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'''Original Editors ''' - [[User:Annelies Beckers|Annelies Beckers]]  
'''Original Editors ''' - [[User:Annelies Beckers|Annelies Beckers]] as part of the [[Vrije Universiteit Brussel Evidence-based Practice Project|Vrije Universiteit Brussel Evidence-Based Practice Project]]


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== Introduction  ==


Active Release Techniques (ART) was developed and patented by P. Michael Leahy. There is little scientific proof regarding the effects of ART on different pathologies, with most of the available evidence being anecdotal and based on case reports.<ref name="GEORGE"/><ref name="DROVER">DROVER, J.M, FORAND, D.R., HERZOG, W., ‘Influence of active release technique on quadriceps inhibition and strength: a pilot study’, Journal of Manipulative and Physiological Therapeutics, 2004, volume 27, num. 6, pp. 408-413</ref><ref name="HOWITT"/><ref name="LATERAL">HOWITT, S., ‘Lateral epicondylosis: a case study of conservative care utilizing ART and rehabilitation’, Journal of the Canadian Chiropractic Association, 2006 September, volume 50, num. 3, pp. 182 – 189</ref>
=== Introduction  ===


== Definition  ==
Active Release Techniques (ART) are a soft tissue method that focuses on relieving tissue tension via the removal of fibrosis/adhesions which can develop in tissues as a result of overload due to repetitive use.<ref name="SPINA">SPINA, A.A., ‘External coxa saltans (snapping hip) treated with active release techniques: a case report’, The Journal of the Canadian Chiropractic Association, 2006 September, volume 51, num. 1, pp. 23 – 29</ref> These disorders may lead to muscular weakness, numbness, aching, tingling and burning sensations. ART has been reported to be both a diagnostic and a treatment technique, however, there is little scientific evidence regarding the effects of ART on various pathologies, with most of the available evidence being anecdotal and based on case reports.<ref name="GEORGE" /><ref name="DROVER">DROVER, J.M, FORAND, D.R., HERZOG, W., ‘Influence of active release technique on quadriceps inhibition and strength: a pilot study’, Journal of Manipulative and Physiological Therapeutics, 2004, volume 27, num. 6, pp. 408-413</ref><ref name="HOWITT">HOWITT, S., JUNG, S., HAMMONDS, N., ‘Conservative treatment of a tibialis posterior strain in a novice triathlete: a case report’, The Journal of the Canadian Chiropractic Association, 2009 March, volume 53, num. 1, pp. 23 – 31</ref><ref name="LATERAL">HOWITT, S., ‘Lateral epicondylosis: a case study of conservative care utilizing ART and rehabilitation’, Journal of the Canadian Chiropractic Association, 2006 September, volume 50, num. 3, pp. 182 – 189</ref> 


Active Release Techniques (ART) is a soft tissue method that focuses on relieving tissue tension via the removal of fibrosis/adhesions which can develop in tissues as a result of overload due to repetitive use.<ref name="SPINA">SPINA, A.A., ‘External coxa saltans (snapping hip) treated with active release techniques: a case report’, The Journal of the Canadian Chiropractic Association, 2006 September, volume 51, num. 1, pp. 23 – 29</ref> These disorders may lead to muscular weakness, numbess, aching, tingling and burning sensations. ART can be both a diagnostic and treatment technique.   
=== History of ART ===
[[File:ART_founder.jpg|right]]
ART was developed and patented by Dr. P. Michael Leahy, DC, CCSP, a Doctor of Chiropractic medicine. Dr. Leahy noticed that the symptoms of patients were related to changes in their soft tissues so he developed this technique which revolved completely around the patient's symptoms. He documented his first work in 1985 under the title of ''Myofascial Release, ''but later patented it under the name ''Active Release Techniques''.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; &nbsp;&nbsp;  


