I had a great conversation about this very topic with our local ART guy. He is currently taking a biomechanics course specifically designed to help him spot gait impedence and what methods are going to aid the mechanics of the individual. Most of it was related to golf but it was fascinating.He reinforced a lot of the points many are making. A hard therapy session will most likely be more detriment to mechanics rather than helpful. He rarely does them unless he knows that there will be time for the athlete to adjust to the therapy. He also believes that he can remedy most subltle impedences in a 10-15 minute session prior to competition without negative effect. He feels that most therapists focus too much on the injury site and do damage to the surrounding good tissue. He is firmly against deep tissue work for that very reason.
My comments. ART is pin and stretch from 30 years ago (if not more) and is one method of therapy. What bothers me is that ART is overused now as way to do tissue work with athletes and any one tool is a recipe for problems if you are not careful. The benefits of ART is that only a certain level of therapist can get certified so you are getting a consistent level of skill. ART therapists are mainly chiropractors, so you are getting someone that does manual therapy. Now my problem with therapy is how the work is billed. When seeing a massage therapist it’s billed by hour, not session. When seeing a Chiropractor time is usually limited. I have worked with several therapists and fired one after therapy time decreased every three months with my athletes. He was confused after nobody would come back as his work was skilled but brief. 15 minute sessions are not enough to handle most athletes that are training at a high level. Therapy is an artificial enhancement that allows athletes to do more or at higher intensities. So, if I am billed for 15 minutes of work but being charged more than a massage therapist I look at the value of what they are doing and ask myself what can I do. Often I must prescribe tissue work in a script format in order to optimize the hour of a massage therapist instead of working with some skilled ART people that bill per 15 minute session. While I value their diagnostic abilities my athletes can’t afford 15 minute sessions of dealing with one facet of demands.Frankly ART is a money making machine as it allows chiropractors to bill at a frequent rate as 4 clients can get billed for one hour and one must be careful of who they are working with. Often the elite athlete that is public and famous will get 90 minutes while the poor high school kid will get the crack and stretch and be out faster than they can say Bromance.
Now I am not saying all Chiropractors are billing machines, as some have spent so long with athletes I felt they (the ones I work with) were loosing money and I could tell they cared about my clients. Deep tissue work is not easy and many therapists bill at higher rates because they break down their bodies going deeper. The ability to go deep without disturbing upper layers is a true skill that not everyone has. It’s hard work and requires strokes to sooth the hypertonia/spasm so one can get to trouble zones. While the kinetic chain will interact with other joints and often the injury site is not to blame, you still have to deal with the strain and tear acutely. If someone comes to the ER after being shot by a gang, treat the patient and work on gun control laws later as going to the root of the problem must be done when the immediate needs are taken care of.
A recent two time world champion in athletics just finished up a weekly regenerative series of sessions with a therapist that I know of and I believe that she will find success this year if her training is optimal. What I do know is that athletes need to invest into their bodies as the cost is prohibitive for two reasons. First if you don’t have much money it adds up to a big expense. Second, the therapy is consumed, meaning it must be constantly done over and over as it doesn’t last forever and the harder you train the more you need. When you have been sacrificing for years and finally you are making money do you get the Banana Republic jacket or ten sessions of massage? A year later you are sporting a smooth leather jacket but therapy seems to vanish. Sacrifice is hard to do.
EDIT: STR is a similar system to ART that many massage therapists are going to and manual therapy that is 75 dollars an hour that is very skilled is a better value than 90 dollars for 15 minutes of skilled work all being equal. My goal is not to debate what is better (ART or massage thechniques) but to share that I work with very high end therapists, that are not cheap, but, are a good value. We are not talking about 15 minutes of unskilled therapy that is free from a massage therapist in from a school, but bodywork in general that is high quality and given ample time is just simple math. Just because something is a better rate doesn’t mean it’s less quality. Massage therapists that have a small clinic that do 30 hours at 75 dollars an hour per week are pulling in 100k a year minus overhead and that is good money. My point is to understand that conventional massage techniques done with great skill and experience can be found locally in most places. ART is just one option and I use those that employ that technique so I am not biased against it.