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Deep friction massage in the management of patellar tendinopathy in athletes: short-term clinical outcomes
Chaves P, Simoes D, Paco M, Silva S, Pinho F, Duarte JA, Ribeiro F
Journal of Sport Rehabilitation 2020 Sep;29(7):860-865
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

CONTEXT: Deep friction massage (DFM) is often used in the treatment of tendinopathies; however, the pressure applied may vary and interfere with the obtained results. OBJECTIVE: To assess whether the immediate effects of DFM on pain (pain intensity and time to onset of analgesia) and muscle strength are dependent on the pressure applied during the DFM application in athletes with patellar tendinopathy. DESIGN: Randomized, controlled, cross-over trial. SETTING: University research laboratory (institutional). PARTICIPANTS: Ten athletes with diagnosis of unilateral patellar tendinopathy (age 27.90 (5.24) y). INTERVENTIONS: All participants attended 4 sessions, 3 treatment sessions with DFM applied with different pressures (the mean pressure -- previously determined for each participant -- and the mean pressure +/- 25%) and a control session, each of which was separated by 48 hours. MAIN OUTCOME MEASURES: Pain (intensity upon palpation and time to onset of analgesia), and muscle strength of knee extensors were assessed before and immediately after each session. RESULTS: Pain intensity changed significantly over time (F[1,9] = 52.364; p < 0.001; partial-eta2 = 0.853) and among sessions (F[3,27] = 82.588; p < 0.001; partial-eta2 = 0.902), with a significant interaction for group x time (F[3,27] = 19.841; p < 0.001; partial-eta2 = 0.688). The knee extensors strength did not change significantly over time (F[1,9] = 2.240; p = 0.17; partial-eta2 = 0.199), nor a significant interaction for session x time was observed (F[3,27] = 3.276; p = 0.07; partial-eta2 = 0.267). Regardless of the pressure applied, the time to onset of analgesia was not significantly different (F[2,18] = 1.026; p > 0.05; partial-eta2 = 0.102). CONCLUSION: It was shown that DFM induces an immediate reduction in pain intensity upon palpation, regardless of the pressure performed. Notwithstanding, the reader should take into account the small sample size and the caution needed in the results' interpretation.
Copyright Human Kinetics. Reprinted with permission from Human Kinetics (Champaign, IL).

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