Active Release Technique, or ART for short, is a treatment that was initially developed to treat soft-tissue injuries in athletes as quickly as possible.
Since then, ART has gained popularity with doctors and patients to treat microtraumas, tears, and painful scar tissue in a wide variety of injuries — including plantar fasciitis.
In this article we’ll cover how ART therapy works, how this therapy differs from other soft-tissue treatment methods, potential risks and benefits, how much Active Release Technique costs, and whether ART is effective for plantar fasciitis.
What Is Active Release Technique (ART)?
Active Release Technique (ART) is a patented treatment method that targets injuries to soft tissues in the body (like tendons, ligaments, and nerves). The soft tissues of the body (including the plantar fascia) are vulnerable to injuries like tears, bruising, or pulls, as well as chronic deterioration and microtraumas (small tears that accumulate over time).
Scar tissue and adhesions can build up as a result of these injuries and traumas, which places extra strain on tendons, limits range of mobility, and entraps nerves at the injury site. This scar tissue can lead to significant pain and become a big roadblock to healing, especially in areas of the body that don’t naturally get a lot of blood flow (like the heel and arch!).
ART is performed by a trained medical provider, who uses unique movements and manipulations to help break up painful scar tissue, facilitate blood flow to the injured area, and promote healing.
How is ART Different from Other Soft-Tissue Treatments?
While ART might sound very similar to Graston or deep tissue massage at first glance, Active Release Technight is unique in a few different ways. It can be helpful to compare and contrast these common soft-tissue treatments:
ART vs. Graston
Both of these therapies work to break up adhesions and scar tissue while improving circulation. In Graston, a therapist uses instruments instead of the hands to manipulate tissues. These two treatment methods are often used hand in hand.
ART vs. Deep Tissue Massage
Both of these therapies combine pressure with a series of movements. However, unlike deep tissue massage, the movements in Active Release Therapy do a better job of lengthening and applying tension to scar tissue, which helps break that scar tissue up more effectively. ART and deep tissue massage are sometimes used together in therapy sessions.
How Effective Is Active Release Therapy for Plantar Fasciitis?
As of now, there aren’t peer-reviewed studies that can offer conclusive evidence about the effectiveness of Active Release Technique. However, the feedback from patients and providers is encouraging, and the principles of ART are aligned with tried-and-true treatment methods.
The arch of your foot and heel are avascular. That means these areas get very little blood circulation naturally. When the arch is injured, strained, or overused the body has a more difficult time sending blood cells to the injury, which are crucial for delivering oxygen, nutrients, and collagen to rebuild the damage. That’s one of the biggest reasons why injuries like plantar fasciitis are slower to heal than say, a cut on your arm.
It’s also the reason why ART’s specialized movements to improve circulation and deliver needed blood supply to the plantar fascia and heel are effective. Each of the movements targets a specific muscle, ligament, or tendon in the foot (there’s more than 100, including the flexor digitorum brevis, abductor hallucis, and the flexor digiti minimi brevis!) and deeply works the tissue using principles of friction, lengthening, and pressure to increase circulation and break up stubborn scar tissue.
Potential Risks and Benefits of Active Release Technique
As with any treatment, ART has unique benefits to offer, along with a few risks that can be summed up as follows:
Potential Benefits of ART
- Helps improve circulation and blood flow to the avascular plantar fascia
- Targeted movements break up scar tissue and adhesions
- Improved blood flow delivers oxygen and nutrients that may speed up healing time
- Improves the flexibility of the foot and range of motion
- Relatively inexpensive compared to many medical interventions
Potential Risks of ART
- The procedure can be moderately painful because of the targeted, intense pressure of the movements that aim to break up scar tissue and adhesions
- Outcomes haven’t been well documented in studies — but that’s because the studies haven’t been done. (There is promising anecdotal evidence from providers and patients).
- While ART can be very successful in reducing pain and improving mobility, it isn’t a cure. ART should be done in tandem with lifestyle changes that address why heel pain and plantar fasciitis formed in the first place (like overuse, repetitive stress, or gait imbalance).
What to Expect During an ART Session
Expect your ART session to be part evaluation, part treatment. Your provider will first determine the health, strength, and flexibility of your fascia, ankle, toes, and surrounding muscles and ligaments.
After this evaluation, your provider will use his or her hands to apply pressure, friction, and lengthening techniques to the fascia and surrounding tissues. You will likely be an active participant in your treatment session, moving and standing in different ways to maximally lengthen muscles and ligaments. Keep in mind that these movements can be painful, particularly for individuals who have low pain tolerance; however, most people find that they can tolerate the procedure, and that relief from symptoms occurs within just one to four sessions.
Can I Do ART for Heel Pain at Home?
The movements in ART are extremely specific and deeply work the muscles, tendons, and ligaments in the foot. Without specialized training, trying to apply the necessary pressure and friction to the foot could result in injury.
While there are many easy massage techniques that you can do at home to help improve blood flow, circulation, and break up scar tissue, it’s best to leave Active Release Technique to trained physicians.
Finding an Active Release Technique Provider
If you’re interested in trying ART, there are several different types of providers that offer this therapy. Physical therapists, massage therapists, chiropractors, and doctors are often trained in Active Release Technique.
You can find a certified ART provider in your area by using the directory on the ART website. More than 10,000 providers have been trained worldwide, so chances are high that you have one or several providers nearby!
Cost of Active Release Technique
The cost of ART will depend on your provider, and your insurance coverage. If the therapy is covered by your insurance (and many insurance providers do cover ART if they cover physical therapy), you may only be responsible for a co-pay.
However, even if you are uninsured or your insurance does not cover physical therapy, Active Release Technique is still generally more affordable than many other treatments. Expect to pay similar rates as a chiropractic session or massage visit. You may be able to get a discount for booking several ART sessions upfront (most people need between one and four sessions).
Supplementing Active Release Therapy
While ART is a promising treatment for cases of stubborn or chronic plantar fasciitis, it’s not a miracle cure or a stand-alone treatment. By taking steps to treat the underlying cause of your plantar fasciitis (the reason the condition developed), you can help make sure your arch and heel stay healthy!
Make sure to maintain tried and true conservative treatments that address common causes of plantar fasciitis (like inflexibility and muscle weakness, overuse, and strain to the arch) by regularly stretching and strengthening your arch and surrounding tissues, resting and icing your feet often, and supporting and realigning your arch to a proper height with quality orthotic inserts.
