10 | Akwa | December 2022 / January 2023 / February 2023 Release – Restore - Return Rehabilitation Utilizing AquaStretch™ Techniques AquaStretch™ is a unique combination of the client’s active, intuitive movement with manual pressure and assistance into end range from the therapist (facilitator). This combination leads to releasing fascial adhesions, restoring flexibility, and returning the client to a higher level of function. AquaStretch could be called aqua release because the primary objective is to free up fascial adhesions contributing to pain, reduced circulation, nerve impingement, and limited mobility. Fascial adhesions form between tissues that normally glide past each other. Adhesion formation is part of the natural healing process. Generally, during the remodeling phase of healing, the unnecessary adhesions are reabsorbed. If the client does not move enough or returns to activity too soon, these adhesive cross-links between tissues can become stronger and possibly calcified. Inactivity and lack of normal movement can lead to adhesion formation. Research shows fibro-fatty infiltrates within joints after a period of immobi- lization. This infiltration becomes fibrotic with more pro- longed immobilization. Additionally, histological analysis reveals significant ground substance changes - 30-40% loss of glycosaminoglycans (GAGs) and water. These changes transpire without sig- nificantly reducing collagen fibers. The ground substance, including GAGs, provides lubrication between tissues, and is associated with the critical inter-fiber distance, the distance collagen fibers must maintain from other fibers to prevent excessive intermolecular cross-links or micro-adhesions. Normal collagen has a half-life of 300-500 days; the GAGs only have a half-life of 1.7-7 days. Therefore, immobilized tissues become stiff and “dehydrated” in a short time. What does this mean clinically? First, movement stimulates ground substance production and rehydrates connective tissue, helping maintain the critical inter-fiber distance by lubricating the spaces. Movement also breaks down fibro- fatty macro-adhesions and guides the orientation of new collagen fibers as the body lays them down. AquaStretch provides a mechanism to break up adhesions and promote greater myofascial movement, preventing further adhesion formation. AquaStretch takes a whole-body approach based on the theory that the human body, with connective tissue and fascia, is a tensegrity structure. The term tensegrity comes from the phrase “tension integrity.” R. Buckminster Fuller describes tensegrity structure as demonstrating “continuous tension around localized compression.” Tensegrity structures maintain their integrity through a balance of tensile forces throughout the structure with compression elements within the body of continuous tension. With this configuration, strain is distributed throughout the structure, not just at the initial stress point. “It is the victims who cry out, not the criminals.” Diane Lee. The meaning of this quote indicates the cause of the symp- toms and pain may be distal from the area of complaint. A simple example is when a person breaks their foot and is in a walking boot, which changes their normal movement pat- tern, leading to possible adhesions both at the site of injury and up the lower extremity chain. Several months later, the person complains of knee, hip, or back pain. Which area do you treat? The answer is you treat the whole person. The body’s connective tissue links necessitate dynamic stretching of the whole body, not just the symptom area. AquaStretch addresses distal adhesions, first working towards the cranium; this helps restore normal movement patterns and reduce stress to the area of complaint. AquaStretch restores flexibility and mobility through mechanical release of adhesions, leading to pain reduction and providing mental encouragement to move. This active movement from the client is essential to releasing the adhe- sions. The motion the client goes through is called intuitive By Beth Scalone, PT, DPT, OCS
