Mobilization; is it useful?

By many, self myofascial therapy (foam rolling, compression therapy, mobilization, etc.) has become accepted as an important addition to training programs. With the rise in well rounded, functional training programs the desire to keep the body healthy during training has individuals searching for ways to decrease stress and improve recovery. So when is it appropriate to perform these mobilization techniques? Does foam rolling and/or mobilization do anything at all?

Over the course of my career, I have come to accept that different professionals have different opinions. Nearly all topics relating to health have been controversial at one point. Cardio vs. weight training, high fat vs. low fat, paleo vs. keto, bodybuilding vs. CrossFit, real sugar vs sugar free, glass half empty or half full? Mobilization techniques and its appropriate timing has not been untouched either. Some are of the belief that self myofascial therapies do not work and are a waste of time, while others believe wholeheartedly that mobilization has saved their lives. My perspective is based upon a combination of research and my own clinical experience.

According to the Journal of Physical Therapy “There is evidence that concludes that short bouts of foam rolling prior to exercise increases range of motion without performance impairments. There is even more evidence that concludes that foam rolling after exercises as an active component in recovery helps reduce delayed onset of muscle soreness, muscles fatigue and improve muscular performance.”

According to the Journal of Athletic Training “After an intense bout of exercise, foam rolling is thought to alleviate muscle fatigue and soreness (ie, delayed-onset muscle soreness [DOMS]) and improve muscular performance. Potentially, foam rolling may be an effective therapeutic modality to reduce DOMS while enhancing the recovery of muscular performance.”

According to the Journal of Medical and Science in Sports and Exercise “The most important findings of the present study were that foam rolling (FR) was beneficial in attenuating muscle soreness while improving vertical jump height, muscle activation, and passive and dynamic range of motion (ROM) in comparison with control.”

As you can see here, we have research stating that foam rolling is beneficial before AND after training. In addition, clinically, I have found that it is useful in attaining goals of pain reduction, improved range of motion and balance and improved recovery of tissues, when used to manage treatment with a patient.

In my clinic, we use myofascial therapies as an adjunctive therapy that the patient can do between visits to decrease and control pain. The majority of these athletes report that performing specific mobilization between visits and before their workouts has been helpful. They describe decreased pain levels while training through an injury; which gives them the ability to have some control over the healing process. It gives them more depth without pain through the movement, is helpful in preventing the pain from returning in the future and helps the athlete feel more balanced overall. Important note: each condition/diagnosis may require different timing in which that athlete should or should not perform mobilization techniques. Seeking help in finding the appropriate timing for a specific condition is recommended.

What is the appropriate protocol for the athletes who experience no pain at all?

As the research articles mention: prior to exercise, it helps to increase range of motion allowing for myofascial release of tissues. After exercise, it is useful in recovery from muscle fatigue, soreness and overall increasing muscle performance. It even states that it may be helpful in increasing one's vertical jump height. Pretty awesome!

That being said, nearly every athlete has a compensatory movement pattern; where the body shifts, twists, or bends through an exercise due to tightness or restriction. Not all of these athletes will be experiencing pain. Even the most hypermobile athletes experience this. Identifying these areas and attacking them with mobilization techniques prior to their workout, specifically before the exercises where they shift, twist and/or bend can dramatically improve range of motion and eliminate compensation.

Example:

Squatting with a tight (adductor magnus/gracilis) inner thigh muscle causing a pelvis/hip shift to the right side at the bottom of an athletes squat (see picture below).

Sometimes unnoticed by even the athlete themselves, their squat has adapted to restriction in the soft tissue, causing their hips to shift. This small shift allows the body to move past an obstacle in the tissue, providing a deeper squat (compensation). This creates an abnormal pattern in their movement that will eventually, if not already, result in pain somewhere in the system. In many instances, simple mobilization (foam rolling, smashing/mashing) prior to squatting relieves this shift resulting in proper positioning and biomechanics. NOTE: this shift could also be caused by other factors as well such as joint restriction, other joint defects, past surgery, etc. For this example, we are speaking only of normal soft tissue restriction.

Don’t run out of the gym just yet! If you find yourself very sore after your workouts, and struggling to recover for your next training session, evidence suggests that mobilizing after your workout will help reduce stress on the soft tissue, and aid in recovery so that you will be ready to hit the gym the next day. When asked how long they should spend mobilizing my answer to patients usually involves a combination of factors. Everyone has a strict schedule to keep, but we also want to increase performance in the gym. Generally speaking, more time = more results, however, in my clinical experience, as little as 3-5 extra minutes after training, can yield dramatic results.

Dr. Heather Bourdon-Russell

Owner of UnBroken Chiropractic

www.unbrokenchiropractic.com

References:

Foam Rolling for Delayed-Onset Muscle Soreness and Recovery of Dynamic Performance Measures. Journal of Athletic Training. Pearcey. Gregory E. P.

Foam rolling as a recovery tool after an intense bout of physical activity. Journal of Medicine and Science in sports Exercise. Macdonald . GZ.

Macdonald GZ Button DC Drinkwater EJ, et al. Foam rolling as a recovery tool after an intense bout of physical activity. Med Sci Sports Exerc. 2014;46(1):131‐142. [PubMed]

Sullivan KM Silvey DB Button DC, et al. Roller‐massager application to the hamstrings increases sit‐and‐reach range of motion within five to ten seconds without performance impairments. Int J Sports Phys Ther. 2013;8(3):228‐236. [PMC free article] [PubMed]