Brotastic.
Foam rolling is one of those polarizing topics. To some it’s another coming of Christ; others swear it doesn’t do anything. Hell, some say it’s detrimental.
These argumenters will go into all the physiology, what happens during massage, what scar tissue is, etc. and try to make an argument from that angle.
This has confused me for quite a while.
I’m going to make much different, much more practical arguments. Perhaps you’ll share my confusion after the following.
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The true purpose of foam rolling
Again, I’m not going into the physiology of massage. The purpose of foam rolling is much more simple: To help us get out of musculoskeletal pain.
Done.
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And why do we get in pain?
Primarily because of how we move. Move one way = pain; move another way = less / no pain. There are plenty examples on the site making this argument. Browse around if needed.
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In order for foam rolling to help alleviate pain then it has to
Change how we move.
Foam rolling can’t, by itself, change how we move. Only the brain can do that.
This is where a quote from Thomas Myers (Anatomy Trains) is poignant. It goes something like,
“You can manipulate the tissue all you want. You can loosen it, make it more relaxed, whatever, but you still have to train it.”
Leading to another quote from him,
“Now you can only train the tissue and not manually manipulate it, but it’s a hell of a lot harder.”
Meaning harder to get the tissue to do what you want.
The contention being you don’t need manual therapy to get someone out of pain, but you DO need to change how they move. However, manual therapy may help make training the tissue easier.
It’s important to make sure we’re on the same page terminology wise. From here on out we’re going to consider manual therapy = An actual massage therapist using their fingers, and foam rolling as rolling around on a giant piece of foam. With the idea foam rolling is trying to replicate a manual therapist.
Before getting into specific issues during rolling I’m going to cover some general ones.
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It fucking hurts
Let’s be honest, the act of foam rolling feels awful.
The most obvious issue here is we’re trying to get people out of pain and the act of foam rolling puts them in pain. You’ll often see people masochistically rolling something like their IT band with gruesome facial expressions. “Knee hurts? Let me destroy my IT band! Eat this shit IT band! Screw the foam! Where is my PVC pipe?!?! ROAR!!!”
This is a big reason runners carry foam rollers around like it’s their favorite dildo bible. They love self-inflicted pain (hence all the running to nowhere). From a running website:
What a bad ass.
You even have those who have no problem bruising themselves or their patients. “But that’s because we’re breaking down tissue so new healthy tissue can form blah blah blah.”
Congratulations. While you MAY get a person’s knee to feel better (temporarily) by doing this to them,
they now have an entire thigh feeling like it was substituted for a pinata, beaten by 50 kids with various bats, all during their afternoon sugar high. Meaning the client is still in pain. And the reason their knee may feel better is probably because the bruising pain is greater than the knee pain.
When someone lifts weights, plays sports, or whatever, and they have a traumatic event and a couple days later there’s bruising in that area. Do you:
- Think “Ah crap, they strained / tore / injured something, hence the bleeding.”
- Think “Awesome. That’s just part of getting that tissue to do what we want. No pain no gain son!”
Let’s hope it’s 1. Oh, and what happens when an area is traumatized to the point it bleeds? Like a tear or bruise? The area often attains scar / fibrotic tissue! It doesn’t get rid of it. It gets MORE of it.
From Muscle injuries: Biology and treatment (bolding mine):
The healing of an injured skeletal muscle follows a fairly constant pattern irrespective of the underlying cause (contusion, strain, or laceration). Three phases have been identified in this process:
1. destruction phase, characterized by the rupture and ensuing necrosis of the myofibers, the formation of a hematoma [like a bruise] between the ruptured muscle stumps, and the inflammatory cell reaction;
2. repair phase, consisting of the phagocytosis of the necrotized tissue, the regeneration of the myofibers, and the concomitant production of a connective tissue scar, as well as the capillary ingrowth into the injured area; and
3. remodeling phase, a period during which the maturation of the regenerated myofibers, the contraction and reorganization of the scar tissue, and the recovery of the functional capacity of the muscle occur.
By trying to get rid of scar tissue through bruising people you are -quite literally- giving people scar tissue.
Stop this nonsense. You are hurting people and physically traumatizing them. It rivals the intelligence of my penile head.
Next argument the defenders are thinking: Yes, I realize people report feeling better after rolling; I’m talking about in the act, and I’m just getting started with those issues.
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Foam rolling is an exercise itself
Your average personal training or physical therapy client: Maybe 40 years old, a good deal overweight, hasn’t worked out in years, history of low back and knee problems, etc.
