Transverse friction massage :anaesthetic effect | cyriax.eu

Transverse friction massage :anaesthetic effect

Is it possible to use friction massage as a differential diagnostic medium : a test-retest experimental study

Steven De Coninck, Kurt Meeus 2005 ; presented on the Physiokongress in Aachen (Germany), 2006

 • Purpose :

We would like to confirm the hypothetical diagnosis of a tenoperiostal tendinous lesion of the supraspinatus (tendinitis or tendinosis) by using a diagnostic or "test" friction massage (DFM).

Method :

 Inclusion criteria of the patients : the patient describes pain in the C5-dermatome. Specifically elevation movements during activities of daily life are painful and/or limited. There is no pain at rest. The pain started spontaneously, since max. 1 month (overuse lesion) or after trauma. 

In the clinical examination following tests are positive : isometric abduction against resistance (R abd) ; a painful arc (PA) and/or end range pain on passive elevation (P elev).

Those data were collected by using a Cyriax Assessment Form. 

On every positive test, the patient is asked to give a score to his painlevel by using a VAS. 

Afterwards a diagnostic test friction massage is given on the tenoperiostal aspect of the supraspinatus tendon, for 5 minutes. (In literature, an anaesthetic effect of the friction massage is illustrated after a mean time of 2-3 minutes). 

Immediately afterwards, the tests found positive in the clinical examination are repeated and the patient is asked again to give a pain score by using the VAS.

Hypotheses :

If the patient really has a tenoperiostal supraspinatus problem, then, we expect that the positive tests from the examination became significantly better after applying the test friction massage for 5 minutes.

If not, then probably another pathology is present.

Data / Results :

Clinical examination :

N = 20

9 male, 11 female (age between 25 and 63 y.)

On 11 occasions, all three variables (positive tests from the examination, described in the inclusion criteria) are positive.

In 9 patients there are two positive tests (in 6 cases R abd and PA ; in 3 other cases we found a R abd and P elev positive).

 Post diagnostic friction massage :

17 patients described a clear pain reduction after applying the diagnostic friction massage.

1 patient didn't feel any difference at all with the R abd.

2 patients described for one or more tests a worsening of the pain.

 Before the diagnostic friction massage (DFM), P elev was the most painful test : a mean score of 60,5 on the VAS.

After the DFM this was reduced toa score of 49,5.

On PA there was a pre-score of 58,4 and a post-score of 41,3.

On P elev there was a pre-score of 54,8 and a post-score of 41,1.

 The mean pain reduction score after the DFM was 13,75 for the R abd, 17,1 for the PA and 11,2 for the P elev.

Conclusion :

 In 85% of the cases we found a clear link between the presumeable diagnosis of a tenoperiostal supraspinatus tendinopathy and the DFM.

 By using a Paired Samples Test and Wilcoxon Test we found a significant pain reduction after the DFM on the R abd test and the P elev (p<0.001) and also on the PA (p<0.01).

Discussion :

This test-retest project was a first small step towards a bigger intiative including a higher number of patients. It certainly gives inspiring data for further studies.

A consideration that can be incorporated too in future studies is the differential diagnosis with a chronic subdeltoid bursitis and a calcification of the subdeltoid bursa and/or supraspinatus tendon.

Incorporating the use of diagnostic infiltrations with a 0,5% procaine solution could be very usefull too from the differential diagnostic point of view.

 This project illustrates the way in which a presumeable diagnosis of a contractile lesion could be confirmed in a cost-efficient and fast way.

Involving ligamentous lesions in future projects is adviseable too.

 

Contact :

Steven De Coninck.

 

We wish to respect your privacy at all times

General Data Protection Regulation - European Privacy Regulation

How do we collect your personal data such as name and email address ?

When you are an ETGOM course participant automatically you enter the ETGOM newsletter
When you send us an email with an information request regarding the ETGOM seminars or publications
When you participate at an ETGOM webinar
When you download the free ebook
When we meet in person (e.g. conference)
Or when you register on our “Tips and Tricks in orthopaedic medicine” newsletter

How do we use your personal data

Your data are exclusively used by the ETGOM Teaching Team and organisation partners to inform you about ETGOM activities and publications
Your data will not be transferred to any third party which is not related to orthopaedic medicine continuing education

Your rights

You have the right at all times to view, to update or to delete your personal data
You can unsubscribe from our newsletters, mailing list, at any time
You can refuse or limit the use of your personal data
You can visit the website of OM Consult bvba/ETGOM unrestricted and furthermore consult information about our company, products and services without giving any personal data of you. Only if you want to contact us via the web form, you have to share you personal data. Each time you provide personal information, OM Consult bvba will handle them in accordance with the policy written down in here and the legal liabilities concerning the handling of personal data.

Confidential handling of personal data 
The personal data collected by OM Consult bvba/ETGOM, are saved on a protected place, which is not open for the public. The file can only be consulted by a restricted number of persons who are in service of OM Consult bvba/ETGOM and only if they need this information for practice there job. The data will only be processed for internal purposes. Om Consult bvba ordinarily doesn’t give any personal data to third persons, except to comply with legal liabilities and in case of an express request from the judicial authority or police. In the exceptional case that OM Consult bvba/ETGOM gives information to organizations or companies with which they work together, it will be expressly mentioned or you will be expressly asked for your agreement.

Purpose of handling 
OM Consult bvba/ETGOM handles the collected personal data to identify you and if necessary to contact you and to give you an optimal service. The data can also be used to give you information about news items, new services and new products of OM Consult bvba/ETGOM. If you don’t want to receive such information, you can mention this to OM Consult bvba/ETGOM by e-mail ( info@cyriax.eu) or by letter.