Can You Foam Roll Your Back Pain Away?

Foam rolling
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If you follow the trends in the fitness industry in any way, you’ve probably heard of foam rolling. These days, releasing tight, limited tissues with a foam roller is all but a staple technique for increasing your joint range of motion and recovering from post-workout pain.

It’s also a popular way to address myofascial pain, especially trigger points. The domain of massage therapists as well as many in the physical medicine profession, myofascial pain is generally associated with poor posture, although it may also be due to an injury.

The quintessential characteristic of a trigger point is referred pain. In other words, while the trigger point is a hard nodule that may be felt in one area, it generally results in a reliable, reproducible pattern of pain elsewhere. It’s this reproducibility that enables some types of therapists and doctors to get very specific when identifying and treating trigger points.

Despite its popularity as a quasi-therapy for such things, foam rolling has been the subject of little medical research. And even fewer studies have been done on the way in which this technique could be used to reduce or eliminate low back pain. Just the same, many people claim they find relief for their low back pain by using a foam roller to work over their fascia.

What Is Foam Rolling and Fascia?

Foam rolling is one type of a larger group of techniques known as self-myofascial release, or SMR. SMR is any technique you can do on your own that allows you to positively affect the fascia, usually in a gently sustained and/or gently pushing, pulling, or prodding sort of way.

And if you’re wondering what fascia is, it’s a net-like connective tissue that encases muscles, muscle fibers, and the entire musculoskeletal system.

At least one theory suggests that when fascia fibers become bunched up, this in turn binds whatever structure is contained within. In other words, according to this theory, if you think you have tight muscles, think again.

It could be that your bound up fascia is affecting your muscles.

But the fascial system is more than just a covering for muscles. Its fibers go in every direction and wrap around and through nearly every body structure; this extensive reach allows the fascia to influence not only muscles, but your organs and nervous system, as well.

And it’s strong; ask almost any holistic body worker what’s so special about fascia, and they’ll likely answer that it provides the body with its structural integrity, adding if you removed everything from a living body except the fascial system, the body would still be able to stand up and keep its form.

Foam rolling is the most well know type of SMR. Other types include self-massage techniques that are geared specifically for addressing fascia and using a golf or tennis ball to reach trigger points and larger areas of bound up fascia. According to the National Academy of Sport Medicine, (NASM) medicine balls and handheld rollers qualify, as well. The NASM adds that foam rollers come in a variety of sizes and densities, which may enable you to adjust pressure and related factors, so that your foam rolling efforts meet your tissue right where it’s at.

Making Positive Changes in Fascia With Foam Rolling

Given all this, you might understand foam rolling and other SMR techniques as ways to make positive changes in the fascia, to smooth out kinks and glitches that develop there (and that therefore limit your movements or result in soft tissue related pain.) Many people refer to such effects as release, but in terms of replicable science, the jury is still deliberating.

While proving that foam rolling releases fascial constrictions (rather than using more targeted, but possibly more accurate considerations such as noting temperature and thickness change in the fascia) has so far eluded medical researchers, this is exactly how it’s described by forward thinking body workers and lay people attuned to physical self-care methods.

Some pain researchers have gone so far as to assert that releasing certain types of fascia, at least in the time frame and at the intensity level of a typical foam rolling session, is not possible. This is due to the extreme toughness of the tissue, they say.

But toughness is dependent on where you’re foam rolling. For example, your iliotibial band, located on the side of your thigh, is extremely thick and tough, and difficult, if not impossible to “deform” which, in at least one study, correlates with the term release.

That said, fascia comes in a variety of densities, and can be quite delicate in areas, so it may still be possible to “release” this tissue type of adhesions, trigger points and “glitches.”

Other researchers, like Sanjana, et. al., who published a study in the January 2017 issue of the Journal of Bodywork and Movement Therapy, focus on identifying positive changes that occur in the fascia following foam rolling. Sanjana’s team evaluated the thoracolumbar fascia (which is the big, broad sheath of fascia in your low and mid back areas) in 22 foam rolling study participants. Specifically, the researchers found that the sheath’s thickness decreased after foam rolling sessions. They also found that flexibility (range of motion) increased, while pain decreased in the participants.

