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Active Release Technique?
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So one of the big stories coming out of Ironman this year was the "success" of Active Release Technique (ART). Anybody out there in slowtwitchland have experience with ART? Any ART certified providers who can offer info on the success of the treatment and know of any research that has been conducted?

I happen to be a physical therapist, who has very little working knowledge of ART, other than what I have gleaned from the website www.activerelease.com . I unfortunately also happen to be an injured physical therapist who has not been successful in treating my own injury. I am considering turning to the hands of an ART certified provider.

Greatly appreciate any info you can offer. California 1/2 IM is only 17 weeks away.


Dan Hollingsworth

Nobody grows old by merely living a number of years. People grow old only by deserting their ideals. Years may wrinkle the skin, but to give up interest wrinkles the soul." - Douglas MacArthur
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Re: Active Release Technique? [hollidan] [ In reply to ]
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I got my first ART session in the spring of this last year because I have had a continuous problem with injuries on my left side. I was getting nothing from the othor guys I have visited so I figured what the heck. He did a complete initial exam and then started work. A few of the procedures have been quite painful, but you feel so good after. I had regular sessions every week for the first couple of weeks and then every other week and then once a month.

To sum it up, it got me through IMMOO, I have lots less soreness, I'm more comfortable on the bike and the run and he "fixed" some residual problems in a shoulder from a busted collar bone. It may be in my head, but worth every penny. I'm sold and any friends that have had problems have had them taken care of in short order. My guy is level 3 and has worked at IM MOO previously.

For what its worth
Larry

Larry

Don't be afraid to ride too long or too hard. That's what cell phones are for. Rich Strauss
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Re: Active Release Technique? [hollidan] [ In reply to ]
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I tried it for the first time last year at IMFL. I didn't have any problems going into it per se, but I'm a typically unflexible, tight triathlete. ART really loosened me up, legs and hips especially, and I would credit it partly for a great run (for me) on race day. I know see an ART certified chiropractor once a month to treat a chronic neck problem. Also, very helpful.
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Re: Active Release Technique? [hollidan] [ In reply to ]
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How is ART different than deep tissue massage? Looking at the website it sounds the same to me. I have experience with deep tissue massage and have found the results promising. I'm going to start up regular therapies to see if I can get rid of some nagging overuse problems that haven't been solved by the M.D.'s I've seen.

They seem to make some 'outlandish' claims on the website, like patented technique, "fixed my shoulder in 5 minutes", etc. They sound more like a salesman than a therapist.

---------------------------------------------------------

"What the mind can conceive and believe, the mind and body can achieve; and those who stay will be champions."
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Re: Active Release Technique? [hollidan] [ In reply to ]
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I had shoulder surgery several years ago for impingement syndrome, and the post-op PT was not getting me to where I wanted to be. I started seeing an ART/chiropractic and it helped. I then moved and found another ART/chiropractic who also practiced "trigger point" therapy as well. This got me back to as close to 100% as I could have hoped. Long story short, what I learned along the way makes me think I may have never needed the surgery in the first place, just a better diagnosis and treatment regimen to correct the muscular imbalances that was causing the impingement. Of course, I'll never know now. I've read some claim that ART is nothing more than "myofascial release" marketed under a different name. I've never had it and am not an expert, so I can't really comment. I will say ART is unlike any deep tissue massage I have ever had. If the practictioner is certified, knows anatomy cold, and is partial to sports related injuries, he/she can do you a lot of good.
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Re: Active Release Technique? [Onyx] [ In reply to ]
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My understanding is that the same guy that developed myofascial release technique (MRT) also developed ART. He didn't patent (or trademark or copyright, whatever you'd do for this) MRT so it gradually evolved into a generic term. You'd go to one place that claimed they did MRT and you'd get something totally different than another place that supposedly did the same thing. By trademarking ART and having an ART certification he's better able to ensure that anyone can go to any ART provider and get the same treatment. At least that's what I seem to recall having read somewhere (maybe on their website at one point?)

