Active Release Treatment: Benefits and What to Expect
Active Release Treatment: Benefits & What to Expect
If you’re dealing with stubborn tightness, nagging tendon pain, or the kind of neck/back discomfort that keeps coming back, you’ve probably heard someone recommend active release treatment—more formally called Active Release Technique (ART).
In plain English: Active Release Technique is a hands-on soft-tissue treatment where a trained provider applies precise pressure to a specific muscle/tendon/nerve path while you actively move the area. The goal is to reduce scar tissue/adhesions from overuse, restore normal tissue “glide,” and help you move with less pain (Hospital for Special Surgery).
Below, we’ll cover what ART is, what it’s commonly used for, what the research actually says, and how to decide if it’s worth trying.
What Is Active Release Treatment (ART)?
ART is a patented, hands-on soft-tissue approach used for problems involving:
- Muscles
- Tendons
- Ligaments
- Fascia (connective tissue)
- Some nerve entrapments
It was developed by chiropractor Dr. P. Michael Leahy in the 1990s to address pain and movement problems caused by overuse and small, repeated soft-tissue injuries (Hospital for Special Surgery).
When muscles and other soft tissues are overused, three common problems can occur:
- Acute injury – a pull, strain, or tear.
- Repetitive micro-trauma – repeated low-level stress that slowly irritates tissue.
- Reduced blood flow (hypoxia) – tissue doesn’t get enough oxygen.
Your body responds by laying down scar tissue. Over time, that scar tissue can:
- Stick layers of tissue together ("adhesions")
- Shorten and stiffen muscles
- Change how tendons move
- Trap or irritate nearby nerves
Result: pain, tightness, weakness, and reduced range of motion.
ART is designed to find and treat those restricted areas while the patient actively moves the body part. A certified provider uses their hands to feel for tight, fibrotic, or tender bands of tissue while you move through a specific range of motion (PhysioPedia).
How ART is different from regular massage or stretching
While ART may look like deep tissue massage at a glance, it’s typically more structured and assessment-driven:
- The provider palpates specific structures (a particular muscle, tendon, or nerve path).
- You then move the body part while the provider applies targeted tension.
- Each problem area has its own standardized “protocol” (there are hundreds of them) (Hospital for Special Surgery).
What Conditions Can Active Release Treatment Help With?
According to authoritative sources like the Hospital for Special Surgery and PhysioPedia, clinics commonly use ART for conditions linked to overuse, posture, or repetitive motion, including:
- Chronic neck pain (often from desk work or training)
- Mechanical low back pain
- Shoulder pain (rotator cuff tendinopathy, impingement)
- Hip flexor or adductor strains
- Tension headaches related to neck and upper back muscles
- Carpal tunnel syndrome (mild to moderate cases)
- Tennis elbow / golfer’s elbow (epicondylalgia)
- Plantar fasciitis
- Shin splints
- Sciatic-type symptoms from soft-tissue irritation
Some people also use ART for general tightness and what are often called “muscle knots”—a common issue we explain in our guide to muscle knots and myofascial trigger points.
What Does the Research Say About ART?
ART is widely used in sports and rehab settings, but the formal research base is still limited and tends to be condition-specific.
Chronic neck pain
In a randomized trial of people with chronic neck pain, participants were assigned to ART, joint mobilization, or no treatment for three weeks. Both the ART and joint mobilization groups improved pain and neck range of motion compared to the control group, and changes tended to be greater in the ART group (Kim et al., 2015).
Chronic low back pain (gluteus medius trigger points)
In a small pre-post study of 12 people with chronic low back pain and gluteus medius trigger points, ART twice weekly for three weeks was associated with reduced pain scores and improved pressure pain thresholds (Park, 2013).
Other conditions
Pilot studies and case reports summarized by rehabilitation resources suggest potential benefits of ART for issues like hamstring flexibility, adductor strains, carpal tunnel syndrome, and certain tendinopathies—but many studies are small and short-term (PhysioPedia).
The bottom line on evidence
ART is anatomy-based and plausible, with early evidence for short-term improvements in pain and range of motion for some overuse-related problems. But outcomes vary, and it tends to work best when paired with exercise-based rehab, load management, and recovery fundamentals.
If you’re building a broader recovery plan, our guide to muscle recovery can help you prioritize the basics.
