Tuesday, November 6, 2012

A.R.T. - Active Release Techniques for soft tissue injuries and more


Some of you may have heard the term "A.R.T.", or the words Active Release Techniques. Today I would like to explain what ART treatment is, how it works, what kind of practitioners perform this very effective soft tissue technique and the many conditions this therapy can treat.
As stated above, A.R.T. stands for active release techniques. It is an advanced soft tissue technique that requires intensive training and certification. It is known to be the "gold standard in soft tissue treatment". Healthcare professionals that are able take this post-graduate training and certification in ART are Chiropractors, Registered Massage Therapists, Physiotherapists, Certified Athletic Therapists and Medical Doctors. This advanced training is not open to personal trainers, masseurs, and any other certifications that are not licensed to treat soft tissue problems. The practitoner must be competent in anatomy (not just basic anatomy), physiology and biomechanics. Here is a link to see a photo of an ART treatment being performed: http://www.drbrentmoyer.com/Chiropractic-Services.aspx

A.R.T. treats soft tissue conditions. Soft tissues include muscles, tendons, ligaments, fascia and nerves. It is a patented treatment that was founded and developed by a chiropractor Dr. P. Michael Leahy DC, CCSP.

Common conditions that respond very well to A.R.T. treatment include; back pain, headaches, sciatica, carpal tunnel syndrome, tennis elbow, shoulder or rotator cuff pain, knee pain, plantar fasciitis (heel pain), achilles tendonitis....just to name a few. The common denominator in all the above conditions is that they almost always involve overused muscles or repetitive motions. In the medical arena we call these conditions CTD (cumulative trauma disorders) or RSI (repetitive strain injuries).

Let's go into detail to explain what happens to overused muscles and soft tissues. When a particular muscle or tendon or any soft tissue is overused there are specific changes that will happen in the tissue.
    1.) you can have an acute injury such as a muscle tear, pull, strain or contusion.

    2.) you can have cumulative strain which accumulates small tears, called "micro-trauma"
    3.) or you can have lack of oxygen going to the muscle or tissue, called "hypoxia" creating "trigger points" or "knots" in muscle which can lead to fibrous tissue.

Most of the conditions I listed above will have one or more of the three soft tissue changes that happen to overused muscles.
Let me give you an example of how this can relate to a simple calf strain or leg pains. A female who wears high heels to work 5 days a week will overuse her calf muscles. Each and every step she takes in these heels will create excessive contraction of the gastroc-soleus (calf) muscles. Even when seated, the calf muscle will be over-worked because it is still in constant contraction while in the high heels. Over time this will create very tight, shortened calf muscles causing increased tension and friction in the muscle. The tension and friction causes micro-trauma (small tears) causing inflammation. The inflammation will then cause the body to actually lay down adhesions or scar tissue in an attempt to "fix" the injured and inflamed muscle. It is only at this point in the sequela of events that the patient will actually feel pain or any symptom. This is the classic example of a RSI (repetitive strain injury) and usually the patient will present with tight and achy and sometimes burning pain the affected muscles. The patient will say something like this..."doc my legs are killing me." "They are tender and sore all day long." "It just came on, I don't know what I did and I have never had this pain before..." As you can see, repetitive strain injuries develop over time from overuse. It creates a negative self-perpetuating cascade of events: overused muscle - becomes tight - increases tension - increases friction - causes inflammation and pain - causes scar tissue development - which causes more tightness, more tension, more friction, more inflammation and more scar tissue. You get the idea. This continually happens until the body breaks down and can no longer adapt, thus resulting in pain and symptoms. The tight muscles or scar tissue can even irritate, pinch or compress a nerve causing numbness and tingling and even sharp pains. A.R.T. is also used to reduce nerve entrapments.

Now that you understand how RSI (repetitive strain injuries) happen, it is very easy to understand how A.R.T. works to fix the problem, not mask it. Conventional allopathic medicine would try to treat this by giving anti-inflammatory (NSAID) medications. This may help to reduce some inflammation and pain, but it just masks the problem. The cause of the problem is not the inflammation, it is the tight, fibrotic (scar tissue) muscle. This is where A.R.T. comes in. The treatment will break down the fibrous adhesions (scar tissue); reduce the tension and tightness in the muscle so it can heal properly. Immediately following an ART session, the patient will feel looser and the pain and tension should be reduced. Exercise rehabilitation, postural correction and improving the ergonomics at the workplace are also implemented to get superior results.
For more information Dr. Brent Moyer can be contacted at Brant Arts Chiropractic 905-637-6100. www.drbrentmoyer.com Twitter: @brantartschiro Facebook: Brant Arts Chiropractic