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Rollin' Rollin' Rollin'
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The dreaded foam roller. The thing that everyone loves to hate. How is it possible that something so painful is supposed to help? MOST runners own a foam roller. However, about 90% of those owners will likely confess its permanent residence within their closet, stuffed behind things that area also probably never used. Lets get one thing straight - owning a foam roller and actually using it are NOT the same thing! 

Foam rolling has become increasingly 'popular' amongst the athletic community, particularly in activities involving running. But does it actually work, or just cause a lot of pain for no reason? Here are some common questions and answers that might help you to decide if its worth it or not...

What IS foam rolling? 

For those of you who don't know, foam rolling - or myofascial release - is performed by an individual resting their own body weight on a foam cylinder to exert both direct and sweeping pressure of the soft tissue, thereby generating friction and causing it to stretch ( Pearcey et al, 2015, Macdonald et al, 2013). This helps to warm the soft tissues and ( we believe) break-up adhesion between layers ( Macdonald et al, 2013).

Why do we foam roll?

Fascial restrictions causing tissues to become dehydrated and lose their elasticity can form as a response to injury, inflammation, disease, or even just inactivity. For example, when injury occurs, fascia has a tendency to bind to traumatized areas as a way of protecting the area. However, this causes fibrous adhesion's to form, which in turn can prevent normal muscle mechanics, create pain, and decrease soft tissue extensibility ( Macdonald et al, 2013).  

Basically, foam rolling is a method of ' self - massage' (Macdonald et al, 2013; Macdonald et al, 2014, Pearcey et al, 2015). It has been suggested that it helps to reduce fibrous adhesion between fascial layers, improve muscular imbalances, reduce muscle soreness and joint stress, increase range of motion, and enhance neuromuscular efficiency ( Macdonald et al, 2013; Macdonald et al 2014). 

Is it true that no pain equals no gain? 

Think about it this way - WHY are you sore? Is it delayed onset muscle soreness ( DOMS) or exercised induced muscle damage ( EIMD)? Is there inflammation? Are your muscles tight? Although somewhat normal, pain and stiffness can cause restrictions and inhibition, so its best not to leave it hanging around. Pain has a tendency to overstay its welcome and pain that is there too long will continually cause problems. 

Why is foam rolling painful?

There isn't a lot of research on this, but the most likely reason is because you are compressing muscles/nerves/fascia that are restricted, don't usually receive enough input ( touch and pressure), have reduced blood flow and/or may be inflamed.


THE EVIDENCE: Does foam rolling actually work?

1. Foam rolling increases range of motion and no reduction in strength. 

Macdonald et al (2013) investigated whether an acute bout of foam rolling increased range of motion and also looked at the effect it had on muscle activation and muscle force. There was some speculation in previous studies that foam rolling and massage caused a reduction in muscle force output. 

The results showed that there was an increase in knee joint range of motion after both 2 and 10 minutes of foam rolling the quadriceps muscles. The authors also found that there was no detrimental effects on neuromuscular production, meaning no changes in muscle strength. 

2. Foam rolling helps to improve DOMS, recovery time, and performance

There are several theories regarding the cause of delayed onset muscle soreness. However, most people agree that it is caused by high mechanical stress being place on the myofibrils as seen most commonly during eccentric exercise. This stress damages the muscle and connective tissue and triggers an acute inflammatory response, which leads to a loss of cellular homeostasis ( Macdonald et al 2014).

DOMS has been classified in the literature as a Type 1 muscle strain (Pearcey et al, 2015), which causes tenderness on palpation or movement and is made worse with unaccustomed exercise. It has been found that DOMS increases within the first 24 hours post exercise, peaks at 24-72 hours, and eventually subsides or disappears completely within 5-7 days ( Pearcey et al, 2015). 


3. Should you foam roll with DOMS or Exercise Induced Muscle Soreness ( EIMS)?

A recent study by Pearcey et al ( 2015) found that foam rolling was beneficial for recovery after exercise induced DOMS. In 2014, Macdonald et al investigated whether or not foam rolling could be used as a recovery tool after an acute bout of exercise. They asked subjects to perform exercises that inflicted DOMS symptoms and looked at the effects of 2x60 second foam rolling sessions. Although DOMS is often attributed to muscle damage, this study concluded that the painful symptoms with DOMS is actually due to the connective tissue damage and not muscle cell damage. The theory is that muscle enzyme efflux and myofibril damage are not actually correlated with the sensation of muscle soreness. Therefore, they concluded that foam rolling DOES improve recovery from DOMS by reducing damage in the connective tissue. 


4. How long should I foam roll for? 

This isn't as clear as some of the other research out there. The study by Macdonald et al (2013) showed that after 2 minutes of foam rolling, there was an 8% increase in knee range of motion and no reduction in force output. There was an even bigger gain of 10% within 10 minutes of foam rolling the same muscle group. 

To alleviate symptoms of DOMS including reduced dynamic performance and soreness, Pearcey et al (2015) recommended 3x20 minute bouts of foam rolling every 24 hours after activity. 

If you're wanting to loosen off some tight muscles, a few minutes every day should be sufficient. However if you are trying to ward off and alleviate DOMS you may want to put on a film to distract you! 


5. Foam rolling the Iliotibial Band 

This has recently become a controversial area to foam roll. The iliotibial band is fascia ( connective tissue), not muscle. It is actually a thickening of the fascia lata that envelopes the entire leg  (Flavey et al, 2010). The ITB has a proximal attachments which arise off the iliac crest, with a substantial portion of the gluteus maximus inserting direction into the fascia. The tensor fasciae latae (TFL) muscle also inserts directly into the ITB.  The potential for the IT band to be lengthened is physiologically limited due to its attachment along the length of the femur ( Flavey et al 2010). Previous authors who have presented values of stretch and lengthening of the IT band are likely representing the apparent lengthening of the ITB related to the TFL, as opposed to the true lengthening of the ITB. Ultrasound results have shown that the ITB changes length minimally - about 0.2% to be exact. 

There are theories that the ITB could be getting ' stuck' onto the underlying muscles of the quadriceps and hamstrings and therefore foam rolling would still have an impact on improving the movement of the tissues in this area. However, most research these days tells us that the ITB doesn't really lengthen, so why are we trying to stretch it?


The Bottom Line

Foam rolling is good for you. The amount of time you need to be spending on it will depend on what you are trying to achieve, but its likely longer than you think. Yes, its painful - but its because something is restricted and needs to be moved. Now would be a good time to go into your closet, dust it off, and put in the open where you can see it - and then actually use it! 


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