Tuesday, August 14, 2012

Knead Your Own Dough: Self Myofascial Release thru Foam Rolling

                The idea that people carry themselves in layers is more than just a psychological metaphor.  Anatomically speaking we are composed of layers of specialized tissues that help us function in the surrounding environment.  For a visual, imagine a textbook-human body (no need to get too detailed here). If we begin to peel away the layers of this body we’ll find that once we get past the protective layers of the skin and adipose tissue things get a little less porous and a little more fibrous.  This is where we run into the body’s deeper layer of protection known as the fascia.  Fascia is a type of connective tissue that wraps over the softer structures of the body (e.g. muscles and organs).  In short, it helps to keep everything from splaying out like threads from a stripped cable wire. It also allows for smooth movement of the structures beneath the skin.  Now for a cleaner visual picture an orange.  If we peel away the rind we’re left with several sections still held together by a thin layer of tissue like fascia.  Then if we pull off a slice to eat there is yet another thin layer of skin encasing the carpels (i.e. juice sacs) and seeds.  People have different layers of fascia like an orange has different layers of protective skin.  Some fascia functions to hold muscle fibers together while elsewhere fascia functions to protect and lubricate vital organs. 

              Since fascia functions similarly to other connective tissues it responds to stress in the same way.  Too much trauma on a particular area oftentimes causes the surrounding fascia to stiffen up and develop adhesions, which are like knots in a net.  This can result in feelings of chronic stiffness, pain, and tightness.  The fascia is simply reacting to the stress in order to protect the underlying structures from further damage.  Unfortunately, this natural casting process limits mobility and thus strength in the affected areas.  Physiological responses to stress such as hypertonicity has led many to develop manual therapy techniques geared towards releasing compacted fascia. 
Stretching and massage are the go-to options for people experiencing muscular pain and tightness.  Even though it is ideal for someone to be able to completely relax under the hands of an experienced practitioner isn’t cheap, nor is it all that easy to find time to do so.  There are some popular techniques for self-massage (e.g. rubbing back against a tree) but many of the typically problematic areas are still neglected. One reason is that it is impossible to get at them without performing a feat of contortion in order deliver a weak massage.  Those in the health community have developed a science out of this self-serving activity in order to come up with ways for individuals to be able to better perform self-care.  University labs conducted numerous studies and gathered a massive amount of information on self-manual therapy over the years.  The ironic thing is that some of it supports the use of an oversized rolling pin. 

You’ve probably heard of foam rolling before since its success in relieving chronic tension and promoting freedom of movement is steadily being recognized more and more by the global fitness community.  It is a tool-based practice used for self-myofascial release (SMR),  a fancy way of saying “self-massage.”   Using foam rollers enables people to better control the speed and depth of a massage on an affected area.  This helps them get just what they need from some brief work.  When people use a roller they create pressure using their body-weight which sits on top of the restricted fascia.  The steady increase of pressure from the body causes the fascia to release and give way to a healthier shape.  Initially, when a muscle encounters sudden pressure its natural reflex is to contract against the force in order to guard against overstretching.  When we roll a muscle under a consistent pressure such as body-weight, this helps to counteract that initial stretch reflex.  In other words, rolling slowly prepares trigger happy fascia to roll with the punches.   
A quick and effective rolling session can dramatically benefit your performance in workouts and daily activities, so being mindful of when to do it is important as well.  Since you are helping realign fascia surrounding muscle, we encourage rolling before a bout of strenuous activity.  If you’re less restricted beforehand then you’ll move more efficiently thereby allowing you to benefit more from a workout by teaching the body how it is supposed to move during certain exercises.  This doesn't mean that rolling long after a workout is finished would not be just as beneficial.  It’s still a great addition to a stretching routine before bed at a time when the muscles are about to tighten up during their repairs overnight.  There is no generally prescribed limit on how much you should foam roll or get massages.  Some encourage 2-3 times a day, depending on individual restrictions, but these minutes can add up.  Someone can still get as much benefit by rolling out the areas of restriction 1-2 times a day, preferably before and after strenuous physical activity.  For example, if Jane experienced tightness in her mid-back and hips from working all day in a seated “computer-locked” position, then she could just spend about five or six minutes focusing on rolling out her thoracic spine, gluteals, psoas, and piriformis.  If she had the time, then she could continue onto her calves, lats, quads, and hams as well.  If her time and energy are limited, then sticking with a couple of different key rolls per session will still be a good use of her time.
Even though foam rolling has gained some popularity in health and fitness centers, you may often find rolls standing neatly in the back corner of a gym.  Working with rolls for the first time is much like the first experience working with dumbbells.   It’s difficult to know what to do if you don’t have anyone in front of you demonstrating how to use them.  However, the cool thing is that there is not as much special skill needed in order work with them.  There are some techniques which have been developed and shown to be best in addressing typical hot spots for people.  Following is a brief review of a few of these techniques which can help open you up to other ideas on how to work with a roller.  Feel free to go through the whole series of rolls at once or just hit a couple where you think you need it the most.
Note: For any foam rolling technique, remember to roll slow and controlled.  This gives a little more time for the tissues to adjust to the coming pressure.  If you find a tender spot (i.e. about a 6-7 on a 1-10 pain scale) then hold the position for about 30 seconds or 5-6 deep breaths.  Relax, relax, relax, and then move on.  Click the hyperlinks for demonstrations on how to perform these exercises from the Functional Movement Systems exercise library at www.functionalmovement.com.

