The (Non)Sense of Foam Rolling and Breaking Up Adhesions/Fascia

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The (Non)Sense of Foam Rolling and Breaking Up Adhesions/Fascia

#physiotutors #foamrolling

🎶 Intro/Outro Track: Pharien - What You Say
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This is not medical advice! The content is intended to be educational only for health professionals and students. If you are a patient, seek care of a health care professional.

[abdalabiore]

Your material is probably 10-15 years ahead of what most physios are practicing.

[kinesiopro]

I am the author of the Foam Rolling Chapter in the latest (2022) fascia book - Fascia: The Tensional Network of the Human Body. This is the 2nd edition with the "whos who" of fascia research. I discuss this same concept in my chapter. Can't "roll out" adhesions and scar tissue issues as well as the fact that the name "self myofascial release" is not technically correct. It should be called something like "tool assisted soft tissue mobilization". As an update, however, we have come to find in laboratory studies, that mild to firm VERY slow movement (rolling) over the muscle does help move old fluid out of muscle tissue and surrounding areas and encourage fresh fluid in. THIS is true hydration. Drinking water is great, but it needs to be encouraged into the many many spaces in the body. You can accomplish this with exercise, but there is nothing that takes the place of pressure - tool assisted or manual therapy. So, the hydration aspect and sensory aspect are other things to consider besides performance results or pain relief results.

[ubercorey]

Rolling my quads transformed my leg/knee issues built up over a couple decades of being a blue collar worker. Two weeks of foam rolling every morning and I could stand from a squat with zero pain. Zero. My knees almost completely stopped grinding.

I used to have to use a chair or window ledge to stand up, now I can pop straight up one leg no pain.

Will stick with the foam rolling.

[joem]

As someone with multiple injuries still doing physical therapy and foam rolling. It helps me

[andrei]

I hope you guys will blow up sometime soon. This chanel is a hidden gem

[HyperCircle]

So my 2 cents as a self taught sport deep tissue massage specialist who learned this field after being tired of going to countless fisical therapists who were stuck in their own little worlds (many in the 1980's). My background is as a scientist. I fixed my own frozen shoulder which was surprisingly easy, making 15 years of going to countless specialists all the more frustrating. Not saying everybody is bad, some were good, but way too expensive and typically have blinders to one therapy style. I am grateful, however, as i did learn multiple techniques from the good physical therapists which i merged with updated research on fascia.

It is true, foam rolling has limited uses for compression and shearing. Compression and shearing causes deep tissue fascia to produce fasciocite cells which produce hyaluronic acid. This helps the fascia stay hydrated (thus elastic and promotes gliding). Thats the main premise. However, rolling isnt as effective at compression and shearing, and i agree it is limited to IT band, doms prevention (somewhat) and spinal flexion. This is because it cant provide enough compression and shear for most muscle groups. Smaller diameter rollers are better for the legs(it band) as you can put more weight, thus increasing compression and with movement, shearing. It can be somewhat effective with DOMS however as it does help drain sarcoplasm.

Compression shearing is much better done with golf/lacrosse balls (glutes/piriformis), manual compression shearing(hands/elbows/heel), transverse friction(ciriax) and percussion massage(therabody pro) (best for self application and most efficient)

When people say it breaks up adhesions, it is not primarily between connective tissue fascia and deep fascia (though compression shearing also helps with connective fascia hydration).

Compression shearing is primarily to help shear collagen fibers within deep tissue fascia ; ie epimysium, perimysium and endomysium. For example, you dont want individual muscle cells / fasciculus becoming adhered(non gliding) to each other nor do you want the fascial band to be so tight(dehydration) it limits blood circulation and muscle range. Tight fascia leads to muscle energy crisis and thus muscle trigger points where there isnt enough atp to remove calcium as well as creating an ACh neural feedback loop and the release of sensitizing susbtances (pain). Many things can cause trigger points. In latin america physical therapists call them contractures. I find the terminology easier for people to understand.

Compression + shearing of deep tissue fascia while it is warm (more effective), which, aside from increasing fascia mobility, stimulates production of fasciacyte cells and therefore hyaluronic acid, which in turn helps fascia glide properly and be more elastic as hyaluronic acid is the primary factor in fascia hydration. Make sure patients are taking magnesium - max 400mg. About 100-150mg for a 1L bottle of water with 1/8 tsp of himalayan salt. Magnesium citrate is good for most and wont make you sleepy.

Compression and shearing + transverse friction also helps reset contracted muscle bundles by causing the tissue to become inflamed, thus bringing in oxygen and removing toxings. The longer a muscle bundle has been in a contracture, the more the facsica becomes brittle and dehydrated. Follow up sessions are exponentionally more effective as the tissue becomes more responsive to compression and shearing.

Nothing gives me more joy than helping somebody run after *2 sessions* (with a few maintenance follow ups) when 5 knee "specialists" completely failed. My patients love me. I am cheap and more effective. Because i use a machine primarily, i dont wear myself down as much and im far less painful and more effective. Being a patient for so long was a really good intro into this field.

So far i mainly work with a lot of BJJ, along with muay thai, taekwondo, soccer, pole sport, ultras, triathlonists, surfers, ballet (probably the most impressive muscles out of the bunch), hikers, rowers, gym, calethetics, and weight/ power lifters.
I have thought of going to a med school, but alas when i see what they teach they are behind. We have advanced a lot in terms of fascia understanding. In the end, torn ligaments and cartilage i refer to physical therapists. There are plenty of those and they are important. Many surgeon doctors are scammers who get kickbacks for each surgery they do. If i could, id get them into a rear naked choke and write "i will not suggest surgery for kickbscks in their face". Doing surgery on a knee when it is a myofascial problem should be foundation for a lawsuit. Sorry it's just healing those patients who inevitably end up with worse huffa pad than what they stated is frustrating. They are good for ligaments, cartilage. But thats it. They need to stop looking to do surgeris.

