Active Release Technique
Encyclopedia
Active Release Technique (ART, also called Active Release Techniques) is a soft tissue system/movement-based massage technique developed and patented by P. Michael Leahy, DC, CCSP. It is used to treat problems with muscles, tendons, ligaments, fascia and nerves.

Conditions treated by Active Release Techniques

ART is most commonly used to treat conditions related to adhesions or scar tissue
Granulation tissue
Granulation tissue is the perfused, fibrous connective tissue that replaces a fibrin clot in healing wounds. Granulation tissue typically grows from the base of a wound and is able to fill wounds of almost any size it heals...

 in overused muscles. According to ART practitioners, as adhesions build up, muscles become shorter and weaker, the motion of muscles and joints are altered, and nerve
Nerve
A peripheral nerve, or simply nerve, is an enclosed, cable-like bundle of peripheral axons . A nerve provides a common pathway for the electrochemical nerve impulses that are transmitted along each of the axons. Nerves are found only in the peripheral nervous system...

s can be compressed. As a result, tissues suffer from decreased blood supply, pain, and poor mobility.

Specific conditions that can be treated with ART include headaches, back pain, carpal tunnel syndrome
Carpal tunnel syndrome
Carpal Tunnel Syndrome is an entrapment idiopathic median neuropathy, causing paresthesia, pain, and other symptoms in the distribution of the median nerve due to its compression at the wrist in the carpal tunnel. The pathophysiology is not completely understood but can be considered compression...

 other peripheral nerve entrapments, shin splints
Shin splints
Shin splints or medial tibial stress syndrome refers to pain along or just behind the shins with sports that apply extreme pressure to the legs, such as gymnastics...

, sciatica
Sciatica
Sciatica is a set of symptoms including pain that may be caused by general compression or irritation of one of five spinal nerve roots that give rise to each sciatic nerve, or by compression or irritation of the left or right or both sciatic nerves. The pain is felt in the lower back, buttock, or...

, TMJ, plantar fasciitis
Plantar fasciitis
Plantar fasciitis is a painful inflammatory process of the plantar fascia, the connective tissue on the sole of the foot.Longstanding cases of plantar fasciitis often demonstrate more degenerative changes than inflammatory changes, in which case they are termed plantar fasciosis. The suffix...

, tendonitis
Tendonitis
Tendinitis , meaning inflammation of a tendon , is a type of tendinopathy often confused with the more common tendinosis, which has similar symptoms but requires different treatment...

 and other soft tissue inflammatory
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...

 disorders of the joints.

The goal of ART is to restore the smooth movement of tissues and to release any entrapped nerves or blood vessel
Blood vessel
The blood vessels are the part of the circulatory system that transports blood throughout the body. There are three major types of blood vessels: the arteries, which carry the blood away from the heart; the capillaries, which enable the actual exchange of water and chemicals between the blood and...

s.

Treatment description

In an ART treatment, the provider uses his or her hands to evaluate the texture, tightness and mobility of the soft tissue. Using hand pressure, the practitioner works to remove or break up the fibrous adhesions, with the stretching motions generally in the direction of venous and lymphatic flow, although the opposite direction may occasionally be used.

In the first three levels of ART treatment, as with other soft-tissue treatment forms, movement of the patient's tissue is done by the practitioner. In level four, however, ART requires the patient to actively move the affected tissue in prescribed ways while the practitioner applies pressure. Involvement of the patient is seen as an advantage of ART, as people who are active participants in their own healthcare are believed to experience better outcomes.

Efficacy

Most studies on ART have been small in terms of number of patients followed, and many articles on it are anecdotal. However, a review of then-current literature by a Vanderbilt University student in 2008 concluded that "the results supporting the efficacy of ART have been significant enough to support the treatment as a viable alternative method for treating soft-tissue injuries and pain."

Risks and contraindications

ART is not appropriate in cases of blunt trauma or active inflammation, but otherwise there are no serious contraindications for its use, though treatments should be limited to every other day.

Active Release Technique training and certification

Training in ART earns continuing education credits for chiropractors, physical therapists, massage therapists, certified athletic trainers, medical doctors, and others who are licensed to work on soft-tissue conditions/injuries as well students in those fields. Courses at the Colorado-based Active Release Techniques are not open to practitioners who are not licensed to treat soft-tissue or to obtain malpractice insurance to treat soft-tissue.

The ART courses are approved for CEU's in the United States through the New York Chiropractic College. Active Release Techniques is also an approved provider through the Board of Certification for Athletic Trainers and the National Certification Board for Therapeutic Massage and Bodywork for Massage Therapists.

To receive ART certification, practitioners attend workshops and must pass a practical exam. In addition, to maintain certification practitioners must attend at least one ART seminar annually and pass recredential exams.
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