STW-FST (Stretch to Win - Fascial Stretch Therapy) offers the trainer a PNF-based system that can be used to remove the restrictions that are the barriers to good movement. The squat is used as an example in this article and we will focus on the hip, knee and ankle to complete a 3 article series.
- Introduction to the STW-FST flexibility system,
- Quickly assess mobility and flexibility for restrictions to movement, and
- Implement protocols to address common fault patterns in the squat movement.
The focus of all 3 articles in this series is to introduce you to how to use the Stretch to Win - Fascial Stretch Therapy® (STW-FST) flexibility system to correct faulty movement patterns in the squat. Then training can progress safely and not get interrupted or slowed down by pain, weakness or imbalances caused by movement restrictions. A consequence of this is better, faster, more complete results with greater confidence gained from both trainer and client.
What is STW-FST?
STW-FST is an advanced PNF-based, client assisted flexibility system. The trainer or coach uses hands-on, direct techniques on a table with stabilization straps to assess and remove restrictions to movement in joints, muscles and fascia (see Fig. 1). Results are quicker and more thorough than traditional, isolated stretching due to the following 10 Principles that make up the system.
Fig. 1: Stretch to Win - Fascial Stretch Therapy
First try this exercise called the “Frederick Finger of Fascia” (see Fig. 2-5):
- Exercise 1: Traditional stretching (see Fig. 2, 3)
- Point finger of non-dominant hand up.
- Place finger onto the pad of the non-dominant finger and push back until you feel first slight resistance or pressure.
- Note range of motion (ROM) and how it feels.
|Fig. 2: Start position
||Fig. 3: End position
- Exercise 2: TW - Fascial Stretch Therapy (see Fig. 4, 5)
- Grasp finger firmly then gently traction to ceiling.
- While maintaining traction, guide finger back.
- Note average gain about 3x more without pain or force.
|Fig. 4: Start position
||Fig. 5: End position
- Conclusion: STW-FST yields more gains in ROM of joint, muscle and fascia.
The 10 Principles of the STW-FST System
The complete protocol that we perform to assess and correct imbalances always follows 10 Principles. They are grouped under what they focus on most – joint, muscle, and nervous system.
Joint (Principles 1-3)
- Principle 1: Target the entire joint, and
- Principle 2: Get maximal lengthening with traction. Joints get compressed, so start by decompressing joints before mobilizing and stretching:
In general, always traction the joint and muscle before using client assisted mobilization or stretching.
- About 50% of a healthy person’s lack of ROM (range of motion) at the joint has been suggested in research to be due to tightness in the joint capsule (Johns & Wright, 1962).
- Stretching the joint capsule before the deeper muscles that are close to that joint results in better functional flexibility (activity versus static).
- When ROM in a joint is restricted, ROM in the muscle is also restricted. Because muscles attach to bones and bones connect to other bones by way of joints, restriction in one joint capsule can lead to restrictions and compensations in other parts of the body. For these reasons we always start with traction at the hip joint in lower body protocols.
- Principle 3:Use multiple planes of movement. We move in multiple planes, therefore we should stretch in multiple planes. FST uses multi-plane stretching not found in traditional isolated stretching.
Fig. 6. Single-plane stretch
- Example 1: Traditional stretching. Figure 6 shows traditional sagittal plane single leg raise, targeting one plane of movement.
Fig. 7. Multi-plane FST
- Example 2: Fascial Stretch Therapy. Figure 7 shows FST multi-plane stretch with specific traction, diagonal, rotation, spiral pattern.
Muscle (Principles 4-7)
- Principle 4: Follow a logical order. Start with the joint, then shorter muscles and fascia before addressing longer muscles. Begin mobilizing and stretching from the core of the body and progress out to the extremities. For example, in the lower body all protocols start with the hip. Unlike other techniques that start at the foot or the head, this system works from the deepest layers of fascia out (see Fig. 8).
Fig. 8: Fascial stretching starts from hip joint
Low back researcher, Dr. Stuart McGill, points out that all movement is generated from the ‘punctum fixum’ or fixed point of the core. Restrictions in fascia and the muscles of the pelvis, hip, and lumbar complex can negatively impact all primary movement patterns. If you are not starting at the center of the body, that is a missed opportunity.
