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Trigger points  

CROSS FIBER FRICTION

Developed for the treatment of soft tissue lesions by the British osteopath, Dr. James Cyriax, deep transverse friction effectively reduces fibrosis and encourages the formation of strong, pliable scar tissue at the site of healing injuries. This technique, also known as cross-fiber frictioning, reduces the crystalline roughness that forms between tendons and their sheaths that can result in painful tendonitis. It can also prevent or soften myofascial adhesions.
A deep, non-gliding, oil-less friction stroke, cross-fiber friction is administered with a braced finger or thumb moving across the grain of a muscle, tendon or ligament. The therapist's thumb and the client's skin move as one over the exact site of the lesion with sufficient sweep and duration to create a mechanical effect on the tissue treated. The stroke must be applied directly at the site of the lesion, at right angles to the fibers, and be broad enough to separate the fibers without bouncing over them. The treatment is painful, though always within tolerance, and should be initiated only with the informed consent of the client. It should never be applied during the initial inflammatory stage in an acute injury.

The first treatment should be conservative, lasting one or two minutes only, followed by a day of rest for the treated part. The treatment is resumed on alternate days until the pain abates and full usage is returned, usually within 3 to 10 sessions. Appropriate application of ice following treatment is recommended.