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ART - Does it work for runners?

I awkwardly walked past the front desk of the mega-gym as I hesitantly pointed to the physical therapy office in the corner of the building not knowing if I needed to check in or if it was okay to just keep going. I didn't know exactly what was in store for the next 45 minutes, I only knew I had heard good things about Active Release Technique from friends and other runners, but this would be my first experience.

Active Release Technique (ART) is defined as "a soft tissue method that focuses on relieving tissue tension via the removal of fibrosis/adhesion that can develop in tissues from overload due to repetitive use." ART was founded by a Doctor of Chiropractic, based in Colorado Springs, Colorado, and the founder of Champion Health Clinic - Dr. P. Michael Leahy, DC, CCSP.

Active release technique is designed to accomplish three things and is used to treat problems with muscles, tendons, ligaments, fascia and nerves:

  1. to restore free and unimpeded motion of all soft tissues

  2. to release entrapped nerves, vasculature, and lymphatics

  3. to re-establish optimal texture, resilience and function of soft tissues.

Let me be honest about one thing before I go any further; I know that some people may think that ART borders on "unscientific" or "holistic" treatment, both of which I am very wary of. Though, in this case I think it's worth keeping an open mind about and definitely worth exploring in more detail if you have a soft tissue issue/injury.

Although there haven't been many (any?) large scale studies that I could find which have a significant scientific basis and control groups that would help to answer this question, I do have some experience of my own which I'll share shortly. That being said, there are several small case reports and pilot studies which show promising results when treating myofascial and overuse injuries.

One study that I keep finding reference to is that of 20 participants who did a "sit and reach" test 3x before a single ART treatment focused on their hamstrings and 3x after the treatment. These participants saw an average of over 3 inches of increased flexibility afterward. Interesting, but not all together telling nor large enough to be a good overall indicator of scientific proof...but a good start perhaps.

Dr. Abelson, ART provider of over 20 years and author, in his book Release Your Pain (which I have not read) says that:

"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 analysis and the subsequent treatment, the practitioner:

  • Evaluates gait, motion, and posture.

  • 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.

  • 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 - power, strength, and flexibility."

Or more simply, as my therapist, Justin Wu, says " The concept is to find adhered muscle groups and effectively eliminate the tightness or scar tissue. This promotes an increase in lymphatic flow, arterial flow, and overall muscle performance. An analogy I like to use is this: athletes' muscle groups are like a highway, in order to make sure traffic is running smoothly we need to fill in the pot holes (pot holes being the wear and tear from exercise or injury)."

All that being said, my answer is a resounding YES. Yes, it works. Sure, I'm only one person, and I've only been receiving treatments for a few months, but I can tell you that after just a couple of treatments I noticed a significant difference in how my leg(s) were feeling.

Let's start at the beginning. About a week before my second 24 hour ultra marathon of 2016, I began noticing a "tweak" (verb. to injure slightly, otherwise known as something that runners call injuries they don't want to admit may be actual reasons they should stop running) in my right quadricep just above and on the inside of my knee. In general I find that I'm probably a little more proactive than most runners in this sense, but it still took me 2-3 weeks of running on a "tweaked" quad before I decided to take some action.

Over the past 5 years or so, since I've been involved with Zoom Multisport and have been swimming, biking, and running much more than I did in the past, I've become very familiar with Boston Sports Medicine, one of the TOP physical therapy institutions in the greater Boston area. During my many visits to BSM over these years, luckily all for minor issues, I've also gotten to know the founder/owner Dr. Michael J. Velsmid, DPT, MS, and his approach to treatment well. He runs a fantastic practice with many locations around Boston. He is professional, knowledgeable, and always finds time to get me in to see him directly or one of his therapists.

Anyways, back to the topic at hand...ART...I finally reached out to Dr. Michael Velsmid and he happened to have some time he could fit me in the next day. After a thorough examination he determined that there were no major injuries, but recommended a course of Active Release Technique with one of his therapists, Justin, at the Watertown location. Granted I was a bit skeptical, but Michael and his team have never steered me wrong in the past, so at this point, I trust him completely. I would probably let one of their therapists jump up and down on my legs or whack me with a baseball bat if they told me it would make me run faster or better. That blind trust may be an issue for another discussion though.

The next day I was at the BSM location in Watertown getting my first ART treatment with Justin. I'm not sure exactly what I expected when I went in the door, but suffice it to say I was a little nervous and what was happening was not what I expected. I guess I've always had the (outdated?) frame of mind that "if it doesn't hurt me, it isn't helping" as often is the case when I get a deep tissue massage. Justin did a series of simple walking and flexibility tests to determine what specifically was causing my quad issue. After a few minutes of walking across the room, standing up/bending over, jumping, rolling around on the floor (okay that part didn't happen), etc. I laid on the table and Justin began soft tissue work on my right quad.

This manipulation of the muscle fibers in combination with precision stretching of specific muscles didn't hurt. It wasn't uncomfortable. Basically I was just laying there while he moved my legs around and poked/prodded on them at the same time. After the treatment was over, I went about my day. To my surprise neither Dr. Velsmid nor Justin told me to stop running, even for a day. (Side note - this is probably the most positive thing I can say about Boston Sports Medicine. They will ALWAYS do everything in their power to keep me running through treatment whenever possible.) So I kept running.

That night I ran 8 or 10 miles and didn't really feel any difference, but I figured I would give it at least a few treatments before I decided if they were working or not. Two days later I went back and received a similar treatment on my quadricep and right leg/hip/knee. This time with a little more stretching and a little more pressure than the first visit.

It is here that the switch flipped! I went home that night after the second treatment and ran again, probably about the same distance 8 or 10 miles, but my leg felt better. Not 100% healed, but better than it had felt in weeks. Okay, I thought, maybe there is something to this. I continued to see Justin 2-3x/week for the first few weeks where he continued the ART and stretching while adding in some electric stimulation and cupping at the end of each treatment. This helped to address the initial "tweak" in my right quad and I was back up to running pain free.

Now, I probably can't say with 100% certainty that these treatments miraculously healed me on their own as I had added in more strength training along with some extra rolling/stretching; but I can very confidently say that without the ART treatments my body would never have healed as quickly as it did. It is also very possible that I would have kept running on the "tweaked" quad until it became even worse and caused a more significant injury.

Over the course about 12 weeks, including leading up to my 143.39 mile performance in 24 hours which qualified me for the US National Team, I received regular treatments from Justin and found that my own flexibility had increased and my legs were feeling much better. After working out the quad injury and for the few weeks leading up to the Desert Solstice 24 hour Invitational race he began working on both of my hip flexors (which have caused many mid-race issues in the past) and my IT Bands to make sure my legs were in top form for the race. I can say that this was the only time I've been able to run for 24 straight hours without having significant hip flexor or ITB issues that caused me to stop or slow down.

Now, that may just be one athlete's perspective, but from where I sit, it's a pretty dang good one. So, if you're experiencing some nags, tweaks, or niggles in your body it's time to listen to them. If you're in the greater Boston area, definitely contact Boston Sports Medicine to see Justin. If you're not, then find a certified ART therapist in your area and give it a try. I think you'll be glad you did.

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