What are you trying to do with Foam Rolling?

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If you are one of the athletes, who is foam rolling "all life" out of your ITB, this if for you!!

Do you believe that foam rolling is lengthening muscles, increasing mobility, breaking up adhesions and scar tissue, does it help recovery (Muscle soreness) and athletic performance? Do you just do what you see online and on Facebook in your practice/training? Have you actually ever thought about what you are trying to do and when is the best time and how long you should roll?
So, what is the (or any science) behind foam rolling claiming to release muscle tightness or ‘trigger points’ and relaxing contracted muscles long term? What about improving muscle soreness? Or is it simply not true?
Serious, let’s look into the literature behind all of this and get you sorted with your foam rolling practice.
 
Does foam rolling really make muscles longer and increases mobility?
A research (2016 Scott W.) referring to this, has been done with rats: where they used tools to scrape over their ligaments to see if that changed the ligaments. The collagen in the ligaments remodeled over the course of weeks compared to the control group. Now the problem with this research is that the poor little rats where unconscious and the tools used where human size. So basically, we used this info, while it is not possible to reproduce that same amount of pressure ratio and therefor change the length of collagen in humans is not the case. The claim of dissolving adhesions is not possible only through foam rolling. Joint Range Of Motion seems to improve but needs further substantial research.
 
So why do you feel better when foam rolling?
Let’s explore this from a neurological perspective:
The brain is connected to muscles, ligaments and tendons, joints, skin and fascia via the nervous system with specialised receptors. When you exercise/move, you use the connection between brain and these tissues to protect and coordinate the movements.
For example: if you kick a ball, you do not want to end up with your shin on your chin!? When you extend the leg at high speed, the nervous system sends information about slowing down the movement to protect capsule, muscles and tendons around the knee and hip. We can stimulate the same “nerves and their specialised receptors” when we are foam rolling and influence a response.
So how does this work?
Look at the pictures of the two primary receptors:  called Muscle Spindles and Golgi Tendon Organs.

The muscle spindles monitor the length, and the rate of change in length of our muscles ​​constantly. They are under reflexive control and will fire to varying degrees whenever a muscle lengthens to control the motion (So stopping the shin from hitting your chin after kicking a ball). These spindles are found in the muscle belly and can be influenced in many ways through sensory stimulus, brain based drills and manual manipulation (tapping, stretching, passive ‘shaking’ and foam rolling)
So, do you get it already? Spindles when (over)-triggered facilitate a contraction reflexively within the muscle (see left picture).  If you use a foam roller on the belly of the muscle you are triggering the spindle (worse with strong painful pressure), causing a reflexive contraction. Hence: if you want the muscle to relax, you do not want to roll over the muscle belly and spindles! And certainly, not as hard as you can, causing discomfort!
 
In the second picture, you can see the Golgi Tendon Organs (GTO).
These “organs” keep an eye on the level of tension/contraction within a muscle by monitoring the tendon. Stimulation of GTO’s happens when the tension on the tendon increases (too quick or too much) and this results at a certain point in a reflex inhibition of the spindles and ‘relaxes’ the attached muscle. This is to protect the muscles and tendons to damage.
 
These 2 principles of spindle and Golgi sensor organs are important when it comes to foam rolling the right way!
Because for various reasons (bad posture, repetitive actions/work, overtraining, under training/weakness, emotions, illness of organs or injuries) muscles get tight or weak or both. We can roll to strengthen or to lengthen.
 
We can use foam rolling to strengthen a weak muscle:
ACTION: To facilitate a ‘weak’ muscle we can use the roller to apply pressure through the belly of the muscle while shortening or contracting the same muscle.
The muscle spindles are in the muscle belly and when pressured will have a reflexive response to increase facilitation to the same muscle. This can be further enhanced by actively shortening the muscle at the same time.
DOSE-RESPONS: To strengthen a muscle there is not enough (strong scientific) proof yet about the exact dose. But as a physiotherapist, I test before and after a few reps of rolling to retest the range of motion. Continue till there is no further improvement, instead of just general applying a few standard 3 times etc. (till there is more substantial strong evidence).
 
Foam rolling to lengthen a short muscle:
ACTION: To inhibit a ‘tight’ muscle we can use the roller to apply pressure towards the TENDON (origin/insertion) while lengthening the muscle or contracting its antagonist (reciprocal inhibition).
DOSE-RESPONS: again, to lengthen a muscle there is not enough (strong scientific) proof yet about the exact dose. Test, retest do individually see what works for you.
The GTO’s live in and near the junction where the muscle becomes tendon.
Again: Re-assess. Make sure you do not trigger pain, because that will cause contraction of the muscle instead of lengthening. Make sure that you are not rolling over the muscle belly.
 
The conclusion is: there is a neuromuscular response: it is a changed short term perception!
So, rolling in a painful way is definitely not a good way to relax the muscle to lengthen nor will it send a signal to the muscle it is safe to stimulate to get stronger.
 
When is the best time to roll and how long?
If foam rolling only gives short term neuromuscular responses, then the implementation advice is:
Short rolling 20 sec-1 min (3-5 reps) and then load the tissue.
Longer term: 3-5 times per week performed on a consistent basis to achieve and retain the chronic effects on flexibility.
 