In any case, I had ART done for in impinged nerve in the L5-S1 area that was causing pain and numbness in my hip and upper thigh. The treatments were initially very painful (more than they needed to be until I broke down and shaved my legs) but I saw results almost immediately. I've referred several people to him since then for everything from back pain to carpal tunnel syndrome, and everyone has had tremendous results.
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Re: Active Release Technique? [Jack in Mi] [ In reply to ]
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"How is ART different ....They sound more like a salesman than a therapist"

I'm a chiro with 22 yrs experience and from what I've seen of ART it's no really any different at all from other techniques that have been around for quite awhile. What they have done is amalgomated some, repackaged them and promoted it as being unique and different, which it's really not. This is quite common actually, as there is always someone coming out with what they claim to be the latest, greatest, newest and most effective technique.

The ART techniques have been well promoted but the ART courses offered ( I believe mostly for chiros) are quite expensive so the guys who developed it are likely making tons of $$$. Should have thought of it myself.
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Re: Active Release Technique? [jkatsoudas] [ In reply to ]
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"the same guy that developed myofascial release technique (MRT) also developed ART"

And before that it was called Nimmo technique and before that it was called......If you trace it back far enough it's very similiar to the accupressure and stretching techniques documented being done in Japan and China a thousand years ago.

The science is understood better now, but essentially ART and all the others are just modern variations.
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Re: Active Release Technique? [hollidan] [ In reply to ]
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My Chiropracter in IL uses ART. Not exactly what ART is, but he found my problem and fixed my knee so I am a believer. I went from barely running in July to slowly finishing IMWI in September. He also goes to Kona and Ironman Wisconsin as a volunteer to help those in need.


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Re: Active Release Technique? [cerveloguy] [ In reply to ]
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And before that it was called Nimmo technique and before that it was called......If you trace it back far enough it's very similiar to the accupressure and stretching techniques documented being done in Japan and China a thousand years ago.

The science is understood better now, but essentially ART and all the others are just modern variations.

-------------------------------------

True, but the standardization of the technique seems like it's a key part of their sales pitch, and I can see a value in that. It's similar to Dan's FIST certification for tri bike fitting. I know that I can go to any competent FIST-certified shop and come away with a fit that's probably within millimeters of what I'd get from another FIST shop. I also know they're not going to try to put me in a "big slam" position or use KOPS, or something like that. I'm sure may people can attest to the ridiculous fits that have been inflicted on people by supposed "tri fit experts".
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Re: Active Release Technique? [jkatsoudas] [ In reply to ]
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"the standardization of the technique seems like it's a key part of their sales pitch"

Exactly. But quite often it doesn't always work that way as people will often integrate bits and pieces from other courses they have taken, so often one X,Y,Z technique person can end up being quite different from the other. This can actually be a good thing as sticking only to one "cook book" sytem will in time often be quite limiting. And sooner or later somebody else will be coming out with something claimed as "newer and better" anyways.
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Re: Active Release Technique? [Jack in Mi] [ In reply to ]
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I've had various nagging injuries as well as general tightness from running, biking, etc. I get massages pretty regulary for the tightness, etc, but when I have something that just won't heal or get better - knee problems (as mentioned by another), ITB, piriformis - ART always fixes it. Can't tell you how the specifics are different from massage, just that it works.
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Re: Active Release Technique? [hollidan] [ In reply to ]
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It's the only thing that worked with hip bursitis that I had last year.

clm
Nashville, TN
https://twitter.com/ironclm | http://ironclm.typepad.com
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Re: Active Release Technique? [cerveloguy] [ In reply to ]
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As a Chirpractor and ART provider I can say that few courses including a three yr sport fellowship have helped my patients as much as ART. ART is NOT a repakaging of Nimmo which is a much different technique and a much different therory than ART.



