Jun 20, 2018In Full Swing
One, two, three … harder, stronger, hold, hold. Okay, now relax.” We’ve all seen proprioceptive neuromuscular facilitation (PNF)-assisted stretching start this way: An athlete lies down with their foot on the athletic trainer’s shoulder, pushing with all of their strength, grimacing, and holding for a count of 10. Recently, an alternative type of stretching has gained traction that builds on the foundation set by this conventional method — but with some important differences.
Called fascial stretch therapy (FST), this technique moves and stretches the body’s fascia and joint capsules, rather than focusing on the muscle as traditional static stretching or PNF-assisted stretching does. As such, FST allows the clinician to find any problem areas more quickly and make changes in the tissue that provide longer-lasting results. Based on scientific research, FST has proven to have many advantages beyond those of conventional stretching, such as decreasing pain, reducing injury risk, and increasing performance.
FST PRIMER
In order to understand FST, you have to understand fascia first. Fascia is one sheath of fibrous tissue that connects every muscle, tendon, ligament, and organ in the body from the top of your head to the tips of your toes. I explain it to athletes by having them visualize a piece of sausage — the casing is the fascia, and the meat is the muscle. This is the main reason why athletes don’t get any long-standing results with traditional stretching — it only focuses on the muscle, while FST focuses on the fascia that encases it all.
Because the fascia links everything, putting tensional strain on one part of the body in FST ultimately has an impact on other areas. In this way, FST engages the whole neuromyofascial system. This comprehensive approach brings the body back into homeostasis by unlocking and activating any areas that are restrained. It removes restrictions from movement, stimulates lubrication, and causes a more drastic and longer-lasting change in the tissue than traditional stretching methods. Remember that as athletic trainers, we should be treating the problem, not just the symptom, and FST allows us to do that.
Additional benefits can include:
• Improved performance and recovery
• Relieved pain and tight muscles
• Released endorphins
• Increased body awareness
• Increased balance and symmetry in the body
• Reduced injury risk
• Reduced muscular soreness
• Improved posture and muscle function
• Increased speed and power.
IN SESSION
A FST session is typically performed on a massage therapy table using straps. While straps are not necessary, they are a signature of FST. That being said, there are no facility constraints when it comes to performing FST on an athlete. FST is really about the technique, so it can be utilized anywhere — on a massage table, bench, or even lying on a field.
Regardless of location, as part of FST, the clinician pulls and pushes an athlete’s arms, legs, spine, and neck through various planes of movement. Athletes undergoing FST often feel a lot of decompression throughout their hips and spine, which helps relieve tension in these areas.
In addition, FST includes a synchronized breathing component. The breathing techniques can be altered to fit an athlete’s desired results. Some support the parasympathetic nervous symptom, which helps the athlete relax and reduces the stress on their body, allowing for a deeper stretch. Other breathing techniques awaken the sympathetic nervous system, like in weight training.
A full FST session usually lasts an hour. The first 15 minutes are spent discussing the athlete’s goals and completing an assessment, while the remaining 45 minutes are focused on increasing flexibility. When developing an FST program for a specific athlete, I consider their structural makeup, injury history, and physical goals. Sessions can be adapted to meet different needs, such as rehabilitation, a pregame stretch, or recovery.
An extended treatment plan can be developed depending on an athlete’s needs, time frame, and issues that must be addressed. Some athletes will require two FST sessions per week or more, while others who are looking to maintain their current status may see progress with a session once a week or every other week. The beauty of the technique is that you can adjust it to meet the athletes’ physical needs.
As with any bodywork or manual therapy, FST sessions can be catered to specific sports. For example, when doing FST with a golfer, I focus heavily on rotation of the torso, hips, and upper extremities. But when working with a football lineman, I take into consideration which leg is his power leg (the one he pushes off from). This helps me understand where any issues and tightness are emanating from.
Further, if an athlete is looking to increase power and speed, I do a full lower-body evaluation to start. If I find tight hip flexors and glutes, this becomes the focus of my therapy. Increasing hip mobility and unlocking the glutes allows them to fire and activate, which results in increased power from the lower body.
Although it might sound like FST bends athletes in all sorts of uncomfortable positions, it’s a relatively painless technique. I have seen success using FST with athletes at the high school, college, and professional levels. Compliance has been higher than when I used traditional stretching techniques, and feedback has been positive. After an FST session, my clients usually jump off the table, feeling light on their feet and ready for activity. In addition, many of my veteran athletes regret not using FST throughout their careers to shorten recoveries, reduce injuries, and increase overall production.
