What the heck is Fascial Stretch therapy?

In the diverse world of bodywork that includes massage therapy, chiropractic care & physiotherapy, there is a fantastic modality that has proven to be one of the more effective manual therapies I’ve encountered; as a patient and as a therapist. Surprisingly enough, it’s not commonly known to the average person. Although it has been around for quite some time, it’s beginning to gain more mainstream credibility with the amount of incredible therapists coming up. This modality revolves around manually treating the fascia, or fascial lines of the body.

What is Fascia? It is connective tissue, primarily collagen, beneath the skin that attaches, stabilizes, encloses, and separates muscles and other internal organs. The joint capsule that surrounds joints is involved in optimizing the mechanical function of the joint and is also part of the fascial network. When fascia and joint capsules are restricted, which could be due to injury, trauma, stress (emotional, mental and physical) muscle tightness, strains, and tears can occur, contributing to scar tissue formation, which inhibits movement patterns further in the fascial lines of the body. Here comes in Fascial Stretch Therapy! It is a unique system of manual therapy, which has proved to be highly successful in the treatment of common neuro-myofascial imbalances, disorders and dysfunctions. This method is recognized for restoring and maintaining healthy neurological, musculoskeletal and fascial systems. It includes assisted stretching which focuses on the muscles, joints, and connective tissue. With the client on a treatment table, comfortable straps are applied to stabilize inactive limbs and body parts to facilitate complete relaxation and effectiveness. The practitioner’s priority above all is to downregulate the nervous system by synchronizing their movement and breath with the client’s. What makes this therapy different from other flexibility programs is that each stretch begins with a light traction of the joint being treated. This allows for a deeper stretch by creating more space in joint. The stretches increase range of motion of the joint and extensibility of connective tissues, using multiple planes of movement. It is pain free and relaxing. This is an excellent treatment choice to improve flexibility & mobility, coordination of body segments, training recovery, injury prevention, and improve athletic performance. It is a very powerful therapy that can be used to treat many conditions such as disc herniation, facet joint dysfunctions, tight hips, rotator cuff injuries, chronic headaches, knee tracking issues, plantar fasciitis, and pinched nerves. It can also reduce inflammation, effusion and pain. It is also excellent for sedating the nervous system and therefore beneficial to psychological and emotional well-being. Clients will benefit from this technique as it restores, improves and maintains mobility as well as contributes to pain reduction and holistic wellness as a whole. It has even been shown to be more effective than massage and immediately after a session in regards to increase of range of motion and stability in the joints, lengthening of tight and short tissue and feeling overall excellent and energized. Many of my clients claim they have never felt so good before, feel many years younger and are revitalized. These are also clients who have tried every other modality under the sun; physiotherapy, massage, chiropractic care and more.

Although a truly efficient body-working modality, it is not for necessarily for everyone. At the end of this article, you will see a list of indications, precautions and contraindications out of the FST book by Chris and Ann Frederick. The practitioner needs to be mindful and discern the client’s health history if fascial stretch therapy is compatible with them.

Fascial Stretch Therapy and massage are highly compatible with each other in creating a treatment plan and flow. Usually my preference is to start off with stretching and then get into a massage treatment to avoid slipping and sliding on the client’s skin due to oil and also to not complicate changing and draping. If a client is wearing minimal active wear on the table (such as shorts and a sports bra), you may be able to modify the treatment without necessary draping and oil on throughout the stretch flow, similar to a sports massage. For example, the head, neck and shoulder series you can add myofascial release techniques and then flush the tissue with light oil application using effleurage and similar techniques before moving on the next stretch. Combining both principles can be extremely effective, basically combining both modality’s benefits. All of this really depends on the client’s goals and the practitioner’s treatment plan. There is also the consideration of switching up the modalities in different sessions. Some clients come in and want a stretch some days and then massage the others. Some like both in one session. The practitioner can assess the client per session based on their needs that day. You can discern what areas need focus on circulation and soft tissue work and where other areas need dynamic stretching. All in all, this offers immense creative healing opportunity in being able to use other tools in benefit of the client’s well-being.

In conclusion, as a fascial stretch therapist and massage therapy student, I’ve found combining both modalities to be highly effective in treating clients. It has increased my skills and intuition as a bodyworker and has allowed me to facilitate many people’s well-being and physical healing. One note I want to make that has not been mentioned, that although we don’t directly treat mental health conditions, FST has been the most effective at inducing emotional and trauma releases that are stuck in the body. If facilitated with appropriate therapeutic relationship skills, healing in the deepest, most meaningful manner is possible. I highly recommend all types of bodyworkers to take this course, and future clients to try it out, and set it free with FST!

You can view examples of how I use Fascial Stretch Therapy on my instagram account:

@embodiwork

Fascial Stretch Therapy, Ch 2, pg 33-35

Indications:

- Complaints of stiffness/tightness

- Pain conditions

- Hypomobility

- Co-ordination and balance dysfunction

- Muscle over-compensation/imbalances

- PTSD

- Desire to improve athleticism

Precautions:

- Lack of elasticity of CT in muscles and joints

- Hypermobility

- Skin disorders, including scleroderma or scarring from burns

- Sudden muscle tension

- Contractures

- Stimulation of DTR

- Lack of coordination and strength in the case of active movement

- Limitations imposed by other synergistic muscles

- Paralysis

- Spasticity

- Congenitally long or short ligaments and tendons

- Bone and joint structure limitations

- Gender, for example, pelvic structure

- Hormones such as relaxin

- Pregnancy

- Body fat/obesity

- Significant postural syndromes, such as scoliosis or kyphosis

- Inflammation and effusion

- Pain- stretch threshold or tolerance

- Fear

- Immobilization in a cast or splint

- The presence of any simultaneous movement in another direction.

- Body mass- e.g. large biceps or quads limits flexion

- Temperature – decreased elasticity with cold

- Age, for example, increased collagen disposition

- Ethnic origin differences in pain tolerance

- Training, for example, DOMS or over-training makes one tighter, stiffer, tender

- Circadian variations

- Vocation – sitting all day vs standing all day

- Medications

- A full bladder

Hard contraindications:

- Unmended fractures

- Acute infection and/or injury

- Whiplash

References

Frederick, A., Frederick, C., & Myers, T. W. (2014). Fascial Stretch Therapy. East London, UK: Handspring Publishing.

Frederick, A., & Frederick, C. (2017). Stretch To Win. Champaign, IL: Human Kinetics.