== History of ART ==
=== Purpose ===


ART was developed and patented by Dr. P. Michael Leahy, DC, CCSP, a Doctor of Chiropractic medicine and founder of the Champion Health Clinic based&nbsp; in Colorado Springs, Colorado. Dr. Leahy noticed that the symptoms of patients were related to changes in their soft tissues so he developed this technique which revolve completely around the patient's symptoms. He documented his first work in 1985 under the title of ''Myofascial Release, ''but later patented it under the name ''Active Release Techniques''.<br>  
ART is used to treat symptoms with muscles, tendons, ligaments, fascia and nerves.<ref name="HAMSTRING" /><ref name="ROBB">ROBB, A., PAJACZKOWSKI, J., ‘Immediate effect on pain threshold using active release technique on adductor strains: pilot study’, Journal of bodywork and movement therapies, 2011, volume 15, num. 1, pp. 57-63</ref>  Its design is 3 fold:
* to restore free and unimpeded motion of all soft tissues
* to release entrapped nerves, vasculature and lymphatics
*to re-establish optimal texture, resilience and function of soft tissues.<ref name="WONG">HOWITT, S., WONG, J., ZABUKOVEC, S., ‘The conservative treatment of Trigger Thumb using Graston Techniques and Active Release Techniques’, The Journal of the Canadian Chiropractic Association, 2006 December, volume 50, num. 4, pp. 249 – 254</ref>


&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; &nbsp;&nbsp; [[Image:ART founder.jpg]]  
=== Technique  ===
Tissues are prone to negative changes from trauma, such as swelling, fibrosis and adhesions. During treatment, the clinician uses manual therapy to apply compressive, tensile and shear forces to address repetitive strain injuries, cumulative trauma injuries and constant pressure tension lesions.<ref name="ROBB" /> The clinician applies deep tension at the area of tenderness whilst the patient is instructed to actively move the  injury site  from a shortened to a lengthened position.<ref name="HOWITT" /><ref name="YUIL">YUIL, E.A, MACINTYRE, I.G., ‘Posterior tibialis tendonopathy in an adolenscent soccer player: a case report’, The Journal of the Canadian Chiropractic Association, 2010 December, volume 54, num. 4, pp. 293-300</ref> The placing of a contact point near the lesion and causing the patient to move in a manner that produces a longitudinal sliding motion of soft tissues, e.g, nerves, ligaments and muscles beneath the contact point<ref name=":0">Leahy PM, Patterson T, inventors; Active Release Techniques, Llc, assignee. [https://patents.google.com/patent/US6283916B1/en Expert system soft tissue active motion technique for release of adhesions and associated apparatus for facilitating specific treatment modalities.] United States patent US 6,283,916. 2001 Sep 4.
</ref>.


== Purpose  ==
=== Effectiveness of ART  ===
 
It is used to treat symptoms with muscles, tendons, ligaments, fascia and nerves.<ref name="HAMSTRING"/><ref name="ROBB">ROBB, A., PAJACZKOWSKI, J., ‘Immediate effect on pain threshold using active release technique on adductor strains: pilot study’, Journal of bodywork and movement therapies, 2011, volume 15, num. 1, pp. 57-63</ref>
 
Active release technique is designed to accomplish three things:
 
#to restore free and unimpeded motion of all soft tissues
#to release entrapped nerves, vasculature and lymphatics
#to re-establish optimal texture, resilience and function of soft tissues.<ref name="WONG">HOWITT, S., WONG, J., ZABUKOVEC, S., ‘The conservative treatment of Trigger Thumb using Graston Techniques and Active Release Techniques’, The Journal of the Canadian Chiropractic Association, 2006 December, volume 50, num. 4, pp. 249 – 254</ref>
 
== Technique  ==
 
First the clinician locates the areas of tension or adhesion in a specific tissue. The tissue is then taken from a shortened position into a lengthened one whilst using manual contact to maintain tension along the fibres of that tissue.<ref name="HAMSTRING"/>
 