You realize you’re basically asking this person to perform various plank variations for minutes on end, right?
Planks with crappy form.
Awesome way to piss your lower back off.
Or how about asking people to support a great deal of their bodyweight with just their arms?
I come from a very heavy athletic background. Once I got into the real world it took me about a week to realize your average client -who is not a 16 year old athlete- absolutely, positively, hates foam rolling. It’s exhausting for them. 10 minutes, or however long you have people foam roll, is not a workout’s warm-up for a new client, it is THE workout. A workout where they are in pain, constantly. And for the client -a client who likely has various painful joints, who is nervous about getting really sore because they haven’t worked out in forever- your introduction is to immediately put them in pain. Think about it.
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Direction matters
I wrote about this extensively in a post called Muscles and Onion Bags. The takeaway is you can’t just manipulate a tissue in any direction. If a muscle is short, you need to manipulate (roll) it in a specific direction in order to lengthen it. Manipulate it in the wrong direction and you may actually be tightening an already tight muscle.
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Are you sure you’re even tight?
There’s a difference between a muscle being short and it being stiff. Without complicating this much, if someone else moves you (passive movement) and you have trouble getting the range of motion, that area is short.
Passive knee flexion.
Move something with your own muscles (active movement) and have issues? You’re stiff.
Active knee flexion.
(Yes, you can be both.)
Stiffness matters much more than shortness as stiffness will be evident when we move autonomously, which is what’s most important. That is, lengthening a short muscle does not guarantee better movement. Work on stiffness and you’re much more on your way.
In other words, people use foam rolling to “lengthen” things when often being “short” isn’t the issue.
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“Yeah, but”
I know, the defenders are thinking, “Ok, but I can correct all that. I can not roll as hard so I lessen the pain, I can pick positions that aren’t as strenuous for people and slowly build them up, I can go in the proper direction, I can make sure I only go after truly short muscles, etc.”
Fair enough. You’re trying to turn shit into crap, but ok. However, there’s something you pretty much can’t change.
First, we need to quickly go over
Common pain problems
Let’s cover some of the most common joints people have issues at:
- Lower back
- Knees
- Shoulders
- Hips
Within that, let’s cover (briefly) what movement issues are typical at each of these joints (what causes pain).
Lower back
Too much arching and twisting. A case can easily be made the lower back just overall moves too much.
Knees
The femur turns in; the lower leg turns out. Essentially, the knee caves in too often.
And or the knees hyperextend:
Shoulders
The shoulders are downwardly rotated and or hang too low:
And or the humerus glides too far forward:
Right picture is bad, left is better. From: http://www.manualtherapymentor.com
Or too far upward:
Notice the right shoulder protruding
Hips
The femoral head glides too far forward:
Check out the lower back, knee, shoulder and hip pain categories for more on these issues.
Let’s connect this to foam rolling.
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Common foam rolling positions
Calves:
Quads:
IT band:
Adductors
Hip flexors:
Glutes
Lats:
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Specific joint issues with foam rolling
The easiest way to understand why foam rolling presents issues is this: I constantly hear people mention how important movement is. Well…Why does no one care how we move when foam rolling?
Lower back issues are caused by the lower back rotating, arching, just moving too much. Why does no one care how foam rolling does this,
this,
this,
and this,
all to the lower back???
Since writing this piece on lateral pelvic tilts, I’ve gotten a good amount of emails regarding the topic.
One thing people will reference is foam rolling the IT band to help their lateral pelvic tilt. Uhh, look familiar?
The act of foam rolling causes a person to do exactly what they already do too much of. Foam rolling is literally making a person twist, arch, flex, overall move their lower back. Training wise, this is exactly what we’re trying to get them to STOP doing.
How about the knees?
Knee pain is caused by the knees turning inward / adducting / hyperextending too much, as well as the lower leg turning out too much.
Getting pushed into hyperextension:
Pushing into adduction / internal rotation:
Shoulder pain can be caused by the humerus gliding too far forward or upward. A very common reason for this is someone’s propensity to lean on their elbows and or wrists.
And what are we doing during a ton of foam rolling positions?
The shoulders are getting pushed upwards, which is exactly why someone like the following has shoulder pain:
Or notice how the elbows are constantly behind the shoulders, meaning the humerus is getting pushed into extension, causing the humeral head to travel forward, which is often a reason for pain:
A more subtle variant is downward rotation of the scapulae, which is the most common shoulder issue.
A common occurrence in this issue is the scapula won’t fully upwardly rotate. As the arm approaches full range of motion, the scapula will often suddenly adduct due to the pull of the rhomboids.