How an ART Session Works: Step by Step
Although every practitioner has their own style, an ART visit generally follows this pattern (Hospital for Special Surgery):
1. Assessment and history
Your provider will typically:
- Ask about your symptoms, training load, work setup, and prior injuries
- Observe posture and movement
- Check range of motion and sometimes basic neurologic signs
They’re trying to decide whether your problem likely involves soft-tissue restriction—or whether you need a different type of evaluation or care.
2. Palpation: finding the “hot spots”
Using their hands, the provider feels along specific muscles, tendons, and nerve paths, looking for:
- Tight or ropey bands
- Thickened or gritty-feeling tissue
- Tender spots that reproduce your familiar symptoms
3. The active release
For each protocol, you’ll usually:
- Start in a shortened position.
- The provider applies precise tension with their fingers, thumb, or elbow to the restricted tissue.
- You actively move the body part to a lengthened position while they maintain tension.
This is repeated for several passes and then reassessed.
Most people describe ART as intense but brief. It should be tolerable, and you should always feel comfortable asking your provider to adjust pressure.
4. Re-test and retarget
After a few passes, the provider will typically re-check range of motion and/or symptoms, then move to related tissues up or down the chain.
5. Typical session length and number of sessions
In many clinics:
- ART treatment itself often lasts ~15 minutes and may be part of a longer PT or chiropractic appointment.
- People often experience results within two to four weeks, commonly after three to six visits.
ART’s own website makes stronger marketing claims that many problems are resolved in under four treatments (Active Release Techniques). Real-world outcomes vary based on irritability, severity, and whether you change the habits that caused the flare-up.
ART vs. Other Soft-Tissue Therapies
If you’re already doing massage, foam rolling, or instrument-assisted techniques, it’s reasonable to wonder how ART compares.
Below is a high-level comparison of ART with two other popular options: Graston Technique and ASTYM (both are forms of instrument-assisted soft-tissue mobilization).
| Therapy | How it works | Tools used | Typical uses | Potential advantages | Potential drawbacks |
|---|---|---|---|---|---|
| Active Release Technique (ART) | Provider applies focused tension to a specific structure while you actively move from shortened to lengthened positions. | Hands only | Overuse injuries, chronic neck/back pain, tendinopathies, some nerve entrapments, movement restrictions | Highly anatomy-specific; movement is built in; no tools required | Can be uncomfortable; depends heavily on provider skill; evidence base still developing |
| Graston Technique | A clinician uses shaped metal tools to “scan” tissues for texture changes, then applies targeted instrument strokes to the area to reduce restrictions (often followed by stretching/strength work). | Stainless steel instruments | Tendinopathies, post-surgical scars, chronic tightness | Tools can help cover larger areas and detect tissue texture changes | Bruising/soreness can happen; not appropriate over open wounds/active infections; training quality varies |
| ASTYM | A clinician uses specialized tools along specific treatment patterns (often along muscle groups) with the goal of stimulating a remodeling response in dysfunctional soft tissue, commonly paired with functional exercises. | Proprietary instruments | Often used for chronic tendon and fascia issues | Emphasizes kinetic chain treatment; standardized education programs | Independent research is limited; availability may be limited |
For many people, the best choice is the one that fits into a comprehensive plan: targeted manual work plus progressive strengthening, mobility training, and load management.
Who Should Consider ART — and Who Should Be Cautious?
ART may be worth exploring if:
- Your pain feels muscular or tendon-based (tight, pulling, or localized aching rather than sharp joint pain).
- Symptoms are linked to specific activities or postures, like running, lifting, or long hours at a desk.
- You have persistent tightness or loss of range of motion despite stretching, foam rolling, or general massage.
- You’re willing to pair manual therapy with follow-up exercises.
For desk-related stiffness, our guide to mobility exercises includes simple drills you can plug in between sessions.
If your symptoms started after a clear strain/sprain, our overview of the soft tissue injury recovery process can help you set realistic expectations for healing timelines.
Use caution or get evaluated first if you have:
- Recent trauma (falls, collisions, suspected fractures)
- Unexplained weight loss, fever, or night pain
- Progressive weakness, numbness, or changes in bowel/bladder function
- Active infection, open wounds, or unhealed surgical sites near the treatment area
- Bleeding disorders or use of blood-thinning medications
- Pregnancy, especially for treatment around the abdomen/pelvis/low back (requires modified positioning)
These situations warrant a medical evaluation before pursuing any manual therapy.
