Monday, April 20, 2009

Active Release Technique (ART), Z Health, Hands on Work (Massage, Guided Exericse)

What are your thoughts about ART?

This was a good question that I received about 3 times in the past week, so I thought I would address it here.

It is a general question, so I will answer it in relation to general prinicples. Again, everything needs to be custom to the athletes that you work with of course.

For more info, click the links below

Get Off the Foam Roller

Myth Busters-Painful Soft Tissue Work

Some have believed based on my posts above that I am against soft tissue/hands on work; and that is not true at all. I am against PAINFUL soft tissue work!

All of the ART therapists that I have met so far have been great and extremely knowledgeable. Some do painful soft tissue work and others do not (although they are much less common). I don't believe pain is needed to get a result and will actually diminish your results. You are normally seeing an ART person to get out of pain or change a motor pattern/pain.

Don't try to blow up the safe when you just need the correct combination to open the door.

Here is another great post by Carl Valle at Elite Track and my response to it.

Soft Tissue Therapy by Carl Valle (click the title to open it)

My response to Carl.

Hi there Carl! Thanks for the kinds words as it means a lot coming from someone such as yourself.

In relation to experience with athletes that is an excellent point. To date, I have done a fair amount of Z Health sessions (I do have the exact number documented and not pulled out of thin air if you need further info).

Note that when I say Z Health this may apply to dynamic joint mobility work, visual testing/movements, vestibular work or even hands on work (which means that I am holding
tissue/joint/muscle in a specific orientation while they perform an exercise).

I agree that most of these are not what would be considered high level athletes and more weekend warriors types. I was able do a session with a recent Olympic competitor and was able to get her out of pain for the first time in years (see link below)

Z Health and Marathon Running

The same principles would apply to high level athletes.

I agree 100% that soft tissue work done correctly can have HUGE changes for people. No question about that!

You point about most businesses is a good one. I do run a business in the private sector.

Clients/athletes come to a professional in the field for results. My guarantee is that if I can’t get your pain to less than a 2 on a 1-10 scale in ONE session, it is FREE. No results=no money for me=out of business.

Down with foam rollers! Preach on.

Yes, there is research on eccentric stimuli to help encourage remodeling, esp in the case of
tendonOSIS as you know. I like to think upstream—-what causes tension on the muscles/tendons?

Control from the nervous system, so if we can alter that signal, over time the structures will adapt.

Carl said “..but the direct approach WITH motor changes and other elements is a full approach.”

Yes! I have had cases where I’ve needed to do hands on (touch an athlete just as you would touch them to guide them during an exericse) to get a result. In one specific case I held the hamstrings in a specific orientation with the athlete doing an opposite elbow circle (joint mobility), with her head turned to the right and eyes in the up position.

Her hamstrings worked much better afterward and total time of the drill was about 1 minute (getting to that point was about 40 minutes in that case though). She had to follow up and do a similar drill (without hands on work) 3xs a day for about 3-4 weeks for it to “stick”—there is never a free lunch

In general, I do the minimal approach to get the maximal results. Precise joint mobility work seems to get me there about 70% of the time ( I mean 72.8958859% of the time, hehee). The more times I work with athletes and as their movement progresses, the more other work they will need—hands on (guided exercises), visual (eyes held in a specific position), and vestibular (head motions) ; but with all things “it depends” as I may skip around depending on the client. I like to start simple and then only add complexity when the simple looking things do not work.

I hope that answers the ART question!

Any follow up points, thoughts, clarifications, please post them in the comments below.
Mike T Nelson