Watch the left shoulder / rhomboid area:
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So, when foam rolling the lats you’re not helping this issue because even though the arm is up, the act of gravity on the foam roller is pushing the scapula into adduction,
which is the very same issue we’re trying to avoid. The foam roller essentially blocks full upward rotation from occurring, and in many shoulder issues, this is already happening without the aid of a foam roller.
Look how retracted (adducted) the left scapula is here:
The last thing a guy like that needs is anything which pushes the scapula into retraction. Right shoulder below:
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Finally, the hips. Primary cause of pain is anterior glide of the femur. The head of the femur is consistently going too far forward. One common reason for this is sitting down. The head of the femur can get pushed forward due to the opposing force of gravity in a chair,
Which looks eerily similar to,
The roller is actually pushing the femoral head forward, just like in sitting, and just like in those who often present hip pain.
Also, in anterior glide the anterior hip capsule -which is under the hip flexors- is too lax / loose. Foam rolling proponents state one should foam roll to help loosen up. So, when rolling the hip flexors you are potentially rolling the anterior hip capsule,
and if you’re potentially making an already too lax capsule more lax, you’re spinning your wheels treatment wise.
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Closing thoughts
The defenders
For the group who still wants to debate, the group I know is going “I don’t care what he says, foam rolling worked for me,” my last comment for you is:
So you had X condition and now X condition is gone. Presumably because you started foam rolling. Can you say it was because of the foam rolling? If you also added Y exercise, Z stretch, and Q modification, you can’t attribute anything directly to foam rolling.
You say you have a movement approach…
I recently watched an interview with Shirley Sahrmann. Throughout the years I’ve heard her state physical therapy needs to undergo a paradigm shift. One aspect of this shift needs to be changing towards a movement approach. You know, instead of the pull on some bands, ice and stim some shit, pop some ibuprofen, call it a day approach.
In the interview she was asked how well we’ve done making this transition. She laughs and responds, “Not very, not very.”
Also stating,
“Even though I see people nod accordingly [that they understand the approach], I don’t think they understand.”
I think foam rolling is a perfect example of what she’s saying. Sahrmann herself is not a big manual therapy person, for some of the reasons I outlined above. (You need to consider what else is going on besides what you’re rubbing.) However, I’ve heard multiple people who claim to be of the “movement” approach, people I’ve literally seen say “You get what you train” (a phrase coined by Sahrmann), who completely ignore the movement going on when doing something such as foam rolling. Some of these are practitioners where foam rolling constitutes maybe 10 minutes out of 60 minute session. You wouldn’t let someone put their lower back in a bad position during a single rep of a deadlift, then why are you willing to let them do it during 10 minutes worth of foam rolling?
Or you don’t want your client leaning on their elbows at their work desk, but you’re cool with them doing it during all that rolling?
Piggy backing on Sahrmann once more: Think of the pain issues I went over. Things like humeral superior glide, femoral anterior glide, rotational issues at the lower back, excessive rotation at the knee; what do all these things have in common? The site of pain is where something is moving too much. The idea of foam rolling is to get something to move more. (You don’t hear someone go “I’m foam rolling so I can stiffen up.”)
Consider what’s going on besides the single area you’re humping. Foam rolling is making joints which already move too much, move even more.
“You get what you train”
…even when you’re foam rolling.
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Katrina Brubaker
May 21, 2013
Interesting. I do have one, but could not figure out how it was helping (I am ashamed
to admit that lied in a group of friends that “oh yeah, it is good”). I stopped using it awhile ago. Now my kids play with it as a large log in the road when they are riding bikes or to help hold up a blanket for a fort.
reddyb
May 21, 2013
If it helps make a fort, it’s 15 dollars well spent :).
Trevor
May 24, 2013
Looks like Ben Greenfield is giving you some publicity with this foam roller article…some of this fans agree with you, and some don’t. I don’t know how to link facebook posts, but its a couple articles down on his fan page:
https://www.facebook.com/BGFitness
reddyb
May 24, 2013
Hey Trevor,
I noticed quite a spike in traffic from facebook the last few days and wasn’t sure where it was coming from. Thanks for letting me know.
