movement mobilises the structure relative to the adjacent bone sheath or fascia. Transverse frictions applied to a lesion within the

substance of a muscle are given transversely across the muscle fibres, with the muscles in a relaxed and shortened position. The aim of this is to fully broaden the muscle and break down adhesions between adjacent muscle fibres (40). Tendons, however, are best placed under tension and the frictions applied transversely, affecting both tendons enclosed within synovial sheaths and tendons that are not; this may break down adhesions or smooth off any rough areas around tendons and in adjacent tissues.

The position adopted for a joint capsule or ligaments simply requires it to be easily accessible. Frictions applied across the fibres of alignment mobilise the whole ligament relative to the bone below, and individual fibres within the ligament relative to one another. Hyperaemia may be produced by DTF in the underlying tissues. Clinically, a red, raised area is seen on the skin as the technique is applied, and it is assumed that the same increase in regional blood flow occurs in the underlying tissues (61). This potential increase in the inflammatory response is required in chronic lesions but not in acute lesions. For this reason, if DTF is used in the acute phase of injury, it must be gentle and given over a shorter period in order to avoid hyperaemia production.

DOWN ADHESIONS BETWEEN FIBRES

THE AIM OF TRANSVERSE FRICTIONS IS TO BREAK

CONCLUSION Restoration of function is often the most striking effect of DTF. On reassessment, range of motion is usually increased significantly and muscle contraction performed more easily. Kelly confirmed this in a study looking at 46 subjects, who showed an increase in force of muscle contraction and an increased range of dorsiflexion after DTF of the gastrocnemius muscle (62). The majority of studies have examined the use of DTF

given in conjunction with other treatment modalities, making it arduous to validly extrapolate and interpret any individual implications for therapy. In addition, most of these studies have focused on the treatment of chronic conditions, when in fact the more mature the healing tissue, the more invariable is its structure and the less susceptible it is to alteration by this particular intervention (28).

References

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THE AUTHOR

Paula Clayton joined the English Institute of Sport (EIS) in 2003 as a sports soft-tissue therapist. She now heads the Soft Tissue

Therapy Steering Group at EIS, which is responsible for fostering relationships between physiotherapy and soft-tissue therapy and encouraging best practice through constant integration within the interdisciplinary team. Paula is also the senior soft- tissue therapist for the GB track and field team and has travelled extensively to major championships for the past five years. Before joining EIS, Paula worked in football, with a stint at Birmingham City followed by four years at West Bromwich Albion, where she saw the team promoted to the Premiership.

24 sportEX dynamics 2009;22(Oct):21-24