By the healthiergang writer , ISSA certified personal trainer and student at SaNIS (School of Nutrition and Sports Integration).
Myofascial release
The use of the foam roller or similar tools is becoming increasingly popular in recent years, the problem is that its use is indiscriminate and often the mechanism is not even understood. Actually what good is it? How does it work? Does it give real benefits? Let's see how to answer all these questions in detail.
Foam Rolling
Let's go step by step, foam rolling is a technique used to achieve myofascial release. Specifically, it is characterized by being a self-myofascial release technique, therefore we intervene with massages done independently, without the need for a technician. This is already an indication of the accuracy with which one must proceed (ie if you roll on the roller like pigs in the mud bath, maybe you are doing something wrong).
The technique is relatively recent (70s), originating in osteopathy as an integrative therapy in the context of preventive care and in the healing philosophy that emphasizes the importance of body-mind. It is also often used as pain therapy, it has in fact been supposed to have effects similar to acupuncture [1]. But how does it work? Let's make some anatomical clarifications:
1. DEEP BAND
It is a dense fibrous connective tissue, which penetrates and surrounds the muscles, bones, nerves and blood vessels of the body. It is a passive structure (some research suggests otherwise [2]) that transmits the mechanical tension generated by muscular activities or external forces throughout the body.
2. FASCIAL RESTRICTIONS
Following an accident or trauma or repetitive stress, the fascia can be restricted by tensing and contracting (so-called myofascial pain syndrome). This obviously will lead to problems of different kinds, both in terms of mobility and pain phenomena in the execution of certain movements. In the long run, the phenomenon can lead to the so-called “adhesions”, of a scarring nature, which can stiffen the muscles and cause further trauma.
As you can see, these problems are mostly chronic and, although arising from acute phenomena, they develop over time. Obviously in the athlete the risks are accentuated and prevention plays a central role. The myofascial release therefore allows the fascia to relax bringing benefits also in terms of circulation, thus benefiting all the tissues of the body [6].
3. TRIGGER POINT
They were extensively studied in the 900s by Dr. Travell. These are small points of muscle contraction. As a result of excessive and prolonged contraction (for example due to a tension of the fascia) a state of hypoxia and accumulation of metabolic residues is created locally. The sarcomere becomes unable to release the contraction and assumes a state of mechanical and permanent stiffness.
The sum of more sarcomeres in this abnormal state gives rise to the trigger point nodule which in turn gives rise to the taut bundle of fibers that runs along the entire muscle. In this situation, the muscle involved will be in a state of chronic hypertension and general weakness with logical repercussions, among other things, on athletic performance. It will result in the need for a mechanical intervention. The trigger points can be active (pain on palpation even a short distance from the point) or passive.
Two clarifications are now needed: the first is that the myofascial syndrome and the trigger points are different phenomena, albeit often overlapping and interconnected. We will therefore see that they will have to be treated differently and, for the latter, the intervention of a specific therapist will be more logical even if only for the identification of the same.
The second clarification is that myofascial syndrome and trigger points are different from fibromyalgia and tender points [4], although the two types of phenomena are often confused. Fibromyalgia is a chronic syndrome caused by dysfunction of the limbic system and / or the neuroendocrine axis. Mostly required for a multidisciplinary treatment that includes physiotherapy, exercise and low doses of antidepressants, on the other hand, tender points have a still unknown etiology.
How to intervene?
Now, after the catastrophic picture indicated above you will have bought at least 10 foam rollers and you will have contacted as many specialists. Calm down. As mentioned above, the problems tend to be chronic, so what you have to do is start, little by little, to intervene through a program that is primarily preventive.
We all have tensions in the band, given by prolonged postures over time and above all by the little interest that people tend to give to the issue. Instead, every tissue in our body should also be taken care of outside of training to optimize its adaptation processes and make it generally healthy. So starting a band release program can only be good for everyone in different ways.
As for the treatment of trigger points, well these are a subsequent phase and certainly to be ascertained, so I recommend that you contact a specialist who checks the situation in order to discuss together the possible strategies to be adopted. The treatment of trigger points is a more complex issue that we will eventually analyze in a subsequent article.
Travell initially proposed the use of a needle possibly with the addition of an injection of an anesthetic. The technique has not been well received and currently less invasive methods are preferred through specific massages and the exercise of prolonged local pressures [5].
Self-Myofascial Release
We finally arrive at the autonomous techniques of myofascial release, techniques that see the use of the foam roller as a prince. It is a foam roller on which certain parts of the body are made to slide using the force of gravity to exert pressure at the fascial and muscular level. It starts from the end of the muscle, slowly sliding up to the middle, the operation is repeated sometimes, after which the same procedure is carried out for the other half of the length of the muscle.