Abhinav
July 31, 2013
Interesting article. I have been pro-foam rolling always. When I first did it, it hurt my lower back, IT band. And then it stopped hurting. That was the same time I started doing deadlifts. Maybe the deadlifts and the hyperextensions strengthened my back. But isn’t foam rolling supposed to provide myofascial release? I always thought it was good, but this is a very interesting perspective.
reddyb
July 31, 2013
Hey Abhinav,
I haven’t really dug into this, but this jives well with my thoughts on why people may feel better after foam rolling: http://www.bettermovement.org/2013/how-does-foam-rolling-work/
L
November 25, 2013
why didn’t you name this post “Issues with foam rolling with bad form”?
using foam rollers obviously has its benefits, if this is your argument do you dislike all self myofacial release techniques?
using it for static/active releasing will reduce stiffness, increase mobility and tissue quality like manual therapy will
obviously it doesn’t work as well but I think the general population should foam more, they just need to be taught how
Some T-spine smash on a foam with scapulas protracted will do wonders for most gym junkies or desk-stuck workaholics with downward rotation syndrome and not to mention increasing thoracic extension in a matter of seconds in my experience so I don’t get why the hate
People lift in the gym every day with bad form, that doesn’t mean people shouldn’t lift or that lifting is stupid, people are stupid…
reddyb
November 26, 2013
Hey L,
I’m glad you brought this up. Whenever I’ve seen this post linked somewhere inevitably this criticism comes up: “Well, he just used a bunch of examples of people foam rolling with bad form.”
I thought this was addressed in the post, but maybe I didn’t get it across.
The point was…
-How are you going to roll and not excessively move your back? (If you try to do a bunch of rolling, quads, IT band, whatever, and not roll your back, are you foam rolling or are you doing plank variations?)
-How are you going to roll and not put unnecessary stress on your shoulders? Stress which is in the wrong direction.
-How are you going to roll under your arm pits (lats) and not promote downward rotation?
-How are you going to roll the hips and not irritate the anterior hip capsule?
-How are you going to roll the glutes and not promote anterior glide of the femur?
I’ve never seen anyone address foam rolling technique in this fashion. Anything addressing “foam rolling form” I’ve seen deals with how to get into the muscle more, how to go after certain muscles, etc. Nothing deals with “Here’s how your shoulders should be positioned when rolling your hamstrings so you don’t beat up your shoulder joints.”
The argument that I’m using examples of people with bad form is nonsensical. When rolling their IT band people are told to lay on their side and move up and down on the roller. When rolling their calves people are told to go on the ground, put their calf on the roller, and move up and down on it. That’s what I represented in the article. People are not told to avoid superior migration of the humeral head, they are not told to keep their lower back stationary, none of this is addressed. (Again, how are you going to roll in this position and NOT have this happen? You can’t make jamming your shoulder into your neck shoulder friendly.)
This is an article by NASM, where many get certified and get into all this stuff, with the guy showing the exact issues of random people I pulled and put into my post: http://blog.nasm.org/training-benefits/foam-rolling-applying-the-technique-of-self-myofascial-release/
This contradicts your point of making rolling analogous to lifting. There are copious amounts of resources detailing proper lifting form i.e. squat this way if you have shoulder pain, avoid this exercise if you have shoulder pain. There are not copious -if any- resources detailing the same things with foam rolling. You’re stating it’s not rolling but the way it’s done. I’m stating no, it is rolling.
Which brings me back to my overarching point. Even if the above was addressed, many of the common rolling positions can’t be done with good form. You can’t foam roll your hamstrings and not put a great deal of stress on the shoulder(s). You’re not going to roll your adductors and not promote movement at the lower back.
Please keep in mind I’m not encompassing every permutation of rolling possible. Perhaps someone could get really creative, but we’re talking how 99.9% of people use these things. And no, 99.9% of people are not told to squat with their knees caving in, if you want to use the lifting analogy again.
Many of your other points are addressed in the post, there’s quite a bit of literature out there refuting the common claims of self-myofascial release, there’s a good link right above your comment, and I address other issues with manual therapy in this post: http://b-reddy.org/2013/10/08/a-day-with-tom-myers-of-anatomy-trains/
A short answer to your other questions is your suggestion of “smashing” the T-Spine is in line with what is greatly wrong with this approach.
Jason Lin
December 25, 2013
How do you feel about foam rolling for recovery from sports or working out?
reddyb
December 27, 2013
Not something I’d recommend. Going with what I outlined in this post, you’re putting the joints in a vulnerable position and embracing poor movement patterns. If you’re doing this at the end of a workout where the person is fatigued, these issues get amplified.
It’s been a long time since I really looked at the recovery aspect of a workout, but I’d bet those 20 minutes of recovery work are still much better spent elsewhere. Like taking a nap, which is the best and most important recovery tool humans have (sleep).
kyle
December 27, 2013
“In other words, people use foam rolling to “lengthen” things when often being “short” isn’t the issue.”
