The Effect of Deep Friction Massage versus Stretching of Wrist Extensor Muscles in the Treatment of Patients with Tennis Elbow

Hassan, Safaa M.; Hafez, Ashraf Ramadan; Seif, Hamada Eid; Kachanathu, Shaji John

doi:10.4236/ojtr.2016.41004

Cited by 10 publications

(9 citation statements)

References 22 publications

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“…Stretching causes stimulation of the Golgi Tendon Organ (GTO) and causes the firing of the GTO, leading to an inhibiting response that causes the muscle to relax, and such relaxation might have caused the reduction in pain. Our findings are in conformance with previous studies, which have shown that the combination of stretching exercise, deep friction massage, and ultrasonic therapy is effective in relieving pain in the management of tennis elbow [35,36]. The results of this study also demonstrated that the group treated with the treatment combination of ultrasound therapy, stretching exercise, and wrist manipulation produced a better & significant reduction in pain, improvement in pain free grip strength and functional outcome than the group treated with ultrasound therapy, and stretching exercise alone.…”

Section: Resultssupporting

confidence: 93%

Efficacy of wrist manipulation in the management of lateral epicondylitis

M¹,

V.T.²,

M.S.³

et al. 2021

IJPR

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Background: Lateral epicondylitis is the most common clinical condition characterized by pain generally localized around the lateral epicondyle but sometimes radiating distally to the forearm. Objectives: The study's primary objective was to find out the efficacy of multiple therapeutic interventions consisting of wrist manipulation, ultrasound therapy, and stretching exercise on lateral epicondylitis patients. Subjects and methods: A pre-test, post-test experimental study design was used. A criterion-based simple random sampling was used to recruit patients (N=30) diagnosed with lateral epicondylitis, and they were randomized into two treatment groups. The experimental group-1 was exposed to ultrasound therapy and stretching exercises, whereas those assigned to experimental group-II were given ultrasound therapy, stretching exercise, and wrist manipulation for the period of 2 weeks. The efficacy of treatment was measured through visual analogue scale (VAS), manual hand dynamometer, and DASH Scale. Both paired and unpaired ‘t’ test was employed to study the treatment effectiveness. A p-value <0.05 was considered ‘significant’. Result: The group, which was exposed to the treatment combinations of wrist manipulation, ultrasound therapy, and stretching exercise showed a better reduction in pain intensity (mean difference 1.4) & self-reported upper extremity disability score (mean difference 8.06) and a notable improvement in grip strength (mean difference 4.73) than the other group, that was exposed to the treatment combinations of ultrasound therapy and stretching exercise at 0.05 levels of significance. Conclusion: There is a significant reduction in pain intensity, improvement in pain-free grip strength, and the overall function of the arm following the application of 2 weeks of wrist manipulation technique along with conventional treatment in Lateral Epicondylitis patients. Clinical Implications: Manipulation of the wrist is found to produce a significant effect when combined with conventional methods like ultrasound stretching and strengthening to manage lateral epicondylitis patients. KEY WORDS: Lateral epicondylitis, Ultrasound, Passive stretching, Wrist manipulation.

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Section: Resultssupporting

confidence: 93%

Efficacy of wrist manipulation in the management of lateral epicondylitis

M¹,

V.T.²,

M.S.³

et al. 2021

IJPR

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“…There are several possible reasons for this. First, previous studies have shown that when FM is applied to a specific muscle, the range of motion of the related joint increases [37]. Furthermore, the results of this study showed that FM of the pronator muscle increased SROM.…”

Section: Discussionsupporting

confidence: 49%

Immediate improvements of supination range of motion and strength following pronator teres muscle friction massage: a clinical trial comparing people with and without supination limited motion

