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Can You Ease Back Pain, Shoulder Pain and Knee Pain With Foam Rolling?

Can You Alleviate Muscle Pain and Improve Flexibility by Foam Rolling?

I have heard in the past few months that people do not know what to do with a foam roll or are using a foam roll to “mash” their muscles. You may have heard about mashing…the act of using an extraordinarily heavy item to compress a muscle in your leg, resting it on the muscles until it is (assumingly) going to relax.  For those of you who are mashing and smashing…this sounds painful and this intensity of this kind of rolling may be unnecessary.   

So, should you use a foam roll and should you mash your muscles with it?

The answer I have is yes and no.   Yes, a foam roller, as well as a lacrosse ball and peanut roller, can be fantastic devices to use in your exercise routine to assist with calming the feeling of muscle pain and stiffness. But if the intent is to “mash” and “smash” the muscle with the foam roll or ball, then my answer is no…you don’t have to do that!

Here is why…

A foam roller is a long roll of foam, measuring 3 to 6 inches in diameter and 12 to 36 inches in length. Foam rolls can be very firm dense foam or softer/squishy foam. They also can have varying texture to the outer layer of the roller with some having a smooth surface and others having ridges or points. 

The process of “rolling” involves lying a certain section of your body or limb on top of the roller. Your body weight then creates pressure downward, compressing the soft tissue/muscle between the more firm and boney parts of your body and the foam roller. By having a surface that rolls, you can move up and down that region of your body, somewhat similar to a sweeping deep massage. You can become your own make-shift masseuse. There are also preferable positions and directions to apply your body on top of the foam roll to target and align with your muscles. This also will help avoid the point tender areas of your boney prominences, like your pelvis or lower leg bones for instance. 

The most effective rhythm of the roll, speed of the roll, and duration of the roll are still being studied and debated in the medical world. Research has supported, thus far, a narrowed down window of 3-5 sets of a 20 to 30 second duration of the roll. Number of rolling sessions per week has been advised to be 3 to 5 times per week.

This can all be debated and discounted at any time, the reason being is that there really is not enough research to advocate any set duration or number of sessions per week or best type of roller. Foam rolling is moderately new and still being researched to support the benefits that so many people, including myself, are reporting.

Some medical professionals believe foam rolling is performing self myofascial release.  What is myofascial release? Myo is Latin for muscle and fascia is described as the connective tissue that surrounds your muscles, bones, nerves and organs. Researchers believe that the myofascial tightness, whether it be from injury or stress, restricts a person’s movement and blood flow to a body region.  The term myofascial release then describes the reduction in tightness or release of the tension between the muscle and the fascia in this body region, and some theorize relief of myofascial tension in one area of the body can greatly reduce tension in other regions far removed from the original area of dysfunction. 

There is also the suggestion that when you are rolling you are compressing the muscle belly against the roll and the weight of your body can trap and isolate trigger points in the muscle group. Once the roll and your body have isolated this one tight band, you can then apply a longer duration of pressure, creating an ischemic (reducing the blood flow momentarily) compression on the muscle causing the trigger point in that muscle to release and the muscle to relax.

Foam rolling has also been reported to improved blood flow in the muscle and some believe that it helps to ease the sensation of DOMs, or delayed onset muscle soreness. How this happens cannot be explained but some feel that foam rolling is enhancing the circulation in the muscles through the rubbing and rolling effect and in relation this may aid in removing the toxins remaining in your muscles from a tough workout.   

One of the biggest hypotheses now being researched is the idea that the nervous system is being stimulated by the rolling. The skin, muscle and fascia are experiencing such a high level of stimulation from the rolling, that the stimulation is bombarding the nervous system, the brain is getting this flurry of signals, which is then creating a novel distraction from the underlying muscle soreness. Your brain will then find the muscle pain and soreness less of a threat during static and dynamic stretching or during/after a workout and allow greater range of motion, a greater stretch, or improved tolerance to manipulation or mobilization of a joint.

None of the theories as to why it works have been proven, yet both medical professionals and the athletic population can report that foam rolling does make them feel good. They report improved flexibility, better sport performance following rolling, and less muscle soreness post-workout. Whether it is from releasing the myofascial tightness, relieving trigger points, or improving circulation to remove delayed onset muscle soreness, almost everyone will report that they feel that foam rolling works.

As a physical therapist, a runner and a CrossFit enthusiast, I have seen firsthand the benefits of foam rolling to my body as well as to the bodies of my patients.  Rolling with one, as well as rolling with smaller options like a lacrosse ball or peanut ball, has a strong effect on the perception of muscle pain and tightness and can instantly improve range of motion and remove pain during a previously painful exercise.  Pre-workout rolling, followed by dynamic and static stretching, appears to prep the body for exercise, allowing greater tolerance to the workout that follows. Similarly, a post-workout rolling and stretching routine has proven to ease muscle soreness quicker than other post workout routines.  For these reasons, I advocate and teach classes in foam rolling, lacrosse ball rolling, and peanut rolling, as well as other devices used to distract the brain from feeling muscles tightness and soreness so that my clients can have improved mobility and workout success. 

If we return to the latest theory that rolling is really just a brain diversion to the perception of pain, then is it better to barbell mash and PVC roll?  No, not for those who have never rolled before or who are not seasoned-rollers, and especially not for those people who have found good results with simply using a softer foam roll.  If your nervous system responds well to a standard foam roll, and you find improved tolerance to stretching and your exercise routine following soft foam rolling, then there is no reason to bash and smash your muscles. If you mash, bash, and smash your muscles, to the point of excessive pain, then you will create a protective response from your brain, which will perceive this level of pain as a threat, and your brain will want to protect you by tightening up vs. relaxing.   The goal of foam rolling will be lost.  In this case less is more and you may find a simple level of stimulation will achieve better affects then trying to apply too much pressure.  Therefore, there is no reason to roll on a PVC, a jagged roll, or land a barbell on your calf to mash your muscles into submission.  The only time I have seen this to be effective is if you have been foam rolling for many months or years, to the point where your nervous system has become so accustomed and desensitized to a softer foam roll that to achieve a moderate level of nervous system stimulation you need to increase the firmness to get that same effect.  But only then is it advised to increase the firmness of your roll.  In the meantime, enjoy the roll, lull the nervous system into a comfortable state, and go easy on that mashing!

If you are interested in learning more about how to foam roll, lacrosse roll and peanut roll, as well as how to use theracanes and mobility bands, please visit my website at bodyfitphysicaltherapy.com or my Facebook page at BodyFit Physical Therapy in Avon CT for when and where I am holding my next Mobility Night.  A Mobility Night is a full hour of foam rolling, dynamic stretching and static stretching instruction and participation, with a focus on one section of the body. Night One: Focuses on the neck, shoulders and trunk; Night Two: Focuses on the lumbar spine, hips and groin; Night Three: Focuses on the various ways to stretch the hamstrings; Night Four: Focuses on the upper and lower legs, ankles and feet.  Or make an appointment for a private session by calling me at 860-507-7365 or email me at cindy@bodyfitphysicaltherapy.com.


Thank you for reading!


Cindy Langer MSPT, FMT, CMCP—TPI Certified