I believe most people do foaming to reduce stiffness, not lengthen muscles
what are your thoughts on other self myofacial release techniques like using lacrosse balls and other trigger point equipment?
reddyb
December 28, 2013
Considering your average person who foam rolls doesn’t know the difference between stiffness and shortness, I disagree.
If I renamed this post, “Issues with lacrosse balls and other trigger point equipment” everything would still apply.
kyle
December 29, 2013
how on earth would you then go about reducing stiffness if you are against MFR in general?
Sometimes you are going to have to address some tissue directly to increase its quality and at the same time quality of movements, manual therapy is obviously the best choice but lets be realistic you cant go to the physio every day
reddyb
December 30, 2013
I think you’re confusing what stiffness is. Stiffness is not a “knot” or whatever MFR term you want to use. Stiffness is what happens during movement. To improve stiffness then, you have to address movement. You don’t need to see a physio everyday, you merely need to focus on how you move everyday.
With MFR, people are not focusing on the moving aspect. Instead, they’re trying to get rid of a knot, or loosen up a particular area, in the hopes this affects how they move. While doing this though, they are unintentionally moving in a crappy manner. You don’t get quality movement by working yourself through crappy and painful movement.
Using the foam rolling examples above, people are making their stiffness worse. If the pelvis moves into posterior tilt when trying to stretch the hamstrings, the hamstrings are stiff. When foam rolling the hamstrings, the pelvis always moves into posterior tilt (see pictures above). Therefore, you are not improving the stiffness of the hamstrings when foam rolling.
Addressing stiffness deals with addressing how things move in relation to something else. E.g. How the knee moves relative to how the pelvis moves. Philosophically, MFR does not address this. You don’t see anyone worrying about their pelvic position when foam rolling their hamstrings. Physiologically, MFR does address movement. But in a negative way. You have to move when you foam roll, but you have to move in a poor manner.
Aileen
January 5, 2014
You will be thinking I am stalking you!! Your article is hilarious and exactly what I have been up to with my foam roller and a rolling pin (suggested by a physio because it doesn’t “‘give'” as much as a foam roller therefore is twice as painful) for months and months. I rolled every day after which I would experience a little bit relief, which I now know was only relative to the pain I was inflicting on my poor leg from my hip to my ankle, After reading your articles, I put the rolling pin back in the kitchen cupboard, still trying to think of somewhere to stick the foam roller, and stopped this self flagellation and stopped stretching my hip flexors. Today and the past two weeks I have no pain, I am on the first week of your programme to release TFL by strengthening psoas and things are looking good……now if I can just think of another use for the foam roller!
reddyb
January 6, 2014
Welcome to the sane side!
TyWall (@TyWall)
March 24, 2014
Awesome article. I’ve been into foam rolling the past few years, but lately have been cutting it down more and more. There was a period of time where I thought mobilitywod was a cure-all. I’m going to cut out all my supine rolling for a while and see how it goes…What are your thoughts on using a stick on yourself or having someone else use it on you (assuming proper body positions can be achieved). Also, would you recommend using a lax ball against a wall for the pecs/shoulders/mid-upper back? I’m figuring gravity won’t be working against you in that position.
Also, your article on getting the arms overhead is awesome!
reddyb
March 29, 2014
Hey Ty,
I don’t think the stick is achieving much, but I could see a couple positions where one might get something out of it. You’d want to be sure the lower back isn’t moving significantly through flexion. I had teammates in college who were obsessed with the stick. They’d use it while sitting down, and you basically end up doing a ton of sit ups to roll the legs out. Not always the best idea for the lower back. If you could keep the back stationary, I”m thinking laying on your back, and then roll, you could perhaps make it work.
In terms of someone else, I’ve never thought about someone using the stick on another person, but I suppose that could be similar to someone else’s hands, which can do some good -such as certain massage therapies. Someone else’s fingers are always better than another object though. There is something to be said for human touch.
Really, when it comes to manual therapy, the only thing I see clearly beneficial is a good old fashioned massage. Primarily because 1) People say it makes them feel better (there’s always weight in that) 2) The general relaxing nature of it. Most of these self-myofascial techniques are not relaxing. Because of these things (along with this article, etc.), I don’t have any of my clients bother with the stick, foam rolling, lacrosse balls, none of it. If they want to get a basic massage on their own, sure. As long as their massage therapist isn’t sadistic with how much pressure they’re using.
