Project HUGE: Active Release Technique (ART) With Dr. Christopher Anselmi In NYC
Posted December 29, 2008 at 8:45 PM by Ben Nadel
About six or seven years ago, I experienced acute pain in my right knee while squatting on the Smith Machine in my college gym. Although there was no pain when I was standing, I could hardly walk up stairs or get out of bed without wincing; working out was out of the question. I gave it a few days to see if there was any improvement - there was not. So, I went to the school's medical services and ended up talking to their part-time chiropractor.
I can't remember what his name was, but I left school referring to him as the "Magic Man." He was the one who introduced me to Active Release Technique (ART), a specialized soft-tissue treatment meant to break up scare tissue in the muscle. I came to him not being able to walk up stairs without pain and two weeks later, I was back in the gym performing leg presses.
My knees were pain-free for a few years and then, again while squatting, the pain returned. The muscle adhesions had built up again and were causing tightness in the muscle and tendons around my patella (knee cap). This time, however, I was in New York City. And so, without the "magic man" at my disposal, I sought the help of local chiropractors.
I explained to them that I had great prior success with Active Release Technique. At this they nodded and then proceeded to tout the "spinal subluxation" as the root of all evil. When I protested, they brushed me off saying that ART treated the symptoms of my pain, but not its cause.
I was so young and timid then - I didn't dare speak up more than once; I trusted the doctors. And, the same thing happened time and time again. With each successive chiropractor, my knee pain persisted with no diminshment.
Now, at the dawn of a new year, I have stated that January of 2009 is going to be my month of health. As such, I have decided to actively seek out effective treatment for my knee pain. This morning, I contacted Dr. Christopher Anselmi's office here in New York City and got an appointment for this afternoon. I picked him because his website - The Center for Spine Care and Mobility - really seemed to emphasize the use of Active Release Technique in treatment.
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When I sat down with Dr. Anselmi, I was nervous; I was afraid to be given the same old story that I had gotten before. When I mentioned Active Release Technique, it was a monumental relief to hear him say, "It sounds like Active Release Technique is exactly what you need."
Oh thank heavens!!
Then, he sucker-punched me with some more good news - "Let's start with the ART right now."
So, that's how it is that I ended up at 5PM today having someone dig their thumbs into the tender tissue of my quadriceps and IT band. Dr. Anselmi's technique was slightly different than with my previous experience, but the concept is exactly the same. And I'll tell you, when I left his office, my right leg felt like a million bucks! In fact, my leg felt so good after the treatment that I had to stop and randomly step-up on stuff while walking home. A park bench - no pain. A fire stand-pipe - no pain. My front steps - NO PAIN! Squatting down for fun - no pain.
Now, don't get the wrong idea, this is not a one treatment sort of fix; I'm going back to see Dr. Anselmi next week for another appointment. But, I can't tell you how excited I am to already feel more relief in one hour than I've felt in the past 4 or 5 years of seeing chiropractors and being treated for spinal subluxations.
Things are on the up and up my friends!
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Sounds like that was a very successful doctor's visit. Hope the technique continues to prove effective.
Thanks! I am sure it will take a few more visits to get the full benefit, but so far so good.
w00t - congrats man! Great stuff!
Thanks man! I am really excited about it. I keep kneeling down just to test it out. It's been feeling really good. I hope in a few more sessions it will be pain free.
Unfortunately, I think this is a chronic condition and I will have to go back for some ART every now and then as the adhesions build up in the muscle. Really though, such a small price to pay for pain-free knee flexion.
@Ben, I am glad to hear that you are getting relief. Any kind of pain and loss of flexibility just plain sucks.
That said, you know that I am a skeptic, and this is no different. The evidence on ART is not in yet. Any so-called evidence is anecdotal at best. There have really been no long-term studies, to my knowledge, that show, either the effectiveness OR the dangers of ART. The fact that it was invented, and is aggressively touted, by a chiropractor does not help its credibility, in my book, either.
If I were you, I would consider talking to a real doctor, or at least a physical therapist, before continuing with ART treatment long term and repeatedly. What may feel good and invigorating today may cause you years of pain and misery down the road. ART is a VERY aggressive technique (as I am sure you now know). And it would not surprise me in the least if people that receive long-term aggressive therapy like that experience different issues down the line. Early arthritis? Tendon or ligament issues? Who knows.