Sitting on a mat, position a roller underneath one or both ankles just at the base of the Achilles tendon.  If you feel like you could use more pressure, then rest one leg on top of the other so it weighs the other down.  Lift your hips high enough off of the floor to be able to push your lower leg along the roll.  Continue to roll up to where the gastrocnemius tendons pull out alongside the sides of the back of the knee.  Slowly roll back to the Achilles and repeat for ten more good rolls.  

For this roll you’ll begin where you left off with the gastroc-soleus roll, that is, just above the back of the knee on one or both legs.  From this position lift your bottom off of the floor with the help of your hands and push yourself forward so the roller rolls underneath your legs along your hamstrings.  Stop at the sit-bones or feel free to try rolling up a little into the tailbone and tilt to the sides in order to hit each glute cheek individually.  Roll back down to the starting position and repeat for 10 good rolls. 

This roll is perhaps the most complicated to get into and oftentimes the most painful since there is not much protective tissue running along the sides of the legs.  Here you are pressing almost directly on fascia.  Once you get the movement down the feelings afterwards are well worth the struggle.  Sit on the roller as you did before with the ham and glute roll.  This time turn all the way to one side so either the lateral left or right hip and knee rests near the roller.  Take the top leg (i.e. the one not being rolled) and position it in front of you so that you can rely on it for balance and movement while you roll out your bottom leg.  Use your upper body as well to help push your weight off of the ground and over the roller.  Begin rolling from just above the lateral epicondyle of the femur to the lateral spine of the hip bone.  You should feel changes in pressure along the side of your hip and thigh.  Feel free to twist and turn you lower leg to find different adhesions in that leg fascia.  Roll up and down on this area about 10 times and repeat on the other side.

For this roll you will lie face down with the roller resting just above the knees at the base of the quadriceps.  Use your forearms to post your upper body off of the floor and to pull yourself forward allowing the roll to pass under the front of your thighs until it comes up near your pelvis.  From there push yourself back and repeat for a total of 10 rolls.  Again feel free to cross one leg over the other in order to intensify the work.

From the same position as you had with the quadriceps roll, shift to one side of the roll so one of your legs dangles off of the edge.  This will give you room to move the roller up your hip without running into your pelvis.  Roll a little higher than you did with the quadriceps roll but focus just on the front of the hips from the top of your thigh to just below your waistline.  Repeat for about 10 rolls on each side.

Return to a seated position on the roller.  Walk your legs out in front of you as your back begins to fall over the roller.  Roll up the back until the roller sits just in line with the ops of your shoulders, about mid-back level.  This is where you’ll start rolling.  Bridge your hips off of the floor so that you can use your legs to push your body along the roller.  Roll out your mid-back stopping just before the roller hits your lumber spine.  Use your legs again to pull yourself back into the starting position.  Roll up and down the thoracic spine about 10 times.

From the thoracic spine roll position turn onto your side so one arm is extended over the roll and parallel with the floor.  Adjust your legs into a comfortable position that will allow you to use them to push and pull your body along the roll.  The arm closest to the ceiling can be used as support and to control how much weight you allow to rest on top of the roll.  Begin with the roller at about lower chest level on your side.  From this position push yourself along the roller so that it passes underneath your armpit and up into your rear deltoid and upper triceps region.  You may feel the greatest pressure deep in the armpit area where the latissimus and teres major attach to the upper part of the humerus.  Repeat the roll up to 10 times and switch to the other side. 
Learning how to effectively implement the foam roller into a well-balanced training program is just one of the many things we encourage our members to focus on at LTS.  If people don’t perform some self-care in between periods of self-destruction they will quickly run themselves ragged.  Our goal is to improve function, not to render anybody dysfunctional through physically demanding activities.  So, next time you come in. Make an extra effort to spend just a minute or two of the chit-chat time rolling out on the mat instead of sitting at a magazine bench. We guarantee you’ll be thankful for it later.      

-          Noel L. Poff, CSCS, CPT, LMT, FMS, LTS Trainer

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