Massage Therapy Journal Spring 2025

56 • Massage Therapy Journal

Areas of Possible Nerve Entrapment Nerve

Entrapment Area

In the axillary region, deep to the axillary and upper brachial arteries. Also the proximal forearm near the supinator muscle. 60

Radial nerve

Branches of the brachial plexus

Deep to pectoralis minor and between the first rib and clavicle.

In the quadrangular space, which is bordered by the surgical neck of the humerus, inferior aspect of teres minor, long head of triceps and superior aspect of the teres major. 61

Axillary nerve

Suprascapular nerve

At the spinoglenoid or suprascapular notches. 62

In the radial groove of the humerus or deep to the supinator muscle at the radial tunnel. 63 Deep to the bicipital aponeurosis, deep to Struther’s ligament, the carpal tunnel and between the two heads of the pronator teres muscle. Also in the carpal tunnel. 64

Radial nerve and posterior interosseus nerves

Median or anterior interosseus nerves

Ulnar nerve

In the cubital tunnel or Guyon’s tunnel. 65

Cross Fiber Friction: How-To and Contraindications Cross fiber friction , also known as deep friction technique, is a focused, deep, non gliding soft tissue technique where the force moves perpendicular to the fiber direction of a muscle or tendon. This technique is generally done with the thumbs or fingers. The goal is to mobilize dense tissue, increase range of motion, create a local inflammatory response or increase local blood movement. Deep friction massage was developed by Dr. James Cyriax to increase muscle, tendon and ligament mobility. Some clients report tenderness at the site for 24 to 48 hours. Potential Contraindications or Cautions to Using Cross Fiber Friction • Anticoagulant or antiplatelet medications • Local bacterial infections • Bruises • Local bursitis • Local skin diseases • Areas of decreased sensation • Fragile skin

AMTA Continuing Education

Steps for Cross Fiber Friction 1. No oils, creams or lotions on the skin are necessary. 2. Warm the area up with some petrissage or effleurage. 3. Assess the area for restrictions. 4. Apply pressure to immobile tissue.

5. The pressure must be enough to access the muscle or ligament layer, but you need to stay within the client’s pain threshold. The pain should not be more than a 6 or 7 out of 10. Use fingers or thumbs to move across the fibers of the muscle. 6. Continue to cross fiber the area for 10 to 30 seconds. 7. Reassess to see if there has been a change in the mobility of the tissue. Muscle Stripping: How-To and Contraindications Muscle stripping is a specific technique that glides along with the muscle fiber direction. This technique is generally slow, deep, and specifically gliding over the length of a muscle or tendon. The aim is to decrease trigger points, stretch fascial components of the associated muscle and restore muscle fibers to functional capacity.

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