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My First Visit with Transverse Friction Massage

Posted by elyse b on 6/14/04 at 17:26 (152976)

Okay here is what happened. I saw a holistic chiropractor who is certified in transverse friction massage, active release technique, myofacial release and graston technique. We talked all about the questions I had and I told him about Dr. Sandell etc. etc. Of course he would not comment on Dr. Sandell's 'cure.' He did say that he has an extremely high success rate treating PF patients but it could take 3 weeks, 3 months or a year. No guarantees like Dr. Sandell who seems to be able to make that kind of statement. We are talking about $125-$150 a session.

He checked my feet out first and using his fingers to see if it hurt in what particular areas. We decided it was basically my arches and less in my heels. Then he did the graston technique, using a silver tool and running it over my feet. It was definitely painful but nothing one could not tolerate. There was scar tissue and I guess he was breaking it up. His feeling is that he is not going to use just one modality, i.e. TFM but myofacia release, graston and ART all of them in combination. Then he pressed his fingers into my feet. He then released the tightness in my hips with Active Release and myofacia release. He worked a little on my calf muscles but not too much. He gave me one stretch to work on and nothing else until the next visit, the stretch where you pull back on your toes to stretch the fascia. It is his thinking that with the pressure he is putting on my feet (TFM, ART etc.) that he does want me to do anything other than be gentle.

Okay my feet feel extremely sore. Did he tell me to run? No. Did I feel anything breaking up in my feet, kind of but not exactly, it was almost like it had to be breaking up because of the tool. He definitely did not spend an hour with me like John from MN says Dr. Sandell does. After reading up on TFM, it says it should not be done for more than 10 minutes.

I will be interested in hearing what Goose says about her first treatment and the comparisons. I do have to say I expected the doctor to be extremely arrogant, he was not, being holistic, he was very into having positive thoughts and energy which is difficult with PF.

He did say he does more than a physical therapist would do. Do I believe it, I am not sure. I think that the ability to have all the modalities available in one place is a plus. To me the combination of ART, graston and myofacial release is something a physical therapist cannot do or at least the ones I have called cannot do. They seem to only be able to do deep tissue massage and they call it TFM.

John from MN says 4 sessions and he was on the road to recovery, this doctor makes no guarantees like that. It is a tough decision, it so prohibitively expensive that I am going to go for 4 sessions and re-assess. I will write again in the morning to see how I feel.

P.S. he was not so enamored with orthotics.

Elyse

Re: My First Visit with Transverse Friction Massage

Dr. Z on 6/14/04 at 18:44 (152978)

Please keep us updated with your progress

Re: My First Visit with Transverse Friction Massage

HilaryG on 6/14/04 at 18:55 (152980)

Do you mean that he was not enamored with YOUR orthotics or with orthotics in general?

Re: My First Visit with Transverse Friction Massage

Place on 6/14/04 at 19:05 (152981)

Thank you so much for the detailed description, I have my first apt. on Wed with someone certified in Graston. It will give me something to compair it with. I have a feeling that most use a combination of modalities to take care of the problem. I have found temporary relief with the ART but nothing that does not last longer than a day =(. Good luck and keep us posted on your next visit!

Re: My First Visit with Transverse Friction Massage

Pauline on 6/14/04 at 19:33 (152984)

Elyse,
Thank you for the update. I think we are lucky to be able to have both you and Goose reporting back on your treatments and comparing them on line.

This will give us really good feed back if others want to go forward with this treatment. When it comes to P.F. I guess there isn't anything that isn't expensive from purchasing shoes to trying different treatment.

If this works it will be a blessing for everyone especially those that use it for relief.

Can you explain graston technique. I know nothing about that one. How does it differ from the others?

Got my fingers crossed for you guys.

Re: My First Visit with Transverse Friction Massage

Pauline on 6/14/04 at 19:38 (152986)

Do you think he thought your own foot muscles should be doing the work of your orthotics? I've had some doctors tell me they felt this way. Similar to leaving a neck brace on too long. It helps but if you rely on it all the time you're muscles would become weak.

Re: My First Visit with Transverse Friction Massage

elyse b on 6/14/04 at 19:38 (152987)

orthotics in general. He did not even look at my orthotics. Which is different than John H's visit to his physical therapist who was very concerned with biomechanics. My doctor and it seems that Dr. Sandell are less concerned with the biomechanical issues than the break up of tissues. It is a mystery to me because I thought it was the biomechanics that caused this. Again I think there is no one treatment that is better than any other. One has to try them all and see what works. I find it interesting that this doctor who accepts no insurance and who is so expensive would not give me a time limit or an average time frame of his treatments. I have all kinds of thoughts on this, why would I continue this treatment with it being so expensive with no timeframe as opposed to physical therapy which is covered by insurance. A dilemma for sure.

Re: My First Visit with Transverse Friction Massage

elyse b on 6/14/04 at 19:43 (152988)

Pauline see the posting from earlier where I compared ART to Graston. http://www.grastontechnique.com/

They use a silver tool which is very thin which comes in different sizes. They run it over the scar tissue and I assume it works like TFM and it breaks it up.

this is beyond expensive Pauline, $125-$150 a session with no timeframe. I need to mortgage my apartment.

