While going back through my posts, I found this tip hidden in the text: a cross friction rub.

The cross friction rub is a wonderful tip that was given to me by my first Seattle Physical Therapist, Travis Orth. The cross friction rub is done by applying friction perpendicular to the tissue that is in pain for approximately 1-2 minutes. Only apply enough pressure to feel like you are applying friction across the area as the tissue will likely be tender to the touch. The purpose of the friction is to help to increase healing in a tendon/ligament, particularly one that is inflamed and has been diagnosed with tendonitis.

After the cross friction rub, it is a good idea to ice the area. When using ice on your body, you may rub a cube of ice over the area: never stop moving the ice and stop after 2 minutes or when the area becomes numb. Or take a bag of ice covered with a towel and apply it to the area for 15 min being sure to check your skin. Ice can burn your skin – especially the ice packs. Regular ice has less of a chance of burning your skin because it melts on contact, but ice packs are more likely to cause skin burns because the chemicals inside the pack do not melt. As long as you keep this in mind and move the ice or ice pack regularly, the chance of ice burn is relatively low.

In my case, I have worked on my Posterior Tibial Tendons on my right and left ankles. After a run that has left my PTTs slightly inflamed (most runs, actually), I give myself a cross friction rub because it always makes the tendons feel so much better.  I do not usually ice my PTT because the ankles have less circulation and another physical therapist, Brian Crosier, recommended that I try allowing the feet and ankles to go through the normal inflammation cycle. I find that it is the same with or without ice in that area.

Note: This method does not work on all tendons/ligaments. For example, the Illiotibial Band (or IT Band) that has been diagnosed as having tendonitis, does not usually respond to the cross friction rub, although it probably won’t hurt you to try it. In addition, if you have bursitis and are trying to “work it out” by massage or cross friction rub, most likely it will only get worse as bursitis is an irritation of a bursa (a small fluid filled sack that provides cushioning around bones and ligaments). Massaging an inflamed bursa will only make it more inflamed. So, if you want to be sure you are on a ligament or tendon, check the location of the pain to look for a possible bursa (in joints of shoulder, hips, knees and elbows). This website has great illustrations: Bursitis – Mayo Clinic.