Soft tissue release (commonly called STR) is an advanced massage technique widely used in assessing and stretching soft tissues. Soft tissues include muscle fibres, their tendons and the deep and superficial fascia surrounding and invaginating these tissues. Stretching is often used for easing the pain of muscle tension and realigning the body so that it functions in a more optimal way. However, unlike generalised stretching, soft tissue release targets specific areas of tension within a muscle. It is also useful for targeting muscles that are difficult to stretch actively (the fibularis muscle group, or peroneals, for example) and for isolating a muscle within a group of muscles that would normally stretch together (the vastus lateralis from the quadriceps, for example). It has proven useful in the treatment of certain conditions such as medial and lateral epicondylitis and plantar fasciitis, perhaps because it stimulates tissue repair in these conditions.
There are many different forms of stretching. Unlike traditional stretching, STR involves the application of pressure to part of a muscle during the stretch. In this respect, it may be likened to Thai yoga massage. However, unlike Thai yoga massage, it does not target specific acupressure points and is not applied along specific sen lines (meridians; sen means ‘channel’). When applying STR, pressure is applied either generally (for the purposes of genera l stretching) or, more commonly, to a specific area of soft tissue that the therapist and client perceive to be tensioned, regardless of whether this happens to fall on a particular acupoint or meridian. Stretching in genera l is believed to be beneficial for overall health, and the American College of Sports Medicine (2018) recommends that stretching is performed 2 to 3 days a week, with each stretch held for 10 to 30 seconds, repeated 2 to 4 times per muscle group, to include the neck, shoulders, trunk, lower back, chest, hips, anterior and posterior legs, and ankles.
Because there has been no research into the use of STR as a stretching technique, it is not known whether these guidelines would also apply to STR. STR is almost always performed as part of a massage routine, where massage is used to soothe and stretch tissues following this lock-and-stretch approach; therefore, it is likely that benefits of STR reported by clients and therapists are the result of both the stretch and the massage combined.
One of the uses of STR is to help reduce feelings of tension in muscles. It seems logical to therefore use it when a client reports tightness or stiffness. However, a study by Stanton et al. (2017) found that participants who reported feeling stiff in the spine did not have a reduced range of motion (mechanical stiffness) of the spine, compared to participants who reported no stiffness. It is not known why this was, but the authors suggested that the participants who reported stiffness overestimated the amount of force being applied to their spine and were better able to detect changes in that force. Interestingly, they then applied the force they were using as different sounds were played. Not surprisingly, when a creaky sound was played, participants reported thinking a higher level of force was being applied compared to when a ‘whoosh’ sound was played. The authors concluded that feelings of stiffness were not related to actual biomechanical stiffness but may represent a protective construct. In a similar fashion, this raises the question as to whether so-called tight muscles are actually tight. Do people with tight muscles have a reduced range of motion compared to those who do not report tightness? If you have ever treated professional dancers, you will know that they have greater than normal range of motion in the joints compared to the genera l population and yet still often complain that their muscles feel tight. Does this mean that we should stop stretching people who report back stiffness or tight quadriceps and that stretching is of no benefit to them in feeling less stiff or less tight? No, it means that all forms of stretching, including STR, need to be evaluated in light of ongoing research and that you should determine in advance how you are going to measure the effect of your treatment so that you and your client can decide afterwards whether it was effective.
Figure 1: Notice which band is doing the stretching.