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One Doctors explaination of ART

Posted by Pauline on 11/01/03 at 22:33 (136175)

Remembering many discussions here about ART therapy I wrote to Dr. Mollica hoping to learn more about ART. Here is the reply I received. Hopefully it will help shed some like on ART therapy for our readers.

I've never had ART therapy, but like the rest of you wanted to understand more about it.

I am a chiropractor on Long Island who specializes in the treatment and prevention of 'soft' tissue injuries. I treat musculoskeletal injuries with a high success rate of curing plantar fasciitis and teaching my patients on how to prevent the condition from returning. In my private practice I receive many referrals from area podiatrists and treat a variety of athletes for this particular condition.

Plantar fasciitis is a repetitive strain disorder of the plantar fascia which is located in the arch area of the foot. Repeated microscopic tears of the plantar fascia cause a build-up of fibrous adhesions which alter the ability of the plantar fascia to expand and contract. This dysfunction may cause pain, swelling and inflammation on the plantar aspect of the foot.
There are a number of possible causes of plantar fasciitis and they often work in tandem to create a symptom pattern. Some causes include tightness of the foot and calf, improper athletic training, stress on the arch of the foot, and a weakness within the arch.

Active release therapy is a soft tissue management system based on scientific evidence that following an injury sustained by repetitive stress, trauma, or exercise of your muscles, nerves, and connective tissue will develop scar tissue or adhesions. These adhesions cause the motion of the muscles or joints to be altered resulting in a wide variety of symptoms including pain, weakness, numbness, and a reduced range of motion.

Active release therapy is a non-invasive, non-surgical, non-medicine, treatment designed to restore proper muscle function to enable the body to heal and perform at its most efficient level. When the adhesions are removed the plantar fascia will have the ability to expand and contract at its normal level. The restoration of function will stop the pain, swelling, and will improve the individuals gait.

Treatments of active release therapy are conducted in a clinical setting with direct contact between the doctor and the patients skin. Based on the patients medical history and complete examination the doctor will apply direct pressure to the affected area while manipulating the muscle in order to dissolve scar tissue and separate adhesions. This therapy will reduce the patient's pain symptoms and will increase the range of motion within the affected area.

If you need any further information please contact me via email or browse my website.

Sincerely, Dr. Mollica

Dr. Scott Mollica, DC, ART, CSCS
New York Active Therapy, Inc.
1035 Park Blvd. Suite 2B
Mass. Pk., NY 11762

Re: One Doctors explaination of ART

LARA on 11/02/03 at 08:39 (136183)

Thanks. I've been trying to research this recently but not having as much luck as I'd expect. This sounds a lot like 'trigger point therapy' or 'myofacial trigger point release'. Does anyone know the difference?

Re: One Doctors explaination of ART

Dr. Z on 11/02/03 at 11:28 (136194)

It appears from Dr. Mollica letter that he is only talking about ARCH plantar fasciitis and not INSERTIONAL plantar fasciitis. This therapy may help the patients who talk about the arch type pf. Dr.Mollica doesn't really address the typical pf insertional disease.

Re: One Doctors explaination of ART

Pauline on 11/02/03 at 13:52 (136197)

You know Lara I was thinking the same thing. It seems like it just takes on different names depending on who is performing it. I don't really know the difference, but was glad to receive a response from this doctor.

I don't know him, just picked his name out of a phone book and wrote.
I'm sure anyone needing more information could get it easily by contacting someone that actually performs the treatment.

Whether it helps or whether it treats all aspects of P.F. is something that a patient would need to ask about prior to having it done.

One letter cannot be expected to answer everyones individual questions about this treatment, but it's a good starting point. I would encourage anyone thinking about this treatment to seek out more information, and do their homework ahead of time by talking frankly with the doctor of their choice.

My purpose for contacting a doctor who performed ART was merely to try and shed some light on the subject of ART treatment which has so often come up for discussion on this board.

Hopefully others have also found his response informative. I know I did.

Re: One Doctors explaination of ART

Pauline on 11/02/03 at 14:34 (136200)

Dr. Z,
I never expected one response from Dr Mollica to address all aspects of P.F when treating with ART therapy, but I think he provided some good basic information for those that have been asking about it.

The only conclusion I think that can or should be drawn from his response is that people interested in this treatment they should do more research and certainly ask questions before they begin.

What it can help, where it can help, and why it can help I think would require additional information provided by the doctor treating the patient.

Everyone needs to do their homework and ask questions before they spend money for any P.F. treatment. It just makes good sense.

Re: One Doctors explaination of ART

nancy s. on 11/02/03 at 17:48 (136210)

pauline, you did shed light, and i found his response very informative. thank you for posting it.


Re: One Doctors explaination of ART

LARA on 11/03/03 at 07:56 (136247)

I agree with Nancy. And you sent it along at just the right time for me. It didn't answer all my questions - but then I wasn't doing the asking and it did give me a sense of the next set of questions to ask (which is a good thing.) It was very gracious of the podiatrist to respond so thoroughly to your email.

Re: One Doctors explaination of ART

Aly on 11/03/03 at 13:08 (136263)

Hi Lara,

I think I know the difference - emphasis on THINK! :)

If I understand correctly, trigger point therapy is administered by finding knots and sore areas of tension in the muscles and applying strong pressure on the spot, and then releasing after a minute or so and repeating this, bringing blood into the area and loosening up the area.