Ed
April 15, 2014
I feel like the non believers are thinking you dont believe in myofascial release of the muscles. Just to be clear though, is this what you are trying to say in this article;
1. The risks of these MFR techniques (foam roller etc) out weight the benefits?
2. And if so, what form of MFR if any, would you recommend other than a good massage?
reddyb
April 17, 2014
1) Other than extremely nuanced positions, maybe a tennis ball on the feet or something, I think you’d be hard pressed to say foam rolling, or any self MFR (foam rolling, tennis ball), has any benefits. Other than those who think it has benefits. And the reason those people find it beneficial is because they think it’s beneficial. “I don’t care what anyone says, or any research says, I know foam rolling is helpful to me.” Can’t argue with that.
2) Nothing really.
Somewhat tangential to this: As soon as you start saying someone should get a particular type of therapy where they can only do it with the help of someone else, you immediately open the possibility that person will feel they cannot manage their symptoms without help from someone else. I’ve seen some people who I think are trying the right approach with this. People who will go, “We are going to do some manual therapy just to jump start the process.” But, even if you say that, as soon as you merely recommend it, or as soon as you put your hands on someone, the same thing can, and often does happen in that person’s mind. That is, the person starts to think they NEED someone else’s hands. This is why I don’t do any type of manual therapy for my clients anymore. I never want them to feel like -in the long term- that they need me.
(The same thing goes for any piece of equipment. Foam rollers are a poignant example, but this goes for any equipment. I never want someone to feel they need something besides their own self.)
It’s disempowering. You’re telling the person that, for the rest of their life, whenever they have an issue, they need someone else’s hands to help their issue. That whenever their knee starts to bother them, they need to go see someone. This is how chiropractors make a living. Where people think without a chiropractor they can’t manage their symptoms. “I need to be adjusted” which means “I need someone else to help me every time my back doesn’t feel well.” Opposed to, “I need to change how I move, which I can do by myself through the things I’ve been taught.”
Of course, as is often true in any type of healthcare, the approach that’s best for the patient is not what’s best for business.
Taylor a
August 25, 2014
This guys a fucking retard. Foam rolling fixed my knee like nothing else could. Dude should be embarrassed about his blogging and idea of scientific research. Is this supposed to be satire?
reddyb
August 25, 2014
Hey Taylor,
I had no idea foam rolling worked for you. That’s revelatory. Thank you so much for informing me of this phenomenon. Your experience, I mean, it’s certainly shifted my views on things. It’s like knowing the Higgs Boson exists! It even changes the paragraph where I wrote,
I guess I’ll have to also change the paragraph in the beginning of the post, where I conceded manual therapy can be helpful. The one where I quoted Tom Myers…a manual therapist.
Ah, you know what, I should also change where I said I wasn’t going to make a scientific / physiological argument. Because you’re correct. The fact foam rolling worked for you means it doesn’t hurt.
Thank you again. I’m forever indebted.
—-
If you want to have an actual conversation about things, I’m happy to. If you think I’m a moron, that’s alright. But, please have your comments be reminiscent of how you talk to people in person. My assumption is you don’t go around to random people and say to their face they’re fucking retarded. Or you hate their work. (And if that is how you go about your life, please leave this site.) I have no issues with disagreement, but if you have a follow up comment where your argument is essentially a youtube comment of “this person’s an idiot,” then I’m just going to delete it.
nrelax11
March 11, 2015
I think that if one “foam rolls” with all kinetic check points in alignment, then things should be fine. When I put foam rolls in quote, I do so because the point of a foam roll isnt to roll back and forth. Its to help relieve tender spots on tonic muscles. So you roll very slowly over a mucle with good posture and find a tender spot and hold it untill a release. Otherwise, if you just roll back and forth, your more than likely going to activate pain receptors.
Two photos I wanted to comment on. The IT band foam role isnt possible. You can goam roll the tfl to help take tension off the IT band or you can foam roll the vastus lateralis which is what most people feel when they roll over the IT band. The other photo was the Lat foam roll. That photo is mostly showing foam rolling of the teres major. To reall actually get the lat, youd have to roll on your mid back and focus a little towards the outside. This can be done with good form and not reinforcing any compensations.
reddyb
March 16, 2015
Hey nrelax,
-I already addressed your first point in this comment reply: http://b-reddy.org/2013/05/20/issues-with-foam-rolling/#comment-2673
-Holding a position on a tender spot is painful. How else would you know it’s tender? Whether you roll up and down on the tender spot or sit on the tender spot, it’s still tender…it’s still causing pain.
