Finding ART: How I Finally Got the Right Treatment
The first time I heard of ART was a few days after running the Boston Marathon. I headed to my primary care doctor with what I thought was a serious stress fracture (thank you Google for scaring the crap out of me!). After a few x-rays, my doc confirmed there was no stress fracture (thank goodness), but he pressed around in my lower calf and said there was a lot of scar tissue built up there. He recommended I see an Active Release Techniques (ART) doctor. Never heard of it. Luckily, my primary doctor had some training in ART a few years ago, so he knew about it and could actually recommend it.
At the time, I'd been seeing my chiropractor and massage therapist religiously each week for over 6 months. I loved them and was convinced they helped keep me running and avoiding injury for many months. While they still play a part in my recovery and overall health today, enhancing my ability to run many miles and races, neither was able to get to the root of my problem. If you've been following my running journey for a while, you know my problems stem from my hips. They're extremely tight and have been a major pain point for me and making it very difficult to recover from high mileage weeks. Chiropractic work, massages, and deep stretching helped for some time, but the incident both during and after Boston told me something serious was going on. Just to loop you in, my ankles swelled and bruised for days after the race, and I spent the last 5 miles of the marathon barely able to bend my ankle and complete a stride.
If you aren't familiar with ART, it hit the endurance world about 30 years ago and is extremely popular among the Ironman and Ultra running communities for its ability to deeply treat built up scar tissue from excessive overuse. It is a soft tissue system/movement based massage technique and it is painful, but worth it for the relief it provides.
Let's do this!
My first attempt at ART was about a month after Boston. Most ART certified docs are listed on the ART website. Rather than go to the doctor my primary care doctor recommended, I figured I would find someone in my insurance network, only to find out that ART is not covered by insurance because it is considered a massage therapy. I still ended up going with a chiropractor who fell into my network and had several of the ART designations (each doctor is designated based on the part of the body they are certified to treat), and he had good reviews. Nightmare. I went in and explained the issues I was having in my feet and that my other doc found scar tissue in my calf that could be causing it. I also made clear that my hips have been a serious pain point for me. He said we could eventually do ART on my hips, but he wanted to treat my feet first. He wanted to use this machine on me that had a metal pulsing end - telling me the purpose of it was to find the scar tissue and break it up, i.e. he WAS NOT going to actually perform ART on me. When the machine finds scar tissue, its very painful, and if it doesn't find any, there is no pain. He warned that some women who had this treatment said the pain was comparable to childbirth. WTF???
I had to be open minded - I knew ART was painful, so let's do this thang right? I wanted to die. The bottoms of my feet were the worst, and surprisingly, where my primary doc told me I had buildup, the machine didn't find any. I was completely drenched in sweat when I left his office and almost burst into tears. Beyond the fact that this was so painful, the doc was really narcissistic, talking all about himself and the cool things he bought for his office to treat his patients- mostly machines. He spent a majority of the visit telling me I shouldn't be wearing Nikes and that Asics are the best shoe (this guy has never run any race distance before, FYI). I still went back for a second time because I wasn't sure what else I should do, and it was just as painful. A massage therapist come in afterwards to work on the ligaments around my ankle and she told me the machine was developed for race horses to break up their scar tissue so they could recover and race all the time. ARE YOU JOKING ME???? I never went back.
But I eventually went back....
It took me almost a month to even consider ART again. I decided I trusted my primary care doc a lot (he's been my doc for 25+ years), so I called the original ART doc he recommended, Ron Higuera. Ron was a chiropractor, but he really only practiced ART, and he was certified to teach ART. When I went in, I told him everything I experienced from Boston to my hips to this last ART doc and he confirmed that all of the problems in my legs and fee were stemming from my hip. He also said that the doctor I'd previously seen should've never done what he did.
Ron started working on my hips and opening up my sciatica, which stems from you glute and lengthens all the way down to your achilles. With each run, this was tightening, causing strain in the small ligaments of my feet. With deep pushing and stretching, he lengthened my sciatica with each visit.
It's all in the booty!
The root cause of my hips being tight was that my glutes weren't firing. My quads were doing all of the work when I was running, causing my hips to tighten and my quads to constantly feel overworked. When you use your glutes to propel you forward, you lengthen and stretch your hips, using your hamstrings, quads and calves to get you going. This meant training my glutes to fire and adjusting my form a bit.
The great thing about ART is that you need it for 3-4 treatments (maybe a few more if you have something more serious), and then you move on. As an athlete, it's clear I could be in ART my entire life, like the way I need massages and adjustments from my chiro each week. Ron has given me exercises to do before and after each run, and a few to do during the week, that will help my glutes fire during my runs and strengthen them. I'll likely have to visit Ron a few times per year if things get rough again (us runners sometimes forget to do the supplementary things that help us feel good while running), but he's not going to be a weekly or monthly visit for me anymore.
Why does this matter to you?
The point of sharing this with you is not only to inform you about ART and how it can benefit you, but also to share my experience of visiting a terrible doctor. I've always stressed that its important to invest in yourself as an athlete - from getting fitted for shoes to weekly or monthly massages at the height of training. All of this needs to be taken with a grain of salt though - if something's not working for you, find another doctor or stop doing it. Ask questions about why a professional is doing what they are. Many times we blindly trust the professionals in our life because they have advanced degrees and knowledge we don't, but they all don't practice the same. Similar to the different methodologies and effectiveness of training for a race, there are more effective treatments and doctors with methods that will benefit you more than others. Don't stop until you find someone to help!