I was converted to foam rolling about 5 years ago and I've been telling anyone that will listen how good they are. I'm amazed as I travel round the UK giving hands on coaching sessions just how many personal trainers and coaches still don't know about this simple and highly effective piece of kit. Here's the first part of a two part overview...just in case you've also been living under a rock and don't know how to get them most out of some high density foam.
Introduction
Forget about using the latest high tech gadgets and gizmo's, the answer to unravelling the knots in your client's connective tissue could lie in simple piece of foam. For less than the price of a 'hands on' massage your clients can improve flexibility, function, performance, and reduce injuries. What's more, it can all be achieved in the comfort of their own home (in fact you can take the foam roll anywhere, so if you fancy a quick roll at lunch time at work, you can!).
I'm not suggesting we throw soft tissue therapists on the scrapheap never to give a massage again. No, what I'm suggesting is that there may be a viable alternative that makes more sense to today's cash strapped client.
Light Bulbs
I remember watching Mike Boyles Foam Roll Techniques DVD back in 2005 (Mike is a strength and conditioning coach who has more than 30 years experience working with an impressive variety of professional athletes, from the US Women's Olympic teams in Soccer and Ice Hockey to the Boston Bruins, Boston Breakers and New England Revolution), and rolling around on the floor on top of a foam roll to see what all the fuss was about. It wasn't long before I felt the benefits! From that point forward my approach to strength and conditioning changed and during the past 6 years I've come to realise just how important the fascial system is and the impact it can have on training and performance.
The foam roll or 'poor mans massage' as I like to call it is a fantastic and simple tool that helps maintain tissue quality. It's changed the way I work with clients. What was once a training technique that had athletes and clients wondering what the hell I was getting them to do is now becoming increasingly popular and can even be found in some of the more 'mainstream' health clubs and gyms. Every client that I work with spends time on a foam roll, whether they are a professional footballer or regular Joe off the street.
So how can rolling around on something that resembles a pool noodle be of benefit to overall muscle function and ultimately enhance training and performance? To understand the impact of foam rolling on these areas we need to do a whistle stop tour of fascia and massage.
Fascia
The word fascia means a band or bandage in Latin (1). Until 2005 I had been blissfully unaware of a this amazing connective tissue that some argue is just as important as muscle when it comes to optimising function and performance (6). Looking back I feel pretty stupid, but I think I can be forgiven, you see at no point during my formal education had fascia ever been mentioned. I thought I knew all about the soft tissue system (ligaments, tendons and muscles) but this highly specialised connective tissue layer called fascia didn't even enter into the picture. What made it worse was that prior to the 'light bulb' moment I had also considered these soft tissues as a bunch of independent structures. So much for those anatomy lectures!
As I started to delve into the world of the fascial system I realised that the soft tissue system is inextricably linked with the neural system (nerves and CNS), and articular system (joints) and works as an integrated functional unit (6,7). The light was on and burning brightly and I was beginning to see how a small piece of foam could have a big impact on tissue quality, and more importantly, function and performance.
There are 3 types of fascia (superficial, myofascia, subserous) and maintaining the condition of fascia is just as important as looking after the other components of the musculoskeletal system, particularly when you consider that fascia connects the whole body in an 'endless web' (7).
1. Superficial - flexible connective tissue structure that attaches directly underneath the first two layers skin and covers the entire body. Its functions include fat and water storage and the provision of pathways for nerve and blood vessels. (6)
2. Myofascia - a firmer, deeper level layer of fascia (tougher and tighter) that wraps itself in and around every muscle and continues outward to attach to every tendon, ligament and bone (1). It aids muscle movements and also provides pathways for nerves and blood vessels (6). Myofascia is described by Thomas Myers as the bundled together, inseparable muscle tissue (myo-) and its accompanying web of connective tissue (fascia). (7)
3. Subserous Fascia - this layer sits between the deep fascia and the membranes lining the cavities of the body, allowing flexibility and movement of the internal organs. (6)
The fascia that we are most interested in is the fascia that directly affects and influences muscles, myofascia. When fascia is compromised (overuse, injury, etc.) restrictions may occur in all directions (remember, we are talking about an endless web that runs from the tip of your toes to the top of your head). In order to relieve these fascial restrictions, biomechanical forces can be applied (1).
