| Article written on April 13th, 2015 at 11:30am | Follow Garrett on Facebook, Twitter, and Instagram |
In January of this year I took my first Active Release Techniques (ART) course. Immediately I saw the value in this soft-tissue evaluation and treatment technique which would be beneficial for almost anybody looking to improve function in some way. I was fortunate to be able to take the lower extremity course last weekend right here in downtown Nashville. This course not only allowed me to improve my hands-on skills, but provided a greater understanding of functional anatomy. This post describes a few things I learned after becoming a Certified ART Provider, that I feel are misunderstood by quite a few people. And, realize that all of these problems can be effectively treated with Active Release.
Tightness, or lack of relative motion?
Many of us suffer from tightness in our lower extremity, whether it be the hamstrings, quads, or the calf, among many other places. This tightness may not actually be shortness in the muscle itself but lack of relative motion from adjacent structures. Have you ever looked at the anatomy of the human body. The picture usually shows muscles, ligaments, tendons, and nerves with clear cut borders. But, things aren’t that clear cut within the human body as certain tissues can become adhered to adjacent tissues causing a restriction in motion. For example, the upper calf and the lower hamstrings. If there is any adhesion between these tissues it will clearly prohibit their normal sliding in opposite directions which may display as tightness in the calf or hamstring.
This is also possible with nerves. In so many places nerves actually pierce through muscles and travel through the smallest of spaces. What if nerves are being impinged and lose their ability to glide, will this display as tightness? You betcha, and it may even have some type of neurological pattern, such as numbness and tingling. Some common areas are the sciatic nerve at the sacrotuberous ligament, piriformis, superior gemmelus, and between the medial and lateral hamstrings.
Sciatica just means you have specific symptoms but there is no specific location of injury yet uncovered.
The diagnosis of sciatica is a bit lazy in my opinion. This means you may feel radiating symptoms, numbness or tingling anywhere from the lower back, gluteals, posterior thigh, through the bottom of the foot. Do you know how many structures can affect the sciatic nerve from its course starting as a nerve root at the spine to the plantar aspect of the foot? So many!! As I stated above it can be one of so many areas that are actually causing the problem without any resolution because the cause isn’t pinpointed. If this is your diagnosis, I would ask for more answers.
Plantar fasciitis is a blanket term which refers to foot pain and it may not even be the fascia itself.
The plantar aspect of the foot is full of tons of different tissues in a small area. As you can see from the pictures, the plantar fascia is only a small part of what lies within the foot. Are your symptoms caused from an intrinsic muscle, an extrinsic muscle, the plantar aponeurosis, plantar fascia, a nerve being impinged, or a restricted joint? Don’t think rolling on a golf ball, stretching the calf, and anti-inflammatories are going to resolve your issue if it’s not actually the plantar fascia itself.
Chronic ‘tendonitis’ has been found to lack inflammation. Then what’s the ‘itis’?
Research has shown that many of these tendonitis diagnoses actually lack inflammatory cells when extracted and studied. So what is the actual issue? Could the problem be scar tissue build-up or a disorganized fiber alignment? Could it be adjacent structures lacking their relative motion and pulling on the affected tissues? I don’t know exactly, but all I know is it isn’t inflammation or some type of ‘itis.’ This is just some word that was thrown at your injury to make you feel like it will get better from ice/heat, stretching, and rest, when in reality a form of soft-tissue treatment may be your best bet.
By: Garrett McLaughlin, MS, ATC, CSCS, ART