Tissues are prone to negative changes from trauma, such as swelling, fibrosis and adhesions. During treatment, the clinician uses manual therapy to apply compressive, tensile and shear forces to address repetitive strain injuries, cumulative trauma injuries and constant pressure tension lesions.<ref name="ROBB"/> The practitioner applies deep tension at the area of tenderness whilst he patient is instructed to actively move the  injury site  from a shortened to a lengthened position.<ref name="HOWITT" /><ref name="YUIL">YUIL, E.A, MACINTYRE, I.G., ‘Posterior tibialis tendonopathy in an adolenscent soccer player: a case report’, The Journal of the Canadian Chiropractic Association, 2010 December, volume 54, num. 4, pp. 293-300</ref> ART is used by medical practitioners such as chiropractors, physiotherapists and massage therapists.  
 
== Effectiveness of ART  ==


A few pilot studies reported the effects of ART on different pathologies. These studies do not have a control group however and the group numbers were small.  
A few pilot studies reported the effects of ART on different pathologies. These studies do not have a control group however and the group numbers were small.  
Line 40: Line 30:
'''ART and adductor strains'''  
'''ART and adductor strains'''  


The pilot study evaluated the effectiveness of ART to relieve short term pain in the management of adductor muscle strains amongst ice-hockey players (n= 9). Pre and post measurements were significant improved (p = 0,002 &lt; 0,05). The study proved that ART is effective in increasing the Pain Pressure Threshold in adductor muscle pain sensitivity. The pilot study was a short term study.<ref name="ROBB"/>  
The pilot study evaluated the effectiveness of ART to relieve short term pain in the management of adductor muscle strains amongst ice hockey players. Pre and post measurements were significantly improved, demonstrating that ART was effective in increasing the pain pressure threshold in adductor muscle pain sensitivity, although the study was only short term.<ref name="ROBB" />  


'''ART and hamstring flexibility'''  
'''ART and hamstring flexibility'''  


The subjects (n = 20) were significantly more flexible after ART treatment, but these results cannot be applied across the general population due to  the small group sample which only included young, healthy males. The pilot study was also only a short term study.<ref name="HAMSTRING">GEORGE, J.W., TUNSTALL, A.C., TEPE, R.E., SKAGGS, C.D., ‘The effects of active release technique on hamstring flexibility: a pilot study’, Journal of Manipulative and Physiological Therapeutics, 2006, volume 29, num. 3, pp. 224-227</ref>  
The 20 subjects were significantly more flexible after ART treatment, but the small group sample only included young, healthy males which limits its validity to the general population. It was also only a short term study.<ref name="HAMSTRING">GEORGE, J.W., TUNSTALL, A.C., TEPE, R.E., SKAGGS, C.D., ‘The effects of active release technique on hamstring flexibility: a pilot study’, Journal of Manipulative and Physiological Therapeutics, 2006, volume 29, num. 3, pp. 224-227</ref>  


'''ART and carpal tunnel syndrome'''  
'''ART and carpal tunnel syndrome'''  
Line 52: Line 42:
'''ART and quadriceps inhibition and strength'''  
'''ART and quadriceps inhibition and strength'''  


ART did not reduce inhibition or increase strength in the quadriceps muscles of athletes (n = 9) with anterior knee pain. Further study is required.<ref name="DROVER"/>
ART did not reduce inhibition or increase strength in the quadriceps muscles of the 9 athletes with anterior knee pain. Further research is required.<ref name="DROVER" />
 
<br>  


'''Case reports of ART'''  
'''Case reports of ART'''  


A patient with trigger thumb appeared to be relieved of his pain and disability after a treatment plan of Graston Technique and Active Release Techniques. 8 treatments were given over a 4 week period. Range of motion increased with a concomitant decrease in pain by the end of the treatment period.<ref name="WONG"/><br>
A patient with trigger thumb appeared to be relieved of his pain and disability after a treatment programme of Graston Technique and ART. 8 treatments were given over a 4 week period. Range of motion increased with a concomitant decrease in pain by the end of the treatment period.<ref name="WONG" /><br>  
 
