Learn to move with more skill and less pain

The Foam Rolling Debate

There has been some heated debate on the internets recently concerning the use of foam rollers to improve movement and reduce pain.

For example Greg Lehman recently wrote a nice blog post questioning the use of foam rollers in the management of ITB pain, which provoked a response from Mike Boyle, a well known strength and conditioning coach and strong advocate of foam rollers.

What does the research say? Until now there have been few studies addressing the effectiveness of foam rolling in doing anything at all. But wait!

Brett Contreras has just posted on a new study which suggests that foam rolling can do something other than allow us to waste ten minutes of time writhing in pain. The study found that foam rolling the quadriceps increased range of motion. Even more interesting is that it did not lead to any decrease in strength that is typically seen with other techniques that increase ROM, such as massage or stretching.

While I was in the middle of writing this post, Bret posted again with a detailed critique of the study by Greg Lehman. It’s a great analysis, and its accompanied by some excellent comments from Bret about the importance of questioning everything, especially your own biases.

So Bret’s post unfortunately made most of mine redundant or useless, so I scrapped most of it. But I will retain a few brief thoughts related to the issue of whether foam rolling can improve “tissue quality” by deforming fascia or breaking up adhesions.

For me, the idea that we can alter mature connective tissue through the pressures provided by an elbow or foam roller has always seemed implausible on its face.

Fascia is the stuff that gives our body stability and holds it together. Could the body have really been designed in such as way that its basic structural stuff starts to break down every time it sustains a little pressure? Hopefully my body is made of stronger stuff than that. And if it isn’t, I’m not getting anywhere near a foam roller. If a foam roller can really break apart my fascia just by leaning on it, this would likely be hazardous to my structure, not beneficial. Any tool that is powerful enough to melt my connective tissue cannot possibly be wielded with enough precision to somehow melt out the connections that are bad while keeping the ones that are good.

Of course, the research on the strength of connective tissue suggests that it has nothing to fear from a foam roller. As Paul Ingraham notes, if you want to change the structure of your connective tissue, you better be prepared to get medieval. For example, in this study, researchers concluded that deformation of dense fascia such as the fascia lata or the plantar fascia would require forces far outside the range possible in manual therapy. (But the thin nasal fascia apparently remains a candidate for foam rolling.)

There is a lot more to discuss and debate here, but I guess the one thing I want to make clear is that this study is not evidence that foam rollers are the road to smoother, healthier, and more luxurious fascia. (But we will certainly be hearing such claims in the near future!)

Thanks for reading this far and let me know what you think in the comments.

Treat Your Client Like a Wild Animal

Today’s post is inspired by a brief story told by my excellent Feldenkrais trainer Richard Corbeil. Richard was explaining to our class how we should approach a client in pain (or any client really) if we want to gain their trust and prevent activation of their protective mechanisms. I’m probably not getting all the details… Continue Reading

Power at the End Range

In the previous post I discussed the idea that flexibility is generally overrated as a quality that promotes sports performance. In particular, I argued that: most sports do not involve extreme ranges of motion; most elite athletes in fact have only average flexibility; and quality of motion at a joint is usually far more important… Continue Reading

Flexibility and Sports Performance

In this post I have put together a few semi random thoughts on flexibility and its relationship to sports performance and injury prevention. Flexibility defined Flexibility is basically the range of motion at a particular joint – how far it can move from A to B. I like to think of flexibility as the quantity… Continue Reading

Stretching Increases Strength in Contralateral Muscle

I am too busy right now to do any in depth posts, so here’s a quick little review of an interesting study I just read. I’ve written several times before on this blog about how unilateral exercise can have significant effects on the contralateral side. I find this interesting not just because it’s kind of… Continue Reading

Core Stabilization Versus Education for Low Back Pain

A new study just came out comparing different methods of back pain prevention in a military setting. The headline is that back pain education was more effective than core stabilization exercise. Is that what it really shows? Does that mean I should put down that swiss ball and pick up a book instead? Here’s a… Continue Reading

Maintenance

Sorry about the ugly look around here the last few days. I was having some problems with my theme disappearing. And for some reason wordpress wouldn’t let me write a post. Everything seems to be back in order now. Sheesh…. Continue Reading

Dem Bones: Skeletal Structure and Movement Function

I don’t write about structure that often on this blog. That is not because I don’t think structure is an important determinant of how we move and feel. Structure is incredibly important. It’s just that, unlike function, structure is pretty tough to change significantly in the short term. The best example of the stability of… Continue Reading

Does Anterior Pelvic Tilt Cause Low Back Pain?

Question: What is anterior pelvic tilt? Answer: It means the front end of the pelvis tips forward and the back end hikes up. Question: Will that make my gut look bigger? Answer: Yes. Question: Is that why my low back hurts? Answer: Let’s check the internet… What Google Says An internet search for anterior pelvic… Continue Reading

“Soulless Bodies and Bodiless Souls”

This post is a little philosophical, and you may even find it offensive, so I will apologize in advance and keep it mercifully short. I have done a lot of reading on the internet about the many different approaches to manual therapy. Some ideas are good, some are not so good. And some are rather… Continue Reading