I am conflicted about what to do. I do have a prescription for physical therapy but again as I said earlier, it is very different.

Re: My First Visit with Transverse Friction Massage

elyse b on 6/14/04 at 19:46 (152989)

he was very vague on the orthotic thing. He even had me walking around barefoot. I said I am not supposed to and he said why not? Go figure. I think he feels that when you are in the throes of PF,orthotics just inflame your feet even more. He said he does make them but he would rather not. Again I was a bit confused with all the info flowing into me that I did not get into it. I did speak with a physical therapist this morning as well and he too told me that he felt orthotics were way too overprescribed.

Re: My First Visit with Transverse Friction Massage

Pauline on 6/14/04 at 19:52 (152991)

Elyse,
When I had Transverse friction it was done by a physical therapist. The gal from South Africa as I mentioned before. Since my insurance covered P.T. the treatment was covered no matter what she did.

Any chance of doing the same? $150 a crack is hard to take with no end in sight and no promise of help.

Re: My First Visit with Transverse Friction Massage

Pauline on 6/14/04 at 20:01 (152992)

My personal opinion about orthotics has always been that they have become an easy money maker for many doctors. Some people may actually need them, but many probably don't, but when you're in pain you'll try anything.

Just as some people are born with crooked noses not all of them need to have them straightened, yet many doctors have made bundles straightening septums.

Re: My First Visit with Transverse Friction Massage

Dr. Z on 6/14/04 at 20:31 (152993)

Hi

When you were told to pull you toes back I think the purpose is to try and excercise the intrinic muscles inside the bottom of your foot. The plantar fascia is just too thick to be able to stretch

Re: My First Visit with Transverse Friction Massage

elyse b on 6/14/04 at 20:35 (152995)

I have an appointment with a physical therapist next week and will discuss TFM with him. In PT they do electronic stim and ultrasound which never much of a difference to me. when I spoke to him today, the PT did not hold much water with TFM. Yes $150 is a lot of moolah with no promises.

Re: My First Visit with Transverse Friction Massage

elyse b on 6/14/04 at 20:37 (152996)

Pauline although not an expert nor have I been suffering with PF for more than 3 months, the only thing I can say is that I am now back to wearing my regular shoes as orthotics hurt my feet. That is why I am throwing out $150, I will try anything. It will be interesting to see how I feel in the morning.

Re: My First Visit with Transverse Friction Massage

elyse b on 6/14/04 at 20:38 (152997)

this not a new exercise, every single person I have seen has told me that one. He actually said leaning my foot against the wall would be a better stretch for the fascia as well as stretching the calf and achilles.

Re: My First Visit with Transverse Friction Massage

Pauline on 6/14/04 at 21:53 (153002)

Dr. Z,
Do we simply stretch the same muscles by wearing night splints? Do they have any effect in stretching the P.F?

Re: My First Visit with Transverse Friction Massage

Dr. Z on 6/14/04 at 23:09 (153004)

Pauline

Nite Splints either hold or stretch the posterior calf muscles. They probaby do stretch the intrinic foot muscules. It is my opinion that there is little to no stretching of the actual plantar fascia. The plantar fascia is just too broad, thick and unable to stretch.
I agree with the theory that one of the causes of plantar fascia is that the intrinic muscules are weak and unable to function correctly as one of so called biomechanical factors that contibute to plantar fascitis , with repetitive motion being important another factor.

Re: My First Visit with Transverse Friction Massage

Dorothy on 6/14/04 at 23:28 (153005)

I'm just dropping in here in the middle of your discussion about your PT contact and quandary about your future plans - BUT - it sounds to me as if you are not confident in this person/place and are confused about what you are told and are skeptical/irritated about the charges. Why not back off and reconsider and/or continue to look for someone/a place that is more compatible with YOU??

Re: My First Visit with Transverse Friction Massage

john h on 6/15/04 at 09:01 (153029)

Most family doctors should have no problem issuing a prescription for PT for PF. I asked my Dorctor and she said no problem and gave me a prescription for 3 times a week for 6 weeks. She let me pick my own PT. Elyse do you have insurance? Why not ask your primary card Doc for some PT?

Re: My First Visit with Transverse Friction Massage

john h on 6/15/04 at 09:14 (153035)

The time limit with the PT is going to be the number of visits issued on your prescription from your family Doctor. You can rest assured your PT will use them all as that is how they make a living. At the moment I am less impressed with my PT than I was on my initial visit. Not a lot of TM but the normal things you would expect. The more little procedures they can perform such as ultrasound, electronic stimulation. the more they can bill so you can bet you will get these whether they help or not. So far the positives I am getting out of this is he has galvanized me into a stretich program (it is up to me to do it) and seems to think the orthotic he has casted 'may' help. It is not a rigid one and he said it was barely a semi rigid type. He really seemed to know what he was talking about when it came to orthotics as that was one of his primary jobs for several years at a large hospitals rehab center. Yesterday he told me I probably over stretched and to take it easy. More is not better. As those of you who have been to PT you know the therapist is often working with 3-4 people at the same time. Being selfish I want all his time. Sort of reminds me of some of the girls I used to date??? Three treatments now. One day better, one day worse, and one day the same. I will always say that any Doctor who 'promises' you a cure you should consider moving on fast. Even my PT says he hopes to have me show improvement after the therapy is complete. The question of a promised cure is so ludicrous I would not even pose it.