An athlete with chronic, external coxa saltans is relieved from his symptoms because of treatment with ART. After her first visit the patient reported a pain reduction of 50%. After the fourth treatment the patient didn’t feel any pain anymore but the non-painful snapping was still present at that time. When the treatment was complete the non painful snapping was gone too.<ref name="SPINA"/><br>
 
A 51 year old male was treated for epicondylosis lateralis over two weeks (6 treatments) with ART, rehabilitation and therapeutic modalities. At the end of the treatment there was complete resolution of his symptoms.<ref name="LATERAL"/><br>  


Active release technique was used in treating a novice triathlete. Initial treatment consisted of medical acupuncture with electrical stimulation, therapeutic ultrasound with Traumeel, Active Release Technique of gastrocnemius, soleus, and tibialis posterior muscles above and below the injury and Graston Technique soft tissue mobilization posterior to the medial malleolus followed by ten minutes of ice and elevation. The athlete was relieved of his symptoms and was able to return to his triathlon training.<ref name="HOWITT">HOWITT, S., JUNG, S., HAMMONDS, N., ‘Conservative treatment of a tibialis posterior strain in a novice triathlete: a case report’, The Journal of the Canadian Chiropractic Association, 2009 March, volume 53, num. 1, pp. 23 – 31</ref><br>  
An athlete with chronic, external [http://www.physio-pedia.com/Snapping_Hip_Syndrome coxa saltans] became asymptomatic following treatment with ART.  The patient reported a pain reduction of 50% after the initial session. After the 4th treatment the pain had resolved, although the non-painful snapping sensation was still present. Upon treatment completion, the snapping sensation had also resolved.<ref name="SPINA" /><br>  


An adolescent soccer player was relieved from his pain after 4 treatments over 4 weeks of soft tissue therapy and rehabilitative exercises focusing on the lower limb specifically posterior tibialis muscle. He had chronic medial foot pain due to striking on an opponent’s leg while kicking the ball.<ref name="YUIL"/>  
A 51 year old male was treated for [http://www.physio-pedia.com/Lateral_Epicondylitis epicondylosis lateralis] with 6 treatments over a two week period with ART, rehabilitation and therapeutic modalities. At the end of the treatment period there was complete resolution of his symptoms.<ref name="LATERAL" /><br>  


== Post ART Treatment Exercises<ref name="Dr.Brain Abelson">Dr.Brain Abelson,Kamali Abelson. Release Your Pain.2nd Edition.Printed in 2008. Printed in USA.</ref> ==
An adolescent soccer player presented with tibilais posterior tendinopathy. He was relieved from his pain after 4 treatments over 4 weeks of soft tissue therapy and rehabilitative exercises focusing on the lower limb, specifically the posterior tibialis muscle. He had chronic medial foot pain after striking an opponent’s leg whilst kicking the ball.<ref name="YUIL" />  


Once the ART has released the restrictive adhesions between tissues, post-treatment exercises become a critical part of the healing process and act to ensure the RSI does not return.  
=== Post ART treatment exercises<ref name="Dr.Brain Abelson">Dr.Brain Abelson,Kamali Abelson. Release Your Pain.2nd Edition.Printed in 2008. Printed in USA.</ref>  ===


There are four fundamental areas that must be addressed in any exercise program:
Once the restrictive adhesions between tissues has been released, post treatment exercises become an essential part of the rehabilitation process to ensure the symptoms do not return.


