If you’ve been suffering from chronic knee pain, you might have heard of foam rolling. Foam rolling is on the rise as a popular treatment for chronic knee pain, but does it really work?
First of all, a little review. Foam rolling generally means using solid rollers, made of dense styrofoam or plastic. You place them under your body so that your weight presses the relevant body part onto the roller, and then slowly move that body part up and down against the roller. Some rollers are shaped more like a rolling pin, with handles for you to hold as you roll them up and down your body.
The roller works against your body almost like a rolling pin does rolling pastry; it presses out flesh and muscle, smoothing it flat. Does it really do anything to relieve chronic knee pain or increase joint function in sore, swollen, or inflamed joints?
We’re going to look into it more deeply.
Can Myofascial Release Help Joints Move More Easily?
Foam rolling is sometimes also referred to as myofascial release, because it primarily works on your fascia. The fascia is a layer of slippery connective tissue that covers your entire body. It lies between your skin and your muscles and wraps around every twine of muscle and ligament. Because it’s so slippery, it ensures that all your muscles can contract and relax smoothly below your skin.
But when you exercise, and as you move during your normal daily life, it can make the fascia gather together and appear bumpy. When the fascia fibres get stuck together, they form “adhesions” or “trigger points” that can be painful. Fascial adhesions can restrict your movement, change your gait, and increase the risk of injury. For example, plantar fasciitis is a painful syndrome, caused when the fascia on the bottom of the foot forms adhesions.
Back to myofascial release. When you roll those foam rollers over your body, the rollers push the fibres apart and smooth out the bumps in the fascia. In scientific language, fascial tissue is thixotropic. This means that when you roll over it, you break down scar tissue and turn it back into a kind of gel which can spread evenly over your body. A study published in the International Journal of Sports Physical Therapy concluded that using a foam roller to break the fascia back down to its gel-like state can increase the range of motion (ROM) of the joints.
This may work fairly quickly to heal plantar fasciitis pain because when you roll the bottom of your foot with a foam roller or a hard massage ball, you spread out the fascia again. Myofascial release is not generally considered to be as effective for knee pain, because the fascial adhesions are only one part of the complexity of causes, but it can be part of a long-term solution.
Foam Rolling Can Send the Right Signals to the Brain
Therapists also think that myofascial release works because it stimulates signals to your brain. The fascia is very thickly studded with nerve receptors, which are what make it so painful when adhesions cause it to “catch” on something, but also make it so responsive to massage and foam rolling.
When you roll the fascia, it stimulates the nerve receptors to send a message to the brain, which then sends a message to muscle cells to loosen up. The same neurological signals might help relieve knee pain a little, because they tell your nervous system to decrease pain signals sent by that muscle.
Foam rolling increases blood supply and breaks up knots
When you go to a massage therapist, they do more or less the same thing as a foam roller when they use their thumb, fist, or elbow to break up knots in soft tissue and increase blood flow around your body. Improving blood flow to your muscles and joints is important. Blood carries oxygen and nutrients that your joints need to heal tiny tears that cause pain.
When you compress the soft tissues in your legs and hips with a foam roller, you soften the tissue and release tightness. When the tissues are more relaxed, it lowers pressure on the joints and that can improve joint motion and ease pain.
Can Using a Foam Roller to Loosen Tight Muscles Relieve Joint Pain?
When you press on a muscle with a foam roller, you stretch it out and force it to elongate. Once you release the pressure, the muscle still remains slightly longer, and therefore looser, than it was before, and that can be important for reducing pressure and tension that causes joint pain. In this way, the foam roller works in the same way as ordinary stretches do to ease joint pain.
Using a Foam Roller for IT Band Pain Doesn’t Work
Many runners suffer from iliotibial band, or IT Band syndrome which causes chronic knee pain. The IT Band is a thick belt of fascia that runs from your hip to just below your knee. When it gets too tight, it can pull your knee out of alignment and inflame the area, causing knee pain. It’s very popular to use a foam roller to roll and release the IT Band, but this does not actually work.
Here’s why: your IT Band is far too thick and too tightly anchored at each end to respond to foam rolling. You can’t loosen it by stretching or rolling it with a foam roller. Even experiments using a cadaver couldn’t make this work. In fact, if you try, you may even end up making it tighter and inflame it more, causing more pain.
Foam Rolling Muscles Around the Knee Can Improve Knee Function
But there is an alternative, which is to use the foam roller to release other muscles and tendons that lie around your knee, like your quadriceps in the front of your thigh; the Tensor Fasciae Latae, or TFL, which lies near the top of your hip; and the Tibialis Anterior and Peroneus, which lie down your shin.
When you roll your quads, it loosens them up so they don’t place as much stress on the knee and the joint moves more easily.
When you loosen the TFL, it stops it from pulling the IT Band so tight, and that allows your kneecap to straighten up. It’s been found to bring a noticeable improvement in knee function, but the jury is still out about knee pain. Still, when you improve alignment within your knee joint, you’ll prevent further pain from appearing. Loosening the TFL is best done with a small, hard massage ball, rather than a foam roller.
The tibialis anterior controls your ankle movement. If your ankle or foot biomechanics are misaligned or weak, it destabilises your entire leg, causing knee pain. If your tibialis anterior gets too tight, that can make the head of the fibula, one of the bones in the lower leg which ends at your knee, get stuck. It can’t slide back and forth properly, forcing the kneecap to bear all the force when you move your knee, triggering joint pain and inflammation.
Using a foam roller to release these muscles can improve knee function and help it to move more easily, preventing any increase in pain. By easing tension around the knee joint, foam rolling can also lower existing pain, especially if combined with other therapies like AposHealth to correct the biomechanics of your foot and leg.
Is Foam Rolling Good for Warmups Before Exercise?
One of the main ways that foam rolling works to improve stiff joints and reduce knee pain is that it can be very good as part of a pre-workout warmup routine. When you use a foam roller for a few minutes, it raises the temperature within your muscles, enabling them to produce the same effect with less force.
This can make it possible to go about exercising without exerting as much force on the knee, which in turn can reduce the risk of overstressing the joint and causing pain and injury. So, although the foam roller won’t do much to relieve existing knee pain, it may help prevent further damage and exacerbating the pain.
Foam Rolling Can Improve Knee Function and Fight Knee Pain as Part of a Long-Term Strategy
Overall, foam rolling is more efficient at preventing knee pain from appearing or getting worse than for treating existing knee pain, but it may also be helpful as part of a combined plan to treat chronic knee pain.
Disclaimer: This article is for informational purposes only. If you are suffering from knee and joint pain, please consult with your medical clinician before undertaking any treatment plan.
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