I think that Myofascial release can be done in different ways, but when I had it done, it seemed the emphasis is on stretching out the tissue. For example, I had severe tendonitis in both wrists from my keyboard; when I was treated w/ myofascial release, my therapist pulled on my arm, stretching out all the muscles as far as I could stand it; my arm would be pulled straight and then he would bend my wrist at various angles to maximize the pressure and stretch in several muscles. The arm would be pulled outward at numerous angles so that the shoulders & arm muscles were really stretched out. It felt great and it helped.

After describing the above two therapies, it seems to me that A.R.T. is kind of a combination of the two. My doctor carefully feels along the bottom of my foot, looking for scar tissue or an adhesion (and he finds plenty!). He puts great pressure on it with his thumbs, and in a deep movement along the tissue, 'pulls' or 'stretches' it out. At the same time, he slowly bends back my toes to maximize the stretch and pull of the tissue.

This is in no way like a massage. It can REALLY hurt, in a way that neither trigger point or myofascial release ever did (I only had those done on my back/shoulders/arms.) After a session, my feet feel looser and generally better, but it will take some time to determine my ultimate outcome.

Incidently, my boyfriend's been having some trouble with arch pain, so I got ahold of one of his feet on Saturday ;) and using hand cream and a gentle but firm touch, tried to feel what the tissues of his fascia felt like. I found it quite interesting to note that I was able to find tiny lumps of scar tissue(?) along his fascia when I held his foot taught/ toes back - and if I pressed in with an index finger those spots he'd go through the roof! It happened every time. I've long suspected he's on the road to PF, so I found it interesting indeed. It would seem in theory that perhaps he's regularly causing micro-trauma that's resulting in adhesions; maybe if those adhesions keep forming, the tissue becomes restricted in its natural movement, and eventually PF results? I dunno, I'm just theorizing. The A.R.T. philosophy is that breaking up these adhesions and freeing up the tissue allows natural movement and healing to occur.

Has anyone felt these lumps on their feet? Is there a healthy foot somewhere in your house that you can examine & compare to?

Anyway, hope that was interesting to someone and not just babble! I've decided to do A.R.T. for at least 6 months - my own longer-term study, if you will. I will continue to post my experiences. :)


Re: One Doctors explaination of ART

Pauline on 11/03/03 at 14:11 (136272)

Please keep us posted. Now I'm wondering what is the difference between ART and Rolfing. I tried Rolfing and boy you want to talk about pain. After several sessions I refused to go back. Didn't care about the money loss, just wanted to save my body from sooooooo much pain.

I think the tissue and muscles in my legs and feet were injured by those Rolfing sessions. That woman was digging and separating out each individual muscle. It felt like I was being torn apart piece by piece and kept looking for my body parts to show up on her floor.

Never again.

Re: One Doctors explaination of ART

LARA on 11/04/03 at 07:23 (136320)

Yes, please keep us posted. 8-)
Thanks for the explanation. You're description of trigger-point matches with mine (including the ouch!! part). I thought trigger-point-therapy and myofacial release were the same thing but your first and second paragraph seem to talk about them as slightly different. I'm not trying to be nit-picky, I'm just not familiar enough with this area and want to be sure I'm understanding things.

Re: One Doctors explaination of ART

Aly on 11/04/03 at 13:34 (136359)

Interesting, Pauline, I've never heard of Rolfing until now. I did an online search, and found some info (if anyone's curious) at http://health.yahoo.com/health/alternative_medicine/alternative_therapies/Rolfing/ . It sounds similar in some ways but I'm not positive. It's true, in the beginning ART caused me some of the most intense pain I've ever experienced, but I've learned to take ibuprofen or Aleve beforehand and that lessens the pain I experience.

It does NOT feel like I'm becoming more injured at all - but the first 3 or 4 sessions, I wasn't so sure. My feet hurt more during that time - they were really sore all the time. I'm glad I stuck it out, b/c now they either feel the same as before I go in, or somewhat improved, and definitely 'looser' and with improved circulation.

I have no idea if this is going to work ultimately, but hearing of Hilary's success with it, I have to try it. I'm desperate enough that I'd be willing to withstand any pain to fix my feet...hopefully it will work!! [-o<

Re: One Doctors explaination of ART

Frank on 11/06/03 at 22:38 (136609)

There is not ONE legitimate piece of research supporting this type of treatment. Don't take my word for it. Do a search on the web and you will find nothing but 'marketing' sites for this.

Re: One Doctors explaination of ART

Aly on 11/07/03 at 15:09 (136718)

Hi Frank,

What you say really is true. I HAVE searched all over the web, and I noticed that every site I came across that discusses ART only mentions the outcome they feel is possible, but not much detailed description of technique, and not any studies or anything. While I was disappointed in that, the truth is that all ART is is a particular type of very deep tissue massage - if you've ever had a tight back & shoulders and had someone give you a good backrub, you know it can work wonders.

The lack of research in and of itself does not mean that ART is a sham - I can tell you it's doing SOMETHING, even if only just a deep massage. Only time will tell if it really breaks up my scar tissue and works for me or not, but if it worked for ANYBODY (e.g. Hilary, to name one) I'm willing to try it. And it's not like they're waving scented sticks over my feet and chanting! Given the negative affect PF has had on my life, I'd be stupid to pass up on a treatment has helped someone else, and that might help me; I won't know till I try.

I don't really think there's a magic bullet for PF, but rather a combination of things that need to be in place in order to heal. My instinct is that ART is bringing fresh blood into the area among other things, and that in and of itself has got to be a good thing.

We'll see what happens...