The Elbow - Golfers elbow, deep transverse friction

Execution

The patient lies on the couch with the arm abducted, the elbow in nearly full flexion and fully supinated.
The therapist sits or stands next to the patient and holds the forearm in supination with his ipsilateral hand.
The medial epicondyle is easily seen and palpated.
In a type two lesion, the tenderness is found about five mm distal to the border of the epicondyle.
Treatment is given with the index finger of the contralateral hand, eventually reinforced with the middle finger.
Counter pressure is given with the thumb at the lateral aspect of the elbow.

Friction is produced by an adduction of the arm and a simultaneous extension movement at the wrist which moves the fingers in a lateral direction, transversely over the tendon fibres.
The hand pivots around the stabilised thumb.
During the friction one feels the tendon fibres move under the finger.

During the passive phase, the index finger is brought back
to the starting position, where after the same procedure is repeated.
This to- and fro movement is performed without loosening contact with the skin.
This prevents friction on the skin and formation of a blister.
see: common principles technique deep friction

These movements are repeated with a frequency of about 60 to 80 movements
per minute during about twenty minutes.