of the muscle fibers by using eccentric contraction of the muscle.
Eccentric contraction is the controlled lengthening of a muscle. Concentric contraction is the active shortening of a muscle. When you lift a barbell by bending your elbows, you are performing a concentric contraction of the biceps brachii. When you lower the barbell you are not using your triceps. Instead you are using your biceps in a controlled way to lower the weight. That controlled lengthening of a muscle against gravity is called eccentric contraction.
Eccentric contraction is the fastest way to build muscle strength. It is also the major cause of delayed onset muscle soreness, which is the soreness you feel the day after a workout.
Eccentric contraction causes the laying down of collagen fibers to help in injury healing. It causes the collagen fibers to be aligned in the direction of the muscle fibers so that the muscle can contract efficiently without pain.
Treating Muscle Strains with Multidirectional Friction and Eccentric Contraction
- Have your client locate the area of muscle strain by gently contracting the muscle against resistance. If there is a strain they should be able to point to it with one finger.
- Before beginning friction, massage the muscle to get it in a relaxed resting state. This includes lengthening the antagonist as well as relaxing the muscle involved, so that all stress is taken off the area of muscle strain.
- Friction the area for 20 - 30 seconds moving in multiple directions. Have your fingers moving the skin over the muscle underneath.
- Have the muscle passively contracted, then try to lengthen the muscle with just two fingers applying pressure while your client offers resistance to the lengthening but still allows it to happen.
- Continue to repeat the previous step while gradually increasing your effort to lengthen the muscle while your client increases their resistance. All this should be pain free.
- If pain is felt at any time, friction the area again, then go back to step 3, applying less pressure while lengthening the muscle.
- Avoid concentric contraction of the muscle during this process, and advise your client to be careful not to stress the muscle for a day or two after the treatment. Any exercise should emphasize eccentric contraction.
- The treatment is complete when the client can repeat step 1 and not have pain.
For more information on this work I highly recommend the Orthopedic Massage Training with James Waslaski at www.orthomassage.net
Client Self Care
Advise your client to avoid strong concentric contraction of the muscle for the next few days, and to do exercise that emphasizes eccentric contraction of the affected muscle.
Hamstring Strain Update
Cross Fiber Friction
Eccentric Muscle Contraction
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