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The ART of Active Release Technique

active-release-injuryAfter several years of knee problems related to running, I was healed by a guy sticking his thumb in my ass.

Okay, maybe that oversimplifies it a little bit. AllIow me to start from the beginning:

Injuries suck. For those of us who are accustomed to spending every day in some state of sweat, having a debilitating injury is bad for the body and the soul. In my case, my injuries were cyclical, making them even harder on my emotions: I’d start training for a race, only to discover my knees devolved as my miles increased. Eventually, the pain in my knee would be so severe I had no choice but to stop running for several weeks (or even months!). I’d fall into a deep depression until the pain disappeared, then I’d declare myself ready to sign up for a different race, and … well, you know how it goes. Heartbreak. Every single time.

I tried everything to fix my knee — hours in physical therapy, money wasted on custom orthotics for my running shoes, consultations with experts to change my wonky stride. Nothing worked. When my physical therapist sent me to an orthopedic specialist as a last resort, the doctor took a look at my MRI and said, “I can’t find anything wrong on here, but I think we should schedule surgery to take a look around.”

Surgery? To take a freakin’ look around? I’m not your brother-in-law’s Ford Pinto; you don’t just pop the hood and see if you can figure out what the problem is. Needless to say, I left that doctor’s office in a torrent of tears and hopelessness.

On the recommendation of local runner friends, I got a second opinion from a sports chiropractor. Though I went to my visit expecting a chiropractor of the back-cracking variety, I quickly learned that’s not what he does. Instead, I was at a specialist for Active Release Technique, or ART.

What is Active Release Technique?

It’s hard to describe ART without making it sound weird, but just bear with me.

The Active Release Technique website says it’s “a patented, state of the art soft-tissue system/movement-based massage technique that treats problems with muscles, tendons, ligaments, fascia and nerves.”

My chiropractor described it as “breaking up knots and adhesions in the muscles.”

I describe it as …well, a guy sticks his thumb in my ass. To be more specific, he sticks it in a gluteal muscle and presses down hard while I bend and straighten various joints to shorten and lengthen the muscles he’s working on. Then he moves his thumb a centimeter or two, and we repeat the process.

Want to see what it looks like? Check out this video, where an ART specialist works on an athlete with IT band syndrome, or this one, for a shoulder injury.

How Does ART Work?

Many sport-related injuries are caused by overuse, or repetitive movement. This movement causes your muscles and soft tissues to break down, known as “micro-trauma.” Though this micro-trauma can be beneficial (the rebuilding process is what causes muscles to grow and become stronger), sometimes it produces scar tissue. Scar tissue can block nerves, puts tension on tendons, and tightens tissues that need to move freely. When this  happens, your body moves in abnormal ways to compensate, and, voila! Injury.

That’s why my knee never fully healed. Rest helped reduce the symptoms, but it didn’t cure the cause. Physical therapy only caused more micro-tears, leading to more scar tissue. Only when I actually broke up all the abnormal tissue in my muscles did I find relief.

That’s what ART does.

How Does the Practitioner Find Scar Tissue?

One must have a solid knowledge of anatomy and physiology before enrolling in the specialized training for ART. Most who obtain the certification are medical practitioners, such as doctors, chiropractors and physiotherapists. This background allows the practitioners to know how muscle groups work together and what “normal” and “abnormal” muscles feel like.

When working with a patient, the ART practitioner can trace the location of an injury back to its cause. For example, my knee injury was not really in my knee, but instead caused by tightness in my hips and glutes, which restricted normal movement in my legs when I ran. The knee pain was from changing my stride to compensate for this tightness. When the chiropractor felt those muscles, he quickly pinpointed the location of scar tissue buildup and could set about fixing it.

What Does it Feel Like?

I’m not going to sugarcoat it for you — ART hurts. This may be a “massage technique,” but this isn’t anywhere close to a relaxing spa experience. Most treatments for me were a solid 8 on a pain scale of 1 to 10, and there were a few occasional moments where I saw stars, cried, and said very, very crude things. Sometimes, I’d notice dark bruises the next day.

Did it Work?

For me, it did. Within one session, I experienced some relief from the sharp pain in my knee. After a few weeks of treatment, I was able to run short distances without discomfort. At the three-month mark, I was running long distances again. So long as I visit my chiropractor for maintenance every few months, I remain pain-free. I’ve learned the hard way not to skip my appointments, as the telltale signs of injury come creeping back if I’ve gone too long without an ART session. I’ve learned my body is like a game of Jenga — if one part gets out of whack, the whole thing topples. ART helps keep me upright.

Oh, and the best part? I never had to see that orthopedic surgeon again.

Have you tried Active Release Technique for an injury? How did it work for you? —Susan

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  1. Angela says:

    How can I find someone who knows how to do this technique???

  2. Oxana says:

    That’s amazing how everything in our bodies is connected. I read “thumb in the ass” a bit strange at the beginning (haha!) but not surprised at all that it did help. What bothers me, though, that it seems like you need to keep returning. Does it mean that the scar tissue keeps appearing? And if so, why? Have you asked the doctor how can you not have scar tissue in the first place?

  3. Susan says:

    Oxana, it depends on the cause of the scar tissue. If it’s from an acute injury, then it’s possible a person wouldn’t need to go back after a few sessions. In my case, injuries are caused by the way my body moves (biomechanical issues). I am working on correcting those issues, but find that I do best if I go back to ART every other month or so for a “tune up.”

  4. Susan says:

    Angela, you can find an ART provider using the search function here: http://www.activerelease.com/providerSearch.asp

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