April 14, 2020
Over the last few years many patient have come in to the clinic and described various ways of foam rolling to me. Most people have taken this method off YouTube to help stave off injury. Some are the typical description of their YouTube favourites, while some are more innovative and homemade. Most of the techniques I have no problem with - foam rolling is a fantastic way of self-preservation from the aches and pains of everyday life and training. However there are three descriptions that I loath to hear from patients. These are either because they are just painful, ineffective, injury inducing or a combination of all three.
The main one I hear is foam rolling of the iliotibial band (ITB). I have always had a dislike for this technique as it has grown out of a lack of knowledge from the people recommending it. The ITB is a long tendon that runs down the outside of the thigh. This connects into the bones around the knee, after originating from two main muscles in the hip – the tensor fascia lata and gluteal muscles. These muscles have a huge amount of potential to stretch the release the tension in the ITB. However many of those prescribing foam rolling the ITB have stuck by the premise of ‘no pain, no gain’, and advised patients to foam roll the ITB directly instead of rolling the less painful and more effective Glutes. If you don’t believe me, a study recently showed that it take 925kg of force to stretch the ITB by 1%.
The second one I don’t like to hear is people rolling the plantarfascia with a tennis ball/massage ball. The reason for this is the same as the ITB. This time it takes 460kg of pressure to increase the plantarfascia by 1%. To put it a little differently, stand on a tennis ball with 4 friends on your shoulders to get any benefit from this stretch. Again you are much better at foam rolling the calf muscles as they pull on the heel bone which stresses the plantarfascia.
While the first two techniques are just painful and ineffective, the last technique I dislike hearing is foam rolling the low back – as it is more likely to injure the facet joints in the lower spine. The foam roller forces you to arch your back to an extreme angle that will compress the facet joints and lead to irritation and pain. A better way to self-massage the muscles of the lower back is to use a lacrosse/tennis ball between you back and the wall and roll it up and down parallel to the spine.