The physiotherapy industry loves a good fad! In the 13 years I’ve been a Sports Therapist I’ve seen all kinds of treatments and gadgets come and go. One that appears to be here to stay is the dreaded foam roller. Those of you who have used one will be well aware of the agonising pain it can cause. But is it actually worth putting yourself through it?
In this article we combine our clinical experience with the latest available research on the subject. This will help you to decide if you need to keep dishing out the pain to yourself. Or maybe back off a little and find different ways to get your fix of self abuse for the week!
Why Do People Use A Foam Roller?
Muscles work via respiration. Either with or without oxygen. There are waste products of this muscle respiration which are whisked away in blood, recycled or excreted, and then the whole process starts again.
When muscles work too hard the theory is that the body is unable to keep up with the demands placed upon it and some of these waste products get left behind. It is thought that these waste products can accumulate within muscles, connective tissue (fascia) or both. Leaving behind the nasty sore bits that hurt when you foam roller or have a Sports Massage. Some people / therapists call these areas trigger points. We prefer to call them bits that aren’t working quite the way we would like. Trigger points is catchier I’ll grant you. Our description is more fluffy and less threatening.
These ‘trigger points’ lead to a loss of performance of the muscle and a shortening of the length or flexibility. The idea of foam rolling is that we use the pain caused by rollering to stimulate blood flow to the area which helps transport these waste products away. The muscles then becomes looser and perform better again – when you’ve recovered from how painful the process was!
That’s the theory. What about the practice.
Is There Any Evidence To Suggest It Works?
Using a Foam Roller to release these nasty bits is a relatively new idea. New in the physiotherapy world being less than 30 years old! As such there isn’t loads of research on the subject but that is starting to change. An increasing number of papers are being published on foam rolling. Most of them are small scale but most papers agree that using a foam roll does do something.
This nice article here suggests that foam rolling in the short term increases your range of movement. It also vitally points out that it does not decrease the amount of force a muscle can exert.
Another nice piece of research here concludes that using a foam roller is better than dynamic stretch (when you move around to warm the muscles up) and static stretching (when you stand still and stretch) for increasing range of movement. As research in the physiotherapy world goes this is quite conclusive. As a bonus finding it found that dynamic stretching was better for improving a vertical leap test than foam roller.
I think this is quite reasonable especially considering the research was done shortly after the rollering at which point the mid term affect of the release the trigger point may be masked by the immediate inhibition of the muscles do to the pain it causes.
This is the same effect as reported by many massage papers. Many of which describe that massage slightly decreases maximal output of muscles, thought to be caused by the relaxation effect on the muscle. Indeed another piece of research carried out on Collegiate American Footballers would seem to agree. This research showing an increase hip flexibility (comparative to dynamic stretching) and no impact on strength. Better than the reduction in strength that massage is purported to give.
What Do Physio’s Think Of Foam Rolling?
As with anything in the physio world opinion is divided. Ask 10 different physios opinion on anything and you’re likely to get 10 different answers! Many physio’s are big fans. Some of these physios sell foam rollers for profit. One would hope these two things are not in anyway connected.
However, the short term evidence is reasonable in terms of increasing muscle length and range of movement. That would be an indication to recommend it to clients. But none of the studies focus on the long term. If a muscles keeps getting tight surely there is a reason for it? Especially if it’s on one side of your body more than the other.
As a Sports Therapist I prefer to understand the reason for the tightness and tension first and then treat the underlying cause – rather than treat symptomatic tightness. For example if your quads keep getting tight because your knee is collapsing inwards why foam roller the quads all the time? Maybe you should roller something which stops the knee from collapsing inwards…
Is There A Better Way?
Let’s take a classic example which is probably close to every foam rollers heart. The iliotibial band. Normally referred to as the ITB for short. For those not in the know this is the thick layer of fascia on the outer edge of your thigh. Known as the most painful thing that you can foam roll. It’s like a badge of honour amongst runners as if to say “yeah I’m so tough I can even handle rolling my ITB.”
Whether you can affect the length of the ITB by directly working it is a debate for another day. Any physio worth their salts would I hope explain the connection between you glute (bum) muscles and the ITB. To cut a long story short if the glutes are misbehaving chances are the ITB is too.
Now we could try to roller the glutes. Which can be quite emotional in itself. But the muscles and connective tissue of the glutes are continuous with the connective tissue of the lats on the same side or opposite. And continuous with the same side obliques.
I may have lost some of you who have no idea that these things are! Fear not. The following excerpts from our Brighton YouTube channel (video’s soon to be available on Swindon You Tube Channel!) will show you the practical implications.
What would you rather foam roll? The bit that gives the symptom or the bit that makes the symptom happen in the first place?
Conclusion On Foam Rolling
So the research would suggest that yes indeed foam rolling does do something. Particularly in regard to improving range of movement immediately after all that pain. Does it fix the underlying movement pattern that causes the problem in the first place? No.
Our view at the clinic is that you can use foam rolling as part of your recovery from heavy training. But it’s not going to solve any under lying injury problems you have. It may temporarily ease them and perhaps enable you to squeeze a little more out of your body. But it won’t solve them. Ultimately that biomechanical pattern will find you out.
Foam rolling can be made more effective by having an assessment from an experienced therapist. They will be able to identify the areas that are causing the issue rather than just rolling the symptomatic tight bit over and over again.
However, we prefer to do all the work for you! We like to find out exactly what movement patterns are causing the tightness. Then find out why or how you’re coming to work in this way. Following treatment is focused to make it nice and easy for you to change the movement pattern. If you’d prefer to dish out pain to yourself indefinitely on a regular basis that’s fine by us!
We only recommend foam rolling as a last resort. If for some reason we can’t quite get to the bottom of why something somewhere, not necessarily next to the symptom, it tightening. And we have shown that by releasing this area off it consistently improves symptoms then we will recommend foam rolling.
So I see using a foam roller as failure. Perhaps you should too. And stop using it, quite literally, to beat yourself up! You know where we are if you need us. If you enjoyed this article please spread the joy using the sharing buttons below.
If this article has intrigued you and you’d like how to know more about how it’s all connected then check out the Blog post of the same name here.
This article first appeared on our Brighton site.
