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\u00a0<\/h4>\nBy: Alex Siyufy, DPT, ATC, SCS, Cert. MDT, Cert. DN<\/h4>\n
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March is Athletic Training month!\u00a0 Besides all of the work that Athletic Trainers (ATCs) do on the field, there\u2019s a lot of work that ATCs do \u201coff the field\u201d to get their athletes ready for play.\u00a0 One of the emerging trends in rehabilitation is to release Trigger points (TrPs) via foam rollers.<\/p>\n
Twenty years ago you would hardly have ever seen a foam roller, but now they’re everywhere.\u00a0 A search on Amazon for “Foam Roller” produces over 36 pages of results!\u00a0 But what does the research say about “Foam Rolling” for the release of TrPs.<\/p>\n
A RCT by\u00a0Wilke, Vogt, & Banzer (2018) studied the effects of self-foam rolling on Latent TrPs.\u00a0 The authors took 50 subjects with Latent TrPs in their Gastrocnemius muscles.\u00a0 The subjects were randomized into 3 groups:<\/p>\n
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- Static compression via Foam Roller for 90 seconds<\/li>\n
- Dynamic Foam Roller for\u00a0for 90 seconds<\/li>\n
- Prone lying with Placebo laser\u00a0 for 90 seconds<\/li>\n<\/ol>\n
Each subject’s TrP was assessed pre and post using a pressure algometer.\u00a0 So what were the results?\u00a0 Only one group showed a significant improvement:\u00a0 The Static compression group.<\/p>\n
So is this what you would have expected?\u00a0 Probably not…but when you consider the dosage over the TrP, the outcomes seem to make sense.\u00a0 When you have your patient perform a traditional foam rolling with movement, the TrP is actually getting very little stimuli over the actual TrP, while a larger amount of the adjacent area is being stimulated.\u00a0 Perhaps this is effective in the acute stage of an Active TrP, but not for a Latent, or dormant, TrP.<\/p>\n
How should this feel?\u00a0 \u00a0<\/em><\/strong><\/p>\n
This study instructed subjects to increase the pressure until it feels like a 6-7 on a NPRS.\u00a0 Another study by Aboodarda et al (2015) also had subjects receive TrP release techniques to a 7\/10 on the NPRS.\u00a0 So it looks like that “strong but comfortable” cue might be appropriate.<\/p>\n
Are there any other options for foam rolling?<\/em><\/strong><\/p>\n
Well, it turns out that you might also want to consider changing the location.\u00a0 A study by Cheatham & Kolber (2018) examined the effects of dynamic Foam Rolling on the Quadriceps muscle group.\u00a0 The results showed the ipsilateral Hamstrings and the contralateral Quadriceps had significantly decreased sensitivity and decreased pain when tested with a pressure algometer.\u00a0 This aligns with the centralized sensitization model and the overall neurphysiological response elicited with Foam Rolling<\/p>\n
Summary<\/em><\/strong><\/p>\n
Foam Rolling over the painful or tight area might not be the best option.\u00a0 An evidence-based approach might be to perform static compression (30-90 seconds) directly over the TrP or to perform Foam Rolling over the antagonist group or contralateral extremity.\u00a0<\/p>\n