I only do deep tissue maintenance and contracture release. We needmedical deep tissue massage schools.

[DrFarisArab]

Im an Orthopeadic physical therapist. your channel provide Great materials I appreciate the knowledge you guys provide..keep it up

[viyank]

Mythbusting series is my favourite, more of these

[DD]

Hi Kai,
so refreshing to see actual scientific content in easily understandable format on YouTube. Great English as well!

[RobindenBoer]

I honestly feel like I learn more from your guys' videos than I learn in school. It's brief, highly educational and explained clearly. Thanks!

[chadfriel]

Thanks for the Video. I'd have to agree that exercise is by far the most beneficial for the health of the body. But Foam rolling can be really helpful if you already have pain that is limiting range of motion and not allowing you to perform exercise. For example: if I go to the gym and have knee pain due to patellar tracking problems, and Vastus Lateralis hypertonicity is causing this. It's beneficial for me to foam roll/press for two or three minutes to release tension in the Vastus lateralis. Once the muscle has decreased it's tone and some myofascial release has occurred, I can now perform a pain free squat.

[axonhealth]

As a chiropractor I can not tell you how much of my rehab for disc derangement and radicular symptoms come from your channel. Your channel combined with Don Murphy's CRISP protocols for disc derangement, radiculopathy, myofascial, and facet issues are all anyone needs to provide EXCELLENT care. Thank you so much for everything you do.

[drzhuphysio]

I often use foam rolling to decrease muscle pain, specifically as it relates to DOMS - and often also use foam rolling for trigger point therapy on my TFL as I have experienced ITB syndrome before and have found trigger point therapy on TFL to be effective in conjunction with hip abductor strengthening. I am not refuting the results of the study but I do want to offer my two cents on how you might make foam rolling more effective for yourself and for your clients.

Specifically, I believe there is value in foam rolling a muscle prior to stretching it (take the quad for example). If we know that foam rolling leads to a short term gain in ROM, I’d imagine that foam rolling used in conjunction with stretching immediately after would yield a greater effect on ROM than just stretching by itself. It surely feels this way anecdotally. Foam rolling a muscle before stretching that same muscle allows me to have an overall more enjoyable and deeper stretch than if I were to just stretch alone. Additionally, the technique when foam rolling is also very important. I like to foam roll on bare skin whenever possible and oscillate up and down on small sections of the muscle at the time. This allows you to get that “sliding” and “shearing” effect on the underlying superficial fascia and muscle tissue as the skin does get stretched as you move up/down with the foam roller (again technique is important).

Lastly, and again this is from my personal experience - I do think that a vibrating foam roller is more effective and efficient than a regular foam roller because the vibration helps me tolerate deeper pressure due to the gaiting effect on pain. Tolerating deeper pressure means I’m able to achieve my objective in a shorter time frame (less than the suggested 90s time frame per muscle group).

[athiroajphawinthanawit]

Thank you. Can't wait for a Trigger point video!

[dos]

This should be the only approach in physiotherapy, evidence based and cautious on selling "the cure" to the public. Great content!

[sarahverguetmoniz]

Hi there! As an ultra trail runner and huge fan of foam rolling (i was using it before it became the "trend") i have to say that foam rolling + stretching was what kept me away from any overuse syndrome... at least, for me, it worked more than anything... there is an article (i dont remember the name) that compared the 90-90 test ROM whitouth any 'device', with stretching alone' with FR alone and both combine and the results are speechless, an 'adding' effect that needs to be more studied... but i agree about the fascia/scar tissue... FR ir mors about the golgi organs that 'relaxes' the muscle fibers ;) that being said, i keep recommending FR+stretching to my patients ;)

[Sergei__v]

I tried it just recently and I can see considerable difference in the perception of pain and overall wellbeing. I returned to practicing Taekwondo two weeks ago. The training is hard and keeps me close to lactate threshold through the workout. 4 workouts with a day in between got me well above my average work out load and required considerable recovery. Foam rolling helps with recovery tremendously. I feel great and it only takes 5 minutes. Great stuff

[derekathomson]

I've been foam rolling for many years now and have used various types of rollers, plus tennis and lacrosse balls, a massage gun and various other tools.
Personally I've found it to be highly effective for reducing stiffness and pain in muscles and nearby joints.
It doesn't remove scar tissue or knots in muscles, but definitely, for me, prevents muscles from going into spasm and gets them out of spasm also.
Whether a foam roller, lacrosse ball, massage gun or a massage from a therapist; they can all be effective for reducing or eradicating stiffness, aches and pains.
I find that the benefit will last until some activity or exercise causes problems again, in those muscles ('resctivating the trigger points). The exercises that do this most are those that involve a lot of momentum, like Olympic lifting, or high impact like plyometrics, or repetitive strain exercise like running. If these exercise types are avoided, then the ebenfuts of foam rolling/myofascial release last a lot longer, in my experience.

[winston]

I really like this format! I would be interested to see an analysis on dry needling sometime in the future

[kittensandtheglitz]

Foam rolling is the only thing I’ve found so far to help with my excruciating back pain and stiffness.