Kim

Hwang

Jung

et al. 2018

Journal of Manual & Manipulative Therapy

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Objectives: To investigate the effects of friction massage techniques on the pronator teres muscle on supination range of motion (ROM) and supinator strength in individuals with and without limited supination ROM. Methods: In total, 26 subjects (13 with limited supination ROM and 13 healthy subjects) volunteered to participate in this study. We used a customized wrist cuff. Supination ROM and supinator strength were measured with a 9-axis inertial motion sensor and load cell. The friction massage protocol was executed with the pronator teres muscle in a relaxed position. Then supination ROM and supinator strength were measured again. Results: There was no significant interaction effect on supination ROM, which was significantly greater in the limited supination and control groups. A post hoc t-test revealed that the limited supination group achieved a significantly increased post-test supination ROM (51.7 ± 7.8°) compared to the pre-test value (43.6 ± 5.2°). In addition, the control group achieved a significant increase in post-test supination ROM (67.7 ± 10.0°) compared to the pre-test value (61.4 ± 7.7°). There was no significant interaction effect on supinator strength. Supinator strength was significantly greater in the limited supination and control groups. A post hoc t-test revealed a significant difference in supinator strength between the pre-and post-test values in the limited supination group. Discussion: Friction massage helps restore a limited ROM of the forearm supination motion and immediately increases supinator muscle strength. This technique can be used as an intervention method to improve muscle strength in patients with limited supination ROM.

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“…Regarding the influence of the application of different pressures on the time to the onset of analgesia (study 2), our results showed that a higher pressure of DFM led to a decrease in the time to the onset of analgesia, which may reflect a faster response of the presynaptic modulation mechanisms. Thus, a higher intensity of the mechanical stimulus (DFM pressure) will lead to the higher and faster activation of low-threshold A-α and A-β fibers that inhibit the nociceptive input from A-δ and C afferent fibers, which are responsible for nociceptive conduction at the dorsal horn of the spinal cord [4,5,10,[13][14][15]28,29].…”

Section: Discussionmentioning

confidence: 99%

“…Clinically, its effect on pain is confirmed by the immediate feedback of the patient with tendinopathy, which describes an analgesic effect during and immediately after the application of the technique [10,11]. The positive effects of DFM on pain are often explained by the induction of hyperaemia produced by mechanical stimulus [5,[10][11][12][13], the modulation of nociceptive impulses at the spinal cord ("gate control theory") [4,5,10,[13][14][15], and also the descending mechanisms of pain modulation [5,10,11,[16][17][18][19]. Notwithstanding, regardless of the mechanism beyond the analgesic effect of DFM, the mechanical stimulus seems to be a common trigger of this response [16], which in DFM corresponds to the pressure applied during the technique execution.…”

Section: Introductionmentioning

confidence: 99%

Pressure Applied during Deep Friction Massage: Characterization and Relationship with Time of Onset of Analgesia

et al. 2020

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This study aims to determine if a dose–response relationship exists between the pressure applied during deep friction massage (DFM) and the time to the onset of analgesia in an asymptomatic patellar tendon. For this purpose, pressures applied by physiotherapists during DFM (study 1) were characterized and then, based on these pressures, the effects of different DFM pressures on the time to the onset of analgesia were assessed (study 2). First, the mean pressure applied by 40 physiotherapists during a DFM session was assessed with a pressure sensor through an observational, cross-sectional and analytical study. Next, the effects of different pressure intensities (the median, the percentile 25 (P25), and the percentile 75 (P75) of the mean pressure obtained in study 1) were studied in a crossover trial enrolling 30 participants with an asymptomatic patellar tendon. A pressure sensor was used to register the pressures applied during DFM. Our main results indicated that the physiotherapists applied pressures with a wide variation ((mean pressure: 2.317 kg/cm2 (P25: 1.022 kg/cm2; P75: 4.161 kg/cm2)). It was also shown that higher pressures had shorter times to the onset of analgesia (pressure: 1 kg/m2, time to the onset of analgesia: 67.0 s (P25: 84.5 s; P75: 113.5 s); pressure: 2.3 kg/m2, time to the onset of analgesia: 59.0 s (P25: 73.5 s; P75: 87.3 s); pressure: 4.2 kg/m2, time to the onset of analgesia: 37.8 s (P25: 54.0 s; P75: 62.0 s)) (p ≤ 0.001). In conclusion, the mean DFM pressure obtained by the physiotherapists was 2.3 kg/cm2 (P25: 1.02 kg/cm2; P75: 4.16 kg/cm2). Higher pressures of DFM resulted in shorter times to the onset of analgesia.

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The Effect of Deep Friction Massage versus Stretching of Wrist Extensor Muscles in the Treatment of Patients with Tennis Elbow

Cited by 10 publications

References 22 publications

Efficacy of wrist manipulation in the management of lateral epicondylitis

Efficacy of wrist manipulation in the management of lateral epicondylitis

Immediate improvements of supination range of motion and strength following pronator teres muscle friction massage: a clinical trial comparing people with and without supination limited motion

Pressure Applied during Deep Friction Massage: Characterization and Relationship with Time of Onset of Analgesia

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