Ultrastructural Changes in Untraumatised Rabbit Skeletal Muscle Treated with Deep Transverse Friction

Deep Friction Massage in the Management of Patellar Tendinopathy in Athletes: Short-Term Clinical Outcomes

CONTEXT

Deep friction massage (DFM) is often used in the treatment of tendinopathies; however, the pressure applied may vary and interfere with the obtained results.

OBJECTIVE

To assess whether the immediate effects of DFM on pain (pain intensity and time to onset of analgesia) and muscle strength are dependent on the pressure applied during the DFM application in athletes with patellar tendinopathy.

DESIGN

Randomized, controlled, cross-over trial.

SETTING

University research laboratory (institutional).

PARTICIPANTS

Ten athletes with diagnosis of unilateral patellar tendinopathy (age 27.90 [5.24] y).

INTERVENTIONS

All participants attended 4 sessions, 3 treatment sessions with DFM applied with different pressures (the mean pressure-previously determined for each participant-and the mean pressure ± 25%) and a control session, each of which was separated by 48 hours.

MAIN OUTCOME MEASURES

Pain (intensity upon palpation and time to onset of analgesia), and muscle strength of knee extensors were assessed before and immediately after each session.

RESULTS

Pain intensity changed significantly over time (F1,9 = 52.364; P < .001; ηp2=.853) and among sessions (F3,27 = 82.588; P < .001; ηp2=.902), with a significant interaction for group × time (F3,27 = 19.841; P < .001; ηp2=.688). The knee extensors strength did not change significantly over time (F1,9 = 2.240; P = .17; ηp2=.199), nor a significant interaction for session × time was observed (F3,27 = 3.276; P = .07; ηp2=.267). Regardless of the pressure applied, the time to onset of analgesia was not significantly different (F2,18 = 1.026; P > .05; ηp2=.102).

CONCLUSION

It was shown that DFM induces an immediate reduction in pain intensity upon palpation, regardless of the pressure performed. Notwithstanding, the reader should take into account the small sample size and the caution needed in the results' interpretation.

Deep Friction Massage and the Minimum Skin Pressure Required to Promote a Macroscopic Deformation of the Patellar Tendon

Objective

The purpose of this study was to determine the skin pressure needed to promote the macroscopic deformation of the asymptomatic patellar tendon and to verify if the pressure is associated with the individual's characteristics.

Methods

A descriptive laboratory study was performed with a convenience sample of 18 young, voluntary, and asymptomatic individuals of both sexes. A progressively increasing pressure was applied on the skin over the patellar tendon, through an instrument designed to perform and control the pressure upon an ultrasound probe; data were recorded and analyzed by 2 blind investigators. All statistical analyses were conducted considering α = 0.05.

Results

The average pressure needed to promote a macroscopic deformation of the patellar tendon was 1.12 ± 0.37 kg/cm². Female sex and age were inversely but not significantly associated with the pressure performed. Sports practice, weight, height, body mass index, muscle mass, and subcutaneous thickness were positively but not significantly associated with the pressure executed.

Conclusion

The average pressure needed to promote the macroscopic deformation of the patellar tendon was 1.12 ± 0.37 kg/cm², which was not influenced by the characteristics of the participants.