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Ready, Set, Roll

This is a post by Dr. Dustin Lee PT, DPT



It’s time to dust off that foam roller that you have been neglecting in your office, closet or whatever storage space that seems likely to host such an awkward, space-occupying cylinder. Foam rolling improves range of motion during dynamic motions as well as the ability of the muscle to contract with training 1,4. There are many sizes, shapes and types of foam rollers as well, and selection of the correct one may not be as straightforward as it seems. A foam roller can be an essential component of your training program that can assist with recovery and maintenance of tissue health. You can find a simple list of effective foam rolling techniques at the end of this blog.


STOP! You may skip this next section because it gets a little “science” heavy. If not, feel free to get your inner physical therapy nerd on!


Competitive athletes and weekend warriors can all benefit from the use of a foam roller for maintenance of tissue health and recovery. Foam rolling can also be termed as self-myofascial release. It has similar effects to a massage in that it stimulates blood flow to areas where it may be reduced, promotes mitochondrial biogenesis (aka the creation of more mitochondria...and you thought you would never need to know biology again) and reduces inflammation at sites of muscle injury after a workout 3.


So, let’s talk more about this idea of muscle injury after a workout. No, you most likely did not tear a muscle completely, but certain intensities of exercise can cause microscopic muscle fiber tears. The body will respond by sending in cells that help to clean up the area and promote muscle repair. There is a downside to this process, however; it brings pain and small amounts of swelling with it. If you are thinking, “Oh yeah, this pain is called lactic acid buildup,” then I will ask you to continue reading so we can debunk that statement completely. The pain that is associated with the 24 to 48-hour period after exercise is termed delayed onset muscle soreness, or DOMS for short. This pain is due to the inflammatory chemicals at sites of muscle injury and repair, not from lactic acid buildup. Lactic acid is only present for a short amount of time during intense exercise. It is quickly converted to lactate, a byproduct of muscle work at high intensity, and it produces a free hydrogen ion 1,3,4.


Stop here! If you are confused, that is okay; do not worry about the nitty gritty. Just know that if a hydrogen ion can cause an acidic environment near nerve endings, then that can become painful and upsetting to the nerve for a short time. Pain is an important part of this conversation because it can cause the muscle to temporarily shut down in order to allow for muscle recovery without further microscopic tears. Pain can serve as a protective mechanism to promote tissue healing. However, prolonged inflammation can cause pain and inhibit proper muscle recovery as well. This is where self-myofascial release and foam rolling come into play!


Summary of the above section that you may or may not have read:


Using a foam roller can improve blood flow to areas of microscopic damage or sustained muscle contraction (i.e. trigger points or “knots”). Blood flow allows oxygen to reach the muscle and assist with repair or release of the trigger point or knot. Using a foam roller can decrease the amount of swelling associated with the inflammatory process. Decreasing the swelling means decreasing the volume of inflammatory chemicals in the area, and this means decreased longevity of pain! Decreased pain allows for the better muscle activation necessary for exercise. Using a foam roller can improve the available range of motion of joints by lengthening the soft tissues that surround the muscles. In fact, foam rolling primarily affects the connective tissue that encases muscle fibers. When someone states you are improving the length of the muscle, you can tell them that you are actually improving the quality of the connective tissue around the muscle. Fancy, right? 1,3,4


Okay, okay, now that you have persevered through my nerdy thoughts and information about why foam rolling can be useful, we can move on to the fun stuff.


Which foam roller should you use?



As always, it depends on what you can tolerate and what your needs are. In general, a good rule of thumb is that a firmer foam roller is better than a soft foam roller. There is increased pressure isolated to a smaller area when rolling the soft tissues of the body, which helps to reduce knots and effectively address the connective tissue length properties 2. The rest of the decisions are up to you. Some questions you may still have, though, include:


- Should it have bumps, ridges or spikes? It depends. The thought behind the fancy outer layer of these foam rollers is that it can reach deeper soft tissue structures, especially in the legs. I say, if you want the fancy bumps, go for it, and it not, a simple roller surface will do just fine.


 - Should it be short or long? It depends. Shorter is better for travel purposes, but longer is useful for some mobility exercises, which will be discussed later.


- Should it have a hole in the middle of it? It depends on the company that makes it and how that technology changes the density of the material.


- What color should I get? While looks are important, companies will make different colors to indicate their firm vs. soft rollers. Typically, black is the firmest for some companies. I know, boring.


- Which brand should I use? You are on your own for this one. Your local endurance sport or general sporting goods store should carry the top brands.


What can you do with your foam roller?


I will only provide some examples here, but know that there are plenty of techniques to use with a foam roller.


- Improve ROM and length of soft tissues


       - Rolling the front, side, back, and inside of the thigh






- Rolling the lats


- Improve movement of the spine

       - Shoulder movements while lying on roller lengthwise


- Spine extension while lying on roller sideways


I hope that you enjoyed the information in this blog post and find it useful. Please feel free to email me at Dustin@precisionpt.org with any further questions about foam rolling.

Sincerely,


Dr. Dustin Lee PT, DPT


References

1. Barnes, M. F. (1997). The basic science of myofascial release: Morphologic change in connective tissue. Journal of Bodywork and Movement Therapies, 1(4), 231-238. doi:10.1016/s1360-8592(97)80051-4

2. Curran, P. F., Fiore, R. D., & Crisco, J. J. (2008). A Comparison of the Pressure Exerted on Soft Tissue by 2 Myofascial Rollers. Journal of Sport Rehabilitation, 17(4), 432-442. doi:10.1123/jsr.17.4.432

3. Farr, T., Nottle, C., Nosaka, K., & Sacco, P. (2002). The effects of therapeutic massage on delayed onset muscle soreness and muscle function following downhill walking. Journal of Science and Medicine in Sport, 5(4), 297-306. doi:10.1016/s1440-2440(02)80018-4

4. Macdonald, G. Z., Button, D. C., Drinkwater, E. J., & Behm, D. G. (2014). Foam Rolling as a Recovery Tool after an Intense Bout of Physical Activity. Medicine & Science in Sports & Exercise, 46(1), 131-142. doi:10.1249/mss.0b013e3182a123