When are you going to roll is depending on the goal you are after:
Lengthen? Maybe before you start your training if mobility is your main restricting factor.
Or strengthen hamstrings e.g. in a (Russian/Romanian) deadlift?
Light warming up weight, then roll and contract muscle belly hamstring.
Increase the weight and repeat.
 
If the priority is lengthening then roll over the hamstring tendons around the back of the knee and close to the sitting bones and extend the knee to activate the 4ceps.
Increase the Range of Motion and repeat.
 
While rolling in a painful matter is not a good idea, muscle soreness responds to foam rolling, some research claims (see references).
 
Overall conclusion:
Although still a little inconclusive, foam rolling can improve flexibility and strength. It suggests that it may be a worthwhile addition to your warming-up. Moreover, due to its capability of reducing the effects of DOMS following physical activity, it may also help to recover after exercising. More research is needed to better understand how foam rolling really works, but for now it can be suggested that this modality can provide a meaningful impact on training if as done as explained otherwise it is just a waste of time or even counterproductive.
I hope next time I see you foam rolling it will be with a smile on your face! ;-)
 
You can book me for a full body foam roll session with functional exercise or orthopedic assessment of what your body specific needs are to improve your performance. Call on 0415442029
 
References used to write this blog:
 
Barnes, M. F. (1997). The basic science of myofascial release. Journal of Bodywork and Movement Therapies, 1(4), 231-238. [Link]
 
Bradbury-Squires DJ, Noftall JC, Sullivan KM, et al(2014) Roller massager application to the quadriceps increases knee joint ROM and neuromuscular efficiency during a lunge. J Athl Train
 
Ebrahim, A. W., & Elghany, A. W. A. (2013). The effect of foam roller exercise and Nanoparticle in speeding of healing of sport injuries. Journal of American Science, 6, 9. [PubMed]
 
Gregory E. P., Pearcey, MSc*; David J. Bradbury-Squires, MSc*; Jon-Erik Kawamoto, MSc*; Eric J. Drinkwater, PhD*†; David G. Behm, PhD*; Duane C. Button, PhD* (2015)
Foam Rolling for Delayed-Onset Muscle Soreness and Recovery of Dynamic Performance Measures
International Journal of Kinesiology and Sports Science (3);
 
Halperin, I., Aboodarda, S. J., Button, D. C., Andersen, L. L., & Behm, D. G. (2014). Roller massager improves range of motion of plantar flexor muscles without subsequent decreases in force parameters. International journal of sports physical therapy, 9(1), 92. [PubMed]
 
Healey, K. C., Hatfield, D. L., Blanpied, P., Dorfman, L. R., & Riebe, D. (2014). The effects of myofascial release with foam rolling on performance. The Journal of Strength & Conditioning Research, 28(1), 61-68. [PubMed]
 
Janot, J., Malin, B., Cook, R., Hagenbucher, J., Draeger, A., Jordan, M., & Quinn, E. (2013). Effects of Self Myofascial Release and Static Stretching on Anaerobic Power Output. Journal of Fitness Research, 2(1). [Link]
 
MacDonald, G. Z., Penney, M. D., Mullaley, M. E., Cuconato, A. L., Drake, C. D., Behm, D. G., & Button, D. C. (2013). An acute bout of self-myofascial release increases range of motion without a subsequent decrease in muscle activation or force. The Journal of Strength & Conditioning Research, 27(3), 812-821. [PubMed]
 
Miller, J. K., & Rockey, A. M. (2006). Foam rollers show no increase in the flexibility of the hamstring muscle group. Journal of Undergraduate Research IX [Link]
 
Mohr, A.R., Long, B.C., & Goad, C.L. (2014) Effect of foam rolling and static stretching on passive hip-flexion range of motion. Journal of Sport Rehabilitation, 23(4), pp.296-299. [PubMed]
 
Okamoto T1, Masuhara M, Ikuta K.(2014) Acute effects of self-myofascial release using a foam roller on arterial function J Strength Cond Res. Jan;28(1):69-73.
 
Peacock, C.A., Krein, D.D., Silver, T.A., Sanders, G.J., von Carlowitz, K.P.A. (2014). An acute bout of self-myofascial release in the form of foam rolling improves performance testing. International Journal of Exercise Science, 7(3), pp.202-211. [Link]
 
Pearcey, G.E., Bradbury-Squires, D.J., Kawamoto, J.E., Drinkwater, E.J., Behm, D.G., and Button, D.C. (2015). Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures. Journal of Athletic Training, 50(1), pp.5-15. [PubMed]
 
Schleip, Robert; Müller, Divo Gitta (2013). "Training principles for fascial connective tissues: Scientific foundation and suggested practical applications". Journal of Bodywork and Movement Therapies. 17 (1): 103–15. doi:10.1016/j.jbmt.2012.06.007.
 
Schroeder, AN; Best, TM (2015). "Is self-myofascial release an effective preexercise and recovery strategy? A literature review". Current sports medicine reports. 14 (3): 200–8. doi:10.1249/JSR.0000000000000148. PMID 25968853.
 
Scott W. Cheatham, PT, PhD, DPT, OCS, ATC, CSCS,1 Matt Lee, PT, MPT, CSCS,2 Matt Cain, MS, CSCS, USAW-I,3and  Russell Baker, DAT, ATC4  (2016) The efficacy of instrument assisted soft tissue mobilization: a systematic review J Can Chiropr Assoc. Sep; 60(3): 200–211.