Posture, Injury, Fascia & Foam Rolling

Poor posture and imbalanced or compromised movement may lead to injury, and this triggers a healing response. This healing response starts with inflammation, which may progress to muscle spasm as well as the development of adhesions (i.e., trigger points or knots). The adhesions are part of this normal healing cycle; because they form in the fascial net, which contains nerves, they may therefore cause the referred pain we talked about above. 

Along with causing referred pain, the adhesions may reduce the elasticity of your soft tissues—not what you want if full range of motion and graceful aging is your goal. And as if adhesions weren’t challenging enough, if you don’t break them up, NASM says, their effects on the fascia can become permanent. NASM suggests SMR, and of course foam rolling for the task, saying these techniques may help you alleviate the adhesions as well as restore optimal muscle functioning.

Foam rolling may also help release the muscle encased by the fascia, NASM says. This is because of small nerve receptors that live in the muscle. These receptors are designed to sense and respond to excess muscle tension. Using a foam roller may put so much pressure on that nerve receptor that it is brought to a point where it “has enough” and signals the muscle to relax.

But this doesn’t make foam rolling an extreme sport. NASM advises loading your weight onto your foam roller lightly, with a bit of drag, and keeping it there for a while. If you roll too quickly, they say, you may feel something, but you’re not inducing myofascial release.

What About Using a Foam Roller on My Back?

After reviewing the background information above, you may think that foam rolling the muscles around your spine is the key to relieving low back pain. But the truth is, most fitness and therapy professionals recommend against the direct use of SMR devices on the back.

There are a number of reasons for this, not the least of which is that you need to control the movement and placement of the SMR device. Foam rollers can get big, and they move, but what you really need is to find the right “spot” and stay on it for a sustained period of time. If your therapy tool rolling about, you’ll likely be using excess muscle tension to control it and this may do more harm than good.

Another reason to avoid using your foam roller directly on your back is the proximity of the all-important kidneys and liver. While muscles may provide a bit of padding, these organs don’t get a lot of protection from your bones the way your heart and lungs, which live inside your rib cage, do. Working indirectly may help you respect your organs' vulnerability to injury.

Instead of targeting the back, NASM says, it’s best to approach your spine pain through your hips.

Because the hip muscles connect to the pelvis and the pelvis connects to the spine, these powerhouse muscles exert a lot of influence over both pelvic and spinal positioning; this, in turn, may affect tension levels and the number of fascial restrictions you have in the soft tissue of your back. Plus, getting the foam roller on the right “spot” and keeping it there tends to be a much easier to achieve feat when the roller is under your thighs or hips than when it’s under your back.

Foam Rolling for Low Back Pain Relief: Precautions

Before you take it upon yourself to treat your back pain with foam rolling, be sure you’re matching the therapy to the problem.

Most of the time, back pain is related to your muscles and posture, but sometimes it’s more serious than that. Do your best to make sure your back pain is not due to nerve compression. If you experience pain, weakness, numbness, and/or electrical sensations that go down one leg (what many people call sciatica) it’s best to consult with your doctor or physical therapist before proceeding.

And having another type of medical problem, whether it’s spine-related or not, it’s another reason to get clearance from your medical doctor before trying foam rollling. Some conditions that may not lend themselves to this particular activity include spinal instability, for example, spondylolisthesis, and/or connective tissue disorders. Talking with your doctor prior to starting foam rolling may help you choose the self-care program that is right for you, whether it's foam rolling your illiotibial band, your calves and quadriceps muscles, or your entire body.

Sources:

Chaudhry, H., Three-dimensional mathematical model for deformation of human fasciae in manual therapy. J Am Osteopath Assoc. Aug 2008. https://www.ncbi.nlm.nih.gov/pubmed/18723456

Penney, S., Foam Rolling - Applying the Technique of Self-myofascial Release. NASM. https://www.nasm.org/docs/default-source/pdf/foam-rolling--applying-the-technique-of-self-myofascial-release.pdf?status=Temp&sfvrsn=0.43279164331033826

Sanjana F., Effect of MELT method on thoracolumbar connective tissue: The full study. J Bodyw Mov Ther. Jan 2017 https://www.ncbi.nlm.nih.gov/pubmed/28167175

 

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