Foam Rolling Overview and Practical Application

Introduction

For those that may not know, foam rolling is a self-care process used to massage the body. It consists of placing the body on a round, foam-cylinder and “rolling” the limbs and torso over it. The weight of the body provides pressure on the foam roll that creates a “self- massage”. This process, when done appropriately, can provide numerous health benefits for the user.

History

Various forms of rolling for self-massage have been around since the early to mid 20th century. Toward the later part of the 20th century one of the most popular methods for self-massage was foam rolling. The phrase, “foam rolling”, was originally coined because most of the first formal self-massage tools used in the Physiotherapy and Fitness Industries were round foam-based cylinders.

Traditionally, most foam rolling has been performed on the muscles of the body such as the calves, quadriceps, gluteals, and back muscles. This is where the term, Self Myofascial Release (SMR) came from as it describes the roller is being self-applied to the muscles and fascial network of the body. For most of this century, foam rolling and SMR have been used synonymously as the generic term for using a foam roll on the body.

In 2009, another advancement in foam rolling appeared. An Australian bodyworker, also a long-time colleague and great friend of mine, Ian O’Dwyer, developed the concept of using the foam roll on the boney areas of the body such as the ankles, knees, tailbone, etc. Together, Ian and myself formalized this new foam rolling application and called it Self Osteofascial Engagement. Thus, there are two formal foam rolling applications that allow people to safely and effectively roll their entire body.

Science Behind Foam Rolling

To date, numerous research articles have been written on the use, application, and outcomes of foam rolling. Below is a list of some of the major literature reviews and their conclusions.

1. Beardsley & Škarabot, 2015: a. Increases flexibility b. Reduces muscle soreness c. Does not impede athletic performance d. Improves vascular & parasympathetic function

2. Cheatham et. al., 2015 a. Increases joint range of motion b. Decreases soreness & fatigue

3. Kalichaman & Ben David, 2017 a. Increases joint range of motion b. No decrease in strength or performance

4. Konrad et al., 2022 a. Long-term increase in range of motion when used for greater than 4 weeks

5. Konrad et al., 2023 a. Increase in range of motion of contralateral (opposite) limb

6. Schroeder & Best, 2015 a. Increases joint range of motion b. Increases pre and post muscle performance

7. Wiewelhove et al., 2019 a. Improvement of sprint performance to be expected from the use of pre-rolling, as well as the recovery rate of the performance measures of speed and strength with post-rolling, are significant enough to be relevant

These research reviews show that foam rolling is able to help increasing joint range of motion without negatively affecting the strength and performance of the neuromuscular system. It is also evident that foam rolling has a positive influence on how muscles and tissues feel and perform both before and after exercise. Not only does foam rolling help to decrease muscle soreness, stiffness, and fatigue caused by exercise, but it can also help to increase performance and recovery.

How Foam Rolling Works

There are different techniques that you can use with a foam roller to produce different effects. Some of these techniques include rolling, shifting, and compression. Each of these techniques engages, manipulates, and stimulates the tissues mechanically and neurologically different. This is in large part due to the various types of tissues, directions these tissues run in the body, as well as the numerous sensory receptors throughout the body (Behm et al., 2020; Schleip, 2003a,b; Schleip & Muller, 2013).

Rolling

Most research studies investigate outcomes based on a rolling technique. As the roller moves across your skin it provides a source of pressure on your skin. This pressure can act to engage, stimulate, and manipulate the skin, fat, fascia, blood vessels, nerves, muscles, bones, and sensory receptors under your skin. The use of moderate pressure can stimulate many responses in the central and peripheral nervous systems (Behm et al., 2020; Field et al., 2010).

One response is the flushing of fluid in your tissues. The pressure from the roller pushes water out of the tissues (skin, fat, fascia, and muscle) like squeezing water out of a sponge. When the pressure is removed, water is then able to rush back in. This process creates a flushing effect that in essence rehydrates the tissue with better fluid, much like a filtering process. The flushing effect can further enhance the circulation in your body (Beardsley & Škarabot, 2015; Behm et al., 2020; Schleip & Muller, 2013).

