Foam rolling or “tool-assisted self-manual therapy” is a popular form of self-myofascial release (SMR) that I often prescribe for my patients as well as teach in group settings.
Foam rolling is believed to work via two mechanisms:
- Autogenic Inhibition- Tissue pressure stimulates mechanoreceptors affecting both the central and autonomic nervous systems, resulting in a change in muscle tone and local fluid dynamics *
- Myofascial Release- Breaking up fascial adhesions **
* Autogenic inhibition occurs as a result of sustained pressure for about 30-60 seconds on trigger points. Trigger points are hyperirritable spots/taut bands in the fascia surrounding skeletal muscle. Trigger points can cause local and referred pain, restricted range of motion and muscles weakness.
** Fascial release occurs as the adhesed tissues are “unlocked” through the pressure of the foam roller and the area being actively massaged through cross-friction, spanning and/or distal limb movement.
Simply rolling over an area will generally have little, if any, therapeutic benefits.
Trigger points and fascial adhesions generally result from trauma (injury), both acute and repetitive. They can also be influenced by a number of perpetuating factors, such as:
- Structural– e.g. Postural distortions and movement impairments, poor ergonomics and constrictive clothing
- Biochemical- e.g. Nutritional inadequacies, inflammation and poor hydration
- Psychological– e.g. Stress
Evidence-based uses for Foam Rolling
There is evidence that Foam Rolling Can:
- Increase Flexibility
- Reduce pain resulting from muscle injury
- Affect proprioception/Balance
- Enhance athletic Performance and help to prevent injuries
FOAM ROLLING AND FLEXIBILITY
Using a tennis ball to roll the plantar surface of the foot resulted in improved hamstrings and lumbar spine flexibility, suggesting interconnections within the fascia that influence tension and force transmission.
Performing self-myofascial release on the suboccipital muscles was shown to increase hamstrings flexibility.
FOAM ROLLING AND REDUCING PAIN
A literature review found that SMR appears to have a favorable effect on range of motion, soreness and fatigue following exercise.
In a comprehensive review published in the Journal of Strength and Conditioning Research, several mechanisms were proposed to explain the effects of foam rolling on pain. These included:
- Endocrine hormone release, e.g. Oxytocin
- Inhibition of pain feedback, e.g. Pain gate control
- Reduced inflammation, e.g. “Squeezing out” inflammatory molecules, such as bradykinins, from the tissues, thereby reducing irritation of peripheral nerves
- Deactivation of trigger points, e.g. Normalization of muscle tone and local circulation
FOAM ROLLING TO INCREASE PROPRIOCEPTION/BALANCE
Fascia is intimately involved in proprioception as it is densely populated with nerve endings. Increasing proprioception can lower pain as well as assist with balance.
Park (2015) found that self-myofascial release with a tennis ball to the affected limb led to increased performance on a balance test in chronic stroke patients.
FOAM ROLLING FOR PERFORMANCE ENHANCEMENT
Static stretching has historically been used as a warm-up training method to increase range of motion. While static stretching will produce acute and chronic changes in flexibility, some studies have also shown static stretching to produce undesirable short-term reductions in athletic performance. This is possibly due to adverse effects on soft tissue length-tension relationships and concomitant suboptimum neuromuscular efficiency.
More recently, dynamic warm-ups and movements simulating the activity to be performed have been shown to be effective for performance and injury prevention.
Self-myofascial release (SMR) as part of a warm-up or pre-exercise routine was shown to be effective at improving power, agility, strength, and speed. A warm-up routine consisting of both a dynamic stretch and a foam rolling (SMR) resulted in overall improvements in athletic performance testing.
The National Academy of Sports Medicine (NASM) goes a step further in their programming (The OPT model) and recommends foam rolling to overactive muscles in combination with stretching, based on a movement assessment. In addition, muscles that are underactive are addressed through isolated activation techniques or exercises, followed by whole body integration.
There are three building blocks in the NASM Optimum Performance Training Model (OPT):
Each block incorporates SMR, however the type of stretching depends on the block, e.g. Stabilization- Static stretching, Strength- Active stretching and Power- Dynamic stretching.
Clark, M., & Lucett, S. (Eds.). (2010). NASM essentials of corrective exercise training. Lippincott Williams & Wilkins.
Clark, M. A., Lucett, S., & Corn, R. J. (2008). NASM essentials of personal fitness training. Lippincott Williams & Wilkins.
- Foam rolling works through autogeninc inhibition of tight muscles/trigger points and fascial release of adhesed tissues.
- The evidence points to foam rolling as an effective means to:
- Increase flexibility
- Improve proprioception/balance
- Reduce musculoskeletal pain and soreness
- Enhance athletic performance
- In order to be effective, the application of foam rolling involves specific variables and programming
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