[This article is a guest post by Dr. Ryan Davis, the official chiropractor for CrossFit Impulse. Dr. Davis performs ART and Graston therapy on me twice a week. When I leave his office, my shoulders feel dramatically better than when I arrived. I have seen such huge benefits to my training that I asked him to write an article about these techniques. Read on, and if you have chronic pain somewhere, give ART or Graston a chance. -Jeff]
Two of the best therapy techniques for athletes are Active Release Technique (ART) and Graston. They are used by most professional sports teams from the NFL to NHL. If you’ve ever had a nagging overuse injury, then these treatments can help.
Overuse injuries lead to scar tissue and adhesions in your muscles. This alters muscle function by keeping them artificially short. A muscle that is supposed to be 12 inches long eventually develops enough scar tissue that it’s forced to operate at 11 inches long. Now you don’t have full range of motion or full strength. This alters your movement, making you weaker, less efficient, and possibly entrapping nerves and causing pain.
Self-treatment with lacrosse ball rolling and foam rolling can help. But for athletes training several times per week, it becomes tough to address all the areas demanding attention. And to make things worse, some muscles just can’t be accessed without help from someone else.
ART breaks up scar tissue and restores proper function. This makes you loose, strong, and ready to set PRs. ART is a hands-on, specific massage technique using active movement by the patient. The clinician simply shortens the muscle through direct pressure and then lengthens the muscle with tension. However, this is where the simplicity ends. ART providers are dedicated learners and are taught over 500 protocols. As a certified ART provider, I must have proficient feel for tissue texture, tightness, and movement quality, and demonstrate this competency for certification. ART is unique in these requirements.
Chronic hypoxia is another result of overuse. Hypoxia results when an athlete adds more and more strength without performing sufficient mobility work. This increased muscle tension prevents adequate blood flow. Imagine a hollow rubber tube being pulled tightly from both ends. The tube flattens in the center and eventually blood can’t flow through it. Without sufficient blood flow the junction between muscle and tendon becomes brittle, dry, and painful. Trigger points, those knots in your shoulders that shoot pain every time you push on them, are another form of hypoxia. ART lengthens the stressed tissue, decreases the tension, and increases circulation—removing trigger points and resolving hypoxia.
Now let’s talk about Graston technique. Some parts of your body just don’t get very much blood flow. Your rotator cuff is just one example, which is why it takes cuff injuries so long to heal. Graston intentionally creates inflammation in a small area to stimulate blood flow and healing. Graston uses a stainless steel tool that scrapes the tissue. When the Graston tool is scraped over unhealthy tissue the stainless steel amplifies the “rough” feeling of the tissue. This makes a great prospecting tool for finding problem areas.
In chronic soft tissue injuries the muscle undergoes distinct texture changes. Over time this proceeds from smooth to stringy to ropy to knotted. During Graston therapy this is felt by both the doctor and the patient. It provides great feedback to the patient, “Feel the difference in this healthy tissue and this stringy muscle?”
Both ART and Graston are great treatments for athletes. I like using ART in issues involving restricted motion or increased muscular tension. I prefer applying Graston in stubborn tendon/ligament injuries and as a prospecting tool in complex cases. Stretching and self-mobility are great techniques for preventing injuries. But once pain sets in there is no exercising yourself out of an overuse injury.