#'''Flexibility ''' - Good flexibility enables muscles and joints to move through their full range of motion. Poor flexibility leads to a higher chance of injury to muscles, tendons, and ligaments. Flexibility is joint-specific; a person may have excellent range of motion at one joint, yet be restricted in another. Stretching exercises are only effective if they are executed after the adhesions within the soft-tissue have been released. Stretching exercises that are applied to adhesed tissues will only stretch the tissues above and below the restrictions. The actual restricted and adhesed tissues are seldom stretched, leading to further biomechanical imbalances.  
There are 4 fundamental areas that should be addressed in any exercise program:
#'''Strength ''' - Strengthening exercises are most effective after the adhesions within the soft-tissue have been released. Attempts to strengthen already-shortened and contracted muscles only results in further contraction and restriction. This causes the formation of more adhesions and restrictive tissues, and exacerbates the Repetitive Injury Cycle. This is why the application of generic or non-specific strengthening exercises for RSI seldom works.  
* '''Flexibility: '''Good flexibility enables muscles and joints to move through their full range of motion. Poor flexibility leads to a higher chance of injury to muscles, tendons, and ligaments. Flexibility is joint specific; a person may have excellent range of motion at one joint, yet be restricted in another. Stretching exercises are only effective if they are executed after the adhesions within the soft tissue have been released. Stretching exercises that are applied prior to the adhesions being released will only stretch the tissues above and below the restrictions. The actual restricted and adhered tissues are seldom stretched, leading to further biomechanical imbalances.
#'''Balance and Proprioception''' - Proprioception describes the body's ability to react appropriately (through balance and touch) to external forces. Proprioception exercises should begin early in the rehabilitation process. Effective proprioception exercises are designed to restore the kinesthetic awareness of the patient. These exercises form the basis for the agility, strength, and endurance required for complete rehabilitation.  
* '''Strength: '''Strengthening exercises are most effective after treatment. Attempts to strengthen shortened and contracted muscles may result in further contraction and restriction. This causes the formation of more adhesions and restrictions within the  tissues, exacerbating the repetitive injury cycle. This is why the application of generic or non-specific strengthening exercises for RSI seldom works.  
#'''Cardiovascular''' - Cardiovascular or aerobic exercises are essential for restoring good circulation and for increasing oxygen delivery to soft-tissues. Lack of oxygen and poor circulation is a primary accelerant of repetitive strain injuries.<br>
*'''Balance and proprioception:''' Proprioception describes the body's ability to react appropriately (through balance and touch) to external forces. Proprioception exercises should begin early in the rehabilitation process. Effective proprioception exercises are designed to restore the kinesthetic awareness of the patient. These exercises form the basis for the agility, strength, and endurance required for complete rehabilitation.  
*'''Cardiovascular:''' Cardiovascular or aerobic exercises are essential for restoring good circulation and for increasing oxygen delivery to soft tissues. Lack of oxygen and poor circulation is a primary accelerant of repetitive strain injuries.


== ART and Performance<ref name="Dr.Brain Abelson" />  ==
=== ART and performance<ref name="Dr.Brain Abelson" />  ===


ART is seen effective in athletes of every level.It can provide patients with a means to enhance their sports performance by identifying and releasing restrictions that reduce their performance in that activity. This typically occurs after the practitioner conducts a biomechanical analysis of the patient's motion. During the biomechanical analysis and the subsequent treatment, the practitioner:<br>  
ART is effective for active people of every level. It can provide patients with a means to enhance their sports performance by identifying and releasing restrictions that reduce their performance in their chosen activity. This typically occurs after the practitioner conducts a biomechanical analysis of the patient's motion. During the biomechanical analysis and the subsequent treatment, the practitioner:<br>  


*Evaluates gait, motion, and posture.  
*Evaluates gait, motion, and posture.  
*Identifies the biomechanical dysfunctions that are restricting the performance.  
*Identifies the biomechanical dysfunctions that are restricting the performance.  
*Finds the soft-tissue structures that are the primary cause of the biomechanical dysfunction as well as affected structures along the kinetic chain.  
*Locates the soft tissue structures that are the primary cause of the biomechanical dysfunction as well as affected structures throughout the kinetic chain.  
*Treats the soft-tissue dysfunctions with ART to restore full function to the affected structures.<br>
*Treats the soft tissue dysfunctions with ART to restore full function to the affected structures.<br>
 
