Injury Prevention with Active Release Techniques (ART)
Updated: Feb 7
If you want to stay active, if you’ve struggled with injuries and if you live with muscle and joint pain, then Active Release Techniques could be the game-changer you’ve been looking for! It is a very different type of manual therapy.
Mark Greenfield is the owner of On Your Mark NYC and he is a Licensed Massage Therapist, Certified Personal Trainer, Corrective Exercise Specialist and Active Release Techniques practitioner. He is based in New York City and has over 16 years of experience working with New Yorkers of all backgrounds in his Midtown Manhattan office. He helps individuals prevent and recover from many types of pain and orthopedic injuries.
What is ART?
ART is similar to a massage, except it does so much more than that! I have countless examples of just how awesome it can be for so many injuries. For example, a client of mine had been suffering with a lifetime of shoulder aches, and after one session the aches were gone for almost two years. With some follow-up sessions early on and occasional sessions every few months after that, the issues have never returned.
Active Release Techniques (ART) has exploded in visibility and popularity over the past two decades, and for good reason. This is due to its effectiveness in injury prevention, pain relief, enhancing athletic performance and injury rehabilitation. In my 16 years in the field, no other single treatment or therapy has had nearly the positive impact on my clients than ART. I am continuously amazed at how dramatic, fast and long-lasting ART can be for athletes at all levels.
The incredible experts who have created and trail-blazed Active Release into the fitness and injury landscape continue to make it better all the time. It started with a few dozen techniques but now has well over 500 protocols, each carefully crafted to identify and treat pathologies in specific structures and tissues. ART combines very specific hands-on treatments with client movement to break up scar tissue, separate adhesions within and between muscles, relieve nerve entrapments and restore muscle length and joint range of motion.
What kind of Injuries can ART treat?
ART is great for virtually any injury! Whether it’s low back pain, shoulder impingement, carpal tunnel syndrome, TMJ pain, hamstring strains, plantar fascitis or tendonitis, ART might just be your magic bullet train to recovery. ART is all about movement, range of motion and funciton. It’s not enough to get a passive massage in so many scenarios. The human body is made to move! And that’s what ART can help you do, safely, effectively and without pain!
Who Provides ART?
ART can only be provided by licensed medical and health professionals who have received advanced training in the discipline. This primarily includes Physical Therapists, Chiropractors and Massage Therapists although other licensed providers can and do offer ART as well.
The training and certification requirements are very rigid.
Each practitioner must complete an extensive written exam prior to the course and must then pass a practical exam at the end of each course with a score of 90%. Recertification of some kind is required each year. This ensures that each ART provider truly knows what he or she is doing and maintains their expertise in the discipline years after their initial training.
How Does ART Work?
The basic premise of ART is relatively simple but yet profound and game-changing. According to its founder, Dr. Leahy, one must "shorten the tissue, apply a contact tension and lengthen the tissue or make it slide relative to the adjacent tissue". In other words, let’s get moving!
Every ART session is actually a combination of examination and treatment. The concept is simple: the therapist must first evaluate and find the affected muscles and other soft tissues. Any highly trained and knowledgeable therapist or doctor may also use other assessment techniques such as movement and postural assessments, muscle length examination and muscle strength tests to get a thorough and integrated picture of what may be causing an injury and its symptoms.
Once found, abnormal tissues are treated by first taking up the slack in the muscle, then adding manual pressure and tension to the problem spots. At this point, the muscle and joint are brought to their full range of motion while the therapist continues applying pressure, thus releasing the adhered muscle fibers through their intended range of motion and in the direction in which they are suppose to move.
Fully stretching the muscle to its maximum range of motion is vital because full joint range of motion and muscle elasticity are required for optimal muscle contraction, function and biomechanics. Optimal range of motion, muscle contraction and proper biomechanics are what reduces the risk of injury because they reduce the amount of stress that gets placed on the joints and muscles.