Another response foam rolling produces is ‘unrestricting’ the fascial tissue. Fascia is similar to honey. When its warm it is more fluid-like and when its cold it becomes much more sticky, or viscous. When you are sedentary for long periods of time, and depending on how hydrated or dehydrated you may be, the fascia gets “cold” and will begin to stick to itself and the tissues it surrounds (i.e., muscle and bone). When you foam roll your body, you break up the stickiness, or warm the tissues. This lubricates your tissues, which decreases the internal restrictions caused when tissues are sticking together (Beardsley & Škarabot, 2015; Behm et al., 2020; Schleip, 2003a,b; Schleip & Muller, 2013).

Other notable research articles have demonstrated the following outcomes for foam rolling/self-massage:

• Increase in anti-inflammatory proteins and decrease pro-inflammatory proteins resulting in improved muscle recovery and performance (Pablos et al., 2020)

• Change in serotonin, cortisol, endorphin, and oxytocin helping to decrease pain perception contributing to an increased ROM (Weerapong et al., 2005)

• Enhanced change of direction speed in a 45-degree cutting task, rate of force index, and asymmetrical deficits in non-dominant limbs (Yuan et al., 2023)

• 5 and 10 seconds of foam rolling can significantly improve range of motion (Sullivan et al., 2022)

• 30-minutes of foam rolling is effective for reducing cortisol secretion in response to stress (Kim et al., 2014 )

• Foam rolling is good for activating the core and may be used as a time efficient warm-up (Zahiri et al., 2022)

Shifting

Shifting is another viable, yet less used foam rolling technique. In shifting, the roller is used to grip the skin and push or ‘stretch’ the tissue from side to side. Shifting can be done with the direction of the tissue fibres, across the fibre direction, and even in more circular, or twisting motions.

Shifting is used to engage, manipulate, and stimulate the tissue differently. While research specific to foam rolling has yet to be performed on shifting techniques, there is research that has shown this type of technique with other implements to be effective for improving range of motion and even accelerating ligament healing and stiffening after injury. This is especially true when used with Self-Osteofascial Engagement (Behm et al., 2020; Kim et al. 2017; Loghmani & Warden 2009; Markovic 2015; van Amstel et al., 2022).

Compression

Compression, or sometimes called ischemic pressure, involves maintaining static pressure on a tender area of tissue for a period of time. Some of the first research ever done on foam rolling tested the effects of compression on pain and range of motion. Collectively, research has shown that compression on the neck, shoulder, and/or back muscles is able to significantly reduce pain in trigger points and increase range of motion (Aboodarda et al., 2015; da Silva et al., 2020; Hanten et al. 2000; Hou et al. 2002; Ravichandran et al. 2016).

Practical Application

Only one study has really looked at prescribing acute variables for foam rolling (Behm et al., 2020). The difficulty with setting specific acute variables for foam rolling like we have for strength training are the multiple individual factors that influence foam rolling. Some of these factors include:

• experience with rolling and training

• pain threshold

• tissue health

• emotional wellbeing at the time of rolling

• stress level at the time of rolling

• type of roller – firm or soft; textured or smooth

• speed of rolling

• amount of time you have to roll

Each of these factors can play a role in the response you will have to foam rolling.

For immediate, large improvements in range of motion, the cited study above suggests the following acute variables:

• Sets: 1-3

• Duration: 30-120 seconds total

• Speed: 2-4 seconds per roll (a ‘roll’ = up and back on a specific muscle/area)

That said, I’d like to provide some practical context around these suggested guidelines based on my 25 years of experience using, teaching, studying, and applying foam rolling on thousands of people with various backgrounds and cultures all over the world.

Key Points

1. Research typically studies how much range of motion changed, and usually at one joint. You do not need massive changes to see great benefits. Remember that foam rolling does more than just change range of motion; it also lubricates tissues and effects the nervous system, which makes all tissues move better with each other. When multiple tissues – fascia, muscles, joints – are moving better, you only need small changes in each one to create a bigger overall change in your movement. “Small changes make big differences”.
2. Not everyone needs to foam roll the same areas! Though it won’t necessarily hurt you, it may not influence your range of motion. “Know your body”.
3. Use SMR and SOE applications for your rolling, shifting, and compression techniques with perpendicular (horizontal), parallel (vertical), and even diagonal roller placements. “The body loves variation”.

