Q: What do foam rollers do besides hurt a lot?

As an orthopedic physical therapist, I use foam rollers during the treatment of many of my patients. They do often complain that the foam rolling hurts at the time of the treatment, but they also say they feel better after using the foam roller. This makes it possible to convince my patients that they should continue foam rolling even after they are discharged from physical therapy. Foam rolling makes it possible for my patients to independently maintain the gains they made while working with me in PT.

So what good do foam rollers do?

Well, a survey of 685 sports and orthopedic physical therapists identified the top four benefits of foam rolling:1 Cheatham, Stull, & Ambler-Wright. (n.d.). Roller Massage: Survey of PT Professionals. JOSPT. Retrieved February 18, 2019. https://www.ncbi.nlm.nih.gov/pubmed/30276024

1. Decreased pain (after you’re done using them)

Pain and fatigue are often associated with trigger point soft tissue damage. There are many studies that have shown that massage is helpful in alleviating the pain caused by this soft tissue damage. This is because massage increases blood flow at the areas where pressure is applied, which aids in healing of the tissue. Foam rolling is a technique you can use independently to get similar results to a deep tissue massage. And it’s a lot cheaper too. The average foam roller costs about $20.

2. Decreased muscle stiffness

Muscle stiffness can actually be measured by something called mechanomyography. This is a test that monitors the temporospatial summation of electrical activity at the motor unit (a building block of the musculoskeletal system that is composed of one motor neuron and the skeletal muscle fibers which it innervates). Mechanomyography has been used in several foam rolling studies to demonstrate decreased muscle stiffness after foam rolling. However, this effect lasts an average of only 15 minutes.2Baumgart, Freiwald, Kuhneman, Hatfeil, Huttel, & Hoppe. (n.d.). Foam Rolling of the calf and anterior thigh: Biomechanical loads and acute effects on vertical jump height and muscle stiffness. Retrieved February 18, 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6359537/

3. Increased range of motion

Several studies have explored the change in range of motion (ROM) at a specific joint, after foam rolling was performed to a muscle group adjacent to that joint. One specific study found that hip flexion ROM improved by 23 degrees on average from baseline measures, after foam rolling and statically stretching the hamstring muscle group.3 Mohr, Long, & Goad. (2014). Effect of Foam Rolling and Static Stretching on Passive Hip-Flexion Range of Motion. Journal of Sport Rehabilitation. Retrieved March 1, 2019. https://www.ncbi.nlm.nih.gov/pubmed/24458506 This was compared to an improvement of only 12 degrees of improved hip flexion ROM after static hamstring stretching alone. The group of subjects who only foam rolled their hamstrings and did not stretch, had an average of only 6 degrees of improved hip flexion ROM. So, if you have tight hamstrings, I recommend making the time for both foam rolling and stretching. You might feel a little more pain than you would like, but you will see results!

4. Improved athletic performance

According to a study on collegiate male athletes, foam rolling performed in conjunction with a dynamic warm-up can lead to objective improvements in speed, power, strength, and agility.4 Peacock, Krein, Silver, Sanders, & Carlowitz. (n.d.). An Acute Bout of Self-Myofascial Release in the Form of Foam Rolling Improves Performance Testing. International Journal of Exercise Science. Retrieved March 2, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4831860/ This study showed improvements in 1 rep max bench press and 37 m sprint test after a dynamic warm-up and total body foam rolling, versus just a dynamic warm-up. A dynamic warm-up is a series of movement drills that gradually increase from light to moderate intensity. These may include squats, pushups, jump squats, high knees, etc.

Ok, foam rolling sounds great! How do I use a foam roller?

  1. Research suggests that you should foam roll each muscle group for 30 seconds to 2 minutes daily at a self-selected rhythm.
  2. Foam rollers can be used on many different muscle groups, and it is beneficial to perform total body foam rolling. However, if you have time limitations, it makes sense to foam roll the muscle groups that feel the most stiff or painful to you on that day.
  3. You can use a foam roller either before or after your workout. If foam rolling before your workout, you should use it in conjunction with a dynamic warm-up. If foam rolling after your workout, you should follow your foam rolling with static stretching on similar muscle groups in order to maximize gains in joint range of motion.
  4. Foam rollers apply the greatest amount of pressure at more proximal muscle groups (closest to your center of mass). On average, about 29-50% of your body weight is actually applied to the muscle group you are foam rolling. If you feel too little pressure, you can lift one leg up off the ground to increase the compression at the targeted area.
  5. Here are some examples of how to foam roll specific muscle groups:

Here is a video tutorial for foam rolling different muscle groups:

What kind of foam roller should I get?

There are many different types of foam rollers that you can buy. There are different lengths, densities, and surfaces of foam rollers available on the market. In my experience, foam rollers with higher density tend to last longer, and will give you a longer duration of use. This includes foam rollers labeled as “high density,” and those with a plastic insert in the center of the roller. However, you have to be comfortable with consistently using the foam roller you get. If you have a lower pain tolerance, you should avoid the spiky, deep-tissue massage option, and opt for the lower density foam. I generally recommend the 36-in length foam rollers in order to allow more room for movement without rolling off of the foam.

Want to learn even more? Here is a great summary on the benefits of foam rolling:

About Danielle MacCrory, PT, DPT

Danielle MacCrory is a physical therapist and clinic director at ATI Physical Therapy in Hanover, MD. When she isn't running a clinic, she enjoys spending time with her husband, Aaron, and taking care of her newborn daughter, Claire.
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