-Not sure how you’re making this distinction between latissimus dorsi and teres major. However you’re getting there, I disagree.
nrelax11
June 25, 2015
I couldn’t comment on your last reply, but you were talking about distinguishing between releasing the teres major and lats. I like this video on the topic https://youtu.be/P2cB_3MB0uo
And when I talk about pain during foam rolling, im talking about excessively foam rolling back and forth over a tender spot. People tend to roll back and forth pretty hard over a spot which will likely cause your muscle to tone up even more and try and muscle guard. Stopping on the trigger point and taking some deep breaths will calm down that area and cause a release. The exact reason why it works isnt even fully understood, but people just know it helps
reddyb
June 30, 2015
-I don’t think that rationale of differentiating holds up very well. You could use the same rationale to say the opposite: The lat is like 10x the size of the teres major. If there is a “tension issue” going on, it’s probably the muscle which can generate way, way more tension. (The fact of the matter is both muscles are still being pressurized.)
-If we’re going to get technical with the anatomy here, the teres major and lats both internally rotate the humerus. In order to fully stretch them, or “release” them, we’d want to laterally rotate the humerus (amongst other things). The video you linked has the arm in internal rotation in the first positioning. The muscles are not being fully stretched. (Yes, you could change this aspect.)
-> This still ignores my main point from this article: The position the scapula gets put in, in this position of the arm hung upwards under the body, but on top of the roller. I can’t wrap my head around why one would want to put a scapula into adduction and downward rotation, when it’s supposed to be abducting and upwardly rotating, and when issues with upward rotation are the most common cause of shoulder pain.
-Nor are the lats fully stretched in the thoracic extension rolling maneuver. The lats horizontally abduct the humerii. To fully stretch them you want some horizontal adduction. The lats also extend the lumbar spine. The lumbar spine is extended in the second positioning, and horizontally abducted.
-When someone is gasping for air due to the pain they’re in, it’s tough to be relaxed. Stomach breathing is a good sign someone is relaxed. Notice how much that woman’s stomach does not move. She is chest breathing quite a bit. I understand where you’re coming from, but I do not think someone can make a rational argument here that to get out of pain, one should be put in it. Trigger points are not mild discomfort in the way most go after them. Their name implies significant pain.
There are other issues here which I’ve hit on in other comments. Again, notice the shape the demonstrator is in. The fact she has a body and shoulders which allow her to get on the ground, to place her arms overhead, to roll around, etc. This rules out a huge amount of people with shoulder problems. Why are we bothering with modalities the majority of people can’t even do?
Dave
June 17, 2015
i think your limited knowledge on this subject is misleading people. Foam rolling is an extremely effective self management technique for the appropriate body type. Your distinction between ‘stiffness’ and ‘tightness’ has no basic in physiology. Many people have connective tissue that has a greater proportion of collagen to elastin, whom have connective tissue restriction. These people benefit most from foam rolling. Obviously, as an isolated intervention, foam rolling does not address the postural imbalance that is causing pain or dysfunction. It must be combined with a detailed assessment and targeted strengthening exercises.
I agree that myofascial release techniques are not just ineffective, but detrimental for the incorrect body type. Do you disagree with research that shows ITB rolling, combined with massage, is effective in managing ITB symptoms?
reddyb
June 19, 2015
Hey Dave,
-Not sure what you mean by “the appropriate body type.” I’ve never seen foam rolling articles, or sales pages, declaring it should be used only for particular body types. Feel free to fill me in here.
Forgive my confusion again. Are you saying people will not exhibit differences between passive and active ROM? We’ll have to (strongly) disagree there if so.
If you’re saying there are different definitions of shortness vs stiffness, then that’s true. If you’re saying you disagree with mine, then alright. Not going to argue with you there. I did say at the beginning of that section, “Without complicating this much,” aka I’m not go into this much.
All I was trying to illustrate is for the area being rolled, foam rolling is a passive modality. You’re not actively working on how that section moves. (And, more often than not, some area of the body is passively, or actively (e.g. shoulders when rolling legs), being put in a less than ideal position.) That in order to change how someone moves, you need active modality intervention.
I’m also curious to know how you’re able to differentiate those who have greater proportion of collagen to elastin. This is something you assess when watching people move? I’ve never heard of this, and would be intrigued to know.
Not trying to be rude, but this makes me think you didn’t read this entire page before commenting. I said multiple times I have no doubt people find benefits from foam rolling. I briefly gave some of my own rationale, and linked an article with a similar, but more detailed rationale.
