By Kevin Hirose – BKin, CSCS

Foam rolling, sometimes called Trigger Point Release or Myofascial Release has recently come to the forefront of health and fitness.  You have probably heard of it and you may have done it at some point in the past or even presently.  Perhaps you own a foam roller that sits in your closet or garage.  Well, it may be because you don’t know all the benefits of trigger point release.

For my purposes, foam rolling is not simply a feel good “massage”.  Although it can be utilized in this way, I believe there are more meaningful uses for it such astrigger point release for improved muscle tissue quality, promotion of muscular blood circulation, and reduction of overall neuromuscular tone (tension, not muscle definition).  It might appear to be a simple concept but there is much more occurring than just manual “softening” of muscle tissue.  This blog entry will illustrate the basic science and application of foam rolling.

Muscle, specifically skeletal muscle, contains not only muscle fibres but also many receptors which assist in its function.  One of the receptors, called muscle spindles, function to prevent the muscle from stretching too quickly preventing damage to its structure.  When this occurs the muscle is prevented from lengthening and sometimes stays locked in a shortened state; when this happens one develops a trigger point or adhesion or “knot”.  Generally, one does not “feel” them during daily activities but when you put direct pressure on a point it can hurt – big time. And do not confuse exercise induced muscle soreness from activity with trigger points since they are COMPLETELY different.

TRIGGER POINT = muscle/muscle fibres which are in a shortened state due to stimulation of muscle spindles

MUSCLE SPINDLE = receptors found in the belly of muscle which detect the rate of change in length of muscle fibres

When a trigger point is present, the muscle fibres are in a shortened state and cause the muscle to function less than optimally since they are not able to lengthen freely.  This can cause muscle stiffness, altered movement and even pain, which can all be present simultaneously.  Trigger points can lead to a host problems if left untreated for a long periods such as joint pain to conditions that can lead to serious joint injury and even surgery.  Below is a diagram of a trigger point within a muscle:

My job as a Personal Trainer and Strength & Conditioning Coach is to get clients/athletes stronger and fitter.  But if an individual has trigger points along with altered movement patterns and limited mobility it will not be possible to train him/her effectively.  If I find movement limitations through screening and basic assessments I always have the client do foam rolling first to search for trigger points in the common areas where they are found.  These knots can be treated by therapeutic means such as Intramuscular Stimulation (IMS) or other clinical modality but when it comes to training a client or athlete it is used as a means of training preparation.  Releasing trigger points can restore muscle tissue quality by making it more pliable (flexible).  A more pliable muscle increases the potential to improve mobility, therefore, the client/athlete will be able to move better with less restriction.  This sets the stage for a more effective and potentially safer training session.

How to foam roll:

1) Place the foam roller on the floor.

2) Put the body part suspected or known to have trigger points on the roller

3) Use bodyweight and leverage to control movement and pressure to move the body on the roller.

4) When a knot is found (it can range from mildly uncomfortable to extremely painful) maintain pressure on it for 30-60 sec within pain tolerance and stay relaxed by breathing in and out slowly.

5) Repeat the same process on other major trigger points.

The areas in which you can get trigger points is almost endless and certain tools work better than others for particular muscles/areas due to their location and thickness.

Tools for Trigger Point Release

– foam roller
– rolling stick
– various balls (lacrosse, tennis, hockey ball, medicine ball, golf)
– PVC pipe
– barbell
– walking cane
– “theracane” (cumbersome)
–  hands

                         Various Rolling Sticks                                                                                  “Theracane”

Common Upper Body Areas:

– upper trapezius/levator scapulae (lacrosse ball)
– pec-torals (lacrosse ball)
– latissimus dorsi (foam roller)
– rhomboids (foam roller, lacrosse ball)
– deltoids (esp. front) (lacrosse ball)

Common Lower Body Areas:
– quadriceps (foam roller, stick)
– IT band area* (foam roller, stick)
– hamstrings (lacrosse ball, stick)
– calf complex (foam roller, stick)

* The IT BAND itself CANNOT actually be foam rolled because it is a tendon and does not contain muscle tissue.  However, the muscle which runs down the same area (mainly the vastis lateralis) can be rolled and if pain is felt it is likely that muscle.

Other Common but neglected areas:

– adductors (inner thigh)
– gluteals
– piriformis (glute area above tailbone)-
– tensor fascia latae (just below the side pelvic bones on either side)
– tibialis anterior (shins)
– plantar fascia (bottom of foot)
– biceps
– forearms

  Lacrosse Ball on Trapezius                                           Foam Roller on Adductors (Inner Thigh)

Contraindications (Clark & Lucett, 2011)

However, there are occasions when it is contraindicated (not advisable) due to physical conditions such as advanced diabetes.  Here is a list of others:

– congestive heart failure, kidney failure, organ failure
– osteoporosis
– acute rheumatoid arthritis
– eczema or other skin lesions
– open wounds
– healing fractures
– anti-coagulant therapy (blood thinners)
– bleeding disorders

If you or your client suffers from any of these conditions DO NOT do foam rolling, trigger point release or myofascial release.  It is possible to aggravate these conditions.

Stretching

Static stretching following foam rolling can help increase the pliability of a muscle since the trigger point(s) have been released.  Here is a car analogy – think of the trigger points as brakes and the gas pedal as stretching.  If you try stretching a muscle filled with knots stretching may not be as effective since the knots have not been released.  It would be similar to stepping on the gas pedal while the brakes are still engaged.  I have found through experience that foam rolling followed by static stretching is more effective for improved pliability and done daily can promote long-term muscular flexibility and mobility.

Conclusion

When done correctly and frequently, foam rolling or trigger point release can be part of a training routine which improves muscle pliability and improved movement quality.  This means that your training/workouts can be more effective and safer, reducing injury potential.  It can also lower the intensity and frequency of the daily aches and pains which you thought were a normal part of life and/or the aging process.  The tools are generally inexpensive, especially if you know how to use them correctly.  They can literally be worth a thousand times what you paid for them because of their potential benefits.  So if you have a foam roller sitting in the closet, completely unused, or used as a toy for your children or grandchildren; it’s time to put it to use and make it earn its value.