Active Isolated Stretching: Empowerment through Flexibility
By Marjorie Brook
Active Isolated Stretching: Empowerment through Flexibility
By Marjorie Brook
Massage therapists are expected to alleviate stress, help with relaxation, and relieve pain caused by injuries, repetitive use and physical limitations. A therapist's success in doing so often leads clients to view their massage therapist as a "cure-all." Sooner or later, however, a massage therapist might be faced with questions from their clients such as: "Why does the pain keep coming back?" or "I feel better, but I am afraid to do anything that might start the pain again."
If you would like to empower your clients to take an active part in their own health, consider incorporating Active Isolated Stretching (AIS) in your treatment protocol. While AIS is not the only tool I use, it is my favorite hammer, so to speak. One of the best things about using AIS is that you can teach your clients alternate ways of doing some of the stretches themselves at home while you are working with them.
AIS is a scientifically designed flexibility system that works with the body to create and maintain balance. The method was pioneered and developed by Aaron Mattes, MS, RKT, LMT more than 30 years ago. AIS helps the body to function more efficiently by increasing the range of motion (ROM) of the joint and aiding in neuromuscular re-education. With AIS you isolate each muscle and perform a series of stretches that target the fibers at every angle. Due to the isolation of the muscles, the body is unable to engage any compensatory muscles to perform the stretches. It quickly becomes clear how different muscles have been compensating for pain and injury to direct you right to the problem area(s).
How AIS Works
There are two primary principles that provide the basis for how AIS works. The first is the mechanism of reciprocal inhibition and innervations working together. If you want to lift your arm, your nervous system has to shut off the muscles that bring your arm down (inhibition) while turning on the ones that lift it up (innervations). AIS works with your nervous system and in the process, re-educates the muscles how to function properly and how to utilize and maintain full ROM.
The second principle is to hold the stretch for 2 seconds. Holding a stretch for longer than 2.5 to 3 seconds triggers a protective stretch reflex in the muscle fibers, and the muscle you are trying to stretch contracts. By not tripping the stretch reflex, you are able to get a gentle stretch without having the body work against itself. The stretch is repeated eight to 10 times in a set. The repeated "pumping" action of the muscle allows for increased circulation to the area. By targeting very specific angles of the muscle and promoting full ROM of the joint, the results are a highly efficient and effective stretch, affecting the muscles from origin to insertion. It reaches areas our fingers and hands cannot go. With AIS, you can address injuries such as sprained ankles and pulled muscles as well as physical disorders such as sciatica, multiple sclerosis, scleroderma, scoliosis, and paralysis. Most important, you give your clients the ability to fend off the multitude of physiological and psychological effects their disease or reoccurring injury is causing.
Client Success Stories
I have used AIS with success for clients ranging from children to seniors and presenting a broad range of problems. Below are the stories of two clients who experienced dramatic results with AIS.
Client Story 1: "Tom," 49, suffers from multiple sclerosis (MS). When physical therapy and pain management no longer yielded results, his insurance company stopped coverage, leaving him house-bound without any means of therapy or aid. As a former college athlete, Tom was utterly frustrated at his loss of control over his own body.
When I met Tom, he was 60 lbs overweight, wheelchair-bound and depressed. I explained how AIS works and that I needed his help if the therapy was going to be successful. He looked doubtful but said he would do whatever he could. Since Tom was starting to experience drop foot and his ankles were very swollen, I started there. After showing Tom how to use the stretching strap to assist himself, I asked him to concentrate on lifting up his foot and giving a light pull on the strap at the end of the move. While we worked together, his edema went down, and Tom started to get excited. The motor functionality in his feet started to improve, and Tom's enthusiasm increased. As we progressed on to other areas of his body, I explained how he could perform the stretch on his own, and I also showed his wife how she could assist him. After two sessions, Tom insisted on coming to my office instead of having house calls. After six visits, Tom amazed and thrilled me by coming up the walkway to my office using his walker. His wife informed me with a big smile that he had been doing his exercises every day and his whole attitude had changed. Today, Tom has lost 40 lbs, goes out with friends again and seems to have a new lease on life. He still has bad days and setbacks because of MS, but with the help of AIS, he has the ability to slow down its progression and take some control back over his life.
Client Story 2: "Brad," 14, has pectus excavatum (also known as sunken or funnel chest). Brad's mother is a client who came to me for scar tissue release therapy. She asked if I thought I could do something for her son's fingers, which had been broken two years prior and had not healed properly. As soon as I met Brad, I knew that his fingers were the least of his problems. Despite standing slouched forward, typical of many 14-year-old boys, I could clearly see that his right shoulder was internally rotated and basically stuck to his chest. The left side was rounded forward in compensation with the right. His arms were rotated outward, giving him the appearance of normal function. His head also jutted forward. As far as his fingers were concerned, the phalanges of the two middle fingers were truly sticking out. The fingers had never received any rehabilitation. After a few stretches, I showed Brad specific AIS exercises and gave him a hand-exercise ball to take home.
Once his fingers were taken care of, I asked his mother to explain what was going on with his shoulder. Apparently Brad had broken his collarbone coming through the birth canal. He was put in a sling and that was it. Over the years, she had asked the doctors if there was a problem with the way Brad's shoulder was developing and the reply was always the same: "No that is just the way he is growing." So with her and Brad's permission, I started to work on his shoulder. I gently went through the protocols for the shoulder and neck while explaining to him what I was doing and why. I made sure that he was actively involved in every aspect of the session. Within 20 minutes, Brad's shoulder was no longer pressed against his chest and was already gravitating to its proper functional position. I gave him a homework assignment of stretch and strength exercises and went to work on his mom. While I was working on her, I could see Brad moving his shoulders around. When I asked him how they felt, he replied: "Weird, but in a good way."
On Brad's second visit, he told me that baseball practice was awkward at first because he kept overthrowing the ball until he got used to the way his shoulder was moving. On his third visit, he told me that his endurance was better. I asked him if he was able to take deeper breaths and get more oxygen into his lungs, and he said yes. His mother was happy that she no longer had to tell Brad to stand up straight. On his fourth visit, his mother told me with tears in her eyes how Brad was doing so well in basketball now that the other night he and his father would not come in out of the rain; they just kept shooting basket after basket. Brad continues to come once a week for stretching and strength training. All of his atrophied/undeveloped muscles are coming back to life, and he is learning how to use his body more effectively. Recently, he asked if we could start stretching his legs since soccer season was starting up.
Incorporating AIS in Your Practice
It is always a challenge to introduce any new technique to your clients. People usually prefer the security of your established routine and are wary of anything new. It is slightly more so with AIS since it requires the patient to be an active participant. If a client is hesitant, you can start by introducing small sets of stretching at the beginning of the session before you start to massage. The cervical and wrist stretches can be performed with the client already undressed and on the table. You can also offer to stretch an area of injury or discomfort, like sciatica, before the client gets undressed as a free demonstration. Eventually, you can offer a half-and-half session where the client can be stretched first and then receive a massage. Once your clients experience the results of the stretching, they will be more inclined to book whole stretching sessions.
AIS is a simple and effective technique that helps to enhance performance, decrease the likelihood of injury and reduce muscle soreness. It helps to increase blood supply and lymphatic flow and the delivery of nutrients on a cellular level. AIS improves ROM of the joints and aids in neuromuscular re-education. Used therapeutically, AIS works with the body, not against it, and empowers clients to take an active role in their own well-being. Furthermore, it works hand-in-hand with massage and other bodywork techniques. Inspiring your clients to be active participants in their own healing process and maintaining their health is the most powerful effect of all.