If you’re a massage therapist looking for a modality that meets a client need, assisted stretching could be a great addition to your practice.
Assisted stretching can provide a reliable new stream of income, build your clientele and take pressure off your hands. The general public is learning that assisted stretching is beneficial, and they are seeking it out in growing numbers. In response, stretching studios with names like StretchLab, Stretchzone, LYMBR and Stretch*d are opening around the U.S. This is a relatively new phenomenon. Yoga and Pilates have been joined by one-on-one stretching sessions.Don’t let these studios take business away from you. As a massage therapist with knowledge of anatomy and hands-on skills, you are in the right position to step in and incorporate stretch sessions into your practice or offer one of the many types of stretching as a stand-alone service. Despite the new interest in assisted stretching, some forms of this technique have been practiced for decades. Others build upon rooted stretching methods to expand techniques and benefits.Here, we look at several established types of assisted stretching: Proprioceptive Neuromuscular Facilitation, Active Isolated Stretching, Stretch Therapy, Dynamic Body Stretching and Fascial Stretch Therapy, all of which are taught by providers approved by the National Certification Board for Therapeutic Massage and Bodywork. We’ll also explore assisted stretching programs offered by massage-delivery and franchise massage clinics.This article will also explain the benefits of stretching, how you can incorporate this technique into a massage session, and ways to market a stretching technique to clients. Let’s go!
What is Assisted Stretching?
In simple terms, assisted stretching is a technique where one person helps another person stretch. It has been used in athletic training settings for many years and has recently made its way into gyms, spas and stretch centers available to the general public.
Assisted stretching uses specific techniques to increase mobility and flexibility of a muscle or group of muscles. It requires advanced training in the way the body moves and is often done by massage therapists, physical therapists, chiropractors and athletic trainers. Assisted stretching is a gentle technique that can be used not only on generalized clientele, but also on children, adults, the elderly and those with physical disabilities.
A typical session will include an extensive assessment of an individual’s physical health. A therapist conducting a session will look at a person’s range of motion, flexibility, limitations, alignment, pain and discomfort levels. They will also take into account their client’s goals and develop a stretch program that will gradually help them reach those goals.
With the assistance of a trained stretch therapist, a client can go deeper into a stretch safely, effectively and without injury. These sessions are fully customizable and act as an enhancement to a client’s current wellness program. Clients who are stretched often experience improved posture, pain relief, a reduction in stress, rejuvenation and an overall feeling of well-being.
Stretching’s Benefits
Stretching is an essential component to maintaining optimum health. It supports our joints and muscles as well as our emotional health by reducing stress levels in the body. People who were once stiff and considered inflexible are reaping the benefits of fluid movement and improved posture, among other results, according to many published research studies.
A few of the most prominent benefits of stretching include increased range of motion and flexibility, improved circulation, improved posture, stress relief and pain relief. Let’s look at each of these benefits.
Increased range of motion and flexibility. Range of motion and flexibility go hand in hand. Having greater range of motion provides joints and the muscles supporting them greater flexibility and movement. Studies have found that static stretching increases range of motion and the length of the muscles connected to the specific joint. (See “Current Concepts in Muscle Stretching for Exercise and Rehabilitation,” published in 2012 in the International Journal of Sports Physical Therapy, for example.)
Some research indicates that it’s not the length of the muscle that is affected by stretching, but rather a person’s tolerance to stretching that allows them to stretch further. In both cases, range of motion is positively affected, and its increase allows for greater flexibility, mobility and prevention of injury. Stretching also reduces joint stiffness. making activities like walking or participating in physical tasks more comfortable for the body.
Although research has been focused on stretching, there isn’t yet consensus on stretching benefits in a generalized sense.
In “Current Concepts in Muscle Stretching for Exercise and Rehabilitation,” a review of 101 stretching studies, the authors noted:
“Many exercise studies on older adults include stretching exercises as part of a well-rounded exercise program. Unfortunately, there is no clear dose-response for flexibility training in older adults because stretching interventions are often combined with strengthening, balance, and cardiovascular activities, making it difficult to isolate stretching’s effectiveness.
