ART for Hip Pain


What is Active Release Techniques (ART) to Patients?

The hip joint is one of the most complex joints in our body. It consists of a ball and socket joint that is capable of a wide range of motion.

In addition to this large range of motion there is also a huge amount of force that gets transferred through the hip joint because it attaches the lower extremity to the trunk. Due to this high amount of force, combined with the wide range of motion, the hip must rely on a complex system of muscles to control and protect the area.

Through a variety of causes such as athletic activities, prolonged sitting, repetitive movements, excessive use, or lack of physical activities, one or more of the muscles of the hip region can become tight or weak creating a muscle imbalance. With pathologies like labral tears, osteoarthritis, and FAI, there is limited range of motion which cause structures around the hip to become short or tight.

When a muscle imbalance occurs, the surrounding muscles are put under more stress and end up working harder to compensate for the tight or weak muscle. Over time, this stress can develop into what is known as "micro-trauma". Simply stated, micro-trauma is small scale damage that occurs in muscles, tendons, ligaments, and joint capsules in response to small levels of strain.

The body will respond to this micro-trauma by laying down scar tissue to repair the injured tissue. Following any surgical intervention of the hip joint, the body will also lay down scar tissue that will lead to restrictions in the tissue. It is these restrictions or adhesions that lead to pain, tightness, stiffness, restricted joint motion, and diminished blood flow. If these restrictions go untreated, you are likely to experience more pain and enter into what is known as the "repetitive strain injury cycle".

The repetitive strain injury cycle occurs when continued micro-trauma leads to further adhesion formation which, in turn, will lead to more stress and further micro-trauma. As the cycle builds, your symptoms become more noticeable and often times a simple activity may cause a sudden pain.

Active Release Technique [ART] is a new, highly successful, hands-on treatment method to address problems in the soft tissues of the body including the muscles, ligaments, fascia, and nerves. By locating and treating soft tissue restrictions, it allows the practitioner to: 1) break up restrictive adhesions, 2) reinstate normal tissue flexibility and movement, and 3) more completely restore flexibility, balance, and stability to the injured area and the entire kinetic chain.

The practitioner will first shorten the structure being treated and then apply a very specific pressure with their hands as you actively stretch and lengthen the tissue. As the tissue lengthens, the therapist will assess the texture and tension of the tissue to determine if it is healthy or there is a scar tissue adhesion present. When scar tissue is felt, the amount and direction of tension can be modified to treat the problematic area.

Typically, the majority of hip injuries respond very well to ART treatment, especially when combined with a specific stretching and strengthening program. We usually find a significant improvement in just 4-6 treatment sessions. ART practitioners commonly work with elite athletes and are on site at all the Ironman Triathlon events. It has also been very beneficial in treatment of soft tissue hip pathologies in patients before or following any surgical procedure.

If you are experiencing pain and/or limitations in or around your hip joint, ART may be the treatment for you. Please contact an ART provider for more details. For more information, please go to www.ActiveRelease.com.

Peter Schultz DPT, OCS, CSCS is a Doctor of Physical Therapy practicing since 1999. He is owner and therapist at Dynamic Sports Physical Therapy in New York City. Peter’s specialty is orthopedic and sports injuries with a particular interest in hip rehabilitation. Having had two hip surgeries himself, Peter brings a unique approach to his clients. www.DynamicSportsPT.com.