The Elbow

Technique:

• The patient sits with his arm rested on the couch. The elbow is held in 90° of flexion and the forearm in neutral position between supination and pronation.
• The therapist sits at a right angle to the patient's arm. Friction is performed by the contralateral hand. The other hand stabilises the forearm.
• The therapist palpates at the anterior aspect of the forearm for the muscle belly and for local tenderness. The search is facilitated by an active pronation by the patient.
• The fingertips of index and middle finger are placed at the ulnar side of the tender area.
• The thumb is placed at the lateral aspect of the forearm to give counter-pressure.
• The active phase of the friction is a lateral movement of the fingers across the muscle fibres .
  The fingers are then brought back to the previous (starting) position, medial of the muscle belly (the passive phase of the movement).
• This alternating movement is performed with a sequence of about 90 per minue for fifteen minutes.
• Fingers, skin and subcutis move as a whole over the muscle fibres.>