If I had to come up with one piece of equipment that can be the most effective in treating a vast array of ailments, it would be the foam roller. This simple piece of foam can be found across the globe in almost every gym, PT clinic, training room, and household. This 36-inch long by 6-inch in diameter piece of foam is a godsend for many people. I witnessed the beginning of this movement (pun intended) in 1985. A Physical Therapist from Marin County, Brian Hauswirth, PT, GCFP (Guild Certified Feldenkrais Practitioner), and I were taking a long-term manual therapy course at Folsom Physical Therapy. Brian showed us PTs in the Sacramento region what he and his colleagues were doing with the foam roller in the bay area. Brian taught courses for Gregg, and Vicky Johnson, owners of the Institute of Physical Art (IPA), and another instructor, Kent Keyser, PT, were all using the foam roller in their daily practice with patients. These PTs set the stage for how to use the foam roller in the clinical setting. It went viral (no pun intended). It was an easy sell job for any PT to see how this tool could loosen up the spine by lying on it with the roller perpendicular to the spine and rolling back and forth (see figure 1).
Fig. 1. Perpendicular rolling. “The hallmark exercise.” A great spinal mobility exercise for the thoracic spine. Caution: Do not roll onto the low back. This maneuver could cause a low back injury. This exercise is a contraindication if you have osteopenia or osteoporosis. Consult your PT on the proper use of foam roller exercises.
These Bay Area PTs were getting these rollers from the shipyards of Oakland, California, and cutting them down to the 36 -inch lengths. It just so that they happened to be that length because that was the limit of the box size UPS would ship for a specific price. Today, of the many companies that manufacture and sell foam rollers for the fitness and health care markets, the length is still 36 inches.
Brian Hauswirth and his colleagues at the IPA were the first PTs that were using the foam roller to evaluate and treat patients with musculoskeletal pain problems. Side note: Brian's mother, Carol Hauswirth, is a Nevada County resident and his father, Don passed away last April 24, 2019. He was a Korean War veteran and a POW. Brian and his colleagues in the bay area had extensive training in orthopedic manual therapy (OMT), and integrating some of the concepts of the Feldenkrais method (a type of brain/exercise therapy) allowed them to begin to see the value of this simple tool. In 1985 – 86, Kent Keyser and Brian Hauswirth started teaching courses to PTs in the bay area and then across the US on how to use the foam roller in treating orthopedic and neurologic conditions. The concepts of using foam roller exercises in physical therapy exploded across the US and took on a whole new life of its own for the Hauswirth's. Brian and his wife made a business out of selling foam rollers out of their home. Brian was running his private practice at the same time he was selling the rollers. They would buy the raw foam in 9-foot lengths from the shipyards and would cut and ship them all over the US. This side business continued from 1988-2000. The business of selling foam rollers became so overwhelming and costly with rising malpractice insurance rates that the Hauswirth's let it go. Other companies getting into the market picked up the orders.
Almost every physical therapist, chiropractor, personal trainer, or bodyworker uses a foam roller in their practice and on themselves. I roll out my back and legs every day. I use it to assess my muscle soreness and spine mobility. If I find a tight or painful site, I will work it up and down, side to side until the pain subsides. I find it particularly helpful for people that must sit for extended periods. As a cyclist, being in a flexed spine posture for hours at a time, I find rolling out my spine after rides is a godsend to my aging spine. I keep thinking of Joseph Pilates' quote, "If you are 30 and have a stiff spine, you are old, if you are 60 and have a flexible spine, you are young." I want a flexible spine, and I turn 60 towards the end of this year.
Here are a few of the most effective foam roller exercises to keep your body moving and feeling good. (Note: This list is only a fraction of the many things you can do with a foam roller to keep your body healthy and mobile. These are my terms for the exercises so they may differ from what you have called them)
Before starting your foam roller routine, try this body scan concept to see if the exercises are making you feel better. Lie on the floor, feel the imprint of yourself on the floor. Think of a body print like a handprint or a footprint. Everyone has a unique footprint, as well as body print. Feel the spaces between the floor and your neck, low back, back of your knees and ankles. These spaces are normal, and your body should be comfortable. Then perform one of the exercises at a time for a few minutes and re-check your body print. Is your body flatter? Does it feel more relaxed? If your answer is yes, you are doing the right thing. If not, keep going and keep checking how each exercise makes your body print change.
1. Perpendicular rolling: Lie back onto the foam roller perpendicular to the mid-back. With bent knees, lift your buttocks and slowly roll up and down your back.
2. Parallel rolling / Ironing: Lie on the foam roller lengthwise so that your spine is on the roller from head to tailbone. Arms out to sides touching the ground. Think that you have a cup of water on your belly, and as you move, try not to let it spill. Roll back and forth so that the roller massages the muscles between the shoulder blades and your hips.
3. Parallel reciprocal arm reaches. Lying on the roller lengthwise, raise one arm overhead as if reaching to the wall behind you. The other arm reaches in the opposite direction as if you are sliding the hand down toward the foot. This maneuver will roll out different parts of your arm.
4. Parallel roll, "Touchdowns." Lying on the roller lengthwise, put your arms in the "touchdown" position and raise and lower the arms to feel the stretch in the chest and front of the shoulder region.
5. Parallel snow angels: Lying on the roller lengthwise, put your arms out to the sides, and make snow angels.
6. Gluteal rolling: Sit up on the roller. Roll onto one side of your buttocks. With a hand and foot on the ground, roll out the gluteal muscles with a back and forth motion.
7. Thigh rolling: Position the foam roller under your thighs (Quadriceps). While maintaining a stable trunk, allow your thighs to rest on top of the roller. Then roll up and down the thighs.
8. Shin rolling: Put the foam roller under your shins. While holding this 4-point position, roll out the shins by bringing your hips and knees back and forth.
All these exercises should be without pain. If you are a senior (55 years or older) and have poor bone health, consult your healthcare professional before starting a foam roller exercise program of rolling out your spine. Have fun, stay healthy, and remember having adequate spinal flexibility is a major key to a healthy back.