How Active Release Technique Gets Results When Other Treatments Don’t

If you've been dealing with pain, tightness, or restricted movement that hasn't fully responded to stretching, rest, or conventional treatment, there's a good chance the problem involves soft tissue — and specifically, the kind of soft tissue changes that most treatments don't directly address.

Active Release Technique, commonly known as ART, is one of the most clinically respected soft tissue treatment methods available. It’s used by professional athletes, weekend warriors, and everyday patients dealing with overuse injuries, chronic tightness, and conditions that keep coming back despite other forms of care.

What Is Active Release Technique?

ART is a patented, movement-based soft tissue treatment system designed to identify and resolve problems in muscles, tendons, ligaments, fascia, and nerves. It is not massage, and it’s not stretching. It’s a precisely applied manual technique in which the provider applies specific tension to affected tissue while guiding the patient through active movement. That combination — manual tension plus patient movement — is what makes ART unique and what produces outcomes that passive treatments typically can’t replicate.

There are over 500 specific ART protocols, each targeting different tissues and structures throughout the body. A certified provider selects from those protocols based on a detailed hands-on assessment of each patient’s specific presentation.

What ART Is Actually Treating

When soft tissue is injured — through a single traumatic event or through the cumulative microtrauma of repetitive use — the body repairs it by laying down scar tissue. Over time, that scar tissue can create adhesions: areas where tissue that should move freely becomes bound to adjacent structures.

Adhesions reduce a muscle’s ability to lengthen and shorten through its full range. They alter joint mechanics. They can compress nerves, producing numbness, tingling, or referred pain. And because they change how load is distributed through the musculoskeletal system, they often create compensatory patterns that spread well beyond the original injury site.

Three conditions drive most of what ART addresses. Acute injury from a single event. Cumulative microtrauma from repeated use — extremely common in athletes, desk workers, and anyone with repetitive movement demands. And hypoxia — reduced oxygen delivery to tissue — which compromises tissue health and promotes adhesion formation even without a specific injury.

All three result in the same problem: soft tissue that isn’t moving or functioning the way it should.

Conditions ART Can Treat

Because adhesions can develop virtually anywhere, ART has a broad range of applications. Conditions that respond well include:

Neck pain and upper back tightness — particularly in patients with postural demands from desk work or screen time, where cumulative microtrauma to cervical soft tissues is extremely common.

Low back pain and sciatica — adhesions in the lumbar musculature, hip flexors, and piriformis can contribute to both local back pain and nerve symptoms into the leg.

Shoulder pain — rotator cuff dysfunction and impingement syndromes often involve adhesion formation in the muscles and tendons of the shoulder girdle.

Carpal tunnel syndrome — soft tissue restrictions along the median nerve’s path from the neck through the forearm and wrist respond well to ART nerve mobilization protocols.

Headaches — cervicogenic headaches driven by restrictions at the base of the skull and upper cervical musculature are frequently resolved with ART.

IT band syndrome and knee pain — common in runners and cyclists, these conditions often involve adhesion formation in the lateral soft tissues of the thigh and knee.

Plantar fasciitis — restrictions in the plantar fascia, calf musculature, and intrinsic foot muscles are common drivers of chronic foot pain that ART addresses directly.

What to Expect During Treatment

An ART session at Donato Chiropractic begins with a thorough hands-on examination. Dr. Donato manually evaluates the texture, tightness, and mobility of the muscles, tendons, ligaments, nerves, and fascia relevant to your presentation — assessing not just where pain is located but where soft tissue quality and movement have been compromised.

Treatment then involves applying precise manual tension to the affected tissue while guiding you through a specific active movement. The combination of external tension and your own movement creates relative motion between the tissue being contacted and the surrounding structures — freeing the adhesion and restoring normal tissue mobility.

This is what distinguishes ART from passive soft tissue work. You’re not simply receiving treatment — you’re actively participating in it, and that participation is mechanically integral to how the technique produces results.

Most patients notice meaningful changes within the first few visits. Acute presentations often resolve quickly. Longer-standing conditions involving significant adhesion formation typically require more treatment, but the trajectory of improvement is usually clear early on.

Why ART and Chiropractic Work Well Together

Soft tissue adhesions and joint restrictions frequently coexist — and they reinforce each other. When a joint is restricted, the surrounding muscles develop tension patterns and eventually adhesions that reflect the compromised movement. When soft tissue is restricted, the joints it controls are pulled into poor positions and loaded unevenly.

Treating one without the other often produces incomplete results.

Combining ART with chiropractic adjustments addresses both layers simultaneously. The adjustment restores joint mobility and provides new input to the nervous system. ART addresses the soft tissue environment surrounding the joint — restoring the tissue’s ability to move freely and reducing the mechanical load being placed on the joint from compromised soft tissue above and below it.

At Donato Chiropractic, care is structured to address both when both are contributing — which in most cases of chronic or recurring pain, they are.

Dr. Donato's ART Credentials

Not all ART providers are equivalent. Certification requires extensive hands-on training and testing, and providers can be certified across individual body regions or at the full-body level.

Dr. Keith Donato has been a full-body certified ART provider since 2005, meaning he is trained and tested across all regions of the body with access to the full library of over 500 protocols. He has also been a member of the ART Elite Provider Network (EPN) since 2006 — a distinction reserved for providers who meet a higher standard of training and clinical application.

That depth of experience matters clinically. Selecting the right protocol for a specific tissue and presentation requires both comprehensive knowledge of the ART system and the manual sensitivity developed through years of practice. Patients treated by a full-body certified, EPN-level provider are receiving a meaningfully different level of care.

Is ART Right for You?

ART is worth considering if your tightness or pain rebuilds quickly after massage or stretching, if you have a history of repetitive use in a particular area, if a previous injury never fully resolved, or if nerve-related symptoms like tingling or numbness are part of your presentation.

A thorough assessment at Donato Chiropractic can determine whether ART is appropriate for your specific situation — and how it fits into a broader plan to address not just where you hurt, but why.

Donato Chiropractic is located at 70 Railroad Place, Suite 101A, Saratoga Springs, NY. Dr. Keith Donato has been a full-body certified ART provider and Elite Provider Network member since 2005 and 2006 respectively. To schedule an evaluation, call 518-538-8200 or visit donatochiro.com.