Abstract
Deep transverse friction (DTF) is used in clinical practice and by its nature it may cause muscle injury. This study investigates the morphologic and morphometric changes in untraumatised rabbit skeletal muscle treated with DTF.Method: 16 New Zealand white rabbits were studied. The right vastus lateralis muscle was used as a control and the left vastus lateralis was treated with DTF. Muscle biopsies were taken 10 min, 24 h and 48 h after 1 treatment, 48 h after 2 treatments and 48 h and 6 days after 3 treatments. Treatments were 48 h apart. Biopsies were prepared for light microscopy and tissue morphometry.Results: After 1 DTF treatment, intracellular and extracellular oedema was noted. Contraction bands seen throughout the fibres suggested severe mechanical trauma to the muscle. 48 hours after 1, 2, and 3 treatments, the muscle appeared to be recovering with reduced oedema, and the contraction banding was limited to small focal areas throughout each fibre. Six days after the last treatment, the myofibers, although normal in diameter, showed small focal areas of super contraction and large internalised inclusion bodies composed of a pool of myofilaments or whorls of membranous material. Morphometry showed oedema to be maximal immediately after treatment.Conclusion: DTF causes a severe but reversible injury to untraumatized myofibers. Its possible mode of action in treatment of injured muscle requires further investigation.
Highlights
Deep transverse frictions (DTF) have been part of the physiotherapists’ arma mentarium for many years
There is a reduction in myofibre oedema 48 hours after DTF, and 6 days post DTF the myofibres have returned to control dimensions
This study shows that DTF causes a reversible muscle injury, which initiates an inflammatory response expressed in the form of muscle and myofibre oedema and myofibre super contraction
Summary
Deep transverse frictions (DTF) have been part of the physiotherapists’ arma mentarium for many years. Despite its acceptance by practitioners there is little scientific evidence to support its use, and to date there has been no sys tematic review of the efficacy of deep transverse friction treatment. Further more, the treatment is painful and has potential to cause further damage. Cyriax and Russel popu larised the use of a technique called deep transverse friction (DTF) massage, which provides therapeutic movement over a small area (Cyriax and Russel 1977). The potential advantage of DTF is that it allows pressure to be applied at greater depths within muscle and it has been advocated for treatment of muscle strains and tears, tenosynovitis, tendinitis and ligament sprains. A potential dis advantage is that sustained direct pressure on muscle is known to damage skeletal myofibres (Mars and Hadley 1998)
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