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About Toolbook...
&About Comic Book Catalog...
AboutComicBookCatalog
Comic Book Catalog, Ver. 1.2,
From HeadFirst Software. For those who like
to keep track of their many and varied comic
books, here is your answer to organization.
Enjoy!
books, here is your answer to organization.
Enjoy!
This Toolbook application is SHAREWARE.
You are encouraged to evaluate this program.
If you find it useful, please register your copy by
paying nominal fee of $10. Thank you.
Registrations, comments, and suggestions
can be sent to:
Dane Basch (Headfirst Software)
2811 SW Archer RD
Apt. K-99
Gainesville, FL 32608
CIS #: 72027,3036
America On Line: DaneBasch
Sending in your fee will entitle you to receive a copy of this program without this "Beggar's Box."app
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G H2&
about
Comic Book Collecti, Version 2.0
Helps you to log and keep track of all your comics. Great for proof of ownership, documenting your collection for others, or to protect yourself against loss or theft.
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"About"
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About
Comic Book Collection Catalog, Version 1.2
t-injury, once the inflammatory phase has ceased
(6), the trainer can become more aggressive with the DTF alerting
the patient that pain will be experienced. A good rule of thumb to
follow is to back off if the numbing effects of the DTF are not realized
within one to one and one half minutes (3). Duration of DTF should
last approximately five minutes per contact point (2). Should the
lesion require moving the finger three times in order to completely
sweep the injury, then treatment time would last 15 minutes.
It becomes obvious how useful DTF can be as a therapeutic tool in
the training room. There is no equipment necessary which is beneficial
in the typical training room with a limited budget as in the high
school setting. All that is required of the trainer is the acquisition
of the skill of administering DTF through experience and the patience
of time required for administration when it is called for. The trainer's
hand skilled in DTF could hasten the recovery of an injured athlete
as well as insure that the likelihood of re-injury is cut down.
<+B>ACKNOWLEDGEMENTS
I would like to thank Ron DeAngelo for exposing me to this effective
form of treatment of soft tissue injuries sustained by athletes. My
thanks goes out to the rest of the "universally knowledgeable" staff
at the Palm Beach Institute of Sports Medicine for a most educational
internship. I would also like to thank Tracy Greene for her input
on the finer points of deep transverse friction and to Dane Basch
for the constant use of his computer. Final thanks go to Dr. Christine
Boyd Stopka for pushing me toward excellence in athletic training
and effective paper writing.
<+B>Deep Transverse Friction: An Effective Therapeutic Tool
In many athletic training settings, the trainer is limited to the
tools he/she can use for rehabilitation because of budget or lack
of technical ability. Deep transverse friction massage is a no-cost
technique that can be used in concurrence with traditional therapies
of ice, heat pacystem. Merely pressing
over a sore spot is likely to do nothing more than make the patient
uncomfortable (1). By following the pattern as outlined by Cyriax,
the therapist/trainer can bring about the physiological effects previously
discussed. Cyriax's method of DTF is as follows: (1)
1) The right spot must be found. According to Cyriax, all pain arises
from a lesion. It would stand to reason that unless this lesion is
located (through palpation and functional tests), DTF over healthy
tissue will afford no effect. The therapist must also be observant
of referred pain as well. DTF over a sore spot away from the lesion
will prove as fruitless.
2) The physiotherapist's fingers and the patient's skin must move
as one. Ointments and liniments would therefore be excluded when applying
deep transverse friction. DTF works because the overlying tissue is
that which moves over the lesion, not the therapist's fingers. If
the therapist's fingers are allowed to slide, friction is limited
to the surface between the moving parts (finger and skin).
3) The friction must be given across the fibers composing the affected
structure, hence the name deep <+">transverse <-">friction. Friction
applied across the fibers is called for because longitudinal friction
merely move blood and lymph along, whereas transverse frictions move
the tissue itself (1) affording the mechanical effects described earlier.
Longitudinal friction, applied distal to proximal, might be used following
transverse friction to afford the return flow of blood and edema toward
the heart (8).
4) The friction must be given with sufficient sweep. The entire lesion
must be manipulated for an adhesion reduced by half is still enough
to cause abnormal function.
5) The friction must reach deeply enough. All of the layers of overlying
tissue must be manipulated so that the friction reaches the affected
structure.
6) The patient must adopt a suitable position. The patient must be
made aware that some discomfort will be experienced during DTF.
7) Muscles must be kept relaxed while being given DTF. issue that
is contracted is difficult to mobilize. When the treatment is over,
however, the muscle should undergo a series of contractions so mobility
of the tissues can be maintained.
8) Tendons with a sheath must be kept taut. The sheath must be allowed
to move over the tendon lest the two move as one affording no effect.
Accompanying this pattern, Cyriax has also standardized hand positions
according to the tissue to be treated. These hand positions are as
follows: (1)
1) Index finger crossed over middle finger. This position is used
when applying DTF over a stabilized part. The thumb may be substituted
when using this hand position.
2) Middle finger crossed over index finger as when grasping a limb
with the thumb on the other side
3) Two finger tips as used for larger lesions.
4) Opposed finger and thumb as used for pinching.
