“Fascia” gets a lot of hype these days, especially among athletes. But for many people, this critical body tissue is still a bit of a mystery—likely because it’s harder to picture than, say, your muscles or your heart.
The research surrounding fascia, how it works, and how it can (or can’t) be manipulated is still in its relative infancy. But what we do know is that fascia is a web of connective tissue.
“Fascia surrounds every muscle, bone, nerve fiber, and organ; fascia is interwoven throughout the entire body. Similar to the pith of an orange, it surrounds the peeled orange, as well as each pulp within,” Rachel Frey, CMT, a myofascial release therapist at Fusion Wellness Physical Therapy in California, tells Runner’s World. “Not only is it a structural 3D web of collagen, the fascial system is also comprised of sensory cells that transmit information.”
So if you think of your fascial system as a spider’s web of connective tissue that encases every cell of your body, you’ll understand that when the web gets touched or activated on one end, a reverberation takes place that can be felt, to some degree, across the whole web. But if the web gets gummed up or damaged? The system stops working as well as its intended, which can lead to greater problems down the road.
“Movement is the number-one way to keep fascia healthy, otherwise our bodies will take the shapes that we continually hold,” Frey says. “Stretching, foam rolling, or other self-myofascial release techniques will help move the fluid throughout the fascial tissue.”
One way to move in a way that protects your fascia: use fascia stretch therapy. While Frey suggests seeing a licensed physical therapist or myofascial release therapist to help keep your fascia happy, it’s also important to understand the benefits of movement for this tissue and what exactly fascia stretch therapy can do for you as a runner.
Why is movement important for healthy fascia?
“Healthy fascia wants to glide. Not only is healthy fascia critical to allow muscles [to move through] their full range of motion, the elastic and fluid nature of fascia also acts to store energy and dispense forces across multiple joints,” explains Frey. “Injury, surgery, scarring, inflammation, or simply habitual poor posture can lead to adhesions in the fascia [which causes it to lose] its pliability. If the fascia surrounding a muscle is restricted then the muscle isn’t going to have the space for its full range of motion.”
While this should convince you to take care of your fascia, this tissue is a notoriously strong fiber. “Breaking up” adhesions by placing extreme pressure on these knots—as you would with a foam roller or trigger point ball—isn’t necessarily the way to achieve or maintain healthy fascia, or at least it’s not the only way. There’s value in certain myofascial release techniques, but the value likely lies more in the encouragement of fluid movement through the tissue when using these techniques. Enter: fascia stretch therapy.
What is fascia stretch therapy?
If you’re familiar with self-myofascial release techniques like foam rolling, you’re probably aware that this form of self-massage can be pretty painful. The good news is that fascia stretch therapy is not painful—in fact, shouldn’t be painful.
Rather, fascia stretch therapy’s focus is on movement and range of motion at the joints. It’s intended to help encourage mobility in fascial tissue that has perhaps experienced damage or isn’t moving smoothly, as it’s intended to do.
Fascia stretch therapy (or FST), which you may have also seen called Frederick stretch therapy, is a type of assisted stretching. “It’s a unique, hands-on method that a certified practitioner uses to apply assisted stretching stabilization and/or compression based on customizing the experience for what the client’s body needs at that particular time,” says Chris Frederick, who cofounded the technique with his wife, Ann Frederick in 1995 and is the codirector of the Stretch to Win Institute. “It has since been developed for specific application in sports, fitness, wellness, and medical conditions.”
If you’re thinking, “Well I can stretch on my own, or go to a stretching class… why would I need a certified therapist for that?” This type of assisted stretching isn’t the same as bending down to touch your toes or having a trainer lift your leg as you’re lying down to help you stretch your hamstring. For one thing, fascia stretching takes a more full-body approach.
“One of the differences between FST and other assisted stretching is we look at the body as a whole, with everything connected by fascia, not just as a muscle to stretch. [The program] uses the fascial lines or nets of the body to indicate imbalances and how they affect each other,” Debbie Woodruff, an RRCA- and USATF-certified running coach and certified fascial stretch therapist tells Runner’s World. “For example, plantar fasciitis is a condition that affects many runners. General treatment focuses on the feet. However, an FST therapist will look beyond the feet. The bottom of the feet is the distal point of the posterior [fascial] net, so in addition to treating the feet, we also look at the toes, ankles, calves, hamstrings, and glutes. Occasionally, even farther up the posterior net to the lats.”
Fascia stretching also involves partnered stretching techniques that are difficult (and in some instances, impossible) to do on your own. “It includes slow moving, oscillating movements along with traction that helps decompress the joints and expand space in the soft tissues,” says Woodruff. “We use a form of proprioceptive neuromuscular facilitation (PNF), which requires a client to contract a muscle against resistance, helping them improve range of motion.” This contraction against a stretch can actually help you loosen up and experience a deeper, pain-free stretch.
Woodruff gives the example of partner hamstring stretch in which you’re lying on the floor, with your leg up to the ceiling. Instead of simply helping you lift your leg and stretching your hamstring at the point of discomfort, “an FST therapist would ease you into the stretch pain free, add some dorsiflexion to engage the calf, and find your range of motion,” she says. This might involve varying the angle or oscillating the stretch.
Then, if the therapist feels you need help relaxing to improve the stretch, they would ask you to contract your muscles and “press” against the stretch for a period of time. When they instruct you to relax, the stretch reflex that’s designed to prevent you from overstretching (but that can also prevent movement within a full range of motion), is deactivated momentarily, allowing for a deeper, more comfortable stretch that’s still within a safe zone, based on your personal range of motion.
