Fascial Stretch Therapy (FST) – Are You Sure You Can Stretch Fascia?

Fascial Stretch Therapy (FST) is becoming a popular manual therapy technique used by practitioners and those who can afford to take a $500 dollar weekend course to become certified in the stretching of this unique tissue. It is believed that these treatments can alter the mechanical properties of fascia which anecdotally have been reported to have a variety of benefits.

Much like many of the topics we discuss on the HSC Compound, there seems to be a misinterpretation of the research.

Regarding fascia and its mechanical properties and whether stretching this tissue truly has any benefit seems to be another great example of either an excellent sales tactic, or a complete misunderstanding.

Let’s start with explaining what fascia is and what Fascial Stretch Therapy can apparently offer you as an individual.


What is Fascia?

Fascia is dense fibrous connective tissue that is spread throughout the body connecting muscles, bones and organs. The main function it serves in the body is to funnel mechanical forces when the body is subjected to posture variations (Chaudry et al. 2008). Because this tissue is densely populated with nerves, it is thought that pain and loss of muscle function can stem from this tissue.


Common Claims About Fascial Stretching Therapy (FST)  

Recovery

FST, despite being relied on heavily for its recovery benefits has no research to support this claim. Much like massage therapy, there is no body of evidence to report on the effects of FST and recovery, thus using it for this reason should be dismantled from your manual therapy tool shed. While many individuals have reported feeling better after an FST treatment, who is to say that it is better than any other manual therapy or anything for that matter as they arent objectively comparing to to anything.

From a practical standpoint, FST to treat general soreness would be a painful experience. Not one that many would want to encounter. Further, by the time you booked an appointment for an FST session, chances are your muscle soreness will have resolved itself without any manual therapy needed.  

The bottom line here is that FST does not enhance recovery regardless of what the guru’s tell you. Recovery measures for manual therapy based on a self report from a patient should be taken lightly as no physiological measures of true recovery are or have ever been taken.

That said, if you feel like FST does help you with recovery, then by all means allocate your hard-earned money towards it; however, understand that there is absolutely no science to back this purported claim.
Enhanced Flexibility and Mobility

Before diving into whether FST can influence flexibility and mobility at joint, it is necessary to briefly discuss the brute strength of this tissue.

Considering the mechanical properties of fascia and understanding that this tissue is as strong as Kevlar (which can stop a bullet), the thought that one can physically exert enough force to deform its integrity is absurd.

Any manual therapist that is under the impression that they are truly stretching or mobilizing fascia needs to understand something. This unique tissue is extremely durable! For example, the plantar fascia that runs along the bottom of the foot would require 852 kg of compression and 424 kg of shear force to cause a 1% change in its structure (Chaurdry et al 2006).

Though the guru’s will argue that FST is performed on a variety of different areas, not just the plantar fascia, the strength and force applied to deform the fascia really does not change by large percentages throughout the body.

Unless you’re rolling out fascia with a freight train, you’re not stretching it.

To think that a human can manually apply that kind of force is impossible. Even if that force could be applied there would be some serious damage done to all other structures involved.

Lets return to whether FST can actually increase flexibility and mobility.

NO! Absolutely not! Not through the physical deformation and lengthening of the tissue. No CHANCE!

Any termed “flexibility” or “mobility” hypothetically gained from FST is likely due to a phenomenon that is also experienced from static stretching. This is referred to as Nociception Deception. Essentially, the increased flexibility may be due to the modification of nociceptors nerve endings which positively aid in increasing muscle fibre stretch ability, not true tissue lengthening (Jam 2015).

In other words, some improvement to ROM can be attributed to an increased ability to stretch and ability to tolerate pain  (Jam 2015). This also seems to be the case for static stretching which we debunked recently HERE.


For those investing money into FST and FST practitioners and are assuming that it is an evidence based therapy, know that there is a complete lack of evidence supporting it.

There is a huge body of research on the placebo effect and unfortunately most of the self reported testimonials seen with therapies like this are likely due to placebo.

If you feel as if this type of manual therapy is effective and does provide benefit, then absolutely continue implementing into your daily lives.  However, acknowledge the claims FST has to offer and the little evidence that supports its effectiveness.  


Take Home Points:

  1. There is no body of evidence suggesting FST aids with enhanced recovery, flexibility and mobility.
  2. No human can apply the force that is scientifically proven to actually have any chance in deforming the fascia. The force application is BEYOND PHYSIOLOGICAL MEANS.
  3. Any improvements in ROM and mobility can be associated with the alternation of nociceptor nerve endings that have positive correlation with enhanced muscle stretching capability.    

References:

Hans Chaudhry, Robert Schleip, Zhiming Ji, Bruce Bukiet, Miriam Maney, Thomas Findley. Three-Dimensional Mathematical Model for Deformation of Human Fasciae in Manual Therapy. J Am Osteopath Assoc 2008;108(8):379–390.

Jam, B (2015). Questioning the Use of Static Stretching Before and After Athletic Activities [Review]. Retrieved August 11, 2017, from http://www.aptei.ca/wp-content/uploads/Stretching-Paper-2015.pdf

By | 2017-11-21T01:57:39+00:00 November 21st, 2017|Uncategorized|

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