Assess Your Tissue Health

Most people who foam roll never assess their entire body to find where they have tender areas. The tenderness tells you how healthy your tissues are. The more tender the tissue, the less healthy it is.

To assess your tissue health, spend about 30-45 minutes every month or so (yes, you can do it more if you wish) foam rolling your entire body with a moderate to firm density roller (Cheatham et al., 2018). The Eleiko foam roller is a perfect density. As you roll each area of your body rate that area on a scale of 1-10 (1 = no pain; 10 = excruciating pain).

Scoring

• Areas scoring 8-10 are the unhealthiest tissue and should be the primary focus of your rolling

• Areas scoring 5-7 are not as healthy as they could be and should be the secondary focus of your rolling

Application

When rolling the unhealthy areas scoring 5-10, the following process has worked extremely well for most everyone:

1. Spend about 30 seconds of rolling (up and back) the length of the area at a slow to moderate speed to find the most sensitive spot
2. Stop and hold on the most sensitive spot (compression) for approximately 10-60 seconds, or until the pain reduces about 1-2 points on a 1-10 scale. a. For example: if the spot was an 8, hold until the spot feels like a 6/7. b. A small reduction in sensitivity can have a large effect on your tissue motion. Don’t feel like you have to remove all sensitivity for this to work! c. Avoid tensing your body or holding your breath – breath and relax as much as possible

When rolling areas of the body that score between 1 – 4 on the pain scale, the following process has worked extremely well for most everyone:

Beginners

This is someone with less than 6 months of consistent foam rolling (1-3 x’s per week).

• Sets: 1

• Duration: 15-30 seconds per area - if the area is large such as the quadricep, roll a small section at a time

• Speed: 4-5 seconds per roll (up-back) and shift (side-side)

Intermediate to Advanced

This is someone with more than 6 months of consistent foam rolling (1-3 x’s per week).

• Sets: 1

• Duration: 5-30 seconds per area

• Speed: 2-3 seconds per roll (up-back) and shift (side-side)

When to Roll

You can roll before, during, and after a training session, and on off days.

Before and after your training session, roll your primary and secondary areas. If you’re on a time crunch, roll only those primary and/or secondary areas that will be directly involved in your training session.

• For training preparation, select 1-6 foam roll exercises and follow them up with some low-intensity muscle activation and desired mobility exercises. Keep preparation time under 20 minutes unless this will be the focus of your training session

• For post-training cooldown, select as many foam roll exercises as desired and/or time will allow for. Roll slow and focus on slower, controlled breathing to help stimulate a relaxation (parasympathetic) response. Can also follow up with low-intensity muscle activation

During your training session, it’s ok to roll certain tissues such as your primary and secondary areas as foam rolling isn’t shown to reduce performance, contraction, or strength.

• Keep the rolling short – 5-15 sec time frame with a moderate speed.

On your days off, it is a good time to spend a few extra minutes rolling. If time permits, take 30+ minutes to roll the whole body. This will promote good circulation and potentially help with inflammation and stress.

Conclusion

Foam rolling is a valuable tool scientifically validated to provide many beneficial effects to your tissues and overall health and wellbeing. It has been shown to help enhance your readiness to train, recovery, and overall performance. Rolling is also a time-efficient process with significant improvements seen in as little as 5-10 seconds. Using a moderate-to-firm density foam roller at moderate speeds for less than a minute on a few areas of the body will change how you feel and move.

References

Aboodarda, S. J., Spence, A. J., & Button, D. C. (2015). Pain pressure threshold of a muscle tender spot increases following local and non-local rolling massage. BMC musculoskeletal disorders, 16, 265. https://doi.org/10.1186/s12891-015-0729-5

Beardsley, C., & Škarabot, J. (2015). Effects of self-myofascial release: A systematic review. Journal of bodywork and movement therapies, 19(4), 747–758. https://doi.org/10.1016/j.jbmt.2015.08.007

