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Foam RollingPrinciples & Practices

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In this course, Trigger Point Performance™, Inc. teaches with a “train the trainer” style, for demonstration pur-poses only. Practitioners must ensure they have the legally required licensing for teaching and applying MCT

techniques, including physical contact with consumers. Immediately discontinue contact with consumer if the consumer displays signs of discomfort or upon request.

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Special Thanks to all TriggerPointTM employees and extended family for additional support.

Acknowledgments & Contributors

Education Department

Content Authors

Kyle StullBrynne ElliottJamie Howell

Creative Department

Art Direction & Design

Dimitri GarciaTravis Nottingham

Project Development

Project Management

Kim McCallumChristina DeMarco

TRIGGERPOINTTM PERFORMANCE THERAPY5321 Industrial Oaks Blvd. Ste 110 Austin, TX 78735

Phone: (512) 300-2804Toll Free: (888) 312-2557

Fax: (270) 682-6586 E-mail: info@tptherapy.com

Contact & Local Information

©2010-14 TriggerPoint PerformanceTM Inc. All rights reserved. No part of this document including terms included herein may be used, stored or reproduced in any form or by any means without prior written permission from TriggerPoint PerformanceTM Inc.. Requests and enquiries concerning reproduction and rights should be addressed to TriggerPoint PerformanceTM , 5321 Industrial Oaks Blvd, #110, Austin, Texas, 78735. Telephone 512-300-2804.

None of the information set forth in this booklet shall constitute or be the provision of a medical evaluation or treatment.Users who experience continued pain or problems are encouraged to consult a physician.

TriggerPoint PerformanceTM , does not assume responsibility of any kind for improper use of the TriggerPoint PerformanceTM tools.

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Table of Contents

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I had always been “that guy” – the guy that did everything extreme – and I enjoyed the reaction I got from people when I told them I had just completed a marathon or an Ironman. I enjoyed seeing the shock on people’s faces – I thought that was my confidence! In reality, that was my cockiness. I believe confidence comes from within, but when I was diagnosed with fibromyalgia. I was totally stripped of every piece of confidence I had. I was forced to look within myself in order to understand how I was going to move efficiently through the rest of my life.

I founded Trigger Point Performance in 2002. My wife and I literally started the company out of the back of our car and I made all the products myself for totally selfish needs. I realized that I needed to be able to take care of myself! I did every form of therapy I could in an effort to figure out what was going to be best for my body so that I could continue being an athlete. I can actually remember going to the mall and watching people walk by. I thought about myself, a top-shelf athlete, and I realized that my biomechanics weren’t far from theirs. The difference, how-ever, was that most people have put that strain and wear and tear on their bodies over a lifetime – I had done it to myself in a relatively short amount of time.

After being diagnosed and experiencing the chronic, debilitating pain that comes with fibromyalgia, I looked for all the answers in the main-stream medical world. Unfortunately, this path was a dead end for me, and I realized that what I needed to do was empower myself, I needed to be able to take care of myself! And that’s why I created the Trigger Point Performance products. My rationale was that if I could brush my teeth every day, I could brush my body every day too!

I took a good, hard look at the body and its fulcrums and levers, and I determined how I thought I could help the body perform patterns of movement more efficiently. I was shocked at the quality of life using Myofascial Compression Techniques created for me. I am now able to be the athlete I identify with – I am able to keep up with my kids, to do CrossFit, to run marathons – because I have incorporated MCT into my daily life. I have learned that what you tolerate, you accept; and that a confident body is a confident mind. I rebuilt myself with a sound platform for biomechanics, a newfound understanding of muscular structure, and the guidance of the Lord through every step.

The benefit is that I now get to share that creation with people around the world. We work with people in the NFL, NBA, and MLB. We work with some of the top triathletes in the world, but we also work with soccer moms and weekend warriors. The bottom line is, if you don’t take care of yourself, it’s going to catch up with you. You then may not be able to do what you love to do and you may even become depressed!

I truly believe that physical activity gives me the ability to be passionate about life. I remain active because I unlock my body. My body tells my mind to be healthy every day. The muscles in your body are meant to act independently, yet as one. I want you to take what I’ve created and build it into your everyday life so you can continue to do what you love to do. The guy I am today is dedicated to empowering people to take care of themselves, to achieve goals they never thought possible, and to always understand who and what they are.

Cassidy Phillips

Founder’s Message

TriggerPoint™ is a life-enhancing brand, concentrating on empowering people with revolutionary methodologies and patented products that maintain, regulate

and stimulate the muscular movement of the human body.

TriggerPointTM‘s mission is to provide the most practical style of products, education and therapy to be used by anyone in need of a lifestyle change, performance en-

hancement or general wellness.

TriggerPointTM has successfully become the leaders in personal performance care by market-ing its sustainable human energy and in-home massage products to consumers in the athlet-

ic, health care and personal wellness markets.

TriggerPointTM is on a mission to enable every TriggerPointTM customer to move better. TriggerPointTM’s methodologies en-able athletes of all types to move better through biomechanical, physiological and psychological enhancements by means of My-ofascial Compression™ Techniques. Trigger PointTM’s innovative mobility products are supported by defined methods that make it easy for one to take care of their own body. The methodolo-gies employed by TriggerPointTM aim to enhance mobility, reduce pain, and overall enhance the lifestyles by those that use the tools and methods. Guided by research, experience and innova-tion. TriggerPointTM Education aims to define the methodologies behind Myofascial Compression, providing you with easy to im-plement instructions for self or client care. The Education Team here at TriggerPointTM has a promise to remain cutting edge, to ensure the defined methods are consistently being driven from research, supplying the customer with the most innovative methods to ensure optimal results.

