Self-Myofascial Release: Choosing the Right Tool for the Job

 
By Keats

It’s fair to say that performing self-massage/self-myofascial release (SMFR) has become a staple in the personal training, strength & conditioning, and rehabilitative industries respectively. However, when something such as this becomes so popular, many of the fine points and details of HOW and WHY to perform the activity diminishes as the information gets watered down.

To help discuss the issues involved with teaching athletes and people self-massage, in the fall of 2011, I wrote an article for Training & Conditioning Magazine explaining the theoretical and practical use of the myriad of self-massage tools available today. In the article I also discussed some of limited scientific and mostly anecdotal benefits that users of self-myofascial release experience as well as various indications and contraindications of using a given SMFR device or tool.

General vs Specific Release

One of the the first things to determine when deciding to partake in a given SMFR technique is what is the goal? Are you after pain relief, better posture, relaxation, trigger point reduction, or better mobility and performance? And what are the best tools to achieve each of these goals? Since most people are familiar with foam rollers and massage sticks, it is important to understand which techniques and approach to use depending on the goal. When looking at most of the common uses of SMFR techniques, it appears that the affects are fairly general.

In the world of massage, general techniques would be basic strokes such compressions, effleurage and petrissage, while specific techniques would include deeper muscle stripping, trigger point pressure release (aka ischemic compression),  dry needling, and even spray and stretch using a vapo-coolant. (*To read more about Spray and Stretch check out the bible of trigger point release by Travell and Simons and my article on the subject here).

Skin work (superficial fascia release) can also be more general as in a crossed arm myofascial release hold, or more specific skin rolling, cupping,  or skin stretching techniques to work on superficial nerve health.

However, since most self-massage techinques can’t quite so specific, we have will mostly general effects and slightly more specific effects depending on the application of the pressure from the chosen tool and the specific intent.

It’s All About Pressure!

The Scientific  formula for pressure is as follows:

Pressure (P)= Force (in Newtons, N)/Area (cm^2)

To simplify for SMFR implements, the larger the surface area of the of the object, the less the pressure will be to any specific area. A Foam roller will not have as significant of a local effect as the a tennis or lacrosse ball or even a thera-cane. This should be pretty straight forward. A massage stick can also be used more generally by using larger sweeps across a given area, or taking much smaller strokes over a given area of tenderness to affect a trigger point or what other rehab professionals that are more neurologically-oriented call an Abnormal Impulse Generating Site (AIGS). Whether or not trigger points really exist (this is a hot debate), there is some kind of local phenomenon in which a small area of myofascial tissue becomes neurologically or locally facilitated and shortened (i.e. “taut band”). Call them what you want. but we all get these localized areas of pain and dysfunction and making them less noxious is a good goal to ensure quality movement can take place at the affected joint(s).

General and Specific Treatment Parameters

The key when applying treatment (whether self-massage or regular massage from another person) is to ensure tolerable pressure is applied to the body that should not be interpreted as serious pain. In the school of Neuromuscular Therapy (NMT), which is my primary massage training, we ask for pressure on a scale of 1 to 10 in the 4, 5, or 6 range. Occasional 7′s may be OK, but getting to an 8 or above is to be avoided to avoid over-stimulation of the sympathetic nervous system. The goal is NOT to destroy or kill these sensitive spots as many massage folk and trainers/coaches espouse. Work with your body not against it! Hopefully over time, these tender spots will improve as long  as some quality stretching/mobility work is used after the release followed by some new input into the nervous system to move in a prefred or less stressful way!

General SMFR:

Foam Roll or Stick: longer slow to medium paced sweeps over target area for 10-30 seconds depending on goal of the treatment and time available. Constant movement is the goal. If painful or sensitive spots are encountered, static pressure or smaller, more focused strokes/sweeps can be used to elicit a more local affect.

Specific SMFR:

Using tennis or lacrosse balls, a backnobber or theracane, or the new Tola System (read more below), ischemic compression via direct pressure from the device (i.e. theracane) or using gravity and bodyweight to “melt” into the object. 8-12 second holds (up to 20 second holds in some cases) is what we teach in the Neuromuscular Therapy. Excessive local compression can cause ischemia and subsequent hypoxia (lack of O2) so its better to re-visit a site several times rather than “crushing it” for several seconds or even minutes! Certain myofascial release methods with hands however can be held for up to several minutes with great effect but are not the scope of this article anyway.

I recently wrote a blog about foam rolling the sensitive kyphotic spine which shows how to go from a more “general” release of the spinal tissues and structures to a more specific one as the person’s nervous system warms up to the idea! You can read the blog and associated video here.

Also, be cautious when apply any SMFR Techniques and make sure to avoid these vulnerable are

Back of the upper neck under occiput

Anywhere Directly on the Spine (i.e. Spinous Processes)

Anterior Throat or Face

Brim of the Pelvis (Iliac Crest)

Abodomen or Breast Tissue

Inguinal or Upper Groin Region (Femoral Traingle)

Front of Elbows (Elbow pits)

Back of Knees (Popliteal Fossa)

Another tool that can be used as semi-general and specific and at the same time is what is called “small-ball” release. Of any of the self-massage tools, these can have the safest application near the vulnerable areas listed above. Specifically, the anterior abdomen area (for Psoas release), the Quadratus Lumborum/oblique area between the 12th rib and iliac crest, the upper back/scapular region (including the levator scapulae attachement on the scapula), and even the base of the skull (sub-occipital area) can be effectively and safely treated using the small massage balls. I did a blogpost (with video) on releasing your own hip-flexors using a small ball which can be read here.

The following video discusses some of the topics I just mentioned above:

As you saw in the video, I am extremely fond of a new self-massage device called the Tola System. These little adjustable domes really allow for a graded progression into specificity of pressure; better than almost any other devices I’ve used. You can get the Tola systemhere. OPTP has it cheaper than Amazon and is where I got it. The Pressure Positive Company also makes many wonderful devices for slightly more specific work.

I also created a 2-disc DVD set a few years ago that goes over many way to use SMFR implement. It can be purchased off my products page.

I hope you enjoyed the article and please feel free to share it with anyone you know or email me with any questions or comments about any of this: ksnideman@gmail.com

Keats