Behm, D. G., Alizadeh, S., Hadjizadeh Anvar, S., Mahmoud, M. M. I., Ramsay, E., Hanlon, C., & Cheatham, S. (2020). Foam Rolling Prescription: A Clinical Commentary. Journal of strength and conditioning research, 34(11), 3301–3308. https://doi.org/10.1519/JSC.0000000000003765

Cheatham, S. W., Kolber, M. J., Cain, M., & Lee, M. (2015). THE EFFECTS OF SELF-MYOFASCIAL RELEASE USING A FOAM ROLL OR ROLLER MASSAGER ON JOINT RANGE OF MOTION, MUSCLE RECOVERY, AND PERFORMANCE: A SYSTEMATIC REVIEW. International journal of sports physical therapy, 10(6), 827–838.

Cheatham, S. W., & Stull, K. R. (2018). COMPARISON OF THREE DIFFERENT DENSITY TYPE FOAM ROLLERS ON KNEE RANGE OF MOTION AND PRESSURE PAIN THRESHOLD: A RANDOMIZED CONTROLLED TRIAL. International journal of sports physical therapy, 13(3), 474–482.

da Silva, A. C., De Noronha, M., Liberatori-Junior, R. M., Aily, J. B., Gonçalves, G. H., Arrais-Lima, C., de Araújo Vieira, L. M. S. M., & Mattiello, S. M. (2020). The Effectiveness of Ischemic Compression Technique on Pain and Function in Individuals With Shoulder Pain: A Systematic Review. Journal of manipulative and physiological therapeutics, 43(3), 234–246. https://doi.org/10.1016/j.jmpt.2019.10.013

Field, T., Diego, M., & Hernandez-Reif, M. (2010). Moderate pressure is essential for massage therapy effects. The International journal of neuroscience, 120(5), 381–385. https://doi.org/10.3109/00207450903579475

Hanten, W. P., Olson, S. L., Butts, N. L., & Nowicki, A. L. (2000). Effectiveness of a home program of ischemic pressure followed by sustained stretch for treatment of myofascial trigger points. Physical therapy, 80(10), 997–1003.

Hou, C. R., Tsai, L. C., Cheng, K. F., Chung, K. C., & Hong, C. Z. (2002). Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity. Archives of physical medicine and rehabilitation, 83(10), 1406–1414. https://doi.org/10.1053/apmr.2002.34834

Kalichman, L., & Ben David, C. (2017). Effect of self-myofascial release on myofascial pain, muscle flexibility, and strength: A narrative review. Journal of bodywork and movement therapies, 21(2), 446–451. https://doi.org/10.1016/j.jbmt.2016.11.006

Kim K, Park S, Goo BO and Choi SC (2014). Effect of self-myofascial release on reduction of physical stress: a pilot study. Journal of Physical Therapy Science, 26:1779–1781. DOI: 10.1589/jpts.26.1779.

Kim, J., Sung, D. J., & Lee, J. (2017). Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application. Journal of exercise rehabilitation, 13(1), 12–22. https://doi.org/10.12965/jer.1732824.412

Konrad, A., Nakamura, M., Tilp, M., Donti, O., & Behm, D. G. (2022). Foam Rolling Training Effects on Range of Motion: A Systematic Review and Meta-Analysis. Sports medicine (Auckland, N.Z.), 52(10), 2523–2535. https://doi.org/10.1007/s40279-022-01699-8

Konrad A, Nakamura M, Warneke K, Donti O, Gabriel A. The contralateral effects of foam rolling on range of motion and muscle performance. Eur J Appl Physiol. 2023 Jun;123(6):1167-1178. doi: 10.1007/s00421-023-05142-2. Epub 2023 Jan 25. PMID: 36694004; PMCID: PMC10191906.