It seems you picked one, maybe two, sentences out of this post, addressing topics I point blank said in the article I didn’t want to complicate much for this post (shortness vs stiffness), or wasn’t trying to address (physiology of massage or rolling).
What’s not being addressed is:
1) That the research going over massage as a recovery modality is problematic, for those in favor of massage, of which foam rolling is considered a variation: http://b-reddy.org/2015/02/02/recovery-modalities-whats-worthwhile-along-with-some-massage-discussion/
2) That the trigger point theory is problematic http://www.bodyinmind.org/trigger-point-evaluation/
This matters because people are told to find “trigger points” when rolling, and stay there, or work that area.
3) That you can’t manipulate fascia with a roller, as is commonly suggested (like lengthening): https://www.anatomytrains.com/news/2015/04/27/foam-rolling-and-self-myofascial-release/
Since you think little of my knowledge, maybe you’ll think higher of Tom Myers (quoted above). While I don’t always agree with him, I’m not sure how many people out there, in the world, have more knowledge on fascia. (We can ignore the fact I’ve talked to him, in person, about the topic.)
4) Foam rolling, and the way most people do it, hurts. People are often told to “find the painful spots, and work them out.”
5) The positions people need to get in, in order to roll, are not ideal. That the everyday person, 20lbs overweight or more, hasn’t worked out in a decade or more, is exhausted after a few minutes of foam rolling. If an overweight person is not the appropriate body type, or if a person who hasn’t exercised much is not the appropriate type, or the typical person with lower back pain is not the appropriate type, then, by definition, we’re saying the majority of the population should not foam roll.
6) That these modalities *need* to be used in conjunction with other modalities in order to possibly see a (quite transient) benefit. You know what doesn’t need this? Exercise. That using modalities which aren’t necessary, especially those which require hardware, is a waste in every sense of the word.
7) That the title of this article was not, “Foam rolling doesn’t work, ever” even if people want to make it out that way. It was “Issues with foam rolling.” I’m still waiting for someone to list a bunch of ways foam rolling the quadriceps can be less strenuous on an average 40+ year old woman who has had knee pain for two decades (and lower back pain for three). Because the last [I lost count of how many] women of that nature I trained, they had enough trouble getting up and down out of a chair. Many of them can’t kneel without significant padding for their knees. That I literally have to hold their hand to help them get up off the ground.
Sorry if this comes across harsh, but the defense of “foam rolling worked for me,” or “foam rolling does work for some people,” I don’t appreciate. Because I get at least one client inquiry a week, where the person answers my questionnaire:
“What seems to make you worse?” “Foam rolling.”
“What’s painful?” “Foam rolling.”
“What seems to make you feel better?” “Things improved after I stopped foam rolling.”
nrelax11
June 25, 2015
I think the term myofascial is a bad term that got stuck with foam rolling. I think its just a term that people can remember and somewhat understand. You cannot stretch fascia through foam rolling like you stated for the IT band. There are techniques though that do help unbind some spots of the vastus lateralis from the IT band by using two foam rollers making a T type symbol out of them and getting some friction that way and stretching out the skin. Its a small movement but gets some result. The thing with the IT band is thats its usially either a tight tfl and VL, or just a pelvic alignment issue. Once the alignment issue is fixed, peoples IT problems sometimes magiacally correct themselves. Agree?
reddyb
June 30, 2015
*Only* improving alignment is insufficient for most. You can have perfect alignment, but there’s no telling what happens once the person moves. Alignment can be a window into how someone likely moves, but it’s no guarantee.
Only improving alignment is more for things like say, someone is having issues sitting. Just changing someone’s standing alignment is unlikely to do a whole lot, unless the person is having issues with something where they stand statically for periods at a time. Even in that case, I don’t think just focusing on alignment, or massaging one muscle, is typically comprehensive enough. That said, some may get relief from that.
nrelax11
June 30, 2015
Responding to your response on the lat foam rolling. Im just going on anatomy and saying that foam rolling high up near the armpit is going to hit a bit more tered major. Anyways, you are correct on high model he used. I personally externally rotated and go into downward dog when stretching my lat so I get a little lumbar flexion. I tend to walk a lot in extension. Its hard to belly breath though when your bracing your core to keep your spine in neutral, so you might not see as much expansion in the belly. Proper breathing so actually go up from the belly and expand the upper ribs a little. People who have a lot of extension in the lumbar spine tend to only belly breath. They do get air to expand their ribs enough.
reddyb
July 2, 2015
Curious what you mean by externally rotate and go into downward dog. Do you have any picture or video of this?