And that is exactly my point. Who really knows? The answer is NO ONE. No one knows because ART is not evidence-based medicine. It is something that seems to, anecdotally, work in the short term and may or may not work in the long term and may or may not cause lasting damage.
Just be careful is all I'm suggesting. Your body is your temple.
To me, Active Release Technique seems like nothing more than a specialized form of deep tissue massage; I really thinks that's basically what it is. Some guy is massaging the muscle, just in a very targeted, intense way. I don't know if there are studies on the long term affects of massage, but I have to believe it's nothing but beneficial.
This sounds very much like myofascial pain release which is a fairly accepted type of therapy. Years ago I developed severe tendinitis in both elbows from all the mousing (with poor ergonomics) and ended up on disability for several months as it was too painful to even work at the computer. None of the normal therapies helped me that much. The myofascial release was the only thing that I found that gave me any long term relief and allowed me to eventually go back to work. Although some of the sessions themselves were really painful too!
I think they are quite similar. I think one of the biggest differences is that in Active Release Technique, the muscle changes length as the pressure is applied where as in myofascial treatments, I believe this is not the case. Of course, I am just hazarding a guess at this and may be very off.
Great article and one I can relate to. I've been to about 4 chiropracters over the last 30 years. I visited the first two as a favor to friends that would get a free session if they sent a couple of referrals. Other than typical soreness of an active rugby player, I really didn't have anything wrong. Yet when they learned I did in fact have insurance coverage, wanted to schedule weekly visits which I passed on.
In 2000, I let my back get so bad voer a period of a few months, I honestly could not get up. I would literally roll out of bed, onto the floor, use a table to pull myself up and be standing about 3 minutes later. I found a local chiropractor on my plan. He saw me right away, xrays, adjustment, ELECTRIC STIM....a godsend. I left 50% better, 3 more visits with adjustment, STIM, and vibration massage over about 10 days, and I good as new.
I did seek help one other time and had an awful experience with a chiropractor while my "MagicMan" was on vacation, but that's another story.
Long and short of it, I ended up designing, creating, or better yet just putting together very firm foam balls in a bag to achieve the trigger point and myofascial release that people associate with foam rollers, balls, and CMT's. It light, cheap, and works wonders.
That's crazy to hear how you were getting out of bed! I'm glad to see that things have gotten much better. I am seeing that there is a huge benefit to keeping your muscle relaxed and I think the idea of the bag with many points of pressure is something I will be looking into. I might start looking into some sort of massage therapy as well to help keep everything lose and knott-free.
Unfortunately our choice of profession means getting on a first name basis with your massage therapist(Or any other profession that has you seated for up to 10h in front of PC screen). Too bad there are no ART practitioners in Serbia, but a combination of competent "classic" masseuse and a lot of foam rolling usually does the trick for me.
Ironic this showed up in my inbox again due to the recent comment. I had forgotten about it but had someone else recommend ART as a possible therapy for me. Right now I am undergoing prolotherapy on my lower back and pelvis which is fairly expensive, not covered by insurance and pretty painful to boot. Like ART it's not fully accepted by the medical profession but often gives great results. I had one treatment on my elbows as well which have chronic problems and haven't had any problems since, but not so much luck with my back so far. We'll have to see how the next one goes. The doctor I am seeing is pretty awesome though, he does everything using digital x-rays to check needle placement and does other cutting edge regenerative therapies like platelet-rich-plasma and even stem cell injections. Having had a botched knee surgery screw up on knee permanently, and known quite a few friends and family with similar experiences, I've become much more interested in these types of non-invasive healing methods.
Yeah, I need to make another appointment - get my knee worked on again. The body is like a car - I gotta bring it in for a tune-up every now and then.
I've read a bit about prolotherapy and platalete therapy. Seems very interesting. My sports medicine doc recommended it for my wrist because he thought I over stretched a ligament that wasn't healing properly. He said if we go in and aggravate the area, it will signal the body to come in a fix it. I believe he talked about a salt solution; but, I have read that the prolotherapy is more effective since it uses your own blood cells.
@Ben - Yes, prolo is commonly used for an injury that does not heal properly (which is often what causes chronic pain) but and can be either a sugar or salt solution, something that will irritate and cause an inflammatory reaction in the area. Not sure about that last sentence....prolo doesn't use your own blood cells, that's platelet rich plasma (PRP). That's a newer technique so not as much data on it, but results indeed have been good and often with fewer treatments than is typically needed with prolo.
