Front Matter

122 Canine Sports Medicine and Rehabilitation

can be measured with a Gulick girthometer and
documented in centimeters (Figure  6.1) or it
can be palpated and documented as minimal,
moderate, or severe.

Soft tissue treatment

Varying physiological states are treated using
different STM techniques. For example, effusion
is most effectively treated with longitudinal
strokes of moderate pressure; whereas a muscle
spasm will respond better to ischemic compres­
sion. Once the goal of your soft tissue treatment
is established, the most appropriate technique(s)
can be applied.

Treatment goals

The following are common treatment goals:

● Increase circulation.
● Decrease swelling.
● Increase tissue extensibility.
● Reduce adhesions.
● Increase scar mobility.
● Eliminate trigger points or tender points.
● Promote tendon and ligament healing.

● Increase ROM.

● Decrease pain.

● Decrease muscle spasm.

● Facilitate or inhibit neuromuscular activity.

Techniques

The choice of technique for a particular condi­

tion will depend upon the goal of treatment, the

size and shape of the muscle, tendon, ligament,

or fascia, and the pathological state of the

tissue.

Effleurage consists of long slow strokes, gener­

ally light to moderate pressure, usually parallel

to the direction of the muscle fibers (Figure 6.2).

Petrissage involves short, brisk strokes, mod­

erate to deep pressure, parallel, perpendicular,

or diagonally across the direction of the muscle

fibers. It may include kneading, wringing, or

skin rolling (Figure 6.3).

Tapotement is rhythmic, brisk percussion

often administered with the tips of the fingers;

primarily used as a stimulating stroke to facili­

tate a weak muscle (Figure 6.4).

Cross‐friction massage (also known as deep friction

massage) was made popular by one of the foremost

specialists in the diagnosis and treatment of mus­

culoskeletal injury and pain syndromes, British

physician James Cyriax. He proposed that the

goals of cross‐friction massage were to enhance

tissue mobility, prevent scar tissue build‐up, and

increase cir culation (Chamberlain, 1982). Cross‐

friction massage is performed by applying moder­

ate digital pressure perpendicularly across the

desired tissue (Figure 6.5). Pressure is maintained

in such a way that the finger does not slide across

the skin, but rather takes the skin with it. In so

doing, the force is transmitted directly to deeper

tissues. Cross‐friction massage is commonly used

on tendons, ligaments, and well‐healed scars in

order to promote realignment of noncontractile

fibers. It has been shown to be effective in enhanc­

ing pain reduction and ROM when used as an

adjunct therapy to therapeutic exercise (Sonkusale

et al., 2016).

Ischemic compression is performed by applying

sustained moderate to deep pressure to an area

of localized hyperactivity. It is a therapeutic tech­

nique in which blood flow to a local area is inten­

tionally blocked. It is believed that a resurgence

of local blood flow will occur upon release. Once

discomfort is reduced, increased pressure is

applied. Ischemic compression is thought to

Figure 6.1 Measurement of stifle joint swelling using a
Gulick girthometer.