ART is a soft tissue management system designed to diagnose and treat soft tissue adhesions between adjacent structures such as when two muscles overlay each other. In a normal healthy situation these muscels are covered by fascia that is well lubricated and they slide in relationship with one another with little friction as if they were both covered with the slipery side of scotch tape. When they have scar tissue or adhesions between them they move poorly and with increased friction as if the sticky sides of the tape were dragging on each other.

P.S sorry about the spelling but I havn't figured out the spell check option here

The ART provider uses an indepth knowledge of functional anatomy, the relationship of the offending structures to each other and careful palpation to contact the adhesion and with specific patient motions help remove the adhesion and restore normal movement between the structures.

This therory is quite different from Nimmo, trigger point therapy, and other soft tissue tequniques.

In practice I would be considered quite conservative and a critical thinker when it comes to new techniques. ART ,I can honestly say ,t has revolutionized my treatment of certain types of injuries and patients. It is not a pancea for all injuries but for the athletic population that is prone to repetative strain injuies it is a safe, goal orientated and effective treatment with a very favorable cost/benifit ratio.
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Re: Active Release Technique? [logan] [ In reply to ]
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"As a Chirpractor and ART provider I can say ...."

Your description of what it is/does sounds almost as if it was taken directly from the seminar notes.

However, since I haven't taken the course I can't argue with you, but I have been in this field long enough to believe that nothing is totally original, despite what may be claimed.
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Re: Active Release Technique? [logan] [ In reply to ]
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So does that mean it treats the same injuries differently, or it treats a different problem that the others can't, it uses different pressure spots?

You state that's it different, but not in specific ways. What makes it so different? I'm about to spend my time and money going to get MRT and trigger point therapy, and I would like to know why ART would be better. Or is ART better? It's not clear. There are just a lot of broad statements, but to me (the uneducated) it doesn't sound much different. Do you have any examples of a situation where ART works and trigger point doesn't, or MRT doesn't? I tend to agree with cerveloguy on this one, but I'm willing to listen to your insights.

Thanks,

Jack

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"What the mind can conceive and believe, the mind and body can achieve; and those who stay will be champions."
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Re: Active Release Technique? [Jack in Mi] [ In reply to ]
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"I tend to agree with cerveloguy on this one,"

You an cerveloguy may be correct. But the problem is finding the chiropractor / practitioner for which this is old hat -- because some don't know what they're doing, whereas others know incredibly well what they're doing. How is John Q. Public to know where to go? At least with ART (or equivalent, whatever that may be) certification, the athlete has a better idea of whether the person can deal with soft tissue injuries.

Those with ART certification are perhaps not perfect, but will have some clue about certain types of problems, and are probably more tri-sympathetic / tri-understanding on average than the average chiropractor.

Note, this post is not intended to deny that cerveloguy may know as much as any five others put together; but it is partly about finding a gem like him when hit-and-miss is sometimes the name of the game.
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Re: Active Release Technique? [hollidan] [ In reply to ]
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I'm not too familiar with ART itself, but it sounds like the modality has merit to it. There is a vast amount of ways to treat a medical problem. A general rule I use is: whatever works, works. The problem is, "how can I find what works for me?" While this may be ART for many (which seems to be valid from the testomonials I've read), this may not be the case for others.

I am an osteopathic medical student in Chicago, so I am a bit biased. Osteopathic medicine is an excellent resource, especially for sports medicine. Many people aren't familiar with osteopathy and D.O.'s (doctor of osteopathy), but may be surprised to find that you may already be seeing one as your own physician. D.O.'s, like their M.D. counterparts, are fully qualified medical physicians. They may perform surgery or prescribe medicine but, unlike M.D.'s, they are also able to employ manipulative medicine as a modality of treatment. Many of the techniques we use are very similar to ART, but D.O.'s often times have better resources available for diagnosis and treatment. This allows the D.O. to tackle a medical issue from a variety of different standpoints and they are thereby able to tailor treatment for what each individual may need. I think this is an excellent opportunity for patients and, in my opinion, a first-line approach to solving their medical problems.