As with any therapeutic modality, DTF has indications that call for
its use. The effectiveness of DTF is usually reserved for muscular,
ligamentous, and tendinous lesions.
DTF to muscular lesions is used to mobilize muscle tissue which breaks
adhesions that form between muscle fibers (1). This mobility achieved
through the breaking of adhesions must be maintained through full
contraction of the muscle affected. Cyriax states that these contractions
should come in the form of isometric contractions with the muscle
in its broadest state, or fully flexed. (1) I believe that exercise
in the form of low resistance and high repetitions will afford greater
vascularizing of the area and afford proprioceptive effects. Whatever
method is used, the muscle should not be taxed as to cause re-injury.
For muscular lesions, the action of DTF may be summed up as affording
a mobilization that passive stretching and active exercise (alone)
cannot achieve. (1)
DTF to ligamentous lesions serves to disperse blood clots and/or
effusives. Mobility of the ligament is maintained by breaking up adhesions.
Caution must be used when applying DTF to ligaments so as not to exacerbate
the injury by aggravating torn tissue (3). DTF will afford benefits
in first degree sprains, but proper healing time and/or surgical repair
should be allowed before administering DTF in cases of second and
third degree sprains.
DTF to tendinous lesions is used for tendons both with and without
sheaths. DTF for those tendons with a sheath is used to remedy cases
of teno-synovitis. In teno-synovitis, the tendon does not move freely
within the sheath causing pain and dysfunction. DTF serves to loosen
the sheath from the tendon. Transverse friction is utilized to reduce
the longitudinal friction occurring between the sheath and tendon
(1). DTF to those tendons without sheaths is used remedy cases of
tendonitis. In cases of tendonitis, the DTF is used to break up scar
that continually forms as a result of overuse (1).
As with any therapeutic modality that has indications for its use,
DTF also has its contraindications which include soft tissue infection,
hemorrhage or clotting disorders, inflammatory disease, malignant
tumors, any lesion located under a major nerve, and bursitis (1).
In the case of bursitis, the cause of the inflammation must be found
for bursae do not become inflamed by themselves.
By following this technique as outlined by Cyriax, the trainer can
expect the best results from DTF. Protocols for use of DTF vary according
to indication and severity of the injury. The trainer must literally
get the "feel" of DTF, but the technique is best administered progressively
according to the patient's tolerance. In the sub-acute stages, I have
found that DTF administered with the goal of fluid movement in mind
works best in that the athlete will more than likely be in a hypersensitive
state. At 48 hours post-injury, once the inflammatory phase has ceased
(6), the trainer can become more aggressive with the DTF alerting
the patient that pain will be experienced. A good rule of thumb to
follow is to back off if the numbing effects of the DTF are not realized
within one to one and one half minutes (3). Duration of DTF should
last approximately five minutes per contact point (2). Should the
lesion require moving the finger three times in order to completely
sweep the injury, then treatment time would last 15 minutes.
It becomes obvious how useful DTF can be as a therapeutic tool in
the training room. There is no equipment necessary which is beneficial
in the typical training room with a limited budget as in the high
school setting. All that is required of the trainer is the acquisition
of the skill of administering DTF through experience and the patience
of time required for administration when it is called for. The trainer's
hand skilled in DTF could hasten the recovery of an injured athlete
as well as insure that the likelihood of re-injury is cut down.
<+B>ACKNOWLEDGEMENTS
I would like to thank Ron DeAngelo for exposing me to this effective
form of treatment of soft tissue injuries sustained by athletes. My
thanks goes out to the rest of the "universally knowledgeable" staff
at the Palm Beach Institute of Sports Medicine for a most educational
internship. I would also like to thank Tracy Greene for her input
on the finer points of deep transverse friction and to Dane Basch
for the constant use of his computer. Final thanks go to Dr. Christine
Boyd Stopka for pushing me toward excellence in athletic training
and effective paper writing.
<+B>Deep Transverse Friction: An Effective Therapeutic Tool
In many athletic training settings, the trainer is limited to the
tools he/she can use for rehabilitation because of budget or lack
of technical ability. Deep transverse friction massage is a no-cost
technique that can be used in concurrence with traditional therapies
of ice, heat packs, and exercise to speed the recovery and re-admittance
of the athlete to competition. By following the methods as outlined
by Cyriax, the British physician that standardized the technique,
deep transverse friction can be effective in treating the soft tissue
injuries sustained by athletes. Through practice, the trainer skilled
in deep transverse friction gains a hands-on therapeutic tool which
costs nothing but could save time in the rehabilitation of athletes.
KEY WORDS;
deep transverse friction
friction
manual therapy
massage
transverse friction
<+B>REFERENCES
1. Cyriax, J., M.D. Textbook of Orthopaedic Medicine Vol.II 10th ed.
Balliere Tindall. London 1980. pp.11-14
2. DeAngelo, R.A. Personal communication, Boca Raton, Fl. 8-90
3. Greene, T.A., M.A., P.T. Personal communication, Gainesville, Fl.
4. Krusen, F.H., M.D., et al. Handbook of Physical Medicine and Rehabilitation
2nd ed. W.B. Saunders Co. Philadelphia 1971. p.381
5. Lamar, C.P., M.D., et al. Handbook of Physical Medicine. American