Enhancing Chiropractic Continuing Education: Cyriax Friction Massage Suggestions Posted on Oct 20, 2023
1. Introduction
CCEDseminars | HQ For Chiropractic Continuing Education!Deep friction massage (DFM), also known as Cyriax friction massage, has been a cornerstone in chiropractic care for chronic pain management. While it has been widely utilized in clinical practice, there remains a persistent lack of concrete evidence to substantiate its therapeutic efficacy. In this blog post, we delve into the compelling suggestions put forth by experts Alexios Pitsillides and Dimitrios Stasinopoulos to enhance and modernize this technique according to recent literature. CCEDseminars has made it our mission to develop adjusting and manual therapy chiropractic continuing education courses on a wide range of topics!
2. Terminology Matters
One of the critical aspects often overlooked is terminology. How we label and define a technique can significantly impact its execution and outcomes. Pitsillides and Stasinopoulos propose adopting the term "transverse friction massage (TFM)" as the general nomenclature for this technique. They argue that terms like "deep" can be misleading, especially when dealing with acute injuries. Clear and specific terminology can enhance clinical results and reduce ambiguity. CCEDseminars constantly strives to deliver premier chiropractic continuing education and blog posts that will elevate your practice! Click HERE for exciting resources!
In cases of acute injuries, the authors suggest using "gentle transverse massage (GTM)" instead of "deep transverse friction (DTF)" to better reflect the procedure's nature in this context. This emphasis on precise terminology can lead to more accurate application and better patient outcomes.
3. Interval Between Sessions
One of the areas that demand attention is the interval between TFM sessions, which is currently left at the discretion of the therapist. Pitsillides and Stasinopoulos propose a more structured approach. They argue that the healing process of tendons and ligaments, which have lower metabolic rates, can be enhanced by a systematic approach. They recommend treating tendons and ligaments every third day to strike a balance between collagen synthesis and degradation. This approach aligns with the biological characteristics of these tissues and promotes more effective healing.
4. Self-Treatment for Empowerment
A notable omission in the traditional Cyriax friction massage technique is self-treatment. The authors believe that educating patients to perform gentle transverse massage (GTM) on their own between sessions could lead to improved results. This empowerment allows patients to manage their pain more effectively, especially in cases where the analgesic effect of TFM is relatively short-lived. While the exact dosage of self-treatment remains a topic for further investigation, it holds promise in enhancing patient engagement and outcomes.
5. Rethinking Mill's Manipulation for LET
Cyriax's suggestion to always combine TFM with Mill's manipulation for lateral elbow tendinopathy (LET) is challenged by Pitsillides and Stasinopoulos. They argue that this restriction lacks empirical support and may limit the technique's potential. They suggest exploring alternative manipulations or considering a more individualized approach for LET treatment, emphasizing the need for well-designed randomized controlled trials (RCTs) to guide decision-making in this regard.
6. Tendon Positioning for Optimal Results
Another area of potential improvement lies in the positioning of tendons during the application of TFM. The authors propose that tendons should be placed in a stretched position, guided by the patient's perception of discomfort rather than pain. This adjustment could lead to better therapeutic outcomes by increasing the likelihood of aligning tendon fibers effectively.
7. Addressing Specific Tissue Characteristics
A fundamental shift in the approach to TFM may be required to address specific tissue characteristics. TFM primarily focuses on breaking adhesions and promoting collagen alignment. Still, it may fall short in addressing critical factors such as energy storage and release in tendons and tendon neuroplasticity. To provide more comprehensive rehabilitation, further research is needed to refine the technique based on tissue-specific parameters.
8. Conclusions
In conclusion, Cyriax friction massage has been a longstanding technique in chiropractic care for chronic pain management. However, its therapeutic efficacy has remained a subject of debate due to several factors, including terminology, interval between sessions, self-treatment, manipulations, tendon positioning, and the lack of consideration for specific tissue characteristics. If your passion is to master adjusting and manual therapy, click HERE for a link to exciting chiropractic continuing education!
The valuable insights provided by Alexios Pitsillides and Dimitrios Stasinopoulos encourage chiropractors and practitioners in the field to reconsider and modernize the application of TFM. While the technique shows promise, further research and adaptation are essential to make it a more effective tool in the chiropractic arsenal.
As the chiropractic field continues to evolve, embracing new perspectives and advancements like those presented in this blog post can contribute to improved patient care and outcomes. By enhancing chiropractic continuing education and embracing modernization, practitioners can better meet the diverse needs of their patients in managing chronic pain. CCEDseminars will strive to provide doctors world wide premium chiropractic continuing education!