The head of my OMM (osteopathic manipulative medicine) department has been working with athletes for many years, including many of the Bears players. Many other professional sports teams also have D.O.'s as their team doc's as well because they recognize the resources that these physicians bring to sports med.

Anyways, I am very open minded to different aspects of medicine such as chiropractors, massage therapists, acupuncture, etc. These all play important roles in medicine. But, for me, osteopathic medicine is a great place to start when you have an injury. Besides, you can also take care of any other medical issues at the same time.

if you like, check out the AOA website http://www.aoa-net.org/

Ben
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Re: Active Release Technique? [hollidan] [ In reply to ]
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having heard much about the benefits of ART, i gave it a whirl... i ended up getting about 5 minutes of ART therapy for an additional $40 on top of my normal $10 copay per visit to my chrio. Sorry to say, the end result was a lighter wallet and no change in condition. For what it's worth, ART is patented, so the technique can be better understood by reviewing the patent applications which is free and available to anyone.

jg

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Re: Active Release Technique? [pedaller] [ In reply to ]
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I agree that this may be a big advantage for ART, it's just that the website turned me off and struck a nerve with the way they were selling the product. There is no better advertising than word of mouth, and triathletes have proven they will flock to things when someone says it works. The website just sounded like one of those diet pill or penis enlargement commercials. I tend to think companies are overcompensating for something when they make claims like that. Maybe they're true, I don't know. They would be more successful with me describing ART in the way you did, rather than "patented" and all the rest. But, maybe I'm just being picky and grumpy.

---------------------------------------------------------

"What the mind can conceive and believe, the mind and body can achieve; and those who stay will be champions."
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Re: Active Release Technique? [thaitriguy] [ In reply to ]
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Thaitriguy,

Thanks for the link. Since I've been plagued with sports and overuse injuries, I'm always interested to hear the different philosophies of medicine. Your posting is another example of what makes this forum so great, a joining of so many different perspectives to learn from.

My experience has been almost exclusively with M.D.'s, and I wonder how a D.O. might tackle problems differently. Do most D.O.'s perform the manipulative medicine themselves, or refer to massage therapists? If so, how do their services compare financially to a massage therapist? A big issue for me is that I am largely restricted in my choice of doctors by insurance. In otherwords, if I am paying out of pocket, is a D.O. still a viable option for similar types of treatment performed by massage therapists? Are there any networks that list D.O.'s and their specialty by geographical location? (Note: after I typed this up, I checked out the website and found a list of sports medicine D.O.'s in Michigan, thanks)

Jack in Mi

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"What the mind can conceive and believe, the mind and body can achieve; and those who stay will be champions."
Last edited by: Jack in Mi: Dec 15, 03 19:26
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Re: Active Release Technique? [Jack in Mi] [ In reply to ]
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D.O.'s perform their own manipulations in office. This may include soft tissue techniques to loosen the muscles. They may recommend regular massages if this suits you. Like most physicians, they are under certain insurance policies. So, depending on their/your provider, all you'd have to pay is your co-pay. The link in my previous thread will help you find an osteopathic physician in your area.

Best of luck.
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Re: Active Release Technique? [Jack in Mi] [ In reply to ]
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[reply][quote][reply]So does that mean it treats the same injuries differently, or it treats a different problem that the others can't, it uses different pressure spots?

You state that's it different, but not in specific ways. What makes it so different? I'm about to spend my time and money going to get MRT and trigger point therapy, and I would like to know why ART would be better. Or is ART better? It's not clear. There are just a lot of broad statements, but to me (the uneducated) it doesn't sound much different. Do you have any examples of a situation where ART works and trigger point doesn't, or MRT doesn't? I tend to agree with cerveloguy on this one, but I'm willing to listen to your insights.

Thanks,

Sorry for the generalized statements but the topic of myofascial pain aka soft tissue pain is a very broad topic on which there have been many thousand of pages of text written.

