Part 2 - Self Myofascial Release Foam Rolling Techniques

The last post discussed the physiology of the self myofascial release technique (SMRT).  In this post you'll find animations of techniques that focus on specific areas of concern. The foam roller is being used in these descriptions.  However, depending on the area you're focusing on, there are other tools that may be more appropriate or beneficial. For example, a tennis ball, medicine ball, or a device called The Stick can be utilized with success. I haven't used The Stick myself, but I have found foam rollers and balls to be beneficial. I've included the Self Myofascial Release: Purpose, Methods and Techniques for reference. Just click on the title of this post for this excellent resource by Mike Robertson, MS, CSCS.

Form
Before we get into the actual SMRT exercises we need to discuss form. Form is always of critical importance when performing any exercise.  Be aware of your body positioning and alignment.  For example, when lying on your side make sure your elbow is directly under your shoulder.  Poor alignment and improper placement on the foam roller can lead to injury. Also, remember to breathe deeply while performing SMRT.

Pressure
There are several ways to increase or decrease the amount of pressure we place on a trigger point.  To increase pressure, for example, in the hamstring technique you would remove one leg off the roller. You can also use a denser (harder) foam roller.

Duration
I try to spend at least a minute rolling while I'm noting any trigger spots I feel. Then I locate the trigger point and hold pressure on the spot for 30 seconds to 1 minute.  This can seem like an eternity when you're feeling pain, however, the pain should decrease as you hold the position. The pain should be what I can only describe as a "working pain" and definitely not anything near excruciating.  Rule of thumb: Listen to your body. You should feel better after SMRT, not worse. 

Contraindications
Last, but not least, it's important to note that some experts suggest SMRT is appropriate when pain or inflexibility is present, but should be reduced or stopped once the issue has resolved. In addition, SMRT is contraindicated in certain situations including, but not limited to, a recent injury, circulatory problems, pregnancy, osteoporosis and hypertension.  Always check with your medical professional before beginning any exercise program.

Types of Foam Rollers

I prefer the longer roller because I can also use it for balance and stability exercises that require me to lay on it.  You may prefer the shorter roller for ease of transport.  Be aware of the various foam densities and textures. Click here for foam roller options.

SMRT exercises:

SMRT for Hamstrings

• Position the back of the upper thigh on the roller. 
• Make sure that your hands are placed directly under the shoulders.
• If your wrists are uncomfortable you can raise up on your knuckles and straighten the wrists.
• Roll until you find a trigger point(s). Hold until you feel a reduction in pain. Breathe. Release.
• To increase pressure place one leg on top of the other.
• To decrease pressure put one foot on the floor.

SMRT for Quadriceps

• Lay face down with the front of the upper thigh on the roller.
• Position elbows directly under the shoulders. Make sure your neck is aligned with your spine.
• Maintain core strength. Think of drawing your navel in toward the spine.
• Roll forward and back extending down the length of your thigh to the top of your knee until you locate a trigger point(s). Hold. Breathe. Release.

SMRT for Illiotibial Band

• This particular SMRT can be particularly painful for some.  If this is the case remember to adjust the pressure as needed.
• Lay on your side with your upper thigh on the roller.
• Make sure your elbow is directly under your shoulder.
• Keep the neck aligned with your spine.
• Roll from the top of the thigh down to just above the knee until you locate a trigger point(s). Hold for 1-2 minutes. Breathe. Release and roll.

Sources:
http://www.optp.com/Foam-Roller-Therapy.aspx
animations from:
http://www.sport-fitness-advisor.com/self-myofascial-release.html

What's self myofascial release?

A few posts ago I discussed the merits of trigger point massage therapy.  If a trip to the massage therapist isn't possible, here's another option: self myofascial release technique (SMRT).  It sounds technical, but it isn't all that difficult to practice.  We've been using foam rollers for SMRT in our group exercise class.  Unfortunately, we haven't really had a chance to discuss the mechanics and benefits of this technique. So, why is SMRT helpful? The key is our body's fascia.

Just what is fascia? It's a thin sheath of tough connective tissue. It spreads throughout the body without interruption, from head to toe, in what I think of as a web. Fascia covers and separates different layers of tissue. It also encloses muscles. When an imbalance occurs in the fascia, pain usually results.

Remember the discussion of trigger point massage a few posts ago? It mentions how often times the pain we feel in one location isn't always at the actual site of injury. This is called referred pain. It's important to trace our pain to its source, or trigger point, in order to treat the cause of the pain and not just the symptom.
   

Dr. Michael Leahy's diagram  is a great illustration of what happens when we develop a trigger point. He calls the process the Cumulative Injury Cycle. I like that he begins the cycle with the term overwork. This word can describe injuries, repetitive motion or prolonged inactivity. It might seem contrary to use the word "overwork" to describe  prolonged inactivity.  However, if you think about sitting at a computer in one position for hours at a time it's easy to see how this could be a type of overwork for our muscles.

Let's take a closer look at overwork in the form of a soft tissue injury like a sprain or strain. Treatment at the acute phase of injury is usually with the RICE (rest, ice, compression, elevation) prescription. Then we'll typically follow this up with strengthening and stretching rehabilitation exercises. In a perfect situation the injury will heal and not cause us any chronic issues. Unfortunately, this is not the norm. 

Sometimes muscle imbalances can result from the injury. These imbalances are compounded by unequal tension in the body's fascia. Internal swelling occurs, blood flow is restricted to the area and scar tissue, or adhesions, form. Adhesions are also referred to as trigger points.  These result when localized areas of muscle and fascia bind together. Adhesions can change a muscle's ability to contract or lengthen. Pain can result.

What about Dr. Leahy's Cumulative Injury Cycle as it relates to other overwork, like repetitive motions or inactivity? These also can cause chronic muscle strain, imbalance and adhesions. Regardless of the cause, in order to break up these adhesions some form of deep tissue or trigger point massage is helpful. This is where you and the foam roller come in.

Basically here's what you do:

• use your body weight to provide direct pressure to an area of concern, while rolling back and forth on the muscle/fascia. 
• Once you find the trigger point, which is typically the area of greatest discomfort, you hold the pressure on that spot for 30-90 seconds or until you feel the discomfort subside. 
• You need to work within your pain tolerance by applying less or more of your body weight on the roller and holding for more or less time. Focusing the pressure on this trigger point will help to break up adhesions. This will allow the muscle to return to its normal ability to contract or lengthen. The end result is less or no pain. It's not a magic bullet, but it helps.

In my next post I'll talk about the mechanics of SMRT and will post some illustrations of a few of the positions. I'll also include suggestions for rollers and other tools to use for your SMRT.

Happy rolling.

Sources:
Complimentary Therapies in Rehabilitation, Carol M. Davies
The Myofascial Release Manual, Carol Manheim