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Active Release Technique: A Solution to Pain Management and Mobility in Runners

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With the array of pain management treatments available, it may get difficult to decide which is best for each type of pain we have. Home remedies are obviously the most convenient option, either using over-the-counter pain medication, massage tools, ice packs, heating pads, and compression gear. Once pain gets to a chronic stage or is not responding to at-home treatment, it is advisable to consider professional pain therapies. With orthopedic and neurological conditions, doctors will usually prescribe physical therapy for patients, which will consist of hands-on treatments as well as an exercise-based approach to relieving and managing pain. Other professional alternative options include chiropractic treatment, massage therapy, and acupuncture, among others.

Many athletes may end up trying several different types of treatments before finding the right one for their issue. Since pain can come in many forms and from many different causes, what works for one body part and injury may not work for another. Unlike at-home treatments, these professional alternatives may get quite costly in both time and money. Those treatments such as physical therapy are thankfully covered by insurance, but even that coverage can get exhausted rather quickly before the issue is fully resolved, leaving patients with quite a bit of out-of-pocket expenses.

Active Release Technique

One treatment technique that is becoming more popular in chiropractic and physical therapy clinics is Active Release Technique, or ART. This procedure is used for injuries and pain in muscles, tendons, ligaments, and even nerve-related disorders. The treatment mainly focuses on relieving tissue tension that results in adhesions and scar tissue from recurring use. Chronic pain may develop after surgeries, traumatic injuries, and in most runners’ cases, ignoring the gradual onsets of the overuse of muscles.

ART is a manual-based therapy technique in which the clinician applies deep pressure to the area of pain or limitation while instructing the patient to move the affected area from a shortened to lengthened position. Although this is considered an “active” technique, the clinician may also passively move the affected area if the patient is unable. This causes almost a stretching-like sensation for the patient, and works to break up any adhesions and scar tissue causing limited muscle mobility and blood flow. The technique also helps to release entrapped nerves.

Scar Tissue

The development of scar tissue in the body is part of the normal healing process after surgeries, tears, strains and sprains. The problem with scar tissue is that it limits the range of motion and mobility of muscles if not addressed. During physical therapy after an injury or surgery, for example, the manual therapy used is for the purpose of improving mobility in joints and getting rid of scar tissue through mobilization and massage techniques. This is probably the most important part of the treatment plan before addressing weakness. One purpose of ART is to assist in removing this scar tissue, which may be present in areas outside of the painful sites. Studies have shown that the scar tissue in the gluteal muscles that causes low back pain have responded to ART treatment with significant improvements in back pain and stiffness.

Soft Tissue Restriction

For athletes, pain may not be the cause of decreased mobility or performance. There may be the presence of muscle and tendon restrictions causing limited movement, which affect proper running mechanics. For example, chronic inflexibility of the hamstrings can lead to decreased stride length and fatigue with holding a certain cadence. With the use of ART, the clinician will evaluate where the restriction is in the hamstring group of muscles and work to release the tension at that site. Another group of muscles that responds well to ART is the calf and Achilles tendon, which can limit the amount of push-off during running if there are any tissue restrictions present.

Many of these adhesions that build up in the muscles go unnoticed in athletes who train consistently. Eventually these adhesions may cause injuries since they limit the full range of motion of joints, therefore increasing the risk of strains and tears. Muscles cannot work at their full strength potential with adhesions present, since full mobility is limited. This will also lead to injuries as competitive runners train beyond their limits at times, and performing at levels that their muscles may not be prepared for.

ART Versus Other Techniques

Although Active Release Technique may seem like a type of massage, it is much more than that. Massage therapy works to relax muscle tissue and relieve tension from chronic stress, but it does not affect scar tissue in any way. ART focuses on targeted areas of adhesions and applies much deeper pressure than a traditional massage. The pressure involved is similar to a deep tissue massage and involves active movement during the process. The Graston technique is another form of muscle treatment that focuses on adhesions, but involves instruments to apply the pressure. Dry needling is another method for pain relief using needles without any medication to disperse pain in trigger points in the body. Again, this treatment does not involve the management of scar tissue.

Muscle Management is a Lifestyle

Unfortunately, for some conditions, once you experience an injury once, you are more prone to developing the issue again if you do nothing to prevent it. As mentioned earlier, scar tissue develops after surgeries, injuries, or chronic overuse and is a normal process of healing. Once the adhesions have broken up and freed mobility and relieved pain, it is important to avoid the build-up of adhesions again. If the cause was overuse, then more rest needs to be incorporated, as well as strengthening of weak muscles. If the cause was a traumatic injury that caused scar tissue build-up, then preventing injuries should be prioritized with maintaining strength and proper flexibility in the body, or simply better body awareness during activity. Before deciding to try Active Release Technique, make sure to consult with a professional regarding your needs and symptoms. ART should only be performed by a certified clinician.


  1. Sajin Tak, Yongwoo Lee, Wonjae Choi, and Gyuchang Lee, The Effects of Active Release Technique on the Gluteus Medius for Pain Relief in Persons with Chronic Low Back Pain, Journal
  2. Hariharasudhan Ravichandran, Balamurugan Janakiraman, Subramanian Sundaram, Berihu Fisseha, Asmare Yitayeh, Active Release Technique in Hamstrings Strain: Rehabilitation and Return to Play – A Case Study, Journal