Jill Murphy, DPT, LAT, CSCS
A long, white cylinder is before you. Your friends have raved all about it. You? Not so much? What are you supposed to do with this thing? It’s so hard and uncomfortable. How does everyone else do this and how is it supposed to benefit you?
Here’s the scoop. As hands-on treatment techniques became popular in physcial therapy and athletic training cirlces, so did teaching patients and athletes how to perform these techniques themselves at home with minimal equipment. Enter the foam roller. The 3 foot long by 6 inch diameter dense, white foam cylinder has existed for over 20 years now and is a mainstay for runners and other athletes with chronic muscle tightness.
How does it work? Just like the benefits of manual therapy, self myofascial mobilization techniques such as using a foam roller improve blood flow, expedite waste removal, improve collagen fiber alignment, and most importantly, reduce pain and stiffness and promote tissue elongation. The best part is that you are in control. While the direct pressure may seem a bit painful, you can control the intensity of the treatment, because you are feeling it yourself every moment and can adjust the pressure immediately. Looking for a quick treatment before that big race? Bring your foam roller along (but don’t over-do it the night before!), and you can treat yourself, anywhere, anytime.
Now that 20 years have past, there are now many different versions of cylinder shaped equipment to self massage a variety of muscles. Capitalism abounds, but even with all of the new versions, the oldie is still the best. It’s not too exceptionally hard, but yet can be plenty firm and durable to last through years of use. And once you actually use a foam roller, you release the extra knobs and hard plastic models can actually too painful and leave bruises that deter you from using it (especially if you are rolling over the surface, versus rolling the device on your muscle). If you are looking for a device for the top of the thigh (your quad muscle), look no further than your kitchen pastry drawer. A rolling pin is an awesome device to roll out tight muscles on the front side of the legs, and the cost is as attractive as the effectiveness of the technique!
So, how to use the foam roller? Know that it is best suited to treat the back and outside of the legs. Common muscles treated are the hamstring, iliotibial (IT) band, and calf muscles (namely gastroc). The other possibilities are the posterior hip muscles (glut max, glut med, piriformis), and although sometimes too harsh feeling, the mid and low back muscles (known as the erector spinae muscle group). The foam roller can also be utilized for spine stabilization exercises and stretches, but that is a whole other article.
Can you over-do the foam rolling? Just like anything else, a little moderation is the best approach. Do not double up treatments too close together (within 24 hours of treating the same exact location). Remember you are actually creating a new injury every time you foam roll a muscle, so timing is of utmost importance. Do not foam roll extensively 24-48 hours before a big run, race, or athletic event. Your tissue will be in the middle of the remodeling process, making it weaker instead of performing better, for your big day. Any extensive foam rolling should be performed after versus before a bout of aerobic exercise and/or strength training. Also, leave at least 48 hours between treatments on the same location to allow the full tissue break down, increased blood flow and inflammatory substances, and then build up of new fibers before breaking them down again. Remember to drink plenty of water to assist with tissue waste removal, and only apply enough pressure on top of the foam roll to feel only slight pain and discomfort. Go easy the very first time foam rolling, as your tissue may generate a larger response in pain, swelling, bruising, and tenderness the first time it is treated compared to future rolling episodes. If this response lasts for more than 24-48 hours, you are applying too much pressure and need to lighten up next time. Feel free to exercise or use heat or a hot shower to warm up the tissue you are about to foam roll to ready the tissue for a quicker muscle release. Finally, don't forget to breathe! Deeper breathing dampens the nervous system, further reducing muscle resting tone.
Hamstring Foam Rolling
Ready to get started? The easiest place to begin is with the hamstrings. Place the foam roll on a low to mid pile carpeted or wood surface, and place the back of your upper thigh over the foam roll, supporting your trunk and upper body with your arms. Foam rolling may seem like a relaxing endeavor, but anyone who has done it will attest to the fact that it actually is quite a bit of work, especially for the arms supporting you the whole time, and for the abdominal muscles keeping the trunk off the floor. Simply support your body off the floor, so just your hands and your non-treatment foot are touching the surface, while your treatment thigh is over the foam roll placed horizontally. This allows you to roll your body forward and backward over the foam roll, creating the pressure needed to produce the myofascial mobilization or release. Find the sore/tight areas as you roll, and as one area melts away and no longer feels as tight or taut, find a new area to roll above or below. You can also roll your leg inward or outward to find more treatment areas on the inner and outer hamstring.
Gastroc/soleus Foam Rolling
Foam rolling the gastroc is very similar to the hamstring, except the foam roll is placed immediately below the knee in the calf region. Don’t forget to check the inner and outer calf regions, as you will be sure to find soft tissue restrictions here as well.
Iliotibial (IT) Band Foam Rolling
Finally, the IT band is easily (although generally not painlessly) rolled if you lay on the outer thigh and roll back and forth (see the picture below). Note that the IT band is not really a muscle, but more of a fibrous band that is more similar to tendon than more extensible muscle fibers. This translates to a little more work on the upper body to reduce the force of the foam rolling to keep it tolerable, yet still effective over the IT band. Keep in mind that the IT band runs from the lateral hip down to and just below the lateral knee. Feel free to work the entire length, but be very light over the lateral knee attachments, as sensitivity here is naturally high as it is simply a tapering tendon attaching to very superficial bone.
Finally, feel free to foam roll the posterior hip muscles (glut med, glut max, piriformis) by sitting on the foam roller and rolling small distances forward and back. Also, the low back can be “rolled out” by lying over the foam roller, with the roll placed perpendicular to the back. Be careful in this area as well, as people with some mid and low back pain and tension tend to feel this treatment is quite severe, so tread lightly!
Foam rolling is a great self-help technique for any athlete to keep your muscle tension in check as your body adapts to the rigors of your training routine. The benefits are many, and drawbacks are minimal, as even the price of a basic foam roll is right on budget, available at MotionWorks Physical Therapy for $20, and on-line (price varies). If you have a few tight areas that are located in parts of the body that are otherwise unreachable, consider adding this device to your weekly routine as both an injury prevention and treatment technique sure to keep your muscles healthy, strong, and supple no matter what challenge comes your way!