Cross friction massage is used to treat MCL sprains (medial collateral knee ligament sprains). Here elite level Sports Physiotherapist Neal Reynolds demonstrates how it is applied and when it is most suitable to use in the rehabilitation process.
Medically reviewed by Dr. Chaminda Goonetilleke, 31st Dec. 2021
The following is meant for information purposes. We always recommend seeking professional advice.
What is cross friction massage?
Always check for contraindications (which mean massage is not suitable or could be harmful) before attempting and sports massage treatment.
Cross friction massage is a specific massage technique that involves applying deep pressure backward and forwards across a ligament or tendon. It is often used in the treatment of medial knee ligament sprains to help stimulate the healing process and re-align newly formed scar tissue.
When can cross friction massage begin?
This will depend on the severity of your injury. Certainly do not apply massage during the acute stage.
- For a grade 1 MCL sprain you probably need to wait 4 or 5 days before attempting cross friction massage.
- For a grade 2 MCL sprain it should be 7 to 10 days or more before beginning cross friction massage.
The important thing is to allow the ligament to lay down new scar tissue and begin to heal. If you apply cross friction massage too early then you may damage newly formed scar tissue. It is better to be over-cautious than over-aggressive.
Massage to the MCL ligament is also beneficial much later in the rehabilitation process. Sometimes the ligament can stick to the bone underneath and freeing this up with massage can help with knee mobility and how the knee feels in general.
How often should I apply cross friction massage?
Gentle massage can be applied every day for a couple of minutes. Monitor how the patient feels afterward and the following day. If it is particularly sore then massage techniques may have been too aggressive.
Make sure the surface of the skin is clear from oil or anything that will make your hand slip. The aim is to apply deep transverse frictions backward and forwards across the ligament. Work with the skin. Your hand should not slip and slide over the skin. The aim is to ‘friction’ the ligament, not the skin.
Use one finger as the contact point on the skin and apply light pressure through the finger. Do not press too hard. Begin very very gently and apply for no more than a couple of minutes. Apply gentle but firm pressure in order to stimulate a healing response in the tissue, but not so hard that you further damage them.