How to Foam Roll for Back Pain

A woman foam rolling her back out

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If you're one of the estimated 85% of adults who has experienced low back pain, you know how challenging it can be to get relief. Depending on the nature of the discomfort, foam rolling may be worth trying.

This approach relies on a technique called called self-myofascial release (SMR) to work on fascia, connective tissue that encases muscles, muscle fibers, and the entire musculoskeletal system that can become stiff, restricting range of motion and causing muscle soreness.

There is little research to confirm foam rolling for back pain is effective, and it has its pros and cons, but when done with care, integrating SMR into your self-care routine may bring relief from discomfort, make it easier to effectively perform stretches that address back pain, and allow you to move more freely during exercise and everyday physical activities.

What Is Foam Rolling?

A foam roller is a lightweight cylinder that varies in length and thickness: Most are 6 inches in diameter and have become ubiquitous in gyms, health clubs, and physical therapy practices.

The goal of foam rolling is to target trigger points—adhesions in fascia that can develop when you’ve worked muscles hard. In its healthy state, fascia is very flexible and has a gel-like consistency that allows muscles to move freely. Adhesions eventually heal, but when they do, tough non-elastic scar tissue forms and muscles can’t move as easily. These adhesions contribute to the painful "knots" you can feel in your muscles.

In practice, foam rolling involves finding trigger points and applying prolonged pressure to them—similar to the way a massage therapist might work out a knot to loosen a muscle. Studies have shown that foam rolling can be effective as part of a pre-workout warmup to get muscles ready for exercise or a post-workout recovery to prevent muscle tightening.

Benefits

It’s believed using a foam roller to put pressure on fascia warms and increases blood flow to the connective tissue while also breaking down scar tissue, restoring the fascia’s natural, supple state. This has several potential benefits:

  • Allows muscles to move more freely, which decreases the risk of injury during physical activity
  • Alleviates soreness and swelling after high-intensity physical activity by increasing the flow of blood and oxygen to muscles
  • Prevents new adhesions from forming
  • Induces relaxation after a workout, which allows muscles to self-repair
  • Induces autogenic inhibition: The theory behind this concept is that when applying steady pressure to a trigger point, the muscles and tendons will initially resist—so much that the body may even shake as it fights the prompt to relax. Sustaining the pressure will cause the nervous system to send out a message that the body has “had enough” and the muscles and tendons will relax and lengthen. This is the same process that’s at work during static stretching.

Challenges and Risks

Using a foam roller for back pain is not a straightforward endeavor. For one thing, because nerves run through the fascia, the pain felt in a specific area may not be in the same spot as the adhesion causing it—what's known as referred pain. For instance, the piriformis, a small muscle under the buttock, can cause lower backache. This makes it important to figure out the source of the pain in order to target it correctly.

What's more, using a foam roller incorrectly could increase discomfort or cause a new injury. If your back pain is due to nerve compression or if you experience pain, weakness, numbness, and/or electrical sensations that go down one leg (known as sciatica), applying pressure to the injured nerves could make your problems worse.

Foam rolling is also not recommended if you have spinal instability, spondylolisthesis, and/or connective tissue disorders. Talking with your doctor prior to starting foam rolling may help you choose the self-care program that is right for you.

Medical Condition Warning

Foam rolling is not recommended for pregnant women whose joints are naturally loose due to a hormone called relaxin. People who have rheumatoid arthritis flare-ups, deep-vein thrombosis, advanced osteoporosis, or neuropathy also should not foam roll. Never apply pressure to open wounds or fractures.

The greatest risk of injury the back with foam rolling is using it directly on the vertebrae of the neck or the mid- to lower vertebrae of the back.Doing so requires using intense muscle control to keep the proper form and hold the roller in place at a trigger point. Using the lower back muscles in this way may cause excess muscle tension, which can do more harm than good.

Using a foam roller directly on the lower back also risks making contact with the kidneys and liver. Muscles provide some padding, but unlike the heart and lungs, which are safely housed in the rib cage, the kidneys and liver don’t have bones protecting them. Putting pressure on certain areas of the back could injure the organs.

3 Foam Roller Techniques for Back Pain

To correctly use a foam roller to relieve back soreness, first identify the tender trigger points around your hips, buttock, hamstrings, or upper back—all places where tightness causes referred pain in the back.

Position the roller on one of these points. Using your core muscles, lean into the spot to add pressure and slowly roll back and forth over the knot in 1-inch increments for 30 to 60 seconds. Don’t be frustrated if you can only hold the roll for 10 seconds in your first session. It will be uncomfortable. However, you shouldn’t feel shooting pain or numbness. If you do, stop the rolling. Drink water after a rolling session, and incorporate muscle stretching to get the most benefit.

Here are three areas where you may find trigger points to target with a foam roller to reduce back pain.

Iliotibial band: The iliotibial band is a thick band of fascia that runs along the outside of the thigh from the pelvis to just below the knee. Working on trigger points in this area can improve range of motion along several muscle groups. 

  1. Sit on the floor with your right leg extended and your left leg slightly bent.
  2. Position the foam roller under your right hamstring, perpendicular to the leg.
  3. Lean back and balance your body between the right elbow and the left foot. 
  4. Roll the right leg up and down over the roller an inch at a time.
  5. Pause on any sore spots for up to 60 seconds, taking slow deep breaths.
  6. Continue for about two minutes.
  7. Switch sides and repeat.

Mid-upper back: Releasing tension in the area around and just below the shoulders can help the relax muscles along the length of the back.

  1. Lie on on your back and position the foam roller under your shoulder blades.
  2. Raise your hips and lean into the roller.
  3. Move the roller up and down (staying within the area of your shoulder blades) until you find a sensitive spot.

3. Hamstrings: The hamstring muscle runs along the back of the upper leg. When tight and inflexible, they can pull on the muscles in lower back and cause pain.

  1. Sit on the floor with your right leg extended and your left leg slightly bent.
  2. Place the foam roller underneath your thigh so that it's so perpendicular to your leg and just below your buttocks.
  3. Gently push your body back and forth over the roller, moving over the entire muscle from gluteus maximus to knee.
  4. Do it for 30 seconds to a minute, then switch legs.

Word from VeryWell

Finding the technique and the tool that works may take some time and professional guidance. As in every case of back pain, recovery takes patience. And, often, what the back needs is rest. Listen to your body and be careful not to overexert the muscles or fascia, which will only delay healing.

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Article Sources
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  3. Cheatham S, Kolber M, Cain M, Lee M. The effect of self-myofascial release using a foam roll or roller massager on joint range of motion muscle recovery and performance: A systematic review. Int J Sports Phys Ther. 2015;10(6):827-38.

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