Foam Rolling
Michael Boyle
Originally printed in Training and Conditioning Magazine December 2006
Foam Rolling?
A decade ago strength and conditioning coaches, athletic trainers, and
physical therapists would have looked quizzically at a thirty six inch
long round piece of foam and wondered "What is that for?". Today nearly
every athletic training room and most strength conditioning facilities
contain an array of foam rollers in different lengths and consistencies.
What
happened? A major change in the attitude toward injury prevention and
treatment has been evidenced by a huge increase in the awareness that
hands on techniques like massage, Muscle Activation (MAT), and Active
Release Therapy (ART) can work wonders for injured athletes. We appear
to be moving away from the eighties injury care mode of isokinetics and
electronics to a more European inspired process that focuses on hands-on
soft tissue care. The success of physical therapists with soft tissue
mobilization (the physical therapy term for massage) and MAT, and a
number of chiropractors with ART has clearly put the focus back on the
muscle. The message at the elite level is "if you want to get better
(healthier) get a good manual therapist in your corner".
What
does all this have to do with foam rollers you might ask? Well. Foam
rollers are the poor mans massage therapist, soft tissue work for the
masses. As strength and conditioning coaches and personal trainers
watched elite level athletes tout their success and improvement from
various soft tissue techniques the obvious question arose. How can I
mass-produce "massage" or soft tissue work for large groups of athletes
at a reasonable cost? Enter the foam roller. Physical Therapist Mike
Clark is credited by many, the author included, with the initial
exposure of the athletic and physical therapy communities to the foam
roller and to what he termed "self myofascial release". Self myofascial
release is simply another technical term for self-massage. In one of
Clarke's early manuals published as a pre-cursor to his book Integrated
Training for the New Millenium Clark included a few photos of
self-myofascial release techniques using a foam roller. The technique
illustrated was simple and nearly self-explanatory. Get a foam roller
and use your bodyweight to apply pressure to sore spots. Kind of a
self-accupresssure technique. I believe these photos began a trend that
is now probably a multi-million dollar business in the manufacture and
sale of these simple tools.
What is a Foam Roller and How do You Use It?
A foam roller is
simply a cylindrical piece of some type of extruded hard-celled foam.
Think pool noodles but a little more dense and larger in diameter. The
techniques are simple. Clarke's initial recommendation was not a
self-massage technique but, more the accupressure concept described
previously. Athletes or patients were simply instructed to use the
roller to apply pressure to sensitive areas in the muscles. Depending on
the orientation of the therapist, these points can alternately be
described as trigger points, knots or simply areas of increased muscle
density. Regardless of the name, those in the fields of athletics and
rehab were familiar with the concepts of sore muscles and the need for
massage.
Note:It is the authors belief that massage fell out of
favor during the physical therapy boom of the 1980's not because it was
ineffective but, because it was not cost effective. With the increase in
use of modalities like ultrasound and electrical stimulation athletic
trainers and therapists could treat more athletes, more rapidly. In
Europe and in elite athlete situations such as high-level track and
field and swimming, a disdain for a modality based approach and an
affinity for European inspired massage still existed. Slowly, the
performance world caught on to the idea that manipulation of the soft
tissue caused athletes to either stay healthier or, to get healthy
faster.
The use of foam rollers has progressed in many circles
from an acupressure type approach to a self-massage approach. The roller
is now used to apply longer more sweeping strokes to the long muscle
groups like the calves, adductors and quadriceps and small directed
force to areas like the TFL, hip rotators and glute medius.
Athletes
are instructed to use the roller to search for tender areas or trigger
point and to roll these areas to decrease density and over-activity. The
major areas that respond well to the foam roller are:
Glute max
and hip rotators- the athlete, client or patient sits on the roller with
a slight tilt and moves from the iliac crest to the hip joint to
address the glute max (video 1a). To address the hip rotators the
affected leg is crossed to place the hip rotator group on stretch. As a
general rule of thumb, ten slow rolls are done in each position although
there are no hard and fast rules for foam rolling (video 1b). Often
athletes or clients are encouraged to simply roll until the pain
disappears.
Video 1a
Video 1b TFL
and Gluteus Medius- the tensor fascia latae and gluteus medius,
although small muscles, are significant factors in anterior knee pain.
