Massage therapists tend to bend over clients, using a lot of forward movements of the arms. Active Isolated Stretching resets the body, reminding us of what it feels like to be upright with good erect posture.

Self-care of the shoulder with Active Isolated Stretching (AIS) is essential for massage therapists who often use forward arm movements. AIS helps reset the body and improve posture and flexibility with short, two-second stretches that avoid triggering pain. By adding AIS to their daily routine, massage therapists can prevent scar tissue, increase movement, and recover faster from shoulder injuries, ensuring long-term shoulder health and reducing discomfort.

The author, Lois Orth-Zitoli, shares her experience of using AIS to treat her own shoulder sprain. By gently and repeatedly moving her shoulder, she was able to reduce pain and increase movement. This method helps prevent scar tissue from forming and allows for early self-rehabilitation, which is crucial for recovery.

As a clinical massage therapist for 32 years, my continuing education has always been focused on learning methods to help people heal from injuries. But as I think back on the experiences that have offered me the most profound learning, I have to tell you that I have always learned the most about a particular injury by having that injury myself.

In these situations, I use my body as a personal laboratory to discover the requirements for healing.

Please do not misunderstand me; I am not suggesting that you need to injure yourself to learn about treating injuries. Hopefully, just reading this article will suffice.

Active Isolated Stretching for Shoulder Sprain

When I crashed on my bike and landed on my left shoulder, I tore the acromioclavicular ligament that holds the acromion process and the clavicle together.

Luckily for me, it was only a grade-one sprain, which doesn’t require surgery. I can’t imagine what a grade-two sprain must feel like, because the pain was bad enough that I had to get a scissors and cut off the shirt I was wearing because I couldn’t move my arm enough to get my shirt over my head. This was not one of my happier days!

It would have been an acceptable protocol to let my arm rest in a sling until the pain subsided, and I could get in to see a physical therapist. But since the body starts to lay down scar tissue within 24-hours of an injury, I wasn’t going to allow myself to become immobile. I began taking my arm out of that sling for movement sessions the day after my fall.

If you have ever observed an animal in the wild after it has been injured or attacked, you have seen that animals rehabilitate by doing slow, gentle movement until they can function again. So I used this same principle for my injury: I started doing slow, easy movements of my shoulder.

I did tiny movements with my arm hanging at my side, medial rotation and then lateral rotation, only going to the edge of the pain, and then moving away from it, in and out, over and over.

I used the principles of AIS as my guide, moving only to the end of my active range of motion (ROM) on each of the stretches and then trying to go a little past that place as pain allowed. With each repetition of a stretch, the pain lessened and movement increased.

Because it took me almost two weeks to get in to see a physical therapist, the techniques of Active Isolated Stretching (AIS), a method of stretching developed by Aaron Mattes, LMT, a kinesiotherapist from Sarasota, Florida., allowed me to start doing some rehabilitation of my shoulder myself, using movement and stretching to prevent scar tissue from adhering as it formed.

As my shoulder healed, I did all of the stretches shown in this article to restore my range of motion.

Active Isolated Stretching: Move In & Out

As massage therapists, we tend to bend over our clients as we work, using a lot of forward movements of the arms. AIS shoulder stretches serve to reset the body, reminding you, proprioceptively speaking, of what it feels like to be upright with good erect posture.

Let’s review the steps in the AIS method before we delve into the shoulder stretches. AIS is a unique approach to stretching because, unlike traditional stretching, one only holds each stretch for two seconds. In this way, you never trigger the stretch reflex, and most importantly, stretching doesn’t hurt.

Another feature is that you move in and out of the stretch—that’s the active part—meaning there is a starting point and an ending point (end range of motion) where you move two-to-three degrees past your active end-range to apply the stretch. This active motion helps to detoxify the body, because as you move the body part being stretched you are moving blood and lymph, which increases oxygen and nutrition.

The other feature of AIS that assists this detoxifying effect is breathing. As you do each stretch, you exhale during the stretching phase, and you inhale as you move back to the starting position between each stretch. Each stretch is typically repeated 10 times during a stretching session.

Even if you have pain or very little range of motion in your shoulder, you can still do these stretches. Because you repeat the stretches, there is no need to push yourself to achieve your deepest stretch on the first one. Especially if you have a sore, stiff shoulder, you can actively move to a place where you feel a little pulling sensation and then apply a gentle assist to increase ROM, counting 1,2,3, as you exhale, then releasing the stretch and moving back to the starting position.