ART Performance Care is applied after trauma-based injuries have resolved. ART Performance Care concentrates upon removing restrictions that inhibit full range of motion, and in restoring full function and performance to affected soft-tissues. This process can result in significant increases in sports performance - power, strength, and flexibility.<br>
 
<br>
 
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ PubMed])  ==
<div class="researchbox"><rss>http://www.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1PkbMHWMHFn8HbQwgB_WVvCdfHf9f269oaJE4gMAw4K9Dm3g1h</rss></div>
== Resources  ==
== References  ==


ART Performance Care is applied after trauma based injuries have resolved. ART Performance Care concentrates upon removing restrictions that inhibit full range of motion, and in restoring full function and performance to affected soft tissues. This process can result in significant increases in sports performance of power, strength, and flexibility.
== References  ==
<references />  
<references />  


[[Category:Interventions]] [[Category:Assessment]] [[Category:Pain]] [[Category:Self_Management]] [[Category:Musculoskeletal/Orthopaedics]] [[Category:Vrije_Universiteit_Brussel_Project]]
[[Category:Interventions]]  
[[Category:Assessment]]  
[[Category:Pain]]  
[[Category:Musculoskeletal/Orthopaedics]]  
[[Category:Vrije_Universiteit_Brussel_Project]]

Latest revision as of 12:47, 3 January 2022

Original Editors - Annelies Beckers as part of the Vrije Universiteit Brussel Evidence-Based Practice Project

Top Contributors - Annelies Beckers, Aarti Sareen, Admin, Scott Cornish, Kim Jackson, Evan Thomas, Magdalena Hytros, Scott Buxton, WikiSysop, Claire Knott and 127.0.0.1

Introduction[edit | edit source]

Active Release Techniques (ART) are a soft tissue method that focuses on relieving tissue tension via the removal of fibrosis/adhesions which can develop in tissues as a result of overload due to repetitive use.[1] These disorders may lead to muscular weakness, numbness, aching, tingling and burning sensations. ART has been reported to be both a diagnostic and a treatment technique, however, there is little scientific evidence regarding the effects of ART on various pathologies, with most of the available evidence being anecdotal and based on case reports.[2][3][4][5]

History of ART[edit | edit source]

ART founder.jpg

ART was developed and patented by Dr. P. Michael Leahy, DC, CCSP, a Doctor of Chiropractic medicine. Dr. Leahy noticed that the symptoms of patients were related to changes in their soft tissues so he developed this technique which revolved completely around the patient's symptoms. He documented his first work in 1985 under the title of Myofascial Release, but later patented it under the name Active Release Techniques.                                                 

Purpose[edit | edit source]

ART is used to treat symptoms with muscles, tendons, ligaments, fascia and nerves.[6][7] Its design is 3 fold:

  • to restore free and unimpeded motion of all soft tissues
  • to release entrapped nerves, vasculature and lymphatics
  • to re-establish optimal texture, resilience and function of soft tissues.[8]

Technique[edit | edit source]

Tissues are prone to negative changes from trauma, such as swelling, fibrosis and adhesions. During treatment, the clinician uses manual therapy to apply compressive, tensile and shear forces to address repetitive strain injuries, cumulative trauma injuries and constant pressure tension lesions.[7] The clinician applies deep tension at the area of tenderness whilst the patient is instructed to actively move the injury site from a shortened to a lengthened position.[4][9] The placing of a contact point near the lesion and causing the patient to move in a manner that produces a longitudinal sliding motion of soft tissues, e.g, nerves, ligaments and muscles beneath the contact point[10].

Effectiveness of ART[edit | edit source]

A few pilot studies reported the effects of ART on different pathologies. These studies do not have a control group however and the group numbers were small.

