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.
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 is apparently deformable. Perhaps "adhesions" are more in the nature of nasal fascia than plantar fascia, and are likely to be broken even if the stronger structures remain intact.
There is a lot more to discuss and debate here, and many questions, but I guess the one thing I want to make clear is that this study is not evidence that foam rollers cause any form of structural change to fascia.
Thanks for reading this far and let me know what you think in the comments.