Ask An Expert: Physiotherapist on the Benefits of Self Myofascial Release

At MoveWell, honesty is central to our values, both environmentally and clinically.  Here, we intend to provide you an outline of the best evidence available to support the use of our products.

What are the benefits of Self-Myofascial Release?

A number of potential benefits for Self-Myofascial Release (SMR) are cited. These include:

  • Improved muscle length tension ratio
  • Improved joint mobility
  • Enhanced recovery over Delayed Onset Muscle Soreness (DOMS)
  • Neuromodulation of injury-related pain soft tissue pain

How well founded are these claims? Two recent systematic reviews (1&3) of the clinical evidence-base looking at Self-Myofascial Release (SMR) have found have a range of valuable effects, including:

  • Increased joint range of motion with no detrimental effect on power output (unlike static stretching)
  • Reduced perceived Delayed Onset Muscle Soreness (DOMS)
  • Indications that SMR may lead to improved vascular function, and increased parasympathetic nervous system activity, which may also be useful in recovery.
  • Finally, there is some evidence that long-term SMR may lead to improved overall flexibility, however not all studies supported this suggestion.

How is Self Myofascial Release beneficial in preparing for exercise?

The first two stages of an effective warm routine should incorporate the following;

STAGE 1 THERMOREGULATION
Raise temperature and increase blood flow to the muscles, preparing the cardiovascular systems for the demands to place upon it.


STAGE 2 DYNAMIC MOBILITY
Preparing articular joints and supporting tissue for the ROM and the movements they are likely to be out through. Considering predominant planes of motions and movement demands.

Although stretching alone has been shown to affect range of motion (ROM) in the short-term, these studies have also suggested an impairment in subsequent power out-put and therefore on undesirable effect on performance. Foam Rolling has therefore been advocated as an alternative to static stretching, to be used in the initial stages of a warm-up, prior to task specific dynamic movements and then activation through load acceptance. 

Optimising joint ROM is paramount prior to sport to ensure the joint is primed to move and take load through its range, reducing likelihood injury. One study looking at specifically at knee ROM and the effects of foam rolling of the quadricep group, demonstrated 12.7% and 10.3% increases in knee-joint flexion at two minutes and ten minutes respectively, following two 1-minute bouts of foam rolling. A further study demonstrated quadriceps ROM into flexion remained 11% and 9% greater at 48 hours and 72 hours, respectively after treating exercise-induced muscle soreness with a foam roller (3).

In addition to this, California State University looked at which type of roller leads to the best results. In short, higher density rollers led to a slight increase in ROM, but importantly, vibration and the surface texture led to no increase in ROM (1).

In light of this, MoveWell is happy to advocate the use of effectual foam rolling in the initial part of a warm-up, prior to task the specific dynamic movements, activation and load acceptance phases. We have bought to market a range of SMFR tools that are simple and effective. Made from Cork – a responsibly sourced natural material, high density, with anti-bacterial and microbial properties.

 

How is SMR beneficial in recovering from exercise?

Massage and SMR have consistently been demonstrated to reduce perceptions of Delayed Onset Muscle Soreness (DOMS). In 2018, Dupuy et al (2) completed a comprehensive meta-analysis into an evidenced-based approach for choosing post-exercise recovery techniques. 99 high quality studies were reviewed and ‘faster recovery’ was determined by several different outcomes, including perceived muscle soreness, perceived fatigue, inflammation (as measured by proxy blood markers like interleukin-6 and C-reactive protein), and muscle damage (as measured by the proxy blood marker creatine kinase). The results highlighted that active recovery, massage, compression garments, immersion, contrast water therapy, and cryotherapy all had positive effects on perceived muscle soreness. Importantly, the best results for mitigating the effects of DOMS, fatigue and inflammation came from massage. It can then be postulated that SMR is a cost-effective way of achieving an effective recovery by as we are able to complete at the correct times post exercise and consistently.

We should be clear that SMR is part of the jigsaw and athletic recovery should be complimented by the following key elements to allow your body the best chance to recover:

  • Achieve optimal sleep (commonly believed to be >8 hours per night, but specific to the individual)
  • Task specific warm up (preparation) and cool down (recovery) addressing movement in all three planes of motion, include SMFR dynamic movements, activation exercises and graduated load acceptance.
  • Avoid static stretching pre-exercise as it has been shown to reduce strength, power and explosiveness
  • Don’t go too hard, too fast, graduate training loads over several weeks.
  • Optimal hydration spread throughout the day
  • Nutritional intake appropriate for your demands
  • No alcohol consumption post exercise.

At MoveWell we have created travel ready packages to enable both consistency in SMR and our activation bands to enable neuromuscular preparation and load acceptance through movement and positions that are specific to the activity being undertaken.


How is SMR beneficial in Injury Rehabilitation?