Re: My First Visit with Transverse Friction Massage

john h on 6/15/04 at 09:55 (153044)

Pauline: I was asking the PT about some of the exercises he was having me do and he said he was trying to work 'all' the muscles in my feet. He also said yesterday to try not using ortotics off and on to see what difference I might notice. He said he has PF on occasion and finds that some days orthotics make it better and some times worse. He is really not big on our axiom of never going barefoot. Actually, I have never found that going barefoot around the house makes any difference one way or the other.Watching the PT do transverse massage I just do not see a lot of different ways you can massage a foot. You can vary the pressure. You can vary the direction. You can give it fancy names but in the final analysis a rose by any other name smells the same. I do think massage therapy by any name can be very beneficial in increasing blood flow, perhaps breaking up adhesions and scar tissue. I do not think we can give it a fancy name and present it as a cure all. I do not expect this thearapy to cure me but will be very satisfied it it can improvement my foot condition 1-2 points in pain level. I have never heard Dr. Ed or Dr Z say ESWT will cure you. I have heard them indicate it might cure you or it might help you and they present it as a good alternative to surgery which makes a lot of sense to me..

Re: My First Visit with Transverse Friction Massage

Pauline on 6/15/04 at 11:06 (153067)

John,
I tend to agree that over the years many different names have probably been given to various forms of massage. They probably differ by the depth of pentration, speed, and intensity.

The P.T. from Africa that frictioned away my first case of P.T. never called it anything. She just did it and it hurt. The one thing that I remember most is the pain and the fact that after the painful massage she always rubbed my feet toward my heart.

I was iced afterward which might carry a double edge sword. Yes ice to calm the area down, but since the circulation was just stimulated why not allow it full blood circulation instead of icing immediately?

I can only tell you I loved the ice. It was put directly on the skin unit my foot seem to freeze. At first it was very cold, but eventually I got used to having ice directly on my skin as it quickly numbed the foot against the cold feeling.

There certainly wasn't any magic in her treatment. She had treated lots of barefoot runners and this is how she did it. She was successful in the treatment provided because of the way that she did it. It was her hands.

The time that she was absent the treatment wasn't the same. The intensity and depth just wasn't there.

I had P.T. 3 times a week for over 4 months. It took a month before I began to notice any difference meaning that my foot felt slightly better and it began to feel less tight.

My Rolfing experience was far different and I would not recommend Rolfing to anyone. My entire body was Rolfed not just my feet. It felt like each and every muscle was being torn and seperated during the treatments actually disected out by the hands of the Rolfer. I walk away from this treatment fast. I tried it when P.F. made a second visit into my life thinking it was similar to the massage I had experienced before. Boy was I wrong.

Re: My First Visit with Transverse Friction Massage

Dr. Z on 6/15/04 at 11:13 (153069)

Pauline,

What do you base your opinion with orthosis. You are giving the impression that they just aren't needed.

Re: My First Visit with Transverse Friction Massage

Elyse B on 6/15/04 at 11:21 (153072)

Yes I have insurance and I have a prescription for PT and am going to start on Tuesday. I still think there is something to this guy as my feet feel pretty good today but way, way, way too early to tell.

Re: My First Visit with Transverse Friction Massage

Elyse B on 6/15/04 at 11:23 (153073)

I concur with you. I have been in PT many times before with my knee issues and shoulder issues. I know exactly what to expect and exactly how much time they can give. I am wondering if coupled with the graston/TFM guy it will help. I am not a huge fan of ultrasound and electronic stim. Per my guy last night I am to do only one stretch and that is what I will do until I see him on Thursday.

Re: My First Visit with Transverse Friction Massage

Pauline on 6/15/04 at 11:47 (153076)

Dr.Z,
I don't think I left that impression at all.
Maybe you read my post toooo quickly and missed the words 'need them'.

'My personal opinion about orthotics has always been that they have become an easy money maker for many doctors. Some people may actually need them, but many probably don't, but when you're in pain you'll try anything'.

Re: My First Visit with Transverse Friction Massage

Dr. Z on 6/15/04 at 13:03 (153093)

Its the over all impression with words such as ' Some people may actually need them' , but many probaby don't. I didn't think that was what impression you wanted to give.
Orthosis have been used by not only podiatrists, but many other doctors. They should be a consideration and part of the treating doctors armentation.
The only qualified person that can determine if they are needed is the doctor who has the experience and biomechanical expertise.

So I ask you what do you base your opinion on that Some may actually need them but many probaby don't.