How to Find a Qualified ART Provider
Because “active release” is sometimes used loosely, it’s worth confirming you’re seeing someone who’s actually trained and certified.
1. Check for ART certification
The official ART organization maintains a provider directory and details its certification pathways (Active Release Techniques). Look for terms like “ART Certified Provider” in the clinician’s bio.
2. Verify their professional license
ART is typically performed by licensed clinicians such as chiropractors, physical therapists, massage therapists (where scope allows), athletic trainers, and some physicians (Hospital for Special Surgery).
3. Ensure there’s a plan for long-term results
A good provider should be able to explain:
- What they think is driving the problem (training load, posture, movement pattern, etc.)
- What you should do at home to maintain improvements
- How they’ll progress you toward strength and resilience (not just temporary relief)
What to Do After an ART Session: Recovery & Aftercare
Think of ART as a window of opportunity: if it reduces pain and restores motion, you’ve got a chance to “teach” your body a better pattern before it stiffens up again.
A practical aftercare plan usually includes:
- Use your new range: Perform light, controlled movements through the range of motion you just gained.
- Add targeted mobility work: Keep sessions short (even 5 minutes) to help maintain tissue glide; our guide to mobility exercises has options for neck/shoulders, hips, and ankles.
- Strengthen progressively: Manual therapy can make movement feel easier, but strength and load tolerance are what usually keep symptoms from returning.
- Adjust load + ergonomics: If the same training spike or desk setup continues, symptoms often come right back.
- Track meaningful progress: Beyond pain scores, consider tracking range of motion, performance (e.g., running volume or lifting loads), and—when rehab is a big focus—side-to-side symmetry. Objective tools can be invaluable here, helping you verify you’re actually closing the gap between sides over time.
A BodySpec note: using DEXA scans to track health changes over time
Manual therapy can help you move better, but many long-term goals (injury resilience, performance, and overall health) come down to what you do consistently with training, nutrition, and recovery.
Regular DEXA scanning tracks changes in fat mass, lean mass, and fat distribution over time—and, importantly for injury recovery, it can quantify muscle-mass differences between your left and right sides.
If you’d like to add body composition tracking to your routine, you can schedule a scan on our BodySpec booking page.
Quick Self-Check: Is ART Worth Exploring for You?
This isn’t a diagnosis, but it can help you decide whether to discuss ART with a qualified clinician.
Consider if the following points apply to your situation:
- My pain/tightness feels linked to specific muscles or tendons, not deep inside a joint.
- Symptoms worsen with repeated use (running, lifting, typing) and ease with rest.
- I feel persistent restriction that stretching/foam rolling hasn’t changed.
- I’ve had symptoms for more than 4–6 weeks despite basic self-care.
- I’m willing to experience some discomfort during treatment if it’s short and controlled.
- I’m open to doing follow-up exercises, not just passive care.
If several apply, ART may be worth discussing as part of a bigger plan.
FAQs About Active Release Treatment
Is active release treatment painful?
Most people describe ART as intense but manageable. You may feel deep pressure and brief reproduction of familiar tenderness. Soreness for a day or two afterward is common.
How many ART sessions do people usually need?
Results vary by condition and symptom irritability. Many people who respond to ART notice improvements over two to four weeks (often three to six visits), especially when it’s paired with a solid exercise plan.
Does insurance cover ART?
Often, ART is billed under broader codes for manual therapy, chiropractic care, or physical therapy, not as a separate line item. Coverage depends on your plan and how the clinic bills.
Can I do ART on myself?
Not exactly. ART relies on a provider’s hands applying tension while you move. However, you can borrow the general idea with self-massage tools (foam roller, ball) plus active mobility drills.
Do I still need exercise if I’m getting ART?
Yes. ART may improve comfort and motion, but exercise is what usually builds long-term resilience. If you want joint-friendly ideas to keep moving while you address pain, see our guide to active recovery workouts.
Key Takeaways
- Active Release Technique (ART) is a hands-on soft-tissue treatment that combines targeted pressure with active movement to address restricted tissues from overuse (Hospital for Special Surgery).
- Early studies suggest ART can reduce pain and improve range of motion for some chronic neck and low back pain presentations, but larger and longer trials are still needed (Kim et al., 2015).
- ART works best as part of a broader plan: strength + mobility + load management + recovery habits.
