Passive Release with Hydrorelease: A Multi-Region Clinical Protocol and Ultrasound Technique Guide

Background and Objectives: Passive release — a release technique performed while the target tissue is held in a passively stretched position — applies to the joint capsule, ligaments, tendons, muscles, peripheral nerves, vessels and subcutaneous tissue; when the release is delivered by injection it is termed “passive release with hydrorelease”. In our experience, no local anesthetic is required, the stretched position makes tender stacking fascia easier to localize, and range of motion tends to improve more than with hydrorelease in a relaxed position. The aim of this article is to describe, in a reproducible form, the treatment points and ultrasound technique of passive release with hydrorelease across multiple body regions. Materials and Methods: This protocol is based on our clinical experience. Eight treatment points in six regions (forearm; shoulder; hip, anterior and posterior; gluteal region; posterior thigh; posterior knee) were selected from our practice. For each point, the patient position, the assistant-maintained passive stretch, the ultrasound visualization, the release procedure, and the safety considerations are described with demonstration videos. Results: The protocol is presented as eight point-by-point descriptions (P1–P8), each pairing a passively stretched position with hydrorelease of the target fascia, ligament or capsule, with the anatomical rationale and corresponding video (Videos S1–S8). Conclusions: This article describes passive release with hydrorelease as a reproducible multi-region protocol. It is a technique description based on our clinical experience; no claim of effectiveness is made, the technique is proposed as one element of multimodal care rather than as a stand-alone treatment, and its prospective evaluation remains a task for future studies.