Oops, sorry for mixing up the techniques. I read a bunch about both and have since forgotten some of the details. I keep hoping that my wrist will heal without it. I've doing (not consistently) wrist exercises. Sometimes it feels better, sometimes it does not. Maybe if I kept up the exercises, it might be better :)
I know I am responding to a very old post but let me tell you all as a reasonably well qualified and established fitness professional (but not an ART specialist) that ART is one of the very best physical therapies available for soft tissue related problems. Pretty much everyone gets some quick, and long lasting, pain relief and increased range of motion after just one session.
This thread always seems to show up in my inbox at the most opportune times. I never followed up on this before (had pretty good luck with the prolo so didn't really need to) but recently have been having some really severe pain in my pelvis, my doctor felt it is probably ischial bursitis (inflammation of the bones you sit on) and femoral tendinopathy. All I know is sitting has become unbearably painful and I'm not sure I want to go through even more very painful (and expensive) prolo treatments. This may just be something that I finally give a try...although my concern would be aggravating the problem and making it worse. But one of the things that is always a challenge for me is I seem to often have problems that aren't something a lot of doctor's have much familiarity with. This seems to be along those lines, just not something they seem to have many options for me.
From what I can see, ART is basically just an intense way to lengthen the muscle forcibly by pushing against the tissue as it lengthens. It's like an short, intense massage. I saw in the doc's office that he had a binder for "Upper", "Lower", and "Spinal" ART so it can be used pretty much anywhere.
Well, I had my first session today. Wasn't too bad (fairly painful but not any worse than other stuff I've done), but can't say I've seen much improvement from it. I'm such a mess though, it may take awhile to see if it works. I do feel that the doctor was able to hone in quickly on my most problematic areas, so hopefully she'll be able to help me. Will let you know how it goes!
Where did he work? Up in your glutes and lower back? I once had a guy work on my lower abdomen - now that was painful.
The results are bit funny. I find that I tend to take a dip before I see any good results. When I get my knee worked on, it tends to be more sensitive for a few days. I'm about to go off to a conference, so I am actually gonna give the knee like two weeks rest. When I get back, I'll get some more treatment and then start to hit the gym harder again.
Ben - darn you, wanted to just drop in quickly and post a reply and got distracted by that RegEx contest! An hour later....
Anyway, my doc is a "she" not a "he". You guys, always assuming....lol
She mainly worked on all the muscles in the pelvis and upper leg area, my piriforms and upper hamstrings tight and painful. Well, pretty much anything in that area is right now. I definitely didn't expect a lot from the first session, but I did seem a bit better today, so that bodes well. I don't think this alone will be enough for me regardless and I do have an appointment with an ortho in a couple weeks. That will probably be some kind of injection therapy, since the bursitis is generally not something massage techniques alone can fix. It's just all the resulting trigger points and muscle tightening I get as a result of that which is really throwing my whole lower half into a musculo-skeletal disaster area. ;-)
What really sucks is the free ColdFusion conference here in Raleigh is this weekend, I live just 30 minutes away! And because of this, I'm not going to be able to go for more than maybe a couple sessions a day.
I'm glad you felt some relief with this treatment; hopefully the other therapies will take the fixing to the next level. Let us know how it goes. I have had right-wrist pain for like 3 years now, although it is very slowly getting better, I think. I believe that we had once discussed the use of injection therapy for stuff like that. I keep meaning to make an appointment with my a doctor to see talk about the wrist (my last doctor was not... confidence building).
Have fun at whatever NCDevCon sessions you *do* get to attend.
Thanks Ben, I'll definitely try to remember to come back and update the thread once I am further out.
You might want to pick up a copy of "It's Not Carpal Tunnel Syndrome". Very good reading for anyone that is starting to see any symptoms of RSI, as far too often it's just attributed to carpal tunnel, but that's more a symptom than the cause. I personally have seen my symptoms regularly shift from one area to the next (although I personally have never had any hand involvement at all, thank goodness) but it often moves from my elbows to my shoulders, to my back, etc. Probably the best thing anyone that works long hours at a computer can do is get a timer program and set it for every 30 minutes, to remind you to just get up, stretch for a few minutes, and then go back to work. It's really hard to be disciplined about this when you are engrossed in your work as most of us are, but it's by far the single most important thing (and relatively easy and cheap to boot) that you can do to keep from developing long term RSI issues.