The goal, then, isn’t to stretch you to the point of pain or to “beat your fascial adhesions into submission,” as some myofascial release proponents suggest, but rather to promote movement to encourage your fascia to return to its ideal “sliding” state that better enables mobility and communication through the fascial web.
What are the benefits of fascia stretch therapy?
For a runner (or anyone, really) the primary benefit of fascia stretch therapy is that it promotes better movement. And anyone who can move better, whether in their sport or everyday life, is going to feel better, perform better, and feel more capable of training hard.
“Some of the benefits include reduction in pain, improved athletic performance, better movement, increased circulation, better balance, better blood flow, faster recovery, and improved posture,” Woodruff says. “I personally encourage new clients to try at least three sessions to determine if fascia stretch therapy will help them feel better. I’ve seen great results in clients who suffer from plantar fasciitis, sciatica, and shoulder issues, including frozen shoulder.”
While research into fascia stretching specifically is somewhat limited (remember, fascial research, as a whole, is still mostly new), one small study from the University of Arizona, involving 10 people, reveals it can reduce pain levels and contribute to improved engagement in activities of daily living (things like cooking, cleaning, and doing other daily tasks) in those who experience non-specific low back pain.
Likewise, a small study of 14 healthy, active participants presented at a 2018 conference from The Royal College of Surgeons Ireland Faculty of Sports and Exercise Medicine found that fascial stretch therapy appeared to contribute to improvements in strength, power, range of motion, and proprioception in an athletic population.
Despite the lack of scientific studies, the anecdotal benefits of clients and practitioners demonstrate the positives of this technique. “FST has been used with many Olympic runners, like our client Sanya Richards-Ross, who was the fastest 400-meter runner in the world. FST is most extensively used in the NFL on football players,” says Frederick.
Without much research to confirm which conditions fascia stretching helps with most, it’s hard to say with certainty that FST will help you address specific injuries. That said, it’s designed to improve mobility and reduce the pain and symptoms of mobility-related injuries. So if you’re dealing with any soft tissue injury that’s impacting how you move, you might benefit from trying FST.
What should you know before trying fascia stretch therapy?
As with any kind of therapy, it’s important to be prepared for what to expect in a fascial stretch therapy session. First: make sure you leave the “no pain, no gain” mentality behind you. FST is not supposed to hurt. “Many people expect to feel pain and don’t feel they’re getting their money’s worth if the treatment doesn’t hurt. Not true! FST is pain-free and uses gentle movements and stretches to improve mobility and flexibility,” Woodruff says.
That said, it’s important to communicate with your practitioner so they know your athletic history, and whether you’ve had any injuries or surgeries. If you are hypermobile, you should also tell your practitioner, “so they know that those regions must be stabilized while allowing tighter areas to be mobilized during FST or any stretching technique,” explains Frederick.
That’s a key point, too: Fascial stretch therapy is an active form of therapy. Just as you would go to a physical therapy session expecting to move around and engage in the process, you need to expect the same with fascia stretching. This isn’t a passive massage situation. “Clients don’t just lie there and let the therapists do the work,” explains Woodruff. Clients will be involved in various movements, possibly adding a contraction to a stretch, or helping the trainer move limbs at varying angles, which helps to improve range of motion.
For example, Woodruff explains that if a runner has tight quads, she would stretch the quads and the hip flexors, rather than solely focusing on the quads. And while stretching the quads (which she typically does with her clients in a side-lying position), she would perform the stretches at different angles, moving the client’s leg to different positions to effectively reach all areas of the muscle. Likewise, for something like shin splints, which Woodruff describes as typically being a “too much, too soon type of injury,” she’d target the calves, in addition to the shins themselves.
Because you’ll be moving around throughout the session, be sure to wear comfortable clothing and socks. Stay hydrated before and after a session. “Soreness is rare, although occasionally someone who is very inactive might feel a little muscle soreness the following day,” Woodruff says.
Finally, let your therapist know if you’ve had a recent surgery or an injury you’re receiving other treatment to address. You may need doctor’s clearance before starting a fascia stretch therapy program.
The bottom line on fascia stretch therapy
These days, there are many potential “tools” in the therapy box when it comes to sports performance and pain management. While fascia research is still relatively new, there’s evidence to support the potential benefits of therapies that help keep fascia pliable, responsive, and healthy. And gentle therapies, like fascia stretching, are a good way to work on maintaining proper range of motion while supporting fascial health without a great risk of injury or tissue damage.
You can find a certified fascial stretch therapist by searching on the Stretch to Win Institute’s website. Those who are certified have a wide range of backgrounds, so if you’d like to see a therapist who is also a personal trainer, massage therapist, physical therapist, or run coach, like Woodruff, you can search by job title (credentials), location, or name.
Laura Williams, M.S., ACSM EP-C holds a master’s degree in exercise and sport science and is a certified exercise physiologist through the American College of Sports Medicine. She also holds sports nutritionist, youth fitness, sports conditioning, and behavioral change specialist certifications through the American Council on Exercise. She has been writing on health, fitness, and wellness for 12 years, with bylines appearing online and in print for Men’s Health, Healthline, Verywell Fit, The Healthy, Giddy, Thrillist, Men’s Journal, Reader’s Digest, and Runner’s World. After losing her first husband to cancer in 2018, she moved to Costa Rica to use surfing, beach running, and horseback riding as part of her healing process. There, she met her current husband, had her son, and now splits time between Texas and Costa Rica.
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