Dr. Joseph Kottoor

Active Release Techniques™


What is ART?

ART provides a way to diagnose and treat the underlying causes of cumulative trauma disorders that result in symptoms of numbness, tingling, burning and aching. ART is a type of manual hands-on therapy that corrects muscular and soft tissue problems caused by adhesion formation as a result of injury, overuse or cumulative trauma.

What is Cumulative Trauma?

Cumulative Trauma disorder (CTD), Repetitive Stress Injury (RSI), Repetitive Motion injury, are all used to describe problems that arise from the cumulative injury cycle (CIC). Some common names of these conditions are Carpal tunnel syndrome, rotator cuff syndrome, chronic low back pain, whiplash injury and poor posture. CTD's create physical signs and symptoms that are predictable and correctable using ART.

What is the cumulative injury cycle (CIC)?

If you set a pendulum into motion, you don't have to keep pushing it each time, it keeps going! Our bodies respond in much the same way. That's why it hurts even after the stress is removed. The cycle can be started in three ways, Acute Injury, Repetitive Injury and constant Pressure or Tension. Left uncorrected, they lead to inflammation, adhesions/fibrosis, weak and tense tissues and decreased circulation all in a specific progression called the Cumulative Injury Cycle.

What are Adhesions?

Our bodies contain special protein structures called connective tissue, also know as Fascia. This substance connects each part to other parts and the whole, very much like a flexible skeleton. When this tissue is healthy it is smooth and slippery, allowing the muscles, nerves, blood vessels or organs to move freely and function properly. Imagine a piece of scotch tape, the smooth side is healthy fascia, the sticky side is scar tissue or unhealthy fascia. Rub both sides of the tape along your skin to "feel" what an adhesion is like. The drag that you feel, the "pulling" sensation, is what an adhesion is like. These adhesions attach to muscles decreasing their ability to work properly. You really know when you have an adhesion on a nerve because you get many abnormal sensations like numbness, tingling or pain.

What is the treatment like?

ART is not a magic bullet or cure-all. Active Release Techniques is noninvasive, very safe, and has virtually no side effects and comes with a record of very good results.

Treatments can be uncomfortable during the movement phases as the scar tissue or adhesions "Break up". This is temporary and subsides almost immediately after the treatment. It is common to feel a duplication of your symptoms during the treatment, a good indication that the problem has been identified. Treatments are about 8-10 minutes per area treated and vary in number from 2 to 10 visits typically. Chiropractic manipulation is frequently done in addition to ART to increase the effectiveness. Patients report that "It hurts good".

Will my condition or problem return after treatment?

Usually, the changes are permanent, but ultimately the answer depends on the patient compliance with recommendations for after care. "If you keep doing what your doing, you keep getting what your getting". This is true for those with repetitive strain injuries (RSI) or cumulative trauma injuries. To not alter the patterns that got you injured in the first place will only cause the problem to recur. An important part of ART treatments is the provider's recommendations to activity modification, stretching and exercises. Each individual is expected to commit to the suggestions for the best results.

What conditions can ART help?

ART can help many conditions/injuries but here are a few:

-tennis/golfer's elbow
-any tendinopathy
-nerve entrapment syndromes

-rotator cuff injuries
-plantar fasciitis
-achilles pain

-ITB syndrome and patellafemoral pain
-frozen shoulder

How does ART improve performance?

Performance of any task: golfing, typing and running faster can be improved significantly with ART. Restoring proper muscle function and movement enables the body to perform at its most efficient level. Adhesions create drag and tension which requires more energy and effort to accomplish a desired movement. Reaction times are also improved as muscle function is improved. ART allows the body to do what you ask of it when you need it!