Fascial Stretching: FST versus ELDOA — Part One
By Kathleen Trotter, FIS, PTS
When it comes to continuing education, I have always felt like a kid in a candy store — wanting to attend every course and certification out there! I have learned to temper this desire. Through experience, I know that not every course is worth my time and money — I have attended more than a few duds — and that even the “best” course taught by the “guru” of the minute is not necessarily the best relative to my business. I have learned the importance of being selective — I can do anything, but not everything
Two certifications I have found worthwhile are Fascial Stretch Therapy (FST) and Étirements Longitudinaux avec Decoaptation Ostéo Articulaire (ELDOA). Are they for you? Maybe – they both serve a purpose and have unique pros and cons.
The question is do the pros benefit YOU and your clientele? Only you can decide. In this article, we’ll look more closely at FST and touch upon ELDOA next month.
FST versus ELDOA
ELDOA and FST both understand the body as an integrated system. Instead of targeting one particular muscle or joint in isolation, both approach the body as a “functionally integrated body” unified by fascia. This spotlight on fascia facilitates their more “global” vs “local” analytical lens.
A quick review of fascia:
Fascia is widely distributed connective tissue composed of interwoven collagenous fibre bundles of varying density. Fascia has lubricating functions and insinuates itself between muscles, nerves, blood vessels, etc., providing structure and protection by sheathing the entire body.
Think of fascia as the link between all the structures of the body — it forms a continuum with other tissue structures, creating interconnections between muscles, etc., making the body a global structure. There isn’t a bone, muscle, organ, or nerve that isn’t linked within body.
FST is an assisted stretching technique created by Ann and Chris Frederick. Although there are complementary homework exercises that address the fascia, the primary technique is performed by a certified therapist on a client — typically using a treatment table.
Goals include, creating optimal mobility of joints, releasing adhesions, mobilizing fascia, and increasing levels of relaxation through joint mechanoreceptors. Multiple techniques are utilized, including modified PNF (proprioceptive neuromuscular facilitation), circumduction, oscillation, and gentle traction. Pain is never allowed and is considered a negative response.
Think of FST as a dynamic mobility “dance” performed by a therapist on a client to address the various fascial lines (or sheaths): the superficial front line, superficial back line, lateral line, spiral line, deep front line, superficial front arm line, deep front arm line, superficial back arm line, deep back arm line, and functional line.
Details of each line are too extensive for the purpose of this article, but the net is, widen your lens — look beyond individual muscles. Have a client with neck and upper back pain? Consider their ankle and hamstring. If their superficial back fascial line (SBL) is tight, their neck pain could potentially be connected to tibialis anterior or hamstring tightness. (If this concept intrigues you, review Thomas Myers’ Anatomy Trains or Ann and Chris Frederick’s Stretch to Win.)
A Look at the Positives
You’ll have fewer cancelations. A client can still train even if they can’t or shouldn’t handle an intense workout — they are recovering from being sick, low energy, in post-race recovery, etc. The session goals morph into promoting blood flow, maintaining the habit of moving, improving mobility, and checking in on goals, progress, growth opportunities, etc. Also, FST keeps things interesting — for you and your client — and helps address a key physical need — mobility — which is typically lost at a rate of 10% each year unless one takes steps to mitigate that downward trend.
A Look at the Negatives
The course is a substantive investment (level 1 is five days and over $2000, and best results require a massage table), and although there are homework exercises, FST is primarily a manual mobility treatment done on a client. Thus, there is an issue of scale and physical burden on the trainer.
Favourite Exercise — Lower-leg Gastrocnemius/Soleus
The client stands with their forearms on the wall, one leg forward in a calf stretch. The trainer sits behind the client on the floor, legs crossed around the ankle of the client’s back leg, grasping the back ankle. The trainer leans back while moving their upper body side to side as the client presses their hips forward. The trainer always attempts to “play the angles” of the stretch — to get as many of the fascial lines as possible
My runner clients love this! When I am lucky enough to have it performed on me, I feel as if I am floating as I run. Amazing.
Up next, the 411 on ELDOA — including my “go to” non-negotiable before-bed exercise — and a cautionary note on contradictions and scope of practice.