Macdonald, G. Z., Button, D. C., Drinkwater, E. J., & Behm, D. G. (2014). Foam rolling as a recovery tool after an intense bout of physical activity. Medicine and science in sports and exercise, 46(1), 131–142. https://doi.org/10.1249/MSS.0b013e3182a123db

Markovic G. (2015). Acute effects of instrument assisted soft tissue mobilization vs. foam rolling on knee and hip range of motion in soccer players. Journal of bodywork and movement therapies, 19(4), 690–696. https://doi.org/10.1016/j.jbmt.2015.04.010

Pablos, A., Ceca, D., Jorda, A., Rivera, P., Colmena, C., Elvira, L., Martínez-Arnau, F. M., & Valles, S. L. (2020). Protective Effects of Foam Rolling against Inflammation and Notexin Induced Muscle Damage in Rats. International journal of medical sciences, 17(1), 71–81. https://doi.org/10.7150/ijms.37981

Pearcey, G. E., Bradbury-Squires, D. J., Kawamoto, J. E., Drinkwater, E. J., Behm, D. G., & Button, D. C. (2015). Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures. Journal of athletic training, 50(1), 5–13. https://doi.org/10.4085/1062-6050-50.1.01

Ravichandran, P., Karthika Ponni, H., & Antony Leo Aseer, P. (2016). Effectiveness of Ischemic Compression on Trapezius Myofascial Trigger Points in Neck Pain. International Journal of Physiotherapy, 3(2). https://doi.org/10.15621/ijphy/2016/v3i2/94883

Schleip, R. (2003). Fascial plasticity – a new neurobiological explanation: Part 1. Journal of Bodywork and Movement Therapies, 7(1), 11–19. https://doi.org/10.1016/s1360-8592(02)00067-0

Schleip, R. (2003). Fascial plasticity – a new neurobiological explanation Part 2. Journal of Bodywork and Movement Therapies, 7(2), 104–116. https://doi.org/10.1016/s1360-8592(02)00076-1

Schleip, R., & Müller, D. G. (2013). Training principles for fascial connective tissues: scientific foundation and suggested practical applications. Journal of bodywork and movement therapies, 17(1), 103–115. https://doi.org/10.1016/j.jbmt.2012.06.007

Schroeder, A. N., & Best, T. M. (2015). Is self myofascial release an effective preexercise and recovery strategy? A literature review. Current sports medicine reports, 14(3), 200–208. https://doi.org/10.1249/JSR.0000000000000148

Sullivan, K. M., Silvey, D. B., Button, D. C., & Behm, D. G. (2013). Roller-massager application to the hamstrings increases sit-and-reach range of motion within five to ten seconds without performance impairments. International journal of sports physical therapy, 8(3), 228–236.

van Amstel, R. N., Jaspers, R. T., & Pool-Goudzwaard, A. L. (2022). Skin Displacement as fascia tissue manipulation at the lower back affects instantaneously the flexion-and extension spine, pelvis, and hip range of motion. Frontiers in physiology, 13, 1067816. https://doi.org/10.3389/fphys.2022.1067816

Weerapong, P., Hume, P. A., & Kolt, G. S. (2005). The mechanisms of massage and effects on performance, muscle recovery and injury prevention. Sports medicine (Auckland, N.Z.), 35(3), 235–256. https://doi.org/10.2165/00007256-200535030-00004

Wiewelhove, T., Döweling, A., Schneider, C., Hottenrott, L., Meyer, T., Kellmann, M., Pfeiffer, M., & Ferrauti, A. (2019). A Meta-Analysis of the Effects of Foam Rolling on Performance and Recovery. Frontiers in physiology, 10, 376. https://doi.org/10.3389/fphys.2019.00376

Wilke, J., Müller, A. L., Giesche, F., Power, G., Ahmedi, H., & Behm, D. G. (2020). Acute Effects of Foam Rolling on Range of Motion in Healthy Adults: A Systematic Review with Multilevel Meta-analysis. Sports medicine (Auckland, N.Z.), 50(2), 387–402. https://doi.org/10.1007/s40279-019-01205-7

Yuan, H., Mao, J., Lai, C., Lu, H., Xue, Y., & Liu, Q. (2023). Acute effects of foam rolling and dynamic stretching on angle-specific change of direction ability, flexibility and reactive strength in male basketball players. Biology of sport, 40(3), 877–887. https://doi.org/10.5114/biolsport.2023.121325

Zahiri, A., Alizadeh, S., Daneshjoo, A., Pike, N., Konrad, A., & Behm, D. G. (2022). Core Muscle Activation With Foam Rolling and Static Planks. Frontiers in physiology, 13, 852094. https://doi.org/10.3389/fphys.2022.852094