A large proportion of the active and even inactive population have no doubt either come across or used a foam roller as a form of self-massage. Results can often vary significantly between individuals and in some cases, symptoms can be made worse. In order, to get the best out of your foam roller, it is essential know a little about the principles behind the massage techniques the roller attempts to replicate. It is equally useful to know a little about anatomy, physiology, and types of injury.
An American Physical Therapist, Sean Gallagher is commonly referred to as the originator of the foam roller, as used for self-myofascial release. The use of foam rollers for self-massage appears to date back to the early to mid 1980’s. The foam roller industry has grown hugely in the last 5-10 years, and there are all kinds of videos and books of people happily (smiling) while foam rolling various parts of their body. That said there are many health and fitness products advertised with people happily smiling while using them. For those of you that have used a foam roller, it is undoubtedly not a happy experience, and at worst a gritted teeth experience. There is also an ever-increasing number of foam roller designs, shapes and sizes and a vast industry developed in a relatively short period.
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| Examples of typical foam rollers |
A good massage therapist has a number of advantages over a person attempting self-massage with a foam roller. In order, to get the best out of self-massage foam rolling one needs to understand these differences and try to account for them. When performed correctly a foam roller can be a valuable tool, though it does have limits and cannot replace a good massage therapist. Foam rollers are best suited to treating larger (longer) muscles in the body, such as the legs. It is hard and frequently impossible to foam roller smaller (shorter) muscles. Such muscles tend to be inaccessible to a foam roller, due to the muscles location within the body and the design of the roller and way one uses it. Shorter muscles within the body can and frequently affect longer muscles, which then become the symptom and not the cause. This article touches on the kinetic chain, and some of these other aspects later, though there is no scope to cover such things in detail. This blog post also does not have the time to cover such things as postural and phasic muscles, which are relevant to the kinetic chain. That said such things are likely to be included in future articles.
The relevance of Pressure, Tissue reaction and Pain
When muscles are relaxed, they can be treated more effectively and a good massage therapist will use differing pressure and techniques according to tissue tension. Applying, too much pressure or the wrong type of therapy, tends to be painful, making tissues tense up and create more pain. People in pain often adopt a rapid and shallow breathing pattern, which also leads to further tissue tension. In essence, the body's “fight or flight or (freeze)” response becomes initiated, and the sympathetic nervous fully activates. Any perceived form of "stressor" or "threat" to the body can initiate the "Stress Response" and pain is just one of many possible stressors.
Trying to then pummel the tissues into submission then tends to prove hugely unpleasant for the patient and can even lead to bruising. It may then feel great afterwards, once the pain infliction has ended and the bodies natural endorphins have been released. That said a good massage therapist should know how to work with various tissues and get excellent results without all the pain. A massage therapist has a distinct advantage, the fact that the patient is laying down and can relax. The comfortable position means that the muscles are not under the additional load of holding the patient’s body weight. A good massage or sports massage therapist can then treat the tissues with relatively little pain, providing pressure is used correctly.
In the case of foam rolling, one frequently has to get into positions which result in the tissues one is treating becoming tense or placed under load. As mentioned, massaging muscles under pressure can be painful, even when using a self-massage foam roller. Ideally, one wants to try and have the tissues being treated with the foam roller under as little load as possible. One may have to find some innovative self-massage positions to, as a way to relax the tissues.
A Foam Roller and Massage Therapy
Massage therapy training can vary hugely concerning the types of massage techniques learnt and the duration of training. One of the more basic sets of massage and sports massage techniques taught and used by massage therapists is Petrissage. The way in which one uses a foam roller is very similar to some of the petrissage massage techniques, such as squeezing and stripping. However, a massage therapist learns additional techniques and can use all of these methods more specifically than is possible with a foam roller. That said, self-massage with a foam roller should be able to produce some of the results that a massage therapist can with Petrissage techniques. Such benefits are believed to include, reduced muscle tension, increased venous and lymphatic return, increased tissue permeability, all of which can aid in the removal of waste products.
As a foam roller works based on principles of massage, it makes sense to take some learning from massage therapy. Early on in massage training therapists are taught to massage towards the heart, especially with deep tissue techniques. In brief, blood is pumped from the heart around the body and returned via veins. Blood is in effect, shunted through the veins via a series of one-way valves or gates within the veins. As we move, this causes muscles contractions, which in turn squeezes the blood from section to section. Lymph also similarly moves around the body via muscles contractions and movement. The shunting of the blood in effect pumps the blood back to the heart for re-oxygenation.
The first diagram the shows two sets of valves or gates within a section of vein. One can see that the muscle tissue is relaxed in the first image and so there is minimal change to the structure of the vein. Provided that the valves within the vein are intact and the muscles remain relaxed, blood will stay held between the two sets of valves.
The second diagram demonstrates the squeezing, action of a muscle contraction and the impact on the vein. The muscle contraction squeezes the blood from one section of a vein, via the valves to the next and back towards the heart.
The reason massage therapists are taught to massage towards the heart is due to the relatively fragile nature of these valves within the veins. Pushing blood the opposite way through these tiny one-way gates can lead to structural damage. Damage to or failure of the valves is commonly seen with varicose veins, as blood tends to pool in the various sections. Hence, it equally makes sense that when one is applying self-massage with a foam roller one works towards the heart, rather than backwards and forwards. As with Massage, it is easily possible to overwork soft tissues, which can lead to bruising, inflammation and longer recovery time. Again, a good massage therapist is trained and knows how not to overwork tissues.
The first diagram the shows two sets of valves or gates within a section of vein. One can see that the muscle tissue is relaxed in the first image and so there is minimal change to the structure of the vein. Provided that the valves within the vein are intact and the muscles remain relaxed, blood will stay held between the two sets of valves.
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| Diagram of Vein Section with closed Valves |
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| Diagram of vein section with open valve |
Why NOT to Foam Roller an ITB
I have frequently seen people using foam rollers to treat tight Iliotibial Bands (ITB’s). Unfortunately, in many respects, ITB’s are a structural component, much like tendons and ligaments. Usually, one would not want to stretch structural elements as they provide stability to other parts of the body within the kinetic chain. Too much stretching can lead to laxity in the tissues, which then impacts how other tissues work. Also, a tight ITB is a symptom and so not only is stretching it a pointless exercise, but it is also a highly uncomfortable process. Although using a foam roller on the ITB may produce some tension relief, it is not going to fix the problem. The cause of the ITB tension is going to be somewhere else in the kinetic chain and is likely to be impacting multiple components in the chain. The ITB then usually becomes tight as a result of other dysfunctional tissues, which in turn create additional load on other tissues and further dysfunction.
In summary
- Avoid applying too much pressure.
- Avoid massaging muscles which are under load.
- Massage towards the heart.
- Avoid massaging the symptom (tight ITB) and address the cause.
- Avoid overworking tissues.
- Avoid using a foam roller to treat inflamed tissues, or tissues in spasm (see TPT article).
- Avoid using a foam roller if you meet any of the contraindications for Massage, Sports Massage or Remedial Massage.
- If in doubt seek advice from a suitably qualified therapist or primary care practitioner.
Article written by Dr Terry Davis MChiro, DC, B.Sc (Hons), Adv. Dip. Rem. Massag., Cert. WHS.