Dr Graeme’s comments
We really like what people are trying to achieve with foam rollers. However, the results of clinical trials of their use are not remarkable, and their unsupervised usage does carry some risks. We believe patients or clients would be safer and get more reliable benefits by using one of our vibration massagers with appropriate professional advice.
The use of foam rollers in sports
Dr Graeme’s comments
Professional massage therapy is used extensively by professional sports clubs and athletes. Seeing these benefits but not able to afford these professional services, others playing sports or exercising attempted to emulate this therapy by the use of foam rollers. This is done by using one's body weight to press on the roller, emulating the pressure of a professional masseur. It's proponents claim that it is not as effective as massage therapy performed by a professional, but has the advantage of being inexpensive and practically unlimited.
Do they work?
The use of foam rollers tries to emulate a highly valuable professional therapy. How does the use of foam rollers compare?
One would imagine that the results obtained in clinical trials would be as good as it gets. Subjects would be professionally examined to determine suitability, given appropriate instructions, then well supervised. The results in those clinical trials we found were a mixed bag. They are summarised in the appendix to this article.
Real world usage
In real world usage users would not be appropriately selected, instructed or supervised. Lets look at what is likely to happen.
Use on inappropriate conditions
In the trials subjects would be excluded where usage was inappropriate, such as usage on damaged tissue. In the real world users may apply heavy pressure to things like torn muscles and haematomas.
Appropriate pressure and efflurage
Professional masseurs are able to examine tissues then determine the appropriate pressure. Home users may not have this judgement.
"Good pain" vs "Bad pain"
The use of foam rollers is trying to emulate ischaemic compression (trigger point therapy) and some other forms of massage. These forms of massage are often painful. Masseurs often describe this as "good pain". Properly qualified masseurs are trained to understand the difference between "good pain" and pain produced by pressing on structures such as injured tissue or neurovascular bundles. On the other hand members of the general public usually are not. The dangers of having untrained people applying heavy pressure to these structures thinking they are producing "good pain" are obvious.
As professional sports find, there are huge benefits to be had from the plentiful availability of massage and soft tissue therapy. The idea behind foam rollers being able to provide inexpensive practically unlimited such therapy is an excellent one. However, the optimum usage in clinical trials only produces moderate and inconsistent results, and there are real issues with real world usage. The following is what we suggest is a better solution.
To be safe and get the best possible results professional advice is needed. Routine usage should be discussed with a profession, then further advice should be sought where conditions change, such as a new injury.
Use a vibration massager
We believe that the use of a vibration massage would give safer and more consistent results. They are easy to use with proven benefits. More importantly:
- They are far less reliant on the need for the correct skills and pressure. All one does set the machine at the desired speed, then place the head over the appropriate area for the recommended time. Because of this they should give far more consistent results.
- There is no issue apply pressure or cause pain. This removes any danger of applying too much pressure and mistaking "bad pain" for "good pain".
Appendix One: The research on the use of foam rollers
The treatment group performed self massages using a foam roller over an eight week period. The length of the hamstrings was measures by measuring knee extension with the hip at 90 degrees flexion. Compared with the control group no significant difference was found.
The effect of using foam roller on various aspects of athletics performance were measured. No improvement was found.
Hip extension was measured using a lunge. After one week there was some improvement. The use of five sessions a week produced no further improvement. However, participants felt satisfied with their intervention and were happy with the feeling of self control.
Both hip extension and knee extension were measured. There was a small increase in hip extension, but none for knee flexion.
Hamstring length was assess using hip flexion with the knee extended. The use of foam rollers caused an increase in length.
Hamstring flexibility was assessed using a sit and reach test. The use of foam rollers was shown to increase hamstring flexibility.
A four week trial measured hamstring length using a reach test. Both PNF stretching and the use of foam rollers were assessed. Both showed a similar increase in length.
Hamstring length was assessed by measuring knee extension with the hip at 90 degrees. Foam rollers produced no improvement.
- Miller, Rockey Foam Rollers Show No Increase in the Flexibility of the Hamstring UW-L Journal of Undergraduate Research IX (2006)
- Healey KC1, Hatfield DL, Blanpied P, Dorfman LR, Riebe D. The effects of myofascial release with foam rolling on performance. J Strength Cond Res. 2014 Jan;28(1):61-8
- Bushell JE1, Dawson SM, Webster MM. Clinical Relevance of Foam Rolling on Hip Extension Angle in a Functional Lunge Position. J Strength Cond Res. 2015 Sep;29(9):2397-403.
- Vigotsky AD1, Lehman GJ2, Contreras B3, Beardsley C4, Chung B5, Feser EH1. . Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test. PeerJ. 2015 Sep 24;3:e1281
- Mohr AR1, Long BC, Goad CL Effect of foam rolling and static stretching on passive hip-flexion range of motion. J Sport Rehabil. 2014 Nov;23(4):296-9
- Sullivan KM1, Silvey DB, Button DC, Behm DG. Roller-massager application to the hamstrings increases sit-and-reach range of motion within five to ten seconds without performance impairments. ) Int J Sports Phys Ther. 2013 Jun;8(3):228-36.
- Junker DH1, Stöggl TL The Foam Roll as a Tool to Improve Hamstring Flexibility. J Strength Cond Res. 2015 Dec;29(12):3480-5
- Grace Couture, Dustin Karlik, Stephen C Glass,* and Brian M Hatzel The Effect of Foam Rolling Duration on Hamstring Range of Motion Open Orthop J. 2015; 9: 450–455.
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About Dr Graeme
Several years ago Dr Graeme, a Chiropractor practicing in Victoria, Australia was looking for a serious hand held massager his patients could use at home to get the extra quality massage they needed. The ones he found in the shops and on-line for home use looked nice but were not serious, and... read more