To address the TFL the athlete begins with the body prone and the edge
of the roller placed over the TFL, just below the iliac crest (video 2).
After working the TFL, the athlete turns ninety degrees to a side
position and works from the hip joint to the iliac crest to address the
gluteus medius.
Video 2
Adductors-
the adductors are probably the most neglected area of the lower body. A
great deal of time and energy is focused on the quadriceps and
hamstring groups and very little attention paid to the adductors. There
are two methods to roll the adductors. The first (video 3) is a floor
based technique that will work well for beginners. In the floor
technique the user abducts the leg over the roller and places the roller
at about a 60 degree angle to the leg. The rolling action should be
done in three portions beginning just above the knee in the area of the
vastus medialis and pes anserine. Ten short rolls should be done
covering about one third the length of the femur. Next the roller should
be moved to the mid point of the adductor group and again rolled ten
times in the middle third of the muscle. Last the roller should be moved
high into the groin almost to the pubic symphysis.
Video 3
The secondary technique for the adductors should be used after the
athlete has acclimated to the previous technique. The secondary
technique needs the use of a training room table or the top of a
plyometric box (video 4). Sitting with the leg dropped over the roller
allows the athlete to shift significantly more weight onto the roller
and work deeper into the large adductor triangle.
Video 4
Trainer Beware
It
is important to note that foam rolling can be hard work, particularly
for weaker or overweight clients as the arms are heavily involved in
moving the body. In addition, foam rolling can border on painful. Foam
rollers are available in a number of densities from relatively soft
foam, slightly harder than a pool noodle, to newer high-density rollers
with a much more solid feel. The feel of the roller and the intensity
of the self-massage work must be properly geared to the age, and fitness
level of the client. Good massage work, and correspondingly good
self-massage work, may be uncomfortable much like stretching. It is
important that athletes or clients learn to distinguish between a
moderate level of discomfort related to a trigger point and a
potentially injurious situation. Foam rolling should be used with
discretion in those clients with less muscle density. Foam rolling
should never cause bruising. The reality is that the athlete or client
should feel better, not worse after a brief session with a foam roller.
When to Roll
Coaches
and therapists are not in universal agreement over when to roll, how
often to roll, or how long to roll so only general guidelines can be
provided.
Rolling can provide great benefit both before and after a
workout. Foam rolling prior to a workout can help to decrease muscle
density and allow for better warm-up. Rolling after a workout may help
to aid in recovery from strenuous exercise. The nice thing about using
the foam roller is that it appears it can be done on a daily basis. In
fact, Clair and Amber Davies in the The Trigger Point Therapy Workbook
actually recommend trigger point work up to 12 times a day in situations
of acute pain.
How long an athlete or client rolls is also
individual. In a personal training setting we allow 5-10 minutes for
soft tissue work at the beginning of the session prior to warm-up. With
our athletic clients we do the same.
Foam Rollers versus Massage
The
question often arises "Which is better, massage therapy or a foam
roller?". To me the answer is obvious. Hands work better than foam.
Hands are directly connected to the brain and can feel. A foam roller
cannot feel. If cost was not an issue I would have team of massage
therapists on call for my athletes at all times. However, this is simply
not realistic. Most athletes struggle to afford the services of a
qualified coach or the cost of a facility membership. At the current
state of health care, prevention is generally not a covered cost for
healthy athletes. With no ability to get reimbursed the cost of massage
therapy alone could approach or surpass the cost of training. The foam
roller can provide unlimited self-massage for under twenty dollars? You
do the math.
Conclusion
The use of foam rollers has exploded
over the past ten years and will continue to increase. Athletic
trainers in high school or small college situations can teach their
athletes to perform hands on treatment that might not have been possible
due to work schedules, while strength and conditioning coaches can
provide a form of massage therapy to all of their athletes. Foam rollers
are a small investment to make to see a potentially significant
decrease in the number of soft tissue/ non-contact injuries.
References
Clark,M: Integrated Training for the New Millennium. National Academy of SportsMedicine, Thousand Oaks, CA. 2000
This article is just a sample of the new content added weekly.
Join today to access everything...old and new