ART and adductor strains

The pilot study evaluated the effectiveness of ART to relieve short term pain in the management of adductor muscle strains amongst ice hockey players. Pre and post measurements were significantly improved, demonstrating that ART was effective in increasing the pain pressure threshold in adductor muscle pain sensitivity, although the study was only short term.[7]

ART and hamstring flexibility

The 20 subjects were significantly more flexible after ART treatment, but the small group sample only included young, healthy males which limits its validity to the general population. It was also only a short term study.[6]

ART and carpal tunnel syndrome

This study assessed the effectiveness of ART on the median nerve of 5 subjects who were diagnosed with carpal tunnel syndrome. Both symptom severity and functional status improved after two weeks of treatment intervention. This is a small clinical pilot study which may suggest that ART is an effective management strategy for patients with the carpal tunnel syndrome.[2]

ART and quadriceps inhibition and strength

ART did not reduce inhibition or increase strength in the quadriceps muscles of the 9 athletes with anterior knee pain. Further research is required.[3]

Case reports of ART

A patient with trigger thumb appeared to be relieved of his pain and disability after a treatment programme of Graston Technique and ART. 8 treatments were given over a 4 week period. Range of motion increased with a concomitant decrease in pain by the end of the treatment period.[8]

An athlete with chronic, external coxa saltans became asymptomatic following treatment with ART. The patient reported a pain reduction of 50% after the initial session. After the 4th treatment the pain had resolved, although the non-painful snapping sensation was still present. Upon treatment completion, the snapping sensation had also resolved.[1]

A 51 year old male was treated for epicondylosis lateralis with 6 treatments over a two week period with ART, rehabilitation and therapeutic modalities. At the end of the treatment period there was complete resolution of his symptoms.[5]

An adolescent soccer player presented with tibilais posterior tendinopathy. He was relieved from his pain after 4 treatments over 4 weeks of soft tissue therapy and rehabilitative exercises focusing on the lower limb, specifically the posterior tibialis muscle. He had chronic medial foot pain after striking an opponent’s leg whilst kicking the ball.[9]

Post ART treatment exercises[11][edit | edit source]

Once the restrictive adhesions between tissues has been released, post treatment exercises become an essential part of the rehabilitation process to ensure the symptoms do not return.

There are 4 fundamental areas that should be addressed in any exercise program:

  • Flexibility: Good flexibility enables muscles and joints to move through their full range of motion. Poor flexibility leads to a higher chance of injury to muscles, tendons, and ligaments. Flexibility is joint specific; a person may have excellent range of motion at one joint, yet be restricted in another. Stretching exercises are only effective if they are executed after the adhesions within the soft tissue have been released. Stretching exercises that are applied prior to the adhesions being released will only stretch the tissues above and below the restrictions. The actual restricted and adhered tissues are seldom stretched, leading to further biomechanical imbalances.
  • Strength: Strengthening exercises are most effective after treatment. Attempts to strengthen shortened and contracted muscles may result in further contraction and restriction. This causes the formation of more adhesions and restrictions within the tissues, exacerbating the repetitive injury cycle. This is why the application of generic or non-specific strengthening exercises for RSI seldom works.
  • Balance and proprioception: Proprioception describes the body's ability to react appropriately (through balance and touch) to external forces. Proprioception exercises should begin early in the rehabilitation process. Effective proprioception exercises are designed to restore the kinesthetic awareness of the patient. These exercises form the basis for the agility, strength, and endurance required for complete rehabilitation.
  • Cardiovascular: Cardiovascular or aerobic exercises are essential for restoring good circulation and for increasing oxygen delivery to soft tissues. Lack of oxygen and poor circulation is a primary accelerant of repetitive strain injuries.