Myofascial Release in both passive form and SMR, is best utilized during the correct stages of therapeutic rehabilitation where access to an increased range of motion or pain control enables greater immediate participation in rehabilitation exercises and normalising functional movement. SMR has been shown to effectively modulate painful neuromuscular stimuli (3). This allows a window of increased AROM through which mobility and graduated loading exercises are less painful, more effective and more easily progressed.

The observance of the increased pain pressure threshold (PPT) after foam rolling has now been well documented in the evidence base. Researchers theorize that pressure from the roller elicits a response from cutaneous and mechanoreceptors, the resulting nociceptive response triggers either the gate theory of pain pathway or the diffuse noxious inhibitory control theory pathway. Another study into ankle ROM (3) demonstrated a crossover effect by increasing ROM in the contralateral (untreated) leg. This crossover result suggests an additional global neural response.

MoveWell advocate the use for SMR in the right scenario and the correct stages stages of healing in a therapeutic rehabilitation setting. However, this should be determined by a health professional with appropriate experience.

What is Neuromuscular Preparation?

Once we have raised our temperature and prepared our joints and soft tissue to work through their optimal ROM, the next stage is to gradually get your body ready for the demands you are about to impose on it, whether that be rehabilitation exercise or high intensity exercise/sport – we should prepare the system to operate effectively. This staged approach has been repeatedly proven to prevent injuries and reduced recovery times. In essence, neuromuscular preparation is incorporated into stages 3 and 4 of this model:

STAGE 3 PRE-ACTIVATION
Waking up and preparing muscle groups specific to the plane of movements required in the task being undertaken. Starting with de-loaded movements and graduating the load into the next phase.


STAGE 4 LOAD ACCEPTANCE
Preparing for expected load requirements by performing sports specific movements up-to the loading requirements in a controlled environment.

Are activation bands essential to sports preparation? No. So, what do they add? The bands enable us to graduate load through the pre-activation phase and into the load acceptance phase directly before starting the activity. This effectively prepares muscle and tendons for sports specific loading, importantly in a more functional position for the activity being under-taken. Plus, they can make your warm-up routine more fun and interesting when compared to non-specific, on the floor, against gravity exercises that are often used.

In light of this, MoveWell have developed our activation bands in three resistances, which can be doubled up to increase external load and used to functionally load the system in a graduated way. In addition to this, our multiband also offer a different way to vary the movements to achieve a task specific loading as required.

How long should an exercise warm up be?

As a rule of thumb a pre-exercise warm up should be between 5-10 mins long and graduate movement amplitude and tissue loading through the discussed four phases;

• STAGE 1 THERMOREGULATION
• STAGE 2 DYNAMIC MOBILITY
• STAGE 3 PRE-ACTIVATION
• STAGE 4 LOAD ACCEPTANCE

It should be understood that, if the individual has been static or cold for a long period, e.g. desk based or driving, directly prior to exercise, a warm-up should be slightly longer i.e.15 mins enabling gentle progression. Equally, if an individual has been more active prior, then warm-up could be shorter and focus on the specific elements of the task demands.

In addition, warm-up duration should be tailored to the task in hand. For low intensity tasks – e.g. zone 2 running, which is being completed predominantly in one plane of motion, an athlete may opt for a shorter focused warm-up to stave off injury and build gently load intensity into the run (See Jo Meeks Q&A). However, a CrossFit athlete about to complete a high intensity, high load, WOD for example would need to consider a longer 15-20 minute warm up to ensure they have effectively optimised joint ROM, then activated and graduated load through there system in all planes of motion to near task loading requirements– to ensure less shock to the system and pre-disposition to injury.


How long should an exercise recovery session be?

The length of time is really going to depend on your activity specific fitness level and task demands. Recovery should be incorporated into your routine as part of intense blocks of exercise.

For example, if you’re a distance runner, active recovery directly post run may come in the form of 5-15 minutes of brisk walking and a 5-minute roll and stretch routine – whereby relevant muscle groups are being used at a lower intensity. An active recovery session on a day off, may come in the form of a 20-40 min walk / bike spin and a 20-minute roll and stretch session. For higher intensity exercise across all planes of movement, active recovery directly post session should shift the emphasis to replicate much lower intensity work through those planes of movement, combined with stretching – a 5-minute spin and a 5-10-minute roll and stretch session can go a long way. An active recovery session on a day off, may come in the form of a 20-40 min walk / bike spin / swim and a 20-minute roll and stretch session.

REFs:

1. Filley, A., (2020) Rolling, Rolling, Rolling. Sports Injury Bulletin - https://www.sportsinjurybulletin.com/rollin-rollin-rolling/
2. Dupuy, O., Douzi, W., Theurot, D., Bosquet, L. and Dugué, B. (2018) An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis. April 26; 9:403. Front Physiol.
3. Hamiliton, A., (2018) Roll away the blues. Sports Injury Bulletin - https://www.sportsinjurybulletin.com/roll-away-the-blues/