I will try to summarize as best as I can. the answer to your first question regarding what ART treats is both yes and no. It is a treatment that is applied to people who have soft tissue pain and peripheral nerve entrapments just like many of the other therapies mentioned. It however treats the scar tissue adhesions that may be responsible for your discomforts the other therapies don't.

One of the problems for consumers in deciding what therapy is appropriate for the condition is that myofascial pain is not a diagnosis it is a description that simply means soft tissue pain. So if you have pain from a trigger point than trigger point therapy would be appropriate. However if you have pain originating from a soft tissue adhesion than trigger point therapy would not be appropriate.

ART is specificaly effective at breaking up or softening scar tissue adhesions that interfere with a soft tissues ability to move properly. It is very different from the other therapies in that the practioner shortens the offending structure as much as possible, contacts the adhision and under tension moves or has the patient move an appropriat pattern to lengthen the structure.

with respect to the last part of your post.

Trigger point therapy also called ishemic compression holds that an abnormal area in your muscle can cause pain and that that area can be the sorce of referred pain to locatios distant from the trigger point. These referral zones are said to be predictable and have been mapped out. Trgger point therapy is said to cause a relative decrease in the blood flow to the area during the pressure phase and then a sudden increase in the blood flow during the release phase. this increase is supposed to flush out toxins and the relieve the trigger point. In a situation where your soft tissue pain is caused by a trigger point than it may work. If however your soft tissue pain or peripheral neuropathy is caused by adhesions between structures then TP therapy would not work and ART would be more appropriate.

The bottom line is that your soft tissue system is complicated and made up of several different types of structures with very different physiologic and biomechanical properties. It is woefully simplistic to advance a position that one treatment would be appropriate for all of the possible causes of "myofascial pain"

In my practice I have found that ART is more effective for a large segment of my largly sports pracitice than is trigger point therapy, massage therapy, or any of the other soft tissue techniques (many of which I am also trained in) It doesnt mean that it is great for all people and I still use the other techniques wheere apropriate but not nearly as often as I use ART.

Sorry for my lack of brevity but it is a large topic
Jack[/reply]
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Re: Active Release Technique? [Jack in Mi] [ In reply to ]
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[reply]I agree that this may be a big advantage for ART, it's just that the website turned me off and struck a nerve with the way they were selling the product. There is no better advertising than word of mouth, and triathletes have proven they will flock to things when someone says it works. The website just sounded like one of those diet pill or penis enlargement commercials. I tend to think companies are overcompensating for something when they make claims like that. Maybe they're true, I don't know. They would be more successful with me describing ART in the way you did, rather than "patented" and all the rest. But, maybe I'm just being picky and grumpy.[/reply]

One of the unique things about ART is that it is a technique that is patented. Although there is probably a certain amount of industri in this the predominate reason is to ensure that when you get ART from an accredited provider you are getting ART and not some hodgepodge of other techniques under the guise of ART.

The ART staff take continueing education seriously and in order to remain credentialed in ART you must stay current by taking one course/yr. And yes you have to pay for it but even though I have to pay U.S dollars (I;m from Canada),fly to the destination and stay in a shwanky hotes I have never felt that I had not gotten my money's worth from a seminar and I have been 8 times and counting.

They also produce monthly web casts with difficult cases being treated by Dr. Lehy the originator (P.S Dr. Lehy knows triathletes and himself is a many time iron man finisher including several IMH finishes.)
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Re: Active Release Technique? [cerveloguy] [ In reply to ]
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[reply]"As a Chirpractor and ART provider I can say ...."

Your description of what it is/does sounds almost as if it was taken directly from the seminar notes.

However, since I haven't taken the course I can't argue with you, but I have been in this field long enough to believe that nothing is totally original, despite what may be claimed.[/reply]

Nope my description is my own.

As a fellow chiro and triathlete I would encourage you to take the course. i practice with a doc who has been out 22 yrs as well and he has never been so excited about practice as he has been since he started useing ART. It is worth the effort to learn if for no other reason that it may help you with some of your toughest cases.
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