Human physiology is almost miraculous in its ability to repair itself, but it is not perfect. Anyone who has ever gotten a severe cut on their skin can attest that the wound may heal but there is often a scar to remind us of past injury. This scarring is not just limited to the epidermis; in many cases, damage to muscles, tendons or ligaments can produce scar tissue that may impinge on local nerves or other tissue long after the original injury has healed.
There is a way to shrink or eliminate scar tissue from soft tissue injuries. In 1984, Dr. Michael Leahy of Colorado Springs developed Active Release Techniques or ART as a way of locating and eliminating scar tissue adhesions. Active Release Techniques has been used to treat many health conditions including
- Lower back pain
- Neck pain
- Shoulder strains
- Tension headaches
- Shin splints
- Joint conditions
- Plantar fasciitis
- Tennis elbow
- Sciatic nerve pain
ART is a patented therapeutic technique that professes to alleviate pain and limited range of motion symptoms in 90 percent of treated patients within six sessions. ART practitioners hail from many professions including physicians, physical therapists and massage therapists but they are most commonly chiropractors.
In most cases, Active Release Techniques are not covered by insurance, so most patients will have to pay out of pocket. The good news is that most patients will only require six or fewer sessions before there is significant improvement or resolution of symptoms.
How ART Works
When you injure muscles, tendons or ligaments, scar tissue forms around the injury. Scar tissue is created from collagen cells found in these soft tissues. New collagen cells are formed in the wake of an injury, but they often aggregate without order, producing scars.
Although scar tissue does not disappear quickly naturally, it is not permanent. Your body may use a process called remodeling to loosen and replace these collagen cell adhesions. This process may take weeks, months or years to break up without medical intervention.
Active Release Techniques uses manual manipulation to stretch and realign collagen scar adhesions. This realignment allows the collagen cells to return to their original formation and diminish the scar. This manipulation may take the form of massage or kinesiology tape.
Why Scar Tissue Removal Is Important
There are many ways that scar tissue may be formed including joint sprains, muscle pulls, bone fractures or surgery. Scar tissue does provide benefits in the healing process, primarily providing a scaffolding for nerves and other cells, but it has some detrimental properties that make its removal a priority. If the adhesion grows too large, it may have disadvantages like
- Lack of aesthetic appeal—if the scar is on the surface or it is big enough to deform an area, it may be unsightly and impact the patient’s emotional health.
- Inhibit mobility—scars near joints may interfere with the function of muscles or ligaments, limiting the range of motion and movement.
- Bowel obstructions—people who have abdominal or pelvic surgery may experience abdominal adhesions. This buildup of scar tissue can interfere with bowel function and produce pelvic pain.
- Nerve pain—if the adhesion forms near a nerve it may press on the nerve and cause pain, both at rest or when nearby muscles are in use. In some cases, scar tissue may also limit blood flow to nerves and produce pain.
- Disrupted fascia—all throughout the human body is fascia tissue, covering muscles, nerves and organs. Scar tissue can impede the function of distant muscles and organs by interfering with fascia.
Commonly Used Active Release Techniques
Once your doctor has carefully examined you and determined that you are a candidate for Active Release Techniques, then she will set up an appointment with an experienced physical therapist or ART practitioner. It requires considerable expertise to accurately locate scar tissue adhesions by touch since they do not appear on x-ray or MRI imagery.
A variety of Active Release Techniques are used, depending on the nature of the injury and the state of the adhesion. Every ART session begins with an evaluation of the adhesion, followed by one or more of the following techniques.
- Shoulders—following a shoulder injury, you may want to try to shrink scar tissue that has accumulated between the joint and your neck. With one hand, press on the muscle joining the neck to the shoulder joint, while putting your other hand on your lower back. Then tilt your head in the opposite direction, then straighten your head and extend your arm. Repeat while applying pressure at various positions on your shoulder.
- Achilles tendon—Sit with one leg extended straight ahead. Grab the other leg’s calf and massage it while flexing your toes. Repeat while applying pressure to the inside of the calf, then the outside.
- Hamstring—lie on your back with both feet flat on the floor. Keeping your leg in a bent position, grab your upper hamstring and massage it while you extend your foot toward the ceiling. Release and repeat in the middle and lower hamstring areas.
- Calf—this technique helps with shin and foot pain. Sit with one leg bent. With thumbs on the shin, grab the calf with both hands. Massage while extending your leg and flexing your toes. Repeat all along the calf muscle as well as inside and outside.
There are hundreds of ART techniques that your therapist may use. In most cases, sessions are about 15 to 30 minutes in length, and most courses of treatment last only six sessions.
The signature benefit of Active Release Techniques is a reduction in pain and limited range of motion by shrinking or eliminating scar tissue, but along with this come many secondary benefits including
- Improved flexibility
- Greater range of motion
- Reduced lower back pain
- Reduced neck pain
- Relief from tension headaches
- Management of carpal tunnel syndrome
- Management of shin splints
- Relief from sciatica nerve pain
- Management of plantar fasciitis
- Management of tennis elbow
Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care
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