- Principle 5: Achieve range of motion gain without pain. Many people believe that stretching hurts or at the least is associated with discomfort. Therefore clients are often protective and guard their body even when they agree to be stretched. The result is ineffective stretching.
In our experience, the best and fastest results are achieved without pain. Traction, oscillation and circumduction (TOC) mobilization before stretching is how we begin all FST sessions. These are the benefits to TOC:
- Assesses joint and muscle response to specific movements
- Client immediately relaxes to allow more effective stretching
- Can relieve pain in seconds
- Principle 6: Stretch fascia, not just muscles. Most stretching techniques focus on stretching isolated, individual muscles. While this approach may have some success, in our experience it often fails. This is because isolated muscle-by-muscle approach to stretching fails to address research that has shown:
While stretching one muscle may stretch some of the fascia within and around the muscle and near its attachments, it does not extend into other fascial planes. As explained in the previous 5 Principles, there are many other protocols that must be in place in order to correct restrictions and imbalances in the fascia.
- The brain is organized according to movement patterns and sequences, not isolated muscles.
- Studies show that active muscle contraction as well as passive stretching of one muscle generates forces by adjacent muscles, nerves and fascia.
- Proprioceptors in muscle (spindles and golgi tendon organs or GTOs) constitute only about 20% of the body. The rest is distributed in the fascia in the form of free nerve endings and other receptors.
Start thinking of stretching fascial connections of the musculoskeletal system, not just isolated muscles. (The book “Anatomy Trains” by Thomas Myers is an excellent resource for this; see Fig. 9).
Fig. 9: Superficial back line (kind permission from Myers & Primal Pictures)
- Principle 7: Facilitate body reflexes for optimal results (PNF).Michael Alter, author of “The Science of Flexibility,” states that most research on PNF stretching show better outcomes when compared to traditional static stretching. Fascial Stretch Therapy uses one technique from PNF called Contract-relax (C-R), with which most trainers and coaches are very familiar. However, we have discovered that best results are obtained when using anywhere from a low of 5% to a high of 20% of maximal active contraction. Using multi-planar patterns of C-R combined with multi-planar patterns of FST results in better outcomes to remove restrictions and improve muscle activation in the squat and other patterns.
Nervous system(Principles 8-10)
- Principle 8: Synchronize breathing with movement
- Principle 9: Tune nervous system to current conditions
- Principle 10: Adjust stretching to current goals
These 3 Principles are grouped together as they greatly influence each other.
Trainers know how important coaching proper breathing technique is to the safety and success of their client. Since stretching has always been associated with pain in many clients, they tend to hold their breath during the stretch phase. Just getting them to exhale on the assisted stretch starts the process of changing muscle tone and tension through the nervous system:
- Breathing slow stimulates the parasympathetic system which decreases muscle tone and tension
- Breathing fast stimulates the sympathetic system, which increases muscle tone and tension.
Instead of ‘one-size-fits-all’ traditional, isolated stretching, coaching slower breathing with slow assisted stretches can stimulate the parasympathetic system for post training cool down and recovery. Muscle tension quickly releases with slow breathing-slow stretching for an excellent regeneration session starting right after training or during an off day.
Coaching quicker breathing, as you perform faster, flowing dynamic assisted stretches on your client for 5-10 minutes before training, can often work better than the client’s dynamic warm-up. Under your hands, you can immediately feel and correct restrictions and imbalances that would negatively impact the training session.
Breathing right, stretching right helps to properly stimulate the nervous system for better function and better results.
Summary of Principles
Movement patterns like the squat require full body assessments and strategies for optimal training and coaching. The 10 Principles of STW-FST constitutes an entire system that meets the need to quickly and thoroughly find solutions to problems with faulty movement patterns from mobility restrictions and flexibility imbalances.
3 Problems, 3 Solutions for Faulty Squat Patterns
Faulty squat patterns are often whole body issues. Therefore, the FST solution to many of these problems is to use a series of short or long connected myofascial lines to simultaneously correct them, often all at once.
