Hi Joshua !

can you give an explanation of what this is ?

there seems to be a lot of support for massage alongside ice therapy for tendon pain

and I have noticed cross fibre friction massage seems to be a popular choice

can you give us folks an idea of what it is and how we can do it for ourselves ?

have a nice day


Joshua Answers:


Cross fibre friction is a technique where, essentially, one massages back and forth perpendicular to the tendon direction.

So if you have Wrist Tendonitis where you have a specific spot of wear and tear damage and scar tissue build up, you could 'fix' that spot of damage.

The way you would do that with cross fiber friction, is to rub back and forth across the tendon at that point, and the area close to it.

You can also go up and down along the tendon, or do circles. For most people it doesn't matter that much, the important part is to get in there and rub on it.

Gently at first, then work in firmer and firmer. You are essentially grinding the tissue until it's soft and gummy and pain free instead of dry and crunchy and painful/tender.

Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.

Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert

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Feb 22, 2010
thanks joshua
by: Anonymous

I feel a lot of my pain is due to stiffness as I am very worried about using my ankle and maybe massage will lossen the area up.

most grateful

Aug 28, 2010
It works
by: jim

I am in second day of my friction massage therapy, followed by ice massage. With friction massage, my dequervain tendonitis pain goes away almost immediately. It comes back after a few hours. Hope this completely goes away with time.


Joshua Comments:

Ta Da!

Tendonitis is not a one time fix. It takes time and diligence. Having said that, depending on what you have going on, it doesn't have to take long.

It's a really good sign that some self massage takes the pain completely away. Keep at it, do some ice massage and see what that does, and keep at it.

Oct 26, 2010
massage on the knee ligament causes me more pain
by: Sam

Just a quick question. Is it bad that this technique seems to make my knee tendon more sore? I`ve tried really getting in there with a hard massage and it seems the next I wake up with even more pain? I`ve heard of many people that have had positive results. I feel like a light massage doesn`t really get to the spot. How much pressure is needed to get into all that nasty scar tissue?


Joshua Comments:

Hey Sam.

It's fine to get in there and make it sore. Of course, don't do -too- much.

However, don't focus just on that spot. Work all the tissue around it too. Adductors, hamstrings, quads, hips.

It's safe to say your knee pain is from muscles/connective tissue that is too tight and putting undue pressure on that specific spot.

Where exactly does your knee hurt?

Aug 13, 2013
infra red heat for levaquin tendonitis and knee pain?
by: bob

I have had tendonitis all over, worst in the knees, for 2 months since taking Cipro. I STILL CAN NOT DRIVE AND HAVE MUCH TROUBLE WALKING, I have been doing a lot of ice packs and recently some ice massage. I am wondering about the far or near infra red heating devices. I am wondering if they would be useful now or at some point. The manufacturers say they are good to use with a new injury even while there is still swelling. to me it seems counter productive to add heat to an inflammed area though it is suppose to promote increased blood flow to the area.


Joshua Comments:

Hi Bob.

Sorry to hear that.

Unfortunately, you don't have an 'injury'. You've been poisoned and your body has been massively depeleted of various nutrition. 'Massively' might be an overstatement, so let's just say, you've been depleted enough to cause your symptoms.

Those symptoms may include injury, as far as soft tissue damage, but it's not like injury from stepping on a nail, it's more like injury from drinking gasoline. My point is, you have to deal with the poison, and deal with the effects of the poison.

Far infra-red lasers and heat aren't going to help a Cipro problem in any way shape or form. Ice will help to temporarily reduce pain levels, but does not beneficially affect the CAUSE of the pain and problem.

It's time to start educating yourself about Cipro, and time to start taking steps to give your body the best opportunity to recover.

Cipro tendonitis is not regular tendonitis, not even close. I'd start here: Levaquin Tendonitis

Sep 16, 2013
Number of cross friction mobilizations
by: Matthew

My son has been seeing a therapist for 1 month for his tendonitis problem. How many cross friction mobilizations does it take to relieve and/or know it may be a different problem that requires different measures?


Joshua Comments:

Hi Matthew.

1. What kind of symptoms does your son have?
2. What kind of therapist are you seeing?
3. How many sessions have been done?
4. What exactly happens at these sessions?
5. Why do you think it's tendonitis?
6. Is there any actual tendon injury (rip/tear of any size)?

Sep 18, 2013
Back to Infra red
by: Bob

I have noted your comments on far infra red. You may be right but tell me why why it will not help.

Infra-red increases the blood flow to the area. If its used in conjunction with the ice massage would that not be a good therapy for blood and fluid exchange to the affected area.

I have had massage twice since taking cipro two months age and it makes me hurt worse. Any chance this is doing more damage? I am already addressing nutritional (I have your book) but after 3 months I am trying to speed up the healing.


Joshua Comments:

Hi Bob.

1. If we're talking Cipro Tendonitis then infra red (and massage, and rest, and stretching, and physical therapy, and ultrasound, and exercise, and and and and are all in the entirely wrong category of care. Cipro pain/problem is a system, nutritional depletion dynamic. More blood to an affected tendon is not a bad thing, and is beneficial, but totally misses the crux of the issue.

Having said that, you're working with The Levaquin Tendonitis Solution so you're talking/asking about speeding up recovery.

Ok good.

2. In that case, yes, more blood flow is helpful. Tendons don't have direct blood supply like muscle does. So anything extra you can get to it is good. Massage squeezes the sponge and moves fluid. Infrared can bring more blood to an area, but remember, tendon doesn't have direct blood supply.

Is infrared better than no infrared? Probably. Used with ice? More probably (becauuse more fluid is moving around). With massage or ice and massage? MUCH more probably, since you're directly moving fluid to/around the tendon.

3. In general I say 'infrared doesn't work' because in isolation, it won't. It can be a helpful component, but in an of itself it's not a 'fix'. And people look at infrared, and ultrasound, etc, as a singular 'fix'.

Pain is a multi-factored dynamic, and requires treatment for each of those factors.

But overall, yes, if you're interested in faster healing (keep in mind that tendon only heals so fast anyway), more blood flow is a very smart strategy.

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