6.29.2010

The Green Girl Tries Active Release Techniques (ART)

The Green Girl made an appointment with Dr. Sebastian Gonzales from The Performance Place Sports Care after work yesterday.

Dr. Sebastian Gonzales is a Certified Active Release Techniques (ART) Provider.

ART is a combination of examination and treatment. It involves evaluating the texture, tension, movement and function of muscles, fascia, tendons, ligaments and nerves. ART treats soft-tissue injuries by moving muscle fibers, tendons, and ligaments through a combination of motion and deep, targeted massage to release adhesions, smooth the movement of tissues, release entrapped nerves of blood vessels, and promote healing.

The purpose of my visit was two-fold. First, I wanted to get some treatment for my posterior tibial tendonitis. Second, I wanted to get some advice on my tight calves, quads, and hips.

Dr. Gonzales started the session off with some range of motion and strength analysis.

He recommended I do some exercises to strengthen my glutes. He explained it's difficult to say if my psoas are tight due to weak glutes, or if my glutes are weak because due to tight psoas. He showed me how to isolate my glutes with some butt lifts to help re-educate my neuromuscular system.

Some aspects of the ART manipulation were similar to experiences I've had with Rolfing but I definitely appreciated Dr. Gonzales' holistic approach.

In the past I've mentioned that my plantar fasciitis sometimes manifests itself as an intense, burning pain in my arches and I would have a hard time differentiating the plantar fascia pain from the posterior tibial tendon pain. When I explained this to Dr. Gonzales and I pointed out the different pain locations, he explained my arch pain is actually a result of a sore flexor hallucis brevis muscle.

He spent a great deal of time showing me how to differentiate between the plantar fasciitis, the posterior tibial tendonitis, and the flexor hallucis brevis pain. He said it's easy to get confused because the tendons of flexor hallucis brevis run along the bottom of the foot, under the head of the first metatarsal bone, and attach to the small bone of the big toe.

I have a high pain tolerance but I must admit that the ART hurt significantly more than a deep tissue massage. Surprisingly, my left calf was much worse than the right side. He said my left posterior tibial muscle was extremely tight. I had to focus intently on breathing in and out to endure the intense pain.

After all that, I wasn't sure if I was going to be able to stand but my legs actually felt a lot better. He had me walk around a bit and I marveled at how my calves actually felt a little looser.

Next, Dr. Gonzales took me outside for a running gait analysis. He videotaped me running back and forth across the packing lot a few times.


It was both awkward and fascinating to observe the footage. My untrained eyes couldn't detect any abnormalities but Dr. Gonzales made the following observations (which immediately became glaringly apparent):
  • I have some issues with my left gluteus medeus which are causing pelvic instability
  • My spine rotation on the left side is restricted
  • My knees cross
  • My left arm hardly moves

He is going to have some more in depth analysis performed on my video and then he suggested I talk to my coach about techniques and ways I can correct these issues. In the meantime, he recommended I work on stregthening my glutes and do some exercises to improve my gluteus medeus stability.

I felt like my visit to Dr. Gonzales was really productive. I'm anxious to hear the additional feedback on the video.

9 comments:

  1. Wow--Dr. Gonzalez sounds like a runner's dream! We could all use some of that, I'm sure! Glad you found him.

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  2. Thanks, Miss Zippy. I really liked his approach and I respected how he didn't act like he knew everything. He was honest and said he wasn't a running coach and I should consult with my coach on how to correct these issues.

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  3. Oh! Sounds like a total worthwhile trip!! Totally worth the money too if he loosened those calves! It seems like you really learned and will keep learning a lot from the videotaping I cant wait to hear more!

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  4. Dr. G sounds fabulous, I'm so glad it went so well! Very thorough and comprehensive. Also good, as you said, that he was honest and told you his limits.

    Re the chiro with the doom and gloom - get a 2nmd opinion. Is your ART guy also a chiro? (mine is) Or could he recommend one?

    Onward!

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  5. Awesome!!!! I so hope he helps you!! So far, it's looking good!! Let us know and here is to loose calfs!

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  6. Interesting stuff. I wouldn't have been able to endure the ART stuff. I can barely handle it when a massage gets too intense. I hope you are able to get some relief.

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  7. Rad Runner, MJ, Southbaygirl, and Heather, I am thrilled to announce that my calves did not cramp up on my trail run tonight! Whoo hoo!

    Heather, the massage was so intense that I have some mild bruising on my legs and I'm one of those people who like never bruise. But a little bruising is a small price to pay for some serious muscle relief!

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  8. ART is awesome and it sounds like you found a great doc! He definitely sounds like he knows his stuff.

    A side-affect of my hip issues has been over-active hip flexors (which is inevitably why my surgeon ended up partially releasing them during the joint surgery) and dormant glutes. I can actually see in your video that you have some of that going on. I have spent the last 6 months working on it and once you start noticing your glutes working more, my oh my what a difference! It takes time to fix that but it's worth the effort.

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  9. Very interesting. Sounds like it helped you already. So definitely worth the pain.

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