“Older adults may need longer stretch times than the recommended 15 to 30 seconds … 60-second holds of static stretches were associated with greater improvements in hamstring flexibility in older adults compared to shorter duration holds. Ten weeks of static stretching of the trunk muscles was able to increase spinal mobility (combined flexion and extension ROM) in older adults. Static stretching of the hip flexors and extensors may also improve gait in older adults.
“Furthermore, the effectiveness of type of stretching seems to be related to age and sex: men and older adults under 65 years respond better to contract-relax stretching, while women and older adults over 65 benefit more from static stretching.”
Still, we can begin with the assumption that stretching augments massage by helping clients feel more flexible and relaxed.
Improved circulation. Low-intensity stretching done routinely can increase blood flow to tissues and reduce blood pressure. The increase in circulation to muscles brings oxygen and nutrients to tissues and plays a role in decreasing muscle soreness post-workout.
Improved posture. Well-stretched clients will stand taller after stretching — or at least they will feel like they are. The act of lengthening muscles followed by a strengthening exercise program encourages proper alignment in the body and supports good posture.
When tight pectorals or anterior deltoids pull the shoulders forward, for example, this creates curvature in the upper back that makes a person appear hunched over. By lengthening those muscles and strengthening the antagonist muscles, a client’s posture can be corrected or improved significantly.
Stress relief. Everyone has experienced tension in their body as a result of mental and emotional triggers. Our body reacts to stressors by contracting or tensing up. The longer tension remains in the body, the tighter the muscle tissues get.
Stretching alleviates tension by slowly opening up the muscles on a cellular level. “Our muscles are made of thousands of muscle spindles — like hairs in a ponytail — that give the muscle cell the ability to stretch and contract by sliding past each other in a coordinated fashion,” said Michael Jonesco, an assistant clinical professor of sports medicine and internal medicine at Ohio State University’s Wexner Medical Center, in an article titled “Do you really need to stretch? Science weighs in,” reported in 2018 in the Chicago Tribune.
Stretching also stimulates the body’s parasympathetic nervous system to release endorphins, our body’s feel-good hormones. As a result, many people feel calmer and have a clearer mind after stretching.
Pain relief. Stretching has been used among athletes and rehabilitation centers to alleviate pain caused by anything from sports injuries to car accidents. Restricted movement can cause pain, inhibit movement, and create stiffness and achiness in our bodies. Stretching has been found to counteract these effects.
Studies have found that a routine stretching and strengthening exercise program reduces pain and improves function of associated joints and muscles. (See “Effects of a stretching protocol for the pectoralis minor on muscle length, function, and scapular kinematics in individuals with and without shoulder pain,” published in 2017 in Journal of Hand Therapy, for example.)
Now let’s look at some of the established stretching techniques available for massage therapists to learn.
Proprioceptive Neuromuscular Facilitation
In proprioceptive neuromuscular facilitation (PNF), range of motion and flexibility are gained by passively stretching a muscle while engaging in an isometric stretch. This method follows a specific protocol of contract-relax-stretch, as well as hold times and is recommended to be performed after a warm-up.
Jeff Myers, LMT, and an instructor at Bancroft School of Massage Therapy in Worcester, Massachusetts, explained the technique in more detail.
“Proprioceptive Neuromuscular Facilitation is a technique of stretching that combines both passive and isometric stretches in order to promote or hasten the neuromuscular mechanism through stimulation of the proprioceptors,” he said. “Simply put, PNF stretching fools the nervous system into relaxing the myotactic reflex, [or the] muscle contraction in response to stretching, allowing the targeted muscle to stretch further than with more traditional styles of stretching.”
The massage therapist passively stretches the intended muscle to its comfortable end range while offering resistance to contraction, said Myers. The client uses approximately 25 percent of their strength. After a count of eight to 10 seconds, the client relaxes, and takes a breath as the therapist stretches the muscle a bit further, holding for 10 to 15 seconds. This is generally repeated three times.
Herman Kabat, MD, PhD, and Maggie Knotts have been credited with developing PNF during the mid-1940s in the U.S. It is often included in sports massage training programs or certification courses.