The 5-Step Active Isolated Stretching Process

Below is a summary of the five steps involved in Active Isolated Stretching that I have just described:

1. Move the body part being stretched to the starting position for the stretch.

2. Gently stretch the body part two-to-three degrees past the endpoint (endpoint) and hold the stretch for two seconds (count 1, 2, 3).

3. Inhale during the movement phase of the stretch and exhale during the stretch.

4. Move the body part being stretched back to the starting position between stretches.

5. Repeat each stretch 10 times.

Stretches for You to Try

Warm-up Circles (circumduction): To warm up the shoulders in preparation for stretching, lean over with your spine at a 45-degree angle to your body. Let your arms dangle, and allow them to hang in front of you. Start making small circles with your arms and gradually increase the size of the circles. Reverse the direction of the circles after a minute or so. If needed, you can slightly bend your knees to take pressure off your back.
Horizontal Abduction: Place your arm at shoulder level with your palm pressed against the wall. To stretch your anterior chest and shoulder muscles on the right side, place your left foot forward in a lunge position. Sink into a lunge as you rotate your torso away from the wall, pressing your palm against the wall’s surface. Move your arm forward as shown between stretches. To stretch different sections of the pectoralis major, minor and anterior deltoid muscles, gradually move your arm down and then up the wall. Remember to move your arm back to the starting position between stretches and to exhale during the stretch.
Horizontal Abduction variation
Double Arm Hyperextension: For this stretch, find a surface in your home that is higher than a table. A kitchen island or a cabinet should work. Place a folded towel or a pillow on it for added comfort. Medially rotate your shoulders, and place the backs of your hands on the surface of the counter. Place one foot in front of the other; sink your hips toward the floor as if you were doing a squat. Return to a standing position between stretches. Repeat stretches with your arms in a thumb-down and a palmdown position to isolate the fibers of the biceps and anterior deltoid muscles.
Above: Double Arm Hyperextension variations
Horizontal Flexion: With your elbow straight, reach your arm across your body with your thumb up and your palm facing your body. Be sure to keep your shoulder from moving up or rolling forward. Use your hand or crook of your elbow to pull your arm closer to your body, keeping your arm parallel to your shoulder during the stretch. Return to a starting position between each stretch. Try the thumb-down and palmdown variations of this stretch. This series stretches the rhomboids, infraspinatus and teres minor.
Horizontal Flexion variations
Triceps Stretch: Using the wall, bend your elbow and place your triceps muscle against the wall. Lean into the wall for the stretch, extending your flexed arm upward with your elbow moving in a diagonal direction behind your head. Engage your abdominal muscles to avoid arching your back. Move your arm down and up between stretches.
Forward Elevation: With a straight arm, reach your arm forward and overhead. Place your hand on a wall or side of a doorway. With your lower body in a lunge position, lean into the doorway or wall until you feel a stretch in your shoulder. Move your arm down and up between stretches.
Rope Stretch: Place your lower arm behind your back with your palm facing away from your body. The upper arm is bent at the elbow (like for triceps stretch) with the palm facing your body. Fold the rope in half and place the loop in your lower hand, while your upper hand holds the other end of the rope. Use the hand nearest to your head to pull the rope so that the lower arm moves up the spine between the shoulder blades. Ease up on the rope’s tension between stretches to allow your lower arm to move back to the starting position. If you have flexible shoulders, try to clasp your hands together without the rope. A hand towel can be used to assist you in this stretch if a rope is not available.

Incorporate Active Isolated Stretching into Your Day

With each repetition of a stretch, you will feel your active end ROM increase. To incorporate some AIS stretching into your day, I would recommend warming up before seeing clients with a few of the stretches pictured in this article. You can easily do one or two stretches between clients, and it also feels lovely to decompress before bed with stretching.

If you find yourself reading this article and thinking, “What’s the big deal? It’s just stretching,” here is what I must say to you: You will probably be familiar with most of these stretches, but just try doing them the way I describe: with a short duration, moving in and out of the stretch, and 10 repetitions. You have to feel it to understand the benefit, just like a massage.

AIS will enhance the health of your muscles, tendons, ligaments, fascia and joints and decrease your vulnerability to injury. I hope you will find it easy to make these stretches part of your daily routine.

About the Author:

Lois Orth-Zitoli, LMT, is a public speaker, teacher, massage therapist and health coach. Lois owns Full Circle Health in Chicago, Illinois, and teaches workshops in the Benjamin method of orthopedic massage and injury assessment, as well as stretching workshops.

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