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Cover about 3–4 inches with each application, coordinated with movement of the knee. Repeat several times until the entire area has been thoroughly treated. Give the client a short break after performing about three or four of these, so they are not overwhelmed with excessive sensory input from the simultaneous movement and treatment. Stripping techniques applied during eccentric elongation enhance pliability of the retinacular tissues and decrease excessive pull on the patella. The quadriceps is a powerful muscle group and sometimes lifting the leg by itself in flexion and extension does not recruit sufficient muscle fibers to generate good tension on the retinacular tissues during movement. You can recruit more muscle fibers by adding additional resistance to the movement at the same time you are performing the stripping technique using a resistance band, ankle weight, or simply offering resistance with your hand. When more fibers are recruited during the eccentric motion, the stripping technique is more effective. To use a resistance band, simply loop it around the ankle and step on the other end to anchor it to the floor. Keep in mind that as the client moves through extension, the resistance is constantly increasing up to the final point when the knee is straight. Resistance is gradually decreasing as they move the leg down into flexion while you perform the stripping technique, but a significant number of fibers are still being recruited for this action. Manual resistance may also be used for the eccentric knee extension. Instruct the client to hold the leg in full extension while you offer resistance. Once you establish a level of contraction, instruct the client to slowly let go as you gradually push her leg through the flexion motion, while performing a stripping technique on the retinacular tissues around the knee (Image 4). This process can be repeated several times until all the tissues around the knee are treated. 100 m a s s a g e & b o d y w o r k n o v e m b e r / d e c e m b e r 2 0 1 5 4 You can also incorporate manual resistance when applying active eccentric lengthening techniques.