Foam Rolling or Self Myofascial Release

In this article I will run through 3 of the most effective areas to treat with a foam roller; the lower back, the latissimus dorsi (lats) and the lateral thigh/iliotibial band (ITB). These areas are key in treating and reducing knee, back and shoulder pain. I use these techniques with many of my personal training clients as well as suggesting this as "homework" for many of my sports massage clients.

What is Fascia?

Fascia is a huge continuous system made up of elastin and collagen that covers and interweaves through muscle, bone, nerves and blood vessels. Fascia is everywhere in the human body. In a healthy state the fascia is a wavy formation of tissue and is pliable. There are various factors that can impact on the state of fascia such as physical trauma caused by accidents, poor posture, repetitive stress, surgery and inflammation. Tightness in fascia can also be dependent emotional stress and wellness too.

Restrictions or tightness in fascia exerts pressure on the system that cause pain and tension related headaches from a wellness perspective and restricted movement and instability from a performance perspective. Myofascial release aims to remove the restrictions in the body's fascia that are causing dysfunction or pain.

There are 4 types of receptors which feedback information to the brain that will be effected by sensory input like foam rolling. Golgi receptors, Pacinian corpuscles, Ruffini corpuscles and Interstitial receptors. Golgi receptors feedback pressure, stretch and force on the tissues. Pacinian corpuscles are responsive to rapid pressure changes and vibration and by stimulating these will result in improved proprioceptive feedback and motor control. Ruffini corpuscle stimulation is seen from sustained deep pressure and results in a lowering of the sympathetic nervous system, slow deep continuous pressure is shown to have a relaxing effect on the local tissues as well as the body as a whole. Interstital receptors are stimulated through sustained rapid pressures.

What is Foam Rolling?

Foam rolling or self-myofascial release is a form of self-massage using high density foam tubes to help loosen stiff and sore muscles. Foam rolling helps increase blood and lymph flow to the muscles being treated, reduce the sensitivity of the tissues, reduce bound muscle fascicles increasing joint range of motion. The end goal of foam rolling is to feel and move better. It can be incorporated into exercise/sporting warm ups and cool downs or on its own as a mobility routine.

The Lower Back

The lower back problems and pain is probably one of the biggest taxes on the NHS, simple regular exercise and soft tissue management could at least half this problem. The lower back is effected by many day to day factors such as posture – seated and standing, daily work duties – bending over things, picking up heavy objects or being seated for long periods of time, exercise – lifting weights incorrectly, imbalanced routines with excessive anterior chain bias or sporting injuries. These factors can cause the back to become weak, tight or both leading to pain and if no action is taken towards remedying the pain will become chronic.

Foam rolling combined with a well-coordinated exercise program will help release tension within the lower back muscles and help correct posture. Foam rolling the lower back can be a tricky affair as it is often quite painful and awkward to localise the right areas around the spine, pelvis and ribs.

Using the techniques demonstrated in the video will show you how to manipulate the roller into working on the common tight spots. The lower back has several layers of muscle and direct downward pressure from a roller can often not reach deep enough to release. Positioning the body on the roller can allow the roller better access to the deeper tissue. Similarly, to the lats the back is a large area so taking time finding various points is important. It is best to do one side at a time and vary between working the roller up and down the muscle as well as holding on trigger points. By doing one side at a time you can rotate the body to get deeper into the muscles.

The Lateral Thigh/ITB

This is a commonly tight area that can cause a variety of knee and hip pain and dysfunction. The ITB originates at the iliac tubercle portion of the iliac crest and inserts to the lateral condyle of the tibia – basically saying it attaches from the pelvis down the outside of the thigh to the outside of the knee. Tightness in the lateral thigh/ITB can also restrict certain movement patterns inhibiting performance and increasing risk of injury.

The lateral thigh/ITB is often very painful to release and generally has numerous points along the outside of the thigh that create tightness. When foam rolling the lateral thigh/ITB people tend to lay directly onto the ITB. Personally I find that 1) that is extremely painful causing greater tension within the fascia limiting the point of the exercise and 2) with the thigh/quadriceps there are a lot of crossover points where fascia tends to bind creating stiffness. By putting direct pressure onto the ITB it can potentially lead to it sticking to the tissues beneath creating more stiffness.

You may wonder why I'm saying "lateral thigh/ITB"? Well there's a lot of argument to say that the ITB cannot lengthen or shorten as it not a muscle, that the purpose of the ITB is to provide stability from and transfer forces between the knee and hip so needs to be "tight". Maybe foam rolling the ITB reduces sensitivity in the tissue, increases blood flow which increases its pliability therefore reduces tension on its relative structures? Or maybe we're actually foam rolling the vastus lateralis which is reducing the tension. Regardless of the argument, foam rolling the outside of the significantly reduces knee and hip pain and that's really all we need to care about!

As shown in the video my techniques apply pressure from below and above the ITB creating a stretch on the tissue and a lifting pull on the band freeing it from the tissues beneath. My technique also allows for easy pressure management so you can hold each trigger point to the right level to allow it to release rather than tighten further.

Try this technique before and after sport/training to maximise your movement potential or if you are suffering from any knee or hip related pain or discomfort try foam rolling your lateral thigh/ITB daily to see if that relieves your symptoms.

The Latissimus Dorsi

The lats are a very large muscle that originates on the spinous processes of T7-L5, the thoracolumbar fascia, the iliac crest, the inferior 3-4 ribs and the inferior angle of the scapula and it inserts into the intertubercular groove of the humerus. In English means it starts on your pelvis and lower to middle back and spans up past the ribs and shoulder blade, underneath the shoulder girdle attaching to the upper arm.

As the lats are such a vast muscle the function of it can affect a lot of other parts of the body along the kinetic chain. For example, shoulder mobility can be limited by the fact that someone is in a state of excess spinal extension causing the lats to tighten up and crank down on the shoulder girdle.

The lats also play a big part in core stability, anyone who has done front squats compared back squats will notice a big difference in what they can lift. In the front squat the shoulders are flexed and lats are outstretched meaning they cannot be engaged well unlike in the back squat where it is taught to pull the lats in to tighten up the back creating greater support or reinforcement of the spine allowing for greater loads to be lifted. Also similar in the deadlift where engaging the lats assists in maintaining a strong, controlled posture throughout the lift preventing the spine from flexing.

The lats perform several movement tasks on the arms/shoulder including shoulder extension, adduction and internal rotation. If the lats are tight, it creates a limitation for the person to raise their arms overhead or out to the side without pain or restriction. Foam rolling the lats will allow a greater freedom of overhead movement without requiring the body to go to a state of spinal extension to compensate.

Foam rolling the lats will benefit a large variety of athletes especially those involving lots of repetitive overhead throwing or movement such as cricket, baseball and the majority of racquet sports. It is also very common in people with office jobs to have tight lats where they are in a state or thoracic flexion, shoulder extension, adduction and internal rotation.

In using the techniques demonstrated in the video it will allow a greater range of motion around the shoulder joint relieving shoulder pain, reduce tightness in repetitive actions and enhance the overall performance function of the shoulder. Due to the sheer size of the muscle it will take longer than the previous ITB release and reposition yourself to vary the angle of contact is important to hit all areas of the lat.

Pay careful attention around the edge or "border" of the scapula as this tends to create the greatest sensitivity as the scapula provides a solid surface beneath the muscle increasing the pressure on the muscle. Work with the muscle to find trigger points and allow sufficient time for them to release, concentrating on deep controlled breathes will enhance the release of the fascia and muscle tightness.