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

Massage and Wellness

One of the complimentary therapies that I have begun incorporating into my wellness regimen is massage. Before I was diagnosed with breast cancer I viewed having a massage as a rare luxury.  Now that I'm looking at my health more holistically I've learned that there are many health benefits of massage. It deserves to be a part of my regular health care.The Mayo Clinic states that studies show massage is helpful for: 

• Stress relief
• Managing anxiety and depression
• Pain
• Stiffness
• Blood pressure control
• Sports-related injuries
• Boosting immunity
• Cancer treatment

After discussing with the massage therapist the areas of concern in my back and neck, I settled onto the massage table. I've had Swedish massages in the past, so I was looking forward to a nice relaxing experience. Let me just say...NOT! Perhaps KNOT would be more accurate.  What the therapist performed was a trigger point massage.  It wasn't relaxing, but it what just what my body needed, or should I say kneaded? Okay, I'll stop with the bad puns.

So, just what is trigger point massage? Where a Swedish massage uses gentle pressure and long stroking motions, a trigger point massage focuses on specific points, or sensitive areas of tight muscle fibers that can form in your muscles after injuries or overuse (Mayo Clinic). My massage therapist explained that to their touch these points can feel like knots. I also learned that the pain I was feeling in my back and neck actually originated from trigger points a distance from the site of my actual pain.  This is called referred pain and is a defining symptom of trigger points.

The drawing below illustrates several muscle fibers within a trigger point. In an example of referring pain, this trigger point would cause a headache over your left eye and sometimes at the top of your head. Research has shown that 75% of the time trigger points are the primary cause of pain.  Letter A shows a normal muscle fiber in a resting state. Note how the lines running crosswise are all uniformly spaced. Letter B depicts a knot in a muscle fiber.  Note the density of the crosswise fibers in the bulging section. This is what is felt as a knot. Letter C is the part of the muscle fiber that extends from the knot to the muscle's point of attachment to the skeleton. Note the variation of the crosswise fibers in this muscle fiber. These are more widely spaced and overstretched because of the tightness of the fibers in the knot. Put very simply the result is tension and pain (The Trigger Point Therapy Workbook, Clair Davies).

The good news is that the pain and tension of trigger points can be helped with massage. With the assistance of a knowledgeable and qualified massage therapist, you can even learn to practice self-applied trigger point massage yourself. An excellent resource for learning more about this therapy is called The Trigger Point Therapy Workbook: Your Self Treatment Guide to Pain Relief by Clair Davies.

If you're in the DFW area and are looking for excellent massage therapists, Richard and Diane Maas of the Lewisville Massage Therapy Clinic are highly trained, experienced and qualified therapists. Check out their website http://www.lewisvillemassage.com/Therapists.shtml.

I no longer view a massage as a self-indulgent luxury. It's definitely a powerful tool that is helping me take charge of my health and wellness. 

Sources:
illustration from The Trigger Point Therapy Workbook, Clair Davies 
http://www.mayoclinic.com/health/massage/sa00082
http://www.triggerpointbook.com/triggerp.htm