Learn more about PNF through the International PNF Association.
Active Isolated Stretching
Active Isolated Stretching is a gentle assisted-stretching method that holds a stretch for no longer than two seconds and is then repeated. The antagonistic muscle is contracted while the targeted muscle relaxes.
Aaron Mattes, LMT, and author of Active Isolated Stretching: The Mattes Method, developed the technique over the past four decades. He based it on Sherrington’s Law, which states that a muscle will relax when its opposite contracts. His system’s motto is “lengthen and strengthen.”
Mattes said that Active Isolated Stretching increases range of motion and flexibility and also increases blood, oxygen, nutrition and water to cells in the body — and in turn, benefits the function of the brain’s receptors.
“This is a powerful application of the body’s physiology, and it’s done gently, Mattes told MASSAGE Magazine. “We found that holding a stretch for longer than two seconds activated the stretch reflex, so if you’re holding it longer then you end up with a fight-or-flight situation where muscles that you were trying to stretch by holding longer are contracting to protect themselves.”
Learn more about Active Isolated Stretching through Stretching USA.
Aaron Mattes, developer of Active Isolated Stretching, performs his technique on a young client. Active Isolated Stretching uses specific techniques to increase mobility and flexibility of a muscle or group of muscles. Courtesy of Stretching USA
Pliability Stretch
Pliability Stretch™ is a new frontier of assisted stretching. It’s a gentle stretching technique that addresses the missing component in exercise programs: Muscle pliability; or, the muscles’ ability to stay long, soft, and primed for activity.
With the Pliability Stretch method, the massage therapist begins with a proprietary assessment called Flex IQ™ to gauge the patient’s needs. Using this information, the therapist can customize stretch sessions accordingly.
During the session, the therapist applies gentle force to lengthen and soften a patient’s muscles while they stretch and relax. This promotes oxygen-rich blood flow and anti-inflammatory responses in the moment.
Through repetition, the Pliability Stretch method strengthens the brain-body connection that tells muscles to stay pliable. Compared to short and dense muscles, long and soft muscles are better able to absorb and transfer forces they encounter in sports and everyday life. This enables patients to train and perform everyday activities with less risk of injury and pain.
Pliability Stretch was developed in 2017 by Mara Kimowitz. Fitness and wellness professionals can get certified in the method through the Pliability Stretch course. The course begins with Level 1 and progresses to a Level 2 Corrective Exercise Specialist, and finally, a Level 3 Medical Specialist.
Level-3 practitioners can help people of all abilities, including those managing severe medical conditions. Massage therapists can receive continuing education credits thanks to an affiliation with the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB).
Learn more about Pliability Stretch through Pliability Stretch.
A pliability stretch session.
Stretch Therapy
Stretch Therapy is a system that includes stretching, fascial remodeling, strengthening, neural re-patterning and relaxation. It was developed by Judy Stowers, LMT, a certified Stretch Therapy instructor based in Arizona. Stretch Therapy is rooted in various stretching disciplines, including Kit Laughlin’s mind-body holistic approach to stretching.
Stretch Therapy is floor-based and performed on a mat versus a table. Stowers conducts a thorough assessment of each client and develops a specific program of stretches to teach clients what it feels like to stretch on their own. She trains them to do stretches at home once they’ve learned the technique and positions.
“I focus on how they can feel those sensations in their body, [and] how to do the stretch safely and effectively, and that in turn helps them to create a pattern and habit of stretching on their own, which leads them to a healthier and more productive life,” said Stowers.
Learn more about Stretch Therapy through Apex Bodyworx.
Judy Stowers, developer of Stretch Therapy, teaches her technique to clients and massage therapists. Stretch Therapy is a system that includes stretching, fascial remodeling, strengthening, neural re-patterning and relaxation.
Dynamic Body Stretching
At the start of her career more than 20 years ago, personal trainer and fitness professional Loretta McGrath noticed her clients were requesting stretching more than personal training, and so she soon shifted her professional focus.
She created the Dynamic Body Stretching method, a style of active isolated stretching, that includes easy-to-learn stretching sequences to improve the range of motion, flexibility and strength of a client. McGrath is also the author of Body Alignment for Life.
