Are Foam Rollers Good for Treating Muscle Pain?

Photo by Ketut Subiyanto: https://www.pexels.com/photo/man-lying-with-a-foam-roller-on-his-back-4804294/

Foam rolling has become increasingly popular as a means of both professional therapy and self-treatment of tight, sore muscles.

In case you’re not familiar, what I’m talking about is using firm foam cylinders, usually about six inches in diameter, to roll across areas of muscle tightness - kind of like using a rolling pin to roll out bread dough.

In professional settings, a therapist applies the treatment using varying degrees of pressure, but foam rollers are also commonly prescribed for self-treatment at home as well.

Given their popularity, I would expect the results of foam rolling treatments to be quite good, but my observation of the outcomes of it, at least as a stand-alone treatment, is that the results are pretty mixed.

Results of self-treatment are particularly iffy, likely because of poor technique / inadequate pressure (foam rolling yourself can be awkward and difficult to get enough leverage to really roll things out) and poor compliance with treatment recommendations. Doing it once every now and then when you think about it usually doesn’t produce very good results.

But even professional foam rolling treatments are kind of a mixed bag in terms of results.

As with any treatment, how well it works depends largely on what it’s being used on and the specifics of how the treatment is administered. Unfortunately, as with a lot of things, its popularity has led to foam rolling being applied in a lot of situations it’s not really all that well suited to.

Let’s start with the thing foam rolling does well. Done correctly, it can loosen soft tissue restrictions and improve circulation in relatively broad areas of muscle. So, it works pretty good on generally reducing tightness in larger muscle groups, such as the back, thighs, and calf muscles.

That’s of course beneficial, but that’s pretty much the extent of what it does. But it seems like foam rolling has become a go-to for all sorts of muscle pain, and the results are, frankly, pretty lack-luster in comparison to other methods.

Take for instance, the common issue of trigger points. These are small points of contraction, usually the size of a dime or less, often buried in the muscle tissue and/or tucked in grooves and crevices in the bone structures. This means they can “hide” pretty effectively from the broad surface effect of a foam roller. You could roll an area with a trigger point all day and never really address that issue.

Another common problem with trigger points is that they produce what’s known as referred pain, which tricks you (and oftentimes even health care professionals) into thinking the problem is somewhere other than where it is.

For example, I’ve had more than one patient who was getting (mostly unsuccessful) foam roller treatments with other providers for a “tight IT band” (the IT band is a fibrous band of tissue that runs down the side of the leg from the hip to the knee). Although their pain was in the area of the IT band, it was actually being generated by trigger points in the buttock area and quickly resolved when those trigger points were addressed.

In my experience, more focal areas of muscle contraction than what can really effectively be treated by foam rolling are more common symptom generators than the general tightness that foam rollers are effective at relieving.

Although unquestionably popular, using foam rollers as the go-to treatment for all things muscle just doesn’t work all that well from what I’ve seen.

So, if foam rolling isn’t really all it’s hyped to be, why is it still so popular?

It does, like I said, reduce broad areas of muscle tension, so there are legitimate benefits. But although it often falls short in other ways, it does have a couple of things going for it.

In a professional setting, providers can bill a couple of different insurance codes for foam rolling that are for massage and soft tissue release techniques. Foam rolling, although physically exertive for the person applying it, is usually at least somewhat physically easier overall on the therapist’s body to perform than a lot of other massage techniques.

It is also simpler to learn, allowing for unlicensed assistants to easily perform it under the supervision/instruction of a licensed professional. This allows professionals to provide the treatment at a higher profit point.

But foam rolling is also quite popular as a home therapy, which obviously has nothing to do with the physical wear and tear and business concerns of a health care professional. I suspect there’s a couple of reasons for this that lead people to look past the somewhat limited benefits.

The first is what I call “gadget syndrome”. Human beings typically like gadgets, even simple ones like foam rollers. It’s even better when a gadget has a relatively low price point that makes it affordable to most people – as is the case with foam rollers.

While plain old stretching provides many (and in many cases, all or even more) of the benefits that foam rolling does, gadget syndrome probably gives foam rolling an edge in the perceived value of the treatment for many people.

“Stretching is so old-school. I do foam rolling!”

The second reason I suppose is an actual benefit of foam rollers – you’re more likely to see the roller than a list of stretches that’s buried somewhere in a stack of papers and are reminded to do your self-treatment. That only works if you leave your roller out and don’t stick it in the back of your closet, or maybe use it as a float in your swimming pool, of course.

The bottom line is that foam rollers are a useful tool when applied properly to appropriate conditions, but in my opinion their current popularity is somewhat inflated for the results they actually provide – especially for self-treatment.

As already discussed, regular stretching (without any assistive gadgets) is just as good if not better than foam rolling in many cases.

For self-treatment of trigger points, devices like therapy canes (curved devices with handles that allow for deep, targeted massage of trigger points and small areas of soft tissue restriction) and electric “massage guns” (percussive massagers) are far more effective for most people than foam rollers, in my opinion.

If you’ve had good results with foam rolling, by all means, stick with it. But if you’ve been disappointed with it, perhaps you have a better understanding of why, and hopefully have an idea of how to approach your issues more effectively.

Until next time…

George F. Best, D.C.