By Mike Davis, DPT, ART
Active Release Technique (ART) is a patented soft tissue mobilization system invented by Dr. Michael Leahy. With relevance to ART, soft tissue includes fascia, connective tissue, ligaments, muscles, tendons, and nerves. ART is an anatomically detailed system that is efficient in the treatment of several pathological and potentially pathological entities from fascial adhesions to nerve entrapments, which are commonly observed in traumatic and overuse injuries.
On the surface, one may think that this is a system or technique for individuals that have suffered an œinjury such as an ACL tear, ankle sprain, or sciatica. While individuals with these injuries will benefit from ART, those with physical performance issues and residual muscle soreness will find that ART can in fact help them as well. Those in search of ART can find relief in Certified Active Release Technique Providers via a provider network at www.activerelease.com. For the purpose of this selection, we will focus ART relevant to physical performance.
It is well known that three fundamental aspects of physical performance are mobility, stability, and neuromuscular efficiency. It is also important to remember that while these three fundamental aspects will be addressed independently, just as the systems of the human body (i.e. neuro, cardio, muscular, etc.), they are interwoven/interdependent upon one another to achieve efficient functional movement. Mobility speaks to the ability to achieve a particular position passively. For example, when performing a squat, a certain amount of dorsiflexion is needed at the ankle, along with some knee and hip flexion. If any of these areas are lacking in motion, then the squat will be dysfunctional, as an adjacent joint with go through compensation in an attempt to achieve the squatting position, placing the individual at an increased risk for potential injury. Once the individual is able to achieve a desired position, the next question is can they safely perform that motion actively against resistance (i.e.-gravity), which is stability. Stability is contingent on multiple factors such as, but not limited to, mobility, motor control/coordination, strength, and endurance. Neuromuscular efficiency is the ability of the central/peripheral nervous system (CNS/PNS) to communicate with muscular system via the neuromuscular junction thereby producing a desired effect with a degree of proficiency. ART can be an effective tool in addressing issues in performance related to mobility, stability, and neuromuscular efficiency.
Mobility can be impaired by restrictions in muscular, tendonous, fascial, and/or ligamentous tissues. The key in addressing this issue is the proper identification of the structure responsible for the deficit in mobility. For example, a person may have a problem with ankle dorsiflexion and report that their achilles tendon feels tight with this motion. One may think that all he/she needs to do is to perform some gastrocsoleus stretches. While this may be appropriate, there is also a chance that the true problem is a restriction in the glide between the flexor hallicus longus (muscle to the big toe) as it passes under the achilles on its way to the lateral aspect of the lower leg. If this level of acuity is not utilized, then there is an increased chance that the person will develop a compensatory movement pattern resulting in decreased performance and a possible overuse injury somewhere else along the kinetic chain, which may manifest itself as a mobility, stability, and/or neuromuscular efficiency deficit. Individuals trained in ART have the detailed sense of anatomy along with the manual skills to effectively identify and treat the culprit for mobility dysfunction.
Problems with stability may be rooted in mobility, strength, and/or motor coordination deficits. Often problems with strength and motor coordination are addressed via exercises specific to the impairments. As far as strength is concerned, it is important to assess the continuity of the muscles responsible for a particular action. When a muscle is trained intensely or injured, it is possible that adhesions and scar tissue may form in the muscle as it attempts to repair itself from the damage accrued through strength training or trauma. If this is the case, then that muscle will not respond to strength training effectively to address stability deficits, as it is a dysfunctional unit. ART is effective in both the identification and treatment of discontinuity of muscular tissue. ART is also proficient in the management hypertonic muscles (of non-upper motor neuron origin) as they maybe responsible for coordination deficits via reciprocal inhibition.
As stated earlier, neuromuscular efficiency is reliant on the functional capacity of the CNS/PNS, neuromuscular junction, and the muscular system. When impulses are sent from the CNS to the PNS on their way to the neuromuscular junction, its ability to reach its destination is contingent on an unimpeded pathway. One way that this pathway can be impeded is peripheral nerve entrapments. Throughout our body’s system, there are multiple sites where nerves pierce through, run under, and run over soft tissue structures. As soft tissue structures become tight and short, they may clamp down on the associated nerve resulting in entrapment and the potential problems associated with nerve entrapments. Just as with the muscular system, ART is efficient in the management (identification and treatment) of peripheral nerve entrapments. Relevant to the neuromuscular junction, certain areas of the body, such as the myofascial attachment at the distal plantar surface of the calcaneus, are prone to calcium retention with stress and minimal circulation deficits. As is with the case with œplantar fascitis, calcium retention may be identified via x-ray. If the calcium has ossified, then ART can only assist in the management of progression. If ossification has not yet occurred, then ART is a vehicle to resolve the calcium deposit and to facilitate the restoration of functional mobility, stability, and neuromuscular efficiency.
Soft tissue trauma is a natural repercussion of physical activity as it often correlates with the intensity and/or frequency of the activity. An individual’s physical performance is contingent on the ability to repair/restore soft tissue continuity and to maintain/progress mobility, stability, and neuromuscular efficiency. While ART is by no means the end all be all factor in a person’s ability to perform physically, it is an excellent and effective adjunct and is sometimes the missing key in unlocking efficient functional movement.
Mike Davis is a Physical Therapist and Certified Active Release Technique Provider in the Northern Virginia area and can be reached via email email@example.com