The Dynamic Body Stretching method is supported by a software program developed by McGrath to gauge a client’s range of motion and flexibility. The report gives the therapist a visual picture of the muscles that are weak or imbalanced, what sports might be hindered and what areas represent a high risk for injuries.
“Understanding the physical health of your client is imperative to create a corrective program,” said McGrath. “We do range of motion and passive stretching to get the gradings to log into the software. Then once we get all the data, it allows us to apply our own knowledge to correct their imbalances.”
Learn more about Dynamic Body Stretching through Dynamic Body Stretching.
Loretta McGrath, developer of Dynamic Body Stretching, performs her technique. The Dynamic Body Stretching method is supported by a software program developed by McGrath to gauge a client’s range of motion and flexibility.Courtesy of Dynamic Body Stretching
Fascial Stretch Therapy
The Stretch to Win Institute’s Fascial Stretch Therapy program uses four key principles to gain results for clients seeking a good stretch, among other health benefits:
• It is a traction-based system that focuses on opening the joints before moving into a stretch;
• It is based on stretching the body from the core out;
• It uses gentle, smooth, rhythmic movement;
• There should be no pain for the person experiencing it or practitioner doing it.
Ann Frederick, co-founder with her husband, Chris Frederick, PT, of the Stretch to Win Institute in Chandler, Arizona, said their assisted stretching method creates greater movement in the body and addresses joint decompression. “We are physically moving their body through space. It’s a bigger movement compared to myofascial, which is more local and direct. We work more globally. We are moving through different planes of the body,” said Ann Frederick.
“It is a technique that is based on finesse, not force. It is synergistic,” said Ann Fredrick, who has taught more than 5,000 students the technique over the last 20 years. The Fredricks co-authored the book, Fascial Stretch Therapy.
Learn more about Fascial Stretch Therapy through Stretch to Win.
Ann Frederick, developer of Fascial Stretch Therapy, performs her technique. Fascial Stretch Therapy is based on stretching the body from the core out with gentle, smooth, rhythmic movement. Courtesy of Stretch to Win.
Stretching at Franchises and On-Site
Franchise massage clinics and at least one app-based touch-on-demand company are also meeting client demand for stretching.
Elements Massage franchise now offers Stretch Massage to address clients’ limited range of motion. Massage Envy clinics feature the Streto Method, a total-body stretch that combines static stretching and minimum hold times of 30 seconds to bypass the stretch reflex and induce relaxation. The method begins with the neck and shoulders and moves down the body to the feet. It rests on over 15 years of massage expertise combined with the latest stretch research. It also incorporates PNF stretching.
The Streto Method is a combination of the latest stretch research with relaxation techniques inspired by yoga and meditation, said Massage Envy therapist Stacy Stevens, CMT. “The top-down approach through which each stretch builds on the others to provide a total body stretch experience is also unique.”
Soothe on-demand company now offers a stretch program for the workplace, Soothe Stretch, with which individuals can receive assisted stretching while at work. People whose employers are not subscribed to Soothe At Work can also request assisted stretching via at-home massage if they select the sports massage option.
Combine Stretching with Massage
As a massage therapist, you are poised to integrate assisted stretching into your practice. First, for established massage therapists, the client base is already there. You also have the anatomy background and the manual therapy experience to work with clients one-on-one and create tailored programs. Most massage therapists are already providing customized massage therapy treatments for their clients, so it wouldn’t be a stretch to add assisted stretching to your repertoire.
One way you can include assisted stretching is to offer combination sessions that include shorter massages and short stretch sessions that are 30 to 45 minutes each, in order to stay within the 60- to 90-minute time frame clients are used to. Or you can simply offer sessions that comprise equal parts massage and stretch.
Stowers offers one-on-one stretch therapy sessions and also gives her clients the option of a 30-minute stretch with a 30-minute massage.
“It stands to be a really positive integration,” she said. Her private practice is 60 percent stretching and 40 percent massage, which she said is the right combination to give longevity to her career and additional health benefits to clients.
