A lot of runners swear by this sometimes painful form of bodywork. What is it, and do you need it?
Think of Active Release Techniques (ART) as massage’s crazy cousin that works harder, faster, and more efficiently. It helps athletes ranging from runners and triathletes to NFL players and Olympic weightlifters.
ART began in the ’80s with Colorado’s Dr. Michael Leahy and is now a gold-standard treatment. “In the beginning, the idea was to train 10,000 medical professionals and therapists at a skill level that had never been done before,” said Leahy. “We wanted to cut soft-tissue treatment costs in half. We’ve done that.” The ART provider network now includes 14,000 certified providers, mostly based in North America, but it’s quickly growing on an international level.
ART involves intense active movement-based massage treatments, which sets it apart from passive massage techniques. Injured or not, Leahy said that athletes in training are a candidate for ART. There’s ample evidence to show that ART promotes faster recovery, restoration of normal tissue function and prevents injury. “We fix things before the athlete even knows there’s an issue. ART is how you keep yourself in the game,” said Leahy. “The most limiting factor to race-day performance is how well and consistently you train, but certain issues can hold you back. That’s where ART comes in—you can train better.”
There are more than 500 established treatment protocols for the entire body; however, ART is anything but standard. It’s an art. Instead of treating a general area, the provider uses his hands to feel for abnormal or damaged tissue in muscle, fascia, tendons, ligaments or nerves. Abnormalities include scar tissue, adhesions, and dense tissue. These aren’t always easy things to find.
“It takes time to get the feel of what different tissues feel like and knowing what’s healthy versus abnormal tissue,” said Dr. Vince DiSaia, a certified ART provider and chiropractor located in Orange County, Calif. “But knowing the feel of tissue and correct muscle-movement patterns is what allows us to be very specific with diagnosis and treatment.”
Damaged tissue, namely scar tissue, has two causes: acute trauma, such as a tear or pull, and overuse or chronic injury, which is an accumulation of microtraumas, or small tears that occur repeatedly.
Abnormal tissue can go unnoticed by an athlete or it may manifest into injury. Symptoms of damaged tissue are tightening and shortening of the muscle. This impairs performance due to a loss of mobility, restricted range of motion and loss of strength. Other side effects include poor biomechanics, overcompensation in other body parts, nerve entrapment, tendonitis, and lack of oxygen supply to an affected muscle.
“Often a patient doesn’t know scar tissue is building up until it’s too late and the pain begins,” said DiSaia. “That’s where my job gets unique. I have to unravel the body and trace larger issues back to potentially smaller ‘insulting’ issues. For example, a patient comes in with IT Band Syndrome, but I find ITBS is caused by a dysfunctional hip. You can’t always just look at the part that hurts. I also check for proper functioning, strength deficiencies and what movements need improvement. This is where knowledge of biomechanics, anatomy, strength and sport all come into play.”
Added Leahy: “The most common issues I see in endurance athletes and runners occur between the knee and the hip. Every person we see at Ironman Hawaii, for example, has something going on in the hip.”
Once the problem areas are exposed, the pain— or is it fun?—begins. The ART provider applies intense and repetitive movement-based massage techniques to release buildup of dense scar tissue, restore normal function and decrease bad pain. Incorporating movement allows tissue to heal in the correct patterns.
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“It’s aggressive, but each treatment is significant. In my experience, ART is the fastest road to recovery out there,” said DiSaia, who’s been practicing ART for nearly a decade.
Leahy agrees, saying it’s typical to have positive results after just one session. “ART is very direct. You have a better chance of getting over something fast or simply being able to feel better running, even if you didn’t think you had an issue,” he said.
Still, every patient responds differently to ART. Some heal faster, while some are more sore after treatments. Some can handle intense treatments on multiple body parts in one session, while some can only handle treatment on one issue at a time.
It’s the provider’s job to talk to his patients thoroughly at the beginning of every session—not just the initial consultation—to find out how they feel and how they’re responding. “Treatment is catered to patient tolerance,” said DiSaia. “I won’t go above someone’s pain threshold.”
For the active in-training athlete, it’s suggested to get at least one or two ART sessions a month, especially when it’s getting close to competition.
Injured athletes are a slightly different case. “I’ll see them throughout the healing process and advise them to slowly reintroduce the activity,” said DiSaia. “Often their body is now functioning differently than it was in the injured state or they have to change their biomechanics. Checkups are vital.”
About The Author:
Tawnee Prazak is a triathlete, coach, personal trainer and exercise scientist living in southern California.