ART and performance[11][edit | edit source]

ART is effective for active people of every level. It can provide patients with a means to enhance their sports performance by identifying and releasing restrictions that reduce their performance in their chosen activity. This typically occurs after the practitioner conducts a biomechanical analysis of the patient's motion. During the biomechanical analysis and the subsequent treatment, the practitioner:

  • Evaluates gait, motion, and posture.
  • Identifies the biomechanical dysfunctions that are restricting the performance.
  • Locates the soft tissue structures that are the primary cause of the biomechanical dysfunction as well as affected structures throughout the kinetic chain.
  • Treats the soft tissue dysfunctions with ART to restore full function to the affected structures.

ART Performance Care is applied after trauma based injuries have resolved. ART Performance Care concentrates upon removing restrictions that inhibit full range of motion, and in restoring full function and performance to affected soft tissues. This process can result in significant increases in sports performance of power, strength, and flexibility.

References[edit | edit source]

  1. ↑ 1.0 1.1 SPINA, A.A., ‘External coxa saltans (snapping hip) treated with active release techniques: a case report’, The Journal of the Canadian Chiropractic Association, 2006 September, volume 51, num. 1, pp. 23 – 29
  2. ↑ 2.0 2.1 GEORGE, J.W, TEPE, R.E, BUSOLD, D., KEUSS, S., PRATHER, H., SKAGGS, C.D., ‘The effects of active release technique on carpal tunnel patients: a pilot study’, Journal of chiropractic medicine, 2006, pp. 119-122
  3. ↑ 3.0 3.1 DROVER, J.M, FORAND, D.R., HERZOG, W., ‘Influence of active release technique on quadriceps inhibition and strength: a pilot study’, Journal of Manipulative and Physiological Therapeutics, 2004, volume 27, num. 6, pp. 408-413
  4. ↑ 4.0 4.1 HOWITT, S., JUNG, S., HAMMONDS, N., ‘Conservative treatment of a tibialis posterior strain in a novice triathlete: a case report’, The Journal of the Canadian Chiropractic Association, 2009 March, volume 53, num. 1, pp. 23 – 31
  5. ↑ 5.0 5.1 HOWITT, S., ‘Lateral epicondylosis: a case study of conservative care utilizing ART and rehabilitation’, Journal of the Canadian Chiropractic Association, 2006 September, volume 50, num. 3, pp. 182 – 189
  6. ↑ 6.0 6.1 GEORGE, J.W., TUNSTALL, A.C., TEPE, R.E., SKAGGS, C.D., ‘The effects of active release technique on hamstring flexibility: a pilot study’, Journal of Manipulative and Physiological Therapeutics, 2006, volume 29, num. 3, pp. 224-227
  7. ↑ 7.0 7.1 7.2 ROBB, A., PAJACZKOWSKI, J., ‘Immediate effect on pain threshold using active release technique on adductor strains: pilot study’, Journal of bodywork and movement therapies, 2011, volume 15, num. 1, pp. 57-63
  8. ↑ 8.0 8.1 HOWITT, S., WONG, J., ZABUKOVEC, S., ‘The conservative treatment of Trigger Thumb using Graston Techniques and Active Release Techniques’, The Journal of the Canadian Chiropractic Association, 2006 December, volume 50, num. 4, pp. 249 – 254
  9. ↑ 9.0 9.1 YUIL, E.A, MACINTYRE, I.G., ‘Posterior tibialis tendonopathy in an adolenscent soccer player: a case report’, The Journal of the Canadian Chiropractic Association, 2010 December, volume 54, num. 4, pp. 293-300
  10. ↑ Leahy PM, Patterson T, inventors; Active Release Techniques, Llc, assignee. Expert system soft tissue active motion technique for release of adhesions and associated apparatus for facilitating specific treatment modalities. United States patent US 6,283,916. 2001 Sep 4.
  11. ↑ 11.0 11.1 Dr.Brain Abelson,Kamali Abelson. Release Your Pain.2nd Edition.Printed in 2008. Printed in USA.
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