If you find a particularly sore point do not avoid it, go around it until the tension created on the spot is dissolved. Initially the practice is rather painful, in a short time, both for the progressive loss of tension at the fascial level, and also for a better ability of each, it will become more "gentle". Remember to avoid bony prominences such as knee joints, ankles, etc. Generally, for the treatment of fascial tensions, the use of the technique is recommended for 5-10 minutes a day.
Let's see all the benefits deriving from this methodology.
1. BENEFITS ON FLEXIBILITY
Acute improvement in flexibility has been shown. The only problem lies in the fact that this improvement is limited to a short period (about 10 ') [7] [8] [9]. However, there does not seem to be a dose-dependent efficacy (ie do not massacre hours on the roller, it is useless). Curiously, it does not seem that, in order to obtain the benefits, it is necessary to intervene in the muscles adjacent to the joint involved, however there is still no clear vision about the exact point on which to intervene for each joint [10].
Moreover, an improvement in chronic flexibility has been found when the myofascial release program was continued for more than 2 weeks [10].
2. PERFORMANCE BENEFITS
This is the area on which we have tried to deepen more as the methodology was proposed as an alternative to static stretching to benefit from an increase in flexibility without incurring decreases in performance. In fact, studies on the subject have shown not only that there is no decrease in performance [12] but also an increase in the same in acute [11].
3. DECREASE IN DOMS
Another field in which the application of myofascial release has been proposed is that of the reduction of doms. As difficult as it is to measure it, a benefit has actually been found on the perception of painful sensations associated with them [13] [14].
4. IMPROVEMENT OF BALANCE
There are few studies on the subject [15] and the evidence still scarce, however it seems that there are also improvements in terms of proprioception and balance.
Using the Balls
In addition to the foam roller, it is also possible to use small balls of different types that give us a substantial advantage: the possibility of intervening in a more specific way on certain areas (for example, lateral or rear deltoid). The smaller surface will also lead to a higher pressure and, therefore, to a more intense treatment. The benefits are similar to those of the foam roller.
Generally three types of balls are used:
1. Specific ball for the treatment of trigger points. It tends to be harder than the other two even if it has a higher cost. Certainly the most effective, but this does not mean that you cannot get a benefit from the other two too .. on the contrary ..
2. Lacrosse ball. Harder than the tennis ball, in my opinion the best in terms of value for money.
3. Tennis ball. The softer of the three, the cost is really negligible but a minimal saving compared to that of lacrosse.
Body Rolling
Different from Foam Rolling, Bodyrolling involves the use of balls of different shape, surface, size, hardness, pressure.
Compared to the Foam Roller there is a quid pluris given by the instability. This type of work is usually done in functional training for the improvement of one's own receptivity and stability as well as for specific exercises to strengthen the CORE.
Practical Tips
So, after this general overview, let's see how to use the Self-myofascial release techniques.
1. WARM-UP
First of all, there do not seem to be any circumscriptions to certain activities. There are benefits in terms of flexibility and performance, therefore the methodology lends itself well to being a valid warm-up for the different types of sports.
The ideal is a joint use of the ball and the foam roller. In fact, the two methods lend themselves to being used for specific muscle groups. Just as it will be difficult to intervene on the deltoid with the foam roller, so it is more uncomfortable to use the ball on the hamstrings. It should then be specified that the ball lends itself well to intervene in points where trigger points have formed or are forming, therefore it has a more sectorial and specific use (except of course my advice to have an expert intervene).
The warm-up done in this way will allow greater flexibility which must however be maintained during the exercise. Thus, as we may see in a subsequent article, it will be convenient to intervene with a combination of these methodologies together with dynamic stretching and then start the sporting activity by immediately working in the ROM degrees "unlocked" by the previous work on flexibility.
2. COOL-DOWN
Another use is to cool down. In this sense, we will encourage recovery processes and carry out further work on flexibility. However, I recommend this practice in sports where it is not usual to work on extreme ROMs.
Thus it will make sense in weightlifting where we have potentially lost the acute effect of increasing ROM, it will not make sense in gymnastic exercises where we will have maintained a work on different degrees and angles for the duration of the activity. In this case the advice, always to favor the recovery processes, is to perform a mild static type stretching.
3. OTHER MOMENTS
Not less important! In moments when you are inactive or maintain certain postures for a long time, it can help to "detach" to perform stretching and myofascial release work. This in fact will ease any tension in the fascia (as we have seen) and will facilitate the spraying and innervation of the tissues.
Leaving aside for a moment the discussion of injury prevention and the importance of the warm-up, this is probably the most important moment in which to perform these specific exercises and which is too often underestimated by athletes (amateurs in particular).
In conclusion
Basically it is good to remember that the muscle tissue we care so much must be taken care of. The muscle is active 24 hours a day, not only in the moment of training. Care and dedication exist not only in the training session but also before, after and between the sessions themselves. The processes of recovery, adaptation, growth are all processes that cannot ignore the health of our tissues, if this goes into the background we can apply all the "no Pain no Gain" we want, the results will not be maximized anyway.
