Illustrations, Jo Lee.
Ten years ago, I had my hips replaced due to a genetic condition, and I’ve struggled with chronic pain ever since. So when it comes to therapies for treating that pain, both mainstream and alternative, I’ve tried them all: physio, homeopathy, osteopathy, even reiki. While each one gave me some form of temporary relief, the treatments either became too cost-prohibitive or the effects wore off over time. But when a friend recently asked if I’d tried fascial stretch therapy—a form of assisted stretching mostly done on a table—I decided to try the fast-growing trend to see if it could benefit me and my artificial joints.
Fascial stretch therapy clinics began popping up across Los Angeles about five years ago as part of a boutique fitness trend. Today, they’re in cities across the country, from Vancouver to Halifax. The idea of paying someone to help you stretch has origins in professional sports: trainers stretch players out before and after games to improve performance and help prevent injury. In 1996, fascial stretch therapy, also called FST, was developed for the U.S. men’s Olympic wrestling team by former professional dancer Ann Frederick. The treatment focuses on the layered connective tissue (a.k.a. fascia) around our ligaments and joints, and involves laying on a padded table while a therapist stretches your joints from toes to neck. FST purports all the benefits of stretching—improved flexibility and mobility—plus improved posture and balance, and reduced muscle tension, soreness and fatigue. Since FST is relatively new, there isn’t a ton of academic research on its effects. But one small study from the University of Limerick found that when participants had one-hour fascial stretch therapy sessions twice a week for a month, their range of motion increased up to 31 percent. Flexibility isn’t my strong suit—but those numbers piqued my interest.
I made an appointment at b-Stretched, a chain of Toronto clinics that specialize in stretch, massage and physiotherapy. Its founder, Marco Capizzano, has a decade of experience working with professional athletes as a chiropractor and, more recently, a Stretch To Win-certified fascial stretch therapist. “We’re all born with flexibility. As infants, we can pretty much do everything,” he says. “But as we age, we develop tension and we're not as flexible.” When Capizzano told me this, I thought about how I could do three somersaults in a row when I was little. These days, I’m so stiff that I can barely get into a downward dog. Fascia can tighten up after surgery and when you’re inactive for long periods of time—which is exactly what eight hours a day at a desk job promotes.
I wasn’t sure how my appointment would differ from physio and massage, both of which I’ve done regularly over the years. It turned out to feel something like a combination of the two. Capizzano moved my limbs around the way a physiotherapist might and applied pressure to tight spots around my neck and shoulders like a massage therapist. At one point, Marco gripped my ankles and pulled them, extending my legs. It was a super effective stretch that I’d never be able to do without assistance. He was also very gentle, immediately easing off when I expressed any pain.
I left the clinic feeling like a noodle. Even the tension in my neck from sleeping in an awkward position the night before had melted away. I happily walked myself to the subway and took the stairs without feeling the need to grip the railing for support.
Most times when I do physio, I’ll wake up the morning after the appointment sore from the muscle exercises; even massage and yoga leave my joints feeling tender sometimes. I expected to feel at least a little pain and stiffness the day after this stretch therapy session, especially since I ended up standing for most of the night that followed the appointment. But the next day, when I took my dog for his morning walk, I didn’t feel an ounce of stiffness.
However, there’s good reason not to focus on FST alone going forward. “There are a lot of trendy treatments out there, from K-taping to dry needling, to fascial stretch therapy,” says Ottawa-based physiotherapist Jessica Brooks. “But these treatment alternatives complement our practice and should never be performed in isolation.” Brooks points out that the evidence is mixed for a lot of these therapies and typically, there are no long-term outcomes or studies with any clinical value. “Pain can be measured, but it's subjective,” she adds. “We cannot forget about the placebo effect (when a treatment has a psychological effect rather than a physiological effect).” Fascia doesn't demonstrate the same stretch properties as muscle, Brooks says, so it would be hard to isolate the stretching solely to fascia. The evidence to support exercise as part of the treatment of chronic pain, on the other hand, is “astounding,” says Brooks, and should therefore never be neglected.
“Things don’t change for good overnight, because tension is compounded over weeks and months,” Capizzano says. (Indeed, I started to feel like the Tin Man again early the following week.) That's why he generally recommends fascial stretch therapy two or three times a week to start, and then comes up with a maintenance plan to reach your mobility goals.
Paying someone to help stretch you out a few times a week is probably not an affordable option for the average person. But as a point of comparison, an hour of fascial stretch therapy at b-Stretched costs $100, about $10 more than what I usually pay for a 60-minute Swedish massage. FST isn’t usually covered by health insurance, unless you have a health spending account. After this experience, I’d absolutely take stretch therapy again. While I can't afford two sessions a week, I could see the benefits of going once or twice a month. (If you’re curious, you can get a 15-minute session for $35.) You don’t need a referral for the clinic, but Capizzano says it’s always a good idea to get clearance from your doctor, especially if you've sustained a prior injury.
Capizzano said athletes have extended their careers by improving their mobility through fascial stretch therapy, and I could see (and feel) how: FST instantly put a bounce in my step. “Mobility makes you feel good,” he says. “When you’re less stiff, you want to take on your day and whatever it has in store for you.”
In a standing position, reach to the sky and bend while maintaining eye contact with your hand. Inhale on the reach and exhale on the bend.
In a seated position, reach behind your back with one arm. Use your other arm to grab the elbow of the arm behind your back and gently pull. Maintain an upright posture, inhaling and exhaling while gently pulling the elbow down.
In a seated or standing position, clasp your hands behind your back and inhale, maintaining proper upright posture. Then roll your shoulders back, exhaling; imagine squeezing a pencil between your shoulder blades. If you can’t clasp your hands together, hold a towel.
In a seated or standing position, extend one arm out with your hand positioned up. Inhale, then with the opposite hand, pull your fingers back and exhale.
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