Mattes agreed. While his practice is mainly focused on stretching, he works closely with massage therapists who have had success adding stretching into their services. “It stands all by itself but integrates beautifully,” he said.
Incorporating stretching techniques into a massage session is another way to go. You would have to make adjustments to your client’s draping to ensure they remain covered or limit table stretching to positions that minimize possible exposure — for example, stretching the neck, shoulders, arms, feet and providing leg traction.
Targeting a demographic that is already open to both massage and stretching, such as athletes or weekend warriors, is another possibility. Sports massage therapists may find that these techniques are similar to many of those being used in their session or that they can easily enhance their massage.
Jeff Myers suggests massage therapists gear toward athletes and sports-related injuries.
“In other words, sports or deep tissue massage with a clear focus on treating areas of the body most commonly stressed with specific athletic activity,” he said.
When it comes to integration of modalities, think big. Clients come in with specific health concerns they want fixed or improved. Consider offering stretching sessions and massage as part of a wellness package that would give the client the option of receiving both over a period of time to maximize their results. This may take asking more questions in the evaluation and educating clients on your stretch and massage program.
You can also offer small-group stretching classes. Some things to consider would be space for a class at your office, spa or wellness center. Group classes would provide a solid foundation for clients to learn about proper stretching techniques and for you as a therapist to further demonstrate your expertise as a health care provider.
Whatever direction you choose, adding stretching is likely to have a positive effect on expanding your practice.
How to Market Stretching
Aside from your hands, education is a massage therapist’s greatest tool — but if clients don’t know all that you have to offer, your expertise is like a book that sits on a shelf that is never opened.
Promoting your stretching specialty can be as easy as talking about it with your clients. Share with them that you recently completed stretch training and you are invested in learning new skills to enhance your massage practice. They would appreciate that because it translates into you offering them a better service. They will likely be eager to have you practice your new technique on them.
When considering different forms of marketing, don’t forget about word-of-mouth, as it is shown to provide some of the best-performing marketing leads. Friends who tell friends how incredible their stretch session with you was are likely to be on your schedule by week’s end, excited to have their own experience.
There are also niche-specific phrases you may want to consider using in your advertising, like stretch therapy, stretch therapist, and private stretching sessions. If the training program you completed offers a certification, include a note about that in your marketing material along with your massage therapist title. (For example, LMT and Certified Stretch Therapist.)
Remember to emphasize what problems you can solve with your new stretching modality. Your clients come to you for relaxation, stress relief, pain or achy joints. They want to feel something after their massage — and when they do, it’s that feeling and the service you provide that keeps them rebooking with you.
Marketing online or in a newspaper can increase your exposure to a wider audience. Many therapists are able to create and manage their own social media campaigns on Facebook and Instagram and stay within their budget.
In the end, you are your best advertisement. Practice what you preach, and share, share, share. Whether it’s sharing your expertise at a trade show, wellness event, with your client or through frequent posts on social media, keep putting yourself out there. The more you do, the more likely you will be seen by potential clients.
Network with Health Care Professionals
Massage therapists have the right combination of skills and empathetic nature to provide stretching therapy to clients. This modality can open new streams of income, provide your career with a fresh approach, and give your hands a rest on long days of service.
An assisted stretching specialty opens you up to networking with other health care providers who may have been out of your reach before. Consider reaching out to chiropractors, acupuncturists and personal trainers about referring clients to you. If they do not offer stretching, they may be looking for someone to send their clients to already. Talk with them about offering a referral rate or building a relationship of cross referrals. Perhaps you can schedule times to offer your service in their office.
In combination with massage, assisted stretching will give your clients relief from pain, and increase flexibility and range of motion.
Whether you decide to include some stretching techniques on the table or offer a full hour session, the potential to expand your practice and enhance your client’s health is here.
About the Author:
Aiyana Fraley, LMT, is a freelance writer and health care professional with more than 17 years of experience in the massage field. She teaches yoga and offers sessions in massage, Reiki, sound healing and essential oils. Her articles for MASSAGE Magazine include “Massage Therapy on the Integrative Medical Team” (April) and “What You Don’t Know about ADA Compliance Could Cost You—Big Time.”