Massage
Massage is one strategy that can be used to relieve fascial restriction through general massage, rolfing, mobilsation, manipulation and stretching (1). Many athletes use massage and I first started to see the importance of soft tissue therapy whilst working at the English Institute of Sport. I struggled with the concept initially because as previously highlighted there is a real lack of robust research to back up many of the claims. However, the absence of proof is not proof of absence! Despite nothing really changing in terms of research, I've accepted that massage is an important component in training and injury reduction/rehabilitation strategies.
At it's most basic, massage uses a range of techniques (effleurage, petrissage, kneading compression, stroking, frictions, tapotement and jostling) with the hands to apply pressure to the muscles and tendons (3). There are two primary benefits to massage; 1. Physical - increased blood flow, stimulation of the nervous system and reduced tightness in the muscles and 2. Psychological - controlled arousal prior to competition, increased sense of wellbeing, reduced anxiety and relaxation. (3).
Whilst massage therapy performed by a soft tissue therapist is regarded as the gold standard and is considered as the best choice whenever possible (2) it's not always realistic to have a 'hands on' massage with a well qualified soft tissue therapist. Budgetary restrictions alone can often rule out a 'hands on' massage.
This is where a 'poor mans massage' using a foam roller comes into its own. With the cost of a 30-minute massage starting at around £30 you can see why a more cost effective alternative such a foam rolling (a foam roll will set you back between £8 - £45, depending on the type) is so popular with athletes and coaches. I'm no mathematician but I reckon a one off payment of say £30 for a foam roller is going to work out much more cost effective than a weekly massage!
Foam Rolling
Mike Clarke (an American physiotherpist) is credited as being the first person to introduce the use of a foam roller in a rehab setting for what he called self myofascial release (self massage) (2). Mike Boyle calls foam rolling “soft tissue work for the masses†and what was once used primarily by athletes is now finding its way into many health clubs and private practices. Every client that I work with incorporates foam rolling into their programme and it doesn't matter if they are Joe Average on the street or a professional athlete, they all get up close and personal with a foam roller!
What is a foam roller?
How do I put this without stating the obvious! Well, a foam roller is essentially an extruded hard-celled foam cylinder (something that resembles those pool noodles that you see kids using at the pool, just a bit fatter and shorter). They come in a range of sizes and densities, from fairly soft, to new high density rollers with 'memory foam' to retain their shape (particularly useful in high use areas such as health clubs or after a big lump of a rugby player has been rolling around on it!)
The reported benefits of foam rolling our summarized:
Corrects muscle imbalances Increases joint range of motion
Reduces muscle soreness
Relieves joint stress
Decreases neuromuscular hypertonicity
Increases extensibility of muscultendinous junction
Increases neuromuscular efficiency
Maintains normal functional muscular length (3)
How, What, When are Where!
The beauty of foam rolling is that you can get after pretty much any area on the body that is causing you problems.
Spend 1-2 minutes per self myofascial release technique on each side (when applicable).
When a trigger point is found (painful area, site of sensitised nerves, increased cellular metabolism and decreased circulation) (5) either · Hold for 30-45 seconds
Work over a concentrated area for 1-2 minutes
Keep the abdominal muscles 'tight' which provides stability to the lumbo-pelvic-hip complex during rolling.
Remember to breathe slowly as this will help to reduce any tense reflexes caused by discomfort.
Complete the self myofascial release exercises up to 1-2 times per day (before or after training).
Conclusion
Whilst I am a huge fan of a good 'hands on' massage from a well-trained soft tissue therapist it is not always realistic to have a weekly or even daily massage, even if you do have the time and funds available!
Many of the clients that you work with will need regular soft tissue therapy, and it's important to find some alternative tools. The foam roller is a simple and inexpensive tool that will help your clients maintain good tissue quality, allowing them to train without breaking down.
References
1. Alter, M J, (2004) Science of Flexibility (3rd Ed)
2. Boyle, M (2010) Advances in Functional Training: Training Techniques for Caoches, Personal Trainers and Athletes
3. Castella, R & Clews, W (1996) Smart Sport: The Ultimate Reference Manual For Sports People
4. Clark, M & Russell, A. Self Myofascial Release Techniques
5. Finando, D & Finando, S (2005) Trigger Point Therapy for Myofascial Pain: The Practice of Informed Touch
6. Frederick, A & Frederick, C: Stretch to Win
7. Myers, T W, (2009) Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists.