Friday, August 9, 2013

Self Soft-tissue Mobilization (How to Use a Foam Roller)

So you've probably seen these things. They're all over the place nowadays, in gyms and sporting goods stores. You might even see them at a chiropractor or  a physical therapy clinic. Many of us are familiar with the bitter sweet combination of pain and relief they bring to sore, battered muscles. Others of us are probably asking themselves a very simple and totally reasonable question:

"What the hell are these weird looking foam tubes?"

Well, my post-workout recovery challenged friends, this weird looking foam tube might just be your new best friend. I covered this subject briefly in a previous post but I only really addressed what it's good for, not how to use it. The foam roller is one of the cheapest and most versatile tools for self soft-tissue mobilization (SSTM). Sounds fancy and science-y (and frankly I'm not sure it's a real term) but what it means is that this simple foam cylinder can help unglue immobile tissue, increase joint mobility and range of motion and ultimately help make you bigger, more bad-ass and a bit closer to becoming invincible.

So, how does it work and how do you use one? First, a quick anatomy lesson.
Our muscles and our musculoskeletal system is not one single, contiguous unit. Just like an engine in a car it is a large, functioning system made up of a number of smaller pieces. First and foremost (because this is a Strength blog, damn it) are your muscles:

As you can see your muscles are made up of several smaller units that are all wrapped into bundle and each bundle is made up of similarly smaller units wrapped in similar bundles. Uhm, right. I think that made sense. Anyway, each one of these "bundles" is surrounded by fascia, a type of woven connective tissue that holds everything together. At any point in any of these units a number of things can happen. 

You know how when you go to get a massage they work out all those nasty "knots" in your muscles? This is one of the ways that tissue gets glued down. A "knot" is a group of fibers that at some point contracted and then failed to relax all of the way. In addition to this, all of your tissues need to be be able to slide over one another well enough to allow motion. If some of your muscle tissue is tied down because of some type of scar tissue (frequently referred to as an "adhesion") then the tissues can't move properly which means you can't move properly.

In addition to our muscles we also have tendons and ligaments. Our tendons attach muscles to bone and our ligaments attach bones to each other. Similar to muscles, ligaments and tendons can also become victim to some type of adhesion or get locked down and become immobile due to local inflammation or muscle stiffness. What I mean is this, your tendons attach your muscles to your bones so if the muscle being attached is tonic (partially contracted) the tendon may be pulled tighter than it should at all times which will reduce the motion of the antagonist muscles (the muscles that move the joint in the opposite direction i.e. bicep-tricep, quad-hamstring etc.) and may lead to joint stiffness, pain and lost range of motion. Honestly, you're probably not going to be doing a whole lot of tendon or ligament mobilization with a foam roller. This is usually pretty specific soft tissue work that a trained clinician performs with their hands but I figured it was worth mentioning. 

Ligaments! (That's a foot, in case you weren't sure.)
Tendons! (And this is an elbow. Really. Swear.)

Finally, we can't forget about our big beautiful epidermis. That's a fancy word for skin. Get your mind out of the gutter. While skin isn't a contractile tissue nor is it truly structural, it can still get tacked down the way your muscles, ligaments and tendons do to an extent which can ultimately lead to the same problems. If you're movement's not good then you can't exercise....um...good-ly. Right. 
Skin! Totally how it looks in your body. Same colors and everything. Come on, would I lie to you?
So we've got a few different types of tissue that love to get all up in each others business and cause more physiological drama than a Mean Girl with a Facebook app. So what do we do? Enter your White Knight: Sir Foam Roller of Mobilization.



Sigh. Sometimes even I realize how bad my jokes are. Anyway, these things come in all sorts of shapes and sizes some as simple as a round piece of foam like those pictured above and then theres some crazier ones. Like these. 




If you're new to foam rolling I would recommend starting with the simple, basic foam roller. The more complex variations like the two pictured above tend to be made of a harder material (PVC pipe or something similar on the inside as opposed to foam) and are therefore more painful. They are also ridged or pointed so that you can apply more direct, focused pressure to certain tissues; something that you'll need a little experience with SSTM before you can realistically or effectively approach.

Now that you understand the anatomy and you've acquired your weapon of choice, let's talk about how to use it. It would be wonderful if simple laying down and rolling back and forth on it was effective and I think a lot of personal trainers and fitness publications out there would have you believe this. Hell, I've seen DPTs prescribe this kind of activity to patients. It might feel better for a little while but if you're just fumbling around you're hardly going to effect any kind of significant or long lasting change. In order to do that, you need to have a purpose and a plan. 

Foam Rolling Techniques

1. Intermittent Pressure - This is basically rolling back and forth on a knot. I know, I know. I just told you absently rolling around is pointless and I'm not retracting that statement. The purpose of intermittent pressure is to locate a knot or a location of tied down tissue (these are indicated by a sharp increase in pain when you pass over them. Trust me, you'll know.) Now, using the foam roller as your divining rod and the sensation of pain as your indicator, locate the limits of the knot. Once you've found them, stay inside them and roll back and forth while deliberately attempting to relax your muscles. Continue doing this until you feel a change in the tissue. You can keep doing it for as long as you can stand it but once you've gone a minute or two and feel like nothing's changed, you're probably done with that location for the moment. There's only so much you can fix in a single application.

2. Constant Pressure with Contraction/Relaxation - This is the method that I personally think sucks the most in terms of pain. You begin initially with a similar technique as Intermittent Pressure to locate immobile tissue.  Now, instead of finding the outer limits of the pain, find the central, most painful location. Apply constant pressure and then contract your muscle fully and hold for a few seconds. Once you start to relax do it slowly and consciously, don't just let your muscle go slack in a second. You should be able to relax further than you did when you initially placed the pressure over the muscle. Once again, repeat the technique until you feel that you've effected enough of a change or you feel like nothing significant is happening anymore.

3. Constant pressure with joint motion - Again, begin by locating what feels like tacked down tissue. Now, while maintaining pressure on the tissue, begin moving the joint that muscle controls through it's range of motion. Attempt to move it as much as possible in as many directions without significantly hurting yourself. This type of mobilization is great for breaking up adhesions or scar tissue. You know how sometimes when you have a loose thread on a shirt, if you try to pull it off it just pulls out more thread and keeps unraveling? Well, what do you do in that situation? You hold down the end of it and try to pull off the thread without unraveling more. This functions under the same principle. You pin down one end of the adhesion and try to remove it by moving the adhered tissue underneath it. As above, continue the technique until you feel you're no longer getting anything out of it.

Now that you understand the techniques, a few precautions to pay attention to:
-These mobilizations can take anywhere from 1-10 minutes, in some severe cases maybe even more. If you're spending 30 seconds on the foam roller you're not trying hard enough.
-while a simple foam-core roller may be effective initially, eventually you'll probably need something harder to get deep into your tissues particularly if you're muscular. More muscle is great, but it means more tissue that can get knotted and tacked down and the denser the muscle the harder it becomes to create deep enough pressure to effect change. 
-these mobilizations are uncomfortable. They should not be painful. While some people would claim semantics the truth is that there is a significant difference. In the words of Dr. Kelly Starrett, "don't go into the pain cave." His point is that we are capable of doing some terrible things to ourselves if we go hide in our mental caves and we can shut out an immense amount of pain. Do not do this. If you need to go into the pain cave to deal with your mobilization you are most likely doing it too hard and damaging something.

Or you might be a wimp. But it's probably the first thing. Probably. 

So there you have it, go grab a foam roller and get rolling. You can apply these techniques to just about any muscle in your body. Don't let the floor restrict you, you can put a foam roller up against the wall or on top of a table and lean on it if you have to. Be creative but reasonable. You can also use a tennis ball, a lacrosse ball or even a rolling pin. Anything that will give you consistent, constant pressure. I used a barbell to roll out my quads the other day. It was fan-frigging-tastic. Really.

You can find foam rollers pretty much anywhere these days but my favorite equipment company is Rogue. You can also find a pretty wide selection at Perform Better (which is where the therapy company I worked for purchased theirs) but they can be a little overpriced at times. 

Well, I'm off to go watch my friends boyfriend do something absurdly badass and a little insane. Maybe if you guys are lucky I'll even tell you about it when I get back. Have a nice weekend kids. Good luck and good lifting.

Cheers. 

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