Somatic (Soma-body/atic –movement) Therapy (also known as Active Release Technique) is a series of muscle testing, postural assessment, stretching and muscle exercises that focuses on a specific muscle or group. ST is not massage, although it can be incorporated into a massage session, along with PT, OT, Osteopathic or Chiropractic. (There is also a clinical Social Worker's modality called Somatic Therapy that is not related).
Somatic Therapy was created by Thomas Hanna, Ph.D. while working with Geriatrics and trying to find ways to correct posture deficits. He discovered that age wasn't necessarily the culprit with humped backs, decreased range of motion and strength, but more of many years of bad habits and lack of movement. After working with the Elderly for many years, he began to create a method that increased body awareness to the individual allowing more movement.
What does it treat?
Somatic Therapy was originally created to treat people with poor posture due to injury, illness, or years of bad habits. When a muscle is not used properly for a long period of time, it creates a “de-education” of the muscle fibers that causes the primary muscle to weaken and depend on the secondary muscles to assist. Eventually, the assistants become the primary muscle and the range of motion, strength, and endurance are all compromised because the job is being done by an imposter. From a Nervous System perspective, the motor nerve endings that deliver acetylcholine (ACH) to bridge the nerve/muscle gap begin to break down and deteriorate. This increases the need for the secondary muscles and the downward spiral begins. This can be caused by muscle atrophy while in a cast, post surgery when there was no or insufficient rehab, bad posture habits, poor ergonomics, and even Repetitive Stress Disorder.
How does it work?
The human body is meant to move, and move in certain ways. When there is an injury or illness, the body finds other ways to keep moving. Somatic Therapy is specifically designed to increase blood flow back to the troubled area, increase muscle tissue mass, and rebuild nerve fibers to increase the nerve flow to the muscle in question. This is done through RROM tx (Resistive Range of Motion Techniques) that keeps a constant flow of ACH to the muscle fibers, even when relaxing.
This is performed by the Therapist performing hands-on exercises with the client directly to re-activate the nerve fibers. This is done in a half-hour session with a minimum of six sessions. Most clients do not start to see results until the fourth or fifth session. The sessions should also be no more than four days apart in order to remain on task with the muscles.
How a session goes:
The Therapist starts by assessing the client's posture, range of movement, and perform muscle testing in order to get a “baseline” of what the client is currently capable of. Once this is done, the Therapist determines the primary muscle to be treated and its antagonist (opposite muscle). For example, if the client's bicep is atrophied from a cast due to a fractured Humerus, the Therapist would start with the Bicep Brachii first on the injured arm, then the other arm, and then return to the first arm and work the antagonist (opposite) muscle, in this case, the Tricep Brachii. The Therapist would have the client perform a full range contraction of both sides of the joint and observe what muscles are being used, then offer a small amount of resistance and observe the change.
The Therapist then has the client move the muscle several times through phases of the range of motion each time with resistance in both directions, while at the same time, instructing the client to relax the secondary muscles that are trying to do the job, and focus on using the primary muscle. As you can guess, this is very frustrating, and remains so for several sessions, especially if this is an old injury. To start this, the client must be able to “fire” the correct muscle merely by thinking about it and isolate it from the surrounding tissue. When a client feels a tension free movement without the secondary muscles, it is very rewarding, but the work is far from over. The goal is get full range of motion of all four muscles (Left and Right Agonists and L/R Antagonists) with proper firing sequences.
Pain : If the client is in any pain regarding the area to be worked on, Somatic Therapy cannot be used. Pain indicates an active injury and the motor neurons should not be activated with resistance if the Pain receptors are active. The client should receive soft tissue therapy to relieve the pain. (Note: taking pain relievers, NSAIDs, or narcotics will only decrease the sensory nerves' messages to the brain and prevent ST from working correctly.
Acute Injury : The client should wait until the injury has healed fully to the point that there is no pain with movement.
Illness : When the body is fighting off a cold or fever, the client cannot focus on the session. Please call the Therapist ahead of time and reschedule.
Somatic Therapy works great for the competing athlete that is looking for a clean, natural edge. The Therapist will assess what group needs to be focused on for the event in question and train the brain to “build more nerve highways” to the muscle or groups desired. NOTE: If training for a specific event (e.g. Marathon race) ST should be started 2-3 months prior to the event.
This form of Therapy has worked great for Dancers, Runners, Truck Drivers and Martial Artists in my practice.