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Avoid overuse injuries by following these suggestions

This is an excerpt from Soft Tissue Release by Jane Johnson.

Equipment Required

Soft tissue release may be applied without any equipment at all. The therapist locks the client’s muscles using his or her own upper limb. However, in some cases, using tools to help lock and stretch the muscles may be desirable.

Using Your Body to Apply STR

Your upper body provides a surprising array of options for applying STR. Forearms can provide broad locks, and elbows can provide localized locks; similarly, each part of the upper limb can be used for unique purposes. Massage therapists are notorious for sustaining upper limb injuries due to overuse. These can easily be avoided by using your forearms, fists and elbows using the suggestions provided here.


Forearms are used on large, bulky muscles, such as the quadriceps, calf muscles and gluteals. Your forearm provides a strong, broad lock, good for providing overall stretch and for use with clients who cannot tolerate a more specific lock. These locks are easy to apply, and the amount of contact with the client’s muscles can be varied—a forearm lock to the quadriceps is broad, whereas a lock to the calf is a little more specific. Even though forearm locks create more leverage and are safer for the therapist’s own joints, some therapists avoid these locks, claiming they find it difficult to assess tissues without using their hands. It is worth practicing STR using your forearms in order to avoid potential overuse injuries. The disadvantage of using your forearms is that they provide a less specific stretch than your elbow does, and forearms are difficult to use on small muscle groups.


Elbows are used in applying firm, deep pressure, which locks tissues in such a way as to direct the stretch to the tight parts of the muscle. Elbows are good for working large, bulky muscles, especially when a client wants to stretch a muscle actively or where there is palpable tightness, perhaps resulting from scar tissue. Elbows are also useful for targeting strap-like muscles, such as the levator scapulae, or on muscles that would not be properly locked with the use of forearms due to their location, such as tibialis anterior and fibularis (peroneal) muscles. Using an elbow to lock tissues does not necessitate the application of force. With practice, elbows may be used sensitively on levator scapulae and around the upper fibres of the trapezius in order to provide a localized lock.

Soft Fists

Sometimes it is necessary to provide a broad lock, but there is not enough room for your forearm or hands. Using cupped fingers and applying a soft fist works well on pectorals. You can use the pads of your fingers, but the fingers might press into the ribs, which would be uncomfortable for the client because the pectorals are strong and need a fairly firm lock.

Single Fist

To work an area more specifically than with a forearm, but less specifically than with an elbow, you could use a single fist. This technique works well on the small area of the rhomboids and when working the hamstrings of a client for the first time to gauge resistance in the tissues.


Palms provide a flat surface for a lock but place some stress on the therapist’s wrist joint, so they should be used with care. Because palm pressure is not deep, it is good for providing a gentle lock, which is useful for the application of mild STR before or after sporting events.

This is an excerpt from Soft Tissue Release.

More Excerpts From Soft Tissue Release