To that end, Dr. Leahy, the original creator of Active Release Techniques and his instructors consistently emphasize that 90% of the treatment happens in the final 10% of the movement. This speaks to the importance of getting as much movement as possible, preferably without exacerbating symptoms in the immediate process.
Specific protocols can focus on just 1 tiny muscle or on several large muscles together. This versatility and array of treatment options make Active Release a game-changer within the clinical treatment world.
Risk Factors for Sports Injuries
Of the many risk factors for acquiring an injury, the single greatest one is, previous injury. In other words, if you have been injured before, that injury and/or area of the body is at high risk of getting injured again. One reason for this is that often times when recovering from injuries, people do not correct the underlying issues that contributed to the injury in the first place, the root causes. A skilled ART provider can help you address these underlying issues once they have been identified.
Related to this, a second major risk factor for sports injuries is muscle imbalance.
Muscle imbalance can manifest in many different ways and for different reasons but there is always a common thread; when there is a muscle imbalance, joints and muscles cannot move properly. When movement is impaired, muscles and joints get pushed, pulled, stretched, torqued and contract suboptimally.
Length-tension relationships and force coupling become altered when there are muscle imbalances. Length-tension relationship refers to the resting length of muscles relative to the joints they attach to. When this relationship is disrupted, as with poor posture and very tight hamstrings, the muscles can develop trigger points, muscle adhesions and chronic tension.
Force-coupling refers to the ability of joints and muscles to produce the proper amount of muscle contraction and force during movement. When force coupling is impaired, muscle strains, trigger points, tendonitis and injuries to joints will occur.
ART and Injury Prevention
Now that we have described in some detail how ART works and some injury risk factors, let’s look at why and how ART can help you prevent injuries. At its core, ART is all about restoring proper length, elasticity, blood circulation and range of motion to muscles. If you are an athlete or exercise enthusiast, the chances are that your activity or sport of choice requires repetitive movements, some at high-impact and some requiring a lot of power or force.
Every sport and activity, from sitting to running to playing golf, predispose people to specific injuries. That’s why there are common labels for injuries such as Golfer’s Elbow, Tennis Elbow and Runner’s Knee. So the key to your injury prevention strategy lies in understanding what muscles and joints are most at risk based on the exercises you do most frequently or the ones that are the most taxing on the body.
If you’re not sure what these are, then a qualified ART provider should be able to help you understand. In addition, each person has unique compensations throughout their bodies, weakest links and genetic anatomical challenges. Once you have identified these, ART can do its magic.
For example, if you sit a lot for work and are a runner, there’s a good chance your hip flexors are tight which can predispose you to low back pain and hamstring strains, among other things. While stretching the hip flexors can help and should be done regularly, ART is optimally suited to help restore proper length and pliability of these muscles. And as great as massage is, ART’s unique blend of touch and stretch can be a powerful tool because Active Release is movement-oriented, making it a functional therapy.
Sports massage, deep tissue massage and other medical massage techniques are great but they sometimes fall short because they do not specifically restore proper tissue length. Without proper tissue length, an injured area will continue in the same movement pattern that is causing the problem in the first place.
Another example is cycling. Cyclists spend hours upon hours hunched forward on their bikes and in deep hip flexion. As with running, this can lead to low back and hip injuries and it can also lead to neck, shoulder and upper back dysfunction. ART can help open up the chest area by releasing muscle adhesions and restoring length to the anterior upper body muscles such as the pecs, subscapularis, biceps and neck extensors.
Another example involves golfers and tennis players. These sports require firm grip strength, flexibility and power in order to perform repetitive and forceful motions. The forearm musculature often become overworked, develop trigger points, muscle adhesions and put excess stress on their tendons, leading to muscle strains and tendonitis. ART can release adhesions within these muscles and adhesions between adjacent muscles that can get stuck together.
In summary, there are many things you can do to avoid getting injured. This includes rest, massage, cross-training, coaching, practice, targeted strength and sport-specific exercises. In addition to these, ART can be a game-changer and often the missing piece when trying to prevent and recover from injuries.