Foam Roller in Physical Therapy Exercise Prescription

Exercise prescription is an important part of a physical therapy program and likewise, foam rollers are often a valuable piece of equipment in an exercise or rehabilitation program. Rollers can be used for many different purposes and can have positive effects not only on many different ailments but also on improving sports performance. Foam rollers are inexpensive, easy to use and are therefore well accepted by patients as well.



Foam rollers, sometimes called ‘frollers’, come in several different shapes and sizes. The most common is the 36″ long, 6″ round format. Other variations on shape and size include the half roll, which is a vertical half and therefore flat on one side, and the short roll which is half the length of the typical roll. The half roll is often used for less advanced exercises with the person gradually progressing to use the full roll. Often, less expensive foam rollers are less dense and have cells within the foam that can be crushed with prolonged use and therefore become less effective. It is worthwhile to spend a bit more money on a high-density foam roller as it will generally last much longer. For those interested in taking their foam rollers with them when on the road, or simply want something that takes up less space, there is a great product called the Travel Roller that takes up less space in a suitcase or in your home.

The Foam Roller for Massage and Self Myofascial Release

The most common purpose of the foam roll in exercise prescription is likely for the massage-like effects it can produce. This technique is often referred to as ‘self-myofascial release’ or SMR. To produce the effects of massage you usually use the foam roll in conjunction with your own body weight by lying on the foam roll with the affected muscles directly on top of the roll. By slowly rolling over the target area of the affected body part you are essentially massaging the muscle. By properly positioning yourself and moving on the roll in this way you can actually reach very deep muscle tissues. Conveniently, if you come across a point or points in the muscles that are particularly uncomfortable you know that this is an area that needs to be worked. By rolling over these tight ‘trigger points’ with your body weight you squeeze the muscles and in turn elongate the local muscle fibers. This elongation provides a local stretch that stimulates stretch receptors in the area; the golgi tendon organs. Stretching these receptors can result in a physiological effect called autogenic inhibition which produces a relaxation in the muscles. The deep tissue massage from the direct pressure of rolling over these trigger points also aids in the breakdown of fibrous scar tissue that can build up in injured or tight muscles. Breaking down this scar tissue will increase the flexibility and pliability of the muscle. The deep massage may also result in a localized increase in blood flow that will help to flush excess metabolites and toxins from the area. Using the foam roll to massage the tight areas of a muscles prior to doing your active muscles stretches significantly increases the benefit of your typical stretches. This is because stretching a muscle that has tight trigger points largely stretches the healthy muscles tissues that do not need to be stretched. By working out these trigger points, or ‘knots’, first, you can then more effectively stretch them with your traditional stretching exercises or your foam roll stretches. Don’t be surprised if you find differing amounts of trigger points on one side of the body relative to the other, or differing amounts of discomfort when rolling over the same point in a muscle but on the opposite side. This is indicative of muscle imbalances. We all have muscles imbalances to some degree. Regularly massaging out these trigger points with your foam roller will bring you closer to restoring the optimal balance in your muscles.  

Iliotibial Band/Tensor Fascial Lata self myofascial releasePhoto by: E. Quinn

 

Stretching and Mobility

Regular stretching helps you improve and maintain flexibility. In turn, flexibility is important in maintaining healthy joints with a full range of motion. Many exercises can be performed with a foam roller to enhance a stretching routine. The foam roller can help target specific muscles and tissues. As an example, the pecs and anterior chest are commonly areas of significant muscle and tissue tightness. This tightness often exacerbated by, or directly the result of, the common chronic position people often find themselves in as they hunch over their desks and computers. You can achieve a great pec stretch while lying down with a foam roller underneath you along the length of your spine. Once in this position, bend your elbows to about a 90 degree angle and bring them to be level with your shoulders while letting your hands gently drop back towards the floor. This position can be held for your usual passive stretch duration and repeated. Another example involves the shoulders which can be targeted more specifically by going on hands and knees with one hand on the roll. With the foam roll at various angles to your body on different sets, allow it to slowly roll up your arm as you reach ahead of you or out to the side.  


Foam roller exercises can also be help in increasing the mobility of a stiff back. This can be achieved by rolling back and forth or side to side over a full round foam roller with the roller either parallel or perpendicular to the spine. The rolling should be focused on the stiffer areas, usually the thoracic or mid spine. Your physical therapist can tell you your specific areas that need targeting. Ensure that you do not experience sharp pains while using this technique. If you do, discontinue targeting the offending area.

In addition to rolling over stiff spinal segments, other movements can be performed to improve spinal mobility. On good example is alternate arm raises while lying on a half or full roll with the roll vertically along your spine. Place your head on one end of the roll and raise one straightened arm straight up so that your elbow is beside your ear. At the same time move the other straightened arm down along side your body. Alternate this movement slowly.

There are many more ways that the roll can be used to stretch tight muscles and tissues and to improve mobility. For a routine aimed at addressing your unique needs you should see your physical therapist.

Improving Balance, Strength and Sports Performance

In addition to the more typical uses for muscle massage and stretching, foam rollers are often incorporated into exercise programs to enhance balance and strength. It is common for physical therapists to prescribe exercises that are to be performed on unstable surfaces such as on wobble boards Bosu balls (add description). The foam roller is another piece of equipment that can be used for this purpose.

Performing exercises while standing on an unstable surface helps to improve overall balance, sport specific movements and also improve core strength. In additional to working the main muscles being targeted in the exercise, the deep muscles of both the abdomen and back are also required in order to maintain balance.

There are many progressions that can be used when exercising with a foam roller. Less advanced exercises can involve simply doing bridging with your feet on the roll. Bridging is an exercise that is performed by lying on your back with your knees bent. The bridging part comes in when you push through your feet and lift your hips and torso off of the floor while keeping your head and shoulders on the floor. Initial progressions from the standard floor bridge include bridging with your feet on a half roll, bridging with your feet on a full roll and then on to single leg bridging (only one foot on the roll with the other leg extended straight out) and then to standing on the roll. Free weight exercises such as bicep curls are often performed while balancing in standing on a roll. On the even more advanced end of the spectrum are barbell squats while standing on a foam roll.

Sports performance can dramatically improve by performing exercises and sport specific movements on the unstable surface of a foam roller. To make these activities even more beneficial, try using the foam roll to stretch and massage affected muscles first and then perform the movements on the roll using the newly pliable and lengthened muscles.

Foam rollers are inexpensive and can be very effective tools in reducing pain due to muscle imbalances and tightens as well as in improving flexibility and core strength. Simply rolling over the tender areas in your muscles for a few minutes a day is a great way to increase and maintain your musculoskeletal health. When used in a proper exercise regimen they can help improve your sports performance as well.

While you can achieve very effective deep muscle massage with proper use of a foam roller it is not a replacement for proper treatment from a registered massage therapist. For best results you may want to consult your physical therapist for a proper assessment and prescription of a suitable exercise program.


2 thoughts on “Foam Roller in Physical Therapy Exercise Prescription

  1. My performance in volleyball games have improved in sense that my muscles feel less sore. I was able to identify trigger points by foam rolling and it also has helped in muscle balance. They are now a part of the post-training regimen of our team.

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