These are very localised manipulations performed with the fingers or thumb. They may be applied transversely across muscle fibres or in a circular movement. They are deep movements performed with much pressure. The pressure may be selected at the commencement and kept constant throughout, as is usual with transverse frictions, or the pressure may get progressively deeper, as with circular frictions. The pressure must, however, be completely released before moving on to a new area. Frictions are performed on dry skin, free of oil or talcum powder, so that the fingers move the skin and do not slip over it.

Remember these are specialised movements, used when localised depth and pressure is required. They should not be confused with digital or thumb kneading, which applies constant upward pressure using a circular movement.

Fast stroking is also sometimes referred to as brisk friction because the hands do apply friction to the area, but this covers a large area and is not localised.

Circular frictions: technique

These are small circular movements performed by the fingers or thumb.

1 I The stance is usually walk standing.

Select and examine the small localised area where frictions are required.

Stroke it gently with the sweeping thumb or palm.

Figure 5.10 Circular frictions to tension nodules in trapezius.

^^ Use the thumb or the fingers: the middle finger is usually used to reinforce the index and ring fingers.

^^ Do not hyper-extend any joints when applying pressure, as this will strain and damage the joints. Keep the fingers straight.

^^ Circular frictions are performed in small circles, moving deeper and deeper into the tissues to a maximum depth, then released. Repeat three to four times over the same spot and then move to another area as required.

^^ The fingers or thumb must not slide or rub over the surface of the skin, but the superficial tissues must move with the fingers over the deeper ones.

^^ Areas requiring frictions may be tender and care must be taken not to cause unnecessary pain through excessive pressure.

^^ Effleurage or stroke the area frequently between friction manipulations and at the end of the treatment.

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