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Safety guidelines for passive STR

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

Safety Guidelines for Passive STR

Passive STR is safe and effective. However, it is useful to be aware of certain cautions before practicing this technique.

• When applying STR to the calf with your client in prone, make sure there are no locking clips on your treatment couch that may injure the dorsal surface of your client’s foot during dorsiflexion. When working with your client in prone to apply STR to the calf or hamstrings, avoid pressing into the popliteal space at the back of the knee.
• When working rhomboids in prone, be careful not to place your client’s entire body to the side of the treatment couch. It is safer and more stable to have your client lie diagonally across the couch.
• Whilst working the biceps brachii, avoid putting pressure into the anterior of the elbow, the cubital fossa.
• When applying STR, protect your thumbs. If you find your client does not experience a sensation of stretch and needs a firmer lock, use an alternate lock. If you find that using a different lock places stress on your own body, consider using active-assisted STR, which often enables you to apply greater pressure and alter your stance to a safer working position.
• When integrating STR with oil massage, remember that it is much easier to provide a lock when working through a towel than when working through clothing or on dry skin. For this reason, apply your locks cautiously until you gain feedback from the client as to the appropriateness of your pressure.
• When using passive STR, always get feedback from your client and stop if the client reports pain.
• When applying passive STR, all the usual massage contraindications apply. For example, do not apply STR to areas where there are varicose veins, broken skin, recent injuries or decreased sensitivity.

When Is Passive STR Indicated?

Passive STR may be used directly through clothing all over the body as part of a general stretching routine, or it may be incorporated into a holistic massage treatment. It is useful when used briskly before exercise with the aim of increasing joint range and overcoming cramps. It is used after exercise to help realign muscle fibres and overcome cramps. However, in both pre- and post-exercise settings, it should not be applied too deeply. It is also a useful tool for assessing muscle pliability.

The table below provides suggestions for when treatment for particular muscles can be useful. 

 

 

Muscle	Situation
Calf	To treat calf muscle cramps For clients with tight calves For clients engaged in physical activity involving the lower limbs, such as running, tennis or basketball To treat clients who have been standing or walking for long periods To increase range of motion at the ankle or knee To treat clients who require increased ankle dorsiflexion (e.g., clients previously bedridden now required to stand) To stretch out the calf muscles of clients who wear high-heeled footwear (which results in excessive plantar flexion and possible shortening of these muscles)
Hamstrings	For clients with tight hamstrings For clients who sit for long periods, such as drivers or typists For clients engaged in physical activity involving the lower limbs, such as running or basketball To increase range of motion at the knee For clients with excessive lumbar lordosis
Rhomboids	For clients who are engaged in physical activity involving the upper limbs, such as swimming, racket sports or rowing
Triceps	For clients whose physical activities involve prolonged or repetitive extension of the elbow, such as in racquet sports For massage therapists For treatment after immobilization of the elbow or shoulder To increase elbow flexion
Biceps brachii	For clients whose physical activities involve prolonged or repetitive elbow flexion, such as rowing, digging or carrying For treatment after immobilization of the elbow or shoulder To increase range of movement at the elbow, particularly elbow extension
Wrist and finger extensors and flexors	For musicians such as guitarists, pianists, flautists or trumpet players In the treatment of lateral epicondylitis (extensors) In the treatment of medial epicondylitis (flexors) For clients who perform repeated or prolonged flexion, such as typists, drivers or people carrying heavy bags For clients whose sport requires gripping, such as in rock climbing or rowing For massage therapists For treatment after immobilization of the wrist or elbow
Pectorals	For clients with kyphotic postures For clients who sit for long periods of time, such as drivers or typists For bodybuilders, who may develop excessively tight pectorals relative to posterior trunk muscles For clients who use the pectoralis major as part of their job, hobby or sport, such as trumpet players, tennis players or golfers

 

This is an excerpt from Soft Tissue Release.

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