Weekly Blog
Today I though I would do a piece on foam rollering as it still continues to be a weapon of choice among therapists and PTs. Ive heard of whole sessions of PT being devoted to rolling painfully round on the tube of torture!!! So what does it actually do and are they actually any good??? First I have to say that some people swear by them and that’s personal choice. However, may of the claims are not backed by any scientific evidence and I think its helpful to have a better understanding of what a foam roller can and cannot achieve and how to use them if you are going to use one.
First thing to say is if you are going to get one I would opt for one with a solid PVC core wrapped in foam as evidence has shown this type to be more effective than the traditional ‘foam’ roller. I also use a hand roller which is much more user friendly and easier to apply to the legs. You are in control of the pressure then rather than rolling around on the floor.
How does a foam roller (FR) work?- well FRs are sold as a form of Self Myofascial Release although the underlying biology behind this is still unclear. The benefits that have been investigated for FR’ing may well come from a change in the body’s nervous system rather than actually having an effect on the fascia itself which is non contractile and takes huge forces to make a change to. However, like massage Fr’ing stimulates pressure receptors under the skin which in turn stimulate increased activity in the brain. This is linked to reduce levels of cortisol (stress hormone) and improved pain tolerance. So as Heid pointed out in a piece in 2017 ‘foam rollering may be knocking out stress and quietening your body’s pain detection centers, instead of loosening your muscles’. This is an interesting point as many people don’t have restrictions in ROM in their joints so how can you improve this??
Much of the research for FRs has been very small scale studies on body builders so its very difficult to equate this to other sporting groups. MacDonald et al have done several studies and found that FR’ing does improve the ROM in a joint straight after but again there was no baseline as to how or why the participants had restricted ROM. One interesting study looking purely at runners found that FR’ing reduced increases in muscle soreness from intense downhill running, but had no effect on their performance. This was a very small scale study in well trained- endurance athletes. There are still very few good quality studies for the use of foam rollers on normal everyday athletes!
So, what should you do?- research seems to show that to see benefits you have to roller each muscle for 90 secs- 2 mins daily and it may be most beneficial after an intense workout for helping with DOMs (delayed onset muscle soreness). Dynamic type stretches still may be a much more effective way to improve long term joint ROM if you actually have a restriction and be much less painful than throwing yourself at the mercy of the Foam Roller. Finally, David Behm has conducted several studies and found that pain reduced in both the leg that was being rollered and the one that wasn’t thus supporting the idea that foam rollering has an effect on the nervous system rather than the fascia. He also found FR’ing at 50%, 70% and 90% of a persons pain threshold resulted in similar benefits.
A recent systematic review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4637917/ found very little evidence to support foam rollering due to the poor research that has been done. What it did show was that it may improve ROM in a joint pre and post but this is very short term and we already know that dynamic movement does improve a joints ROM and can have lasting effects.
My final thoughts. Foam rollering should feel nice! There really isn’t any gain in battering the hell out of your poor muscles. If you do genuinely have a restriction in a joint’s ROM from muscle tightness then foam rollering may help improve this but you have to work diligently every day for up to 2 mins on each muscle group. If you haven’t got any restrictions then why put yourself through the agony. Grab a hand roller, sit back and treat your legs to a bit of TLC. Far more beneficial than battering your body with a foam roller.
If we then have a think about our Iliotibial band https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2100245/ it is a thick non contracile sheet of fascia that is tougher than steel. You cant stretch it or have an effect on its length by rubbing or prodding it. It is attached to the tensor fascia lata and the glute max that work together to add tension to the band. At the knee it attaches to the fibular head. ITB pain is an overuse injury and the current thinking is that it is a compression of the fat under the band against the lateral femoral condyle. Symptoms arise from an imbalance in the muscles that are functioning to tension the ITB. Using a roller to roller out the ITB is often advised by sports therapists but actually all you are doing is compressing the soft tissues underneath the band often causing bruising and pain (bruising is a sign of tissue damage!!). As you roll down to above the knee you actually compress the soft tissue against the bone which will only aggravate the painful tissues. Rehab for ITB pain must include some gait retraining and some exercises to restore balance to the muscles around the hip and thigh. Some massage may be beneficial in the short term but this would be focused on the glutes and TFL. So hopefully from this you can see that rollering up and down your poor thigh is both painful and futile. https://www.physio-pedia.com/Iliotibial_Band_Syndrome