- Practice all 3 solutions on colleagues first to get feedback before performing them on clients.
- Perform all stretches on the exhalation and release for inhalation for 1 repetition.
- Repeat all stretches for 3 repetitions, or as needed.
- Re-test squat after each stretch to monitor improvement.
General contraindications related to performing FST technique:
- Stop stretch if pain occurs; gently oscillate to eliminate pain in seconds.
- Stop stretch if pop or extreme give in joint ROM occurs on each repetition of stretching.
- Follow contraindications and precautions as for all other training.
The following will illustrate 3 problems you may witness while assessing a client's squat pattern, then explain a solution for correcting the problem using Fascial Stretch Therapy:
Problem #1: Feet turn out in a squat position
This problem is frequently blamed on the tight, short peroneals in the lower crossed syndrome or with just pronated feet. In our experience, most of the time this is not the issue (see Fig. 10).
Figure 10. Feet turned out
More commonly, this problem can be attributed to all or some of the following myofascial connections:
- Compressed, tight lumbar spine and paraspinals
- Short, tight hip external rotators
- Laterally shifted fascial compartments of quad-IT band
- Adhesions in lateral quad-anterior IT band fascial interface
- Tibial external rotation
- Fibula shifted superiorly, rotated externally
- Short lateral band of plantar fascia
- Solution for Problem #1: Stretch the Lateral Line (see Fig. 11, 12, 13)
- Lean back and traction both legs (Fig. 11)
- Walk to one side with both legs (Fig. 11)
- Drop leg closest to center of the table below level of other leg (Fig. 12)
- Drive dropped leg under other leg (Fig. 13)
- Add arm reach overhead to increase lateral line stretch. Repeat until there are no further gains in ROM or tension limits.
- Feet turn in along with whole leg up to hip
- Positively changes squat and gait
- Bonus: corrects leg length discrepancies; increases shoulder overhead ROM
Problem #2: Excessive forward lean in a squat position
Figure 14. Excessive forward lean
Figure 15. Deep front line (hip flexors) stretch
- Solution for Problem #2: Deep front line (hip flexors) stretch (see Fig. 15)
- Position bottom leg position in hip/knee flexion
- Support top leg at knee joint and ankle
- Facing client, walk leg behind them until stretch felt in hip flexors
Problem #3: Asymmetrical weight shift (AWS) in a squat position
Figure 16. Asymmetrical Weight Shift
Figure 17. Hip joint capsule stretch
- Solution for Problem #3: Hip joint capsule stretch (see Fig. 17)
- Grab hold one ankle and lean back to assess hip joint capsule space and length
- If hypermobile and pops or shifts then stop, is contraindicated
- If little or no movement, then repeat stretch until movement occurs
Watch the Author's demonstration of how to perform traction to improve the squat using Fascial Stretch Therapy:
This article is the first of three in a series that teaches the trainer how to use Fascial Stretch Therapy within a training session to correct a client's poor movement patterns in the squat. The focus of this first article was on learning how to assess and remove restrictions in the joint and muscles around the back, pelvis and hip extending down the leg and up into the spine by way of myofascial lines. Re-testing the squat after each problem and solution example that was given will reveal the dominant problem causing faulty movement patterns, along with secondary ones.
This article demonstrated techniques that are different than traditional, isolated stretching. This was defined with the 10 Principles that address all systems of the body to make it a complete approach.
In article 2, we will focus on the knee and the myofascial lines connecting above and below that influence how the knee functions, tracks and contributes to faulty squat movement patterns.
- Frederick, A., & Frederick, C. (2006). Stretch to Win. USA: Human Kinetics.
- Alter, M.J. (2004). Science of Flexibility (3rd ed.). USA: Human Kinetics.
- Schleip, R., Findley, T.W., Chaitow, L., & Huijing, P.A. (2012). Fascia – The tensional network of the human body. UK: Churchill Livingstone Elsevier.
- Myers, T. (2008). Anatomy Trains. UK: Churchill Livingstone.