TriggerPointTM’s family of products includes The GRID® Foam Roller, TriggerPoint™ Kits and Cold Therapy Products. No matter what level of activity, TriggerPointTM has a tool that’s just right for anyone who wants better mobility.

About TriggerPointTM

About The Education About The Tools

GRID® 1.0 GRID® Mini GRID® 2.0

High & firm• Like the fingertips

Tubular• Like the fingers

• The original GRID® product • Great for travel • Supports up to 500 pounds

5”

13”

5”

4.5”

5”

26”

• Like a palmLow & flat

The GRID® Foam Roller

Our hollow core and sturdy EVA foam construction makes the GRID® firmer than a traditional foam roller—and our proprietary 3-dimensional surface allows blood and oxygen to flow while you roll. The GRID® uses less foam than an ordinary foam roller and is backed by a 1-year waranty.

Multiple sizes. Roll where you live, work and travel.

The TP Massage Ball is the most versatile self-massage tool. It allows individuals to ma-nipulate the neck, back, shoulders, hips, and other areas using the floor, wall, or any hard surface.

TP Massage Ball

TP Factor Ball What is the different between the Factor Ball and the TP Massage Ball? The Factor Ball is bigger and firmer than our original massage ball.

PRE-GENTM

RE-GENTM

Foam rolling can also serve as an effective cool-down method upon comple-tion of exercise. Post workout foam rolling should consist more of a total body flushing method to help promote circulation of metabolic wastes. This pro-cess should be slow and systematic, taking approximately 10 minutes to flush out the entire body.

Foam rolling serves as an important component of the dynamic warm-up pro-cess by preparing the tissues for the upcoming demand. TriggerPoint™ sug-gest focusing on the methodologies discussed in this manual in the prepara-tion phase of an individual’s daily workout plan.

• Increases tissue tolerance• Optimizes length-tension relationship• More efficient movement• Increases force output• Decreases heart rate

BENEFITS

• Flush tissue• Create pliability• Recovery process begins

BENEFITS

As with any piece of exercise related equipment, one should consult with their physician before ap-plying self-manipulation techniques. If your client has one of the following, make sure to seek the

guidance of their physician prior to using any form of soft tissue solution:

• Osteoporosis

• Anticoagulant therapy

• Diabetes

• High blood pressure

• Varicose veins

• Pregnancy

• ANY time you are unsure of a condition

Contraindications

*An extensive list of contraindications can be found in the appendix.

The general rule of thumb is to refer out to the correct professional any time there is doubt.

No legal liability on the information of this document is intended or accepted by TriggerPointtTM Performance. If you are not a licensed medical practitioner you are legally obliged to consult a licensed medical practitioner for any medical diagnosis.

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Most people spend a large portion of their day sitting. When the knees

are bent and the feet are relaxed out in front of you, the calves are in a

shortened position. Spending a few minutes to foam roll this area can

help to relieve tension and restore movement.

Similar to the calves, the quadriceps are very powerful and active mus-

cles. They are involved in almost all activities, and due to the sedentary

population, they can become overactive and shortened. Foam rolling the

quadriceps can help to provide relief for a variety different conditions.

When seated all day, the gluteus muscles become over stretched and

“smashed” together. This often causes the muscles under the glutes

to have to work harder in an effort to maintain force production. Foam

rolling on the glutes and underlying muscles can help to restore blood

flow and reduce the over activity of the smaller muscles.

Poor upper body posture can be associated with improper breathing

and a lack of proper movement through areas of the spine. Using the

foam roller on the mid to upper back can help to restore some move-

ment to this region.

When posture disrupts breathing, the pectorals can become overworked

by trying to lift the ribcage during breathing. Foam rolling through the

pectorals can assist in relaxing the muscles and reducing tension.

The Latissimus dorsi on the side of the trunk can become problematic

with sedentary postures and when the gluteus muscles are not doing

their job. Foam rolling this region can help to reduce the tension in the

muscles and help with proper shoulder motion.

Focus Points— Key areas to focus on everyday

Lower Leg

Upper Leg

Pelvis

Torso Shoulder

Level 1 in Review

• Thoracic spine• Lat• Psoas

Posterior Lower Leg

Anterior Leg

Posterior Hip

Mid to Upper Back

Chest

Side of the trunk

• Gluteal

• Pec

• Quad• Adductor/VMO

• Tibialis anterior• Calf/peroneals• Soleus• Foot

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What is Foam Rolling?

Simply put, foam rolling has been called the poor man’s mas-sage. The act of foam rolling involves using body weight pressure across a cylindrical object in an effort to change the state of the tissues.

The type of foam roller can vary from a less dense type of foam that conforms around the body, to a highly dense foam roller that allows no conformity.

Foam rolling can be used to induce a variety of changes in the tis-sue, depending on the application of use. One method, is to sim-ply use body weight to apply compression forces into a particular area. Compression has been found to have many positive effects on muscle when applied in a controlled and systematic man-ner (Chaitow & DeLany, 2008; Scariati, 1991; Hou et. al 2002). When compression is applied, blood meant for particular tissues

will first be obstructed, and then when the pressure is removed nutrient rich blood will rush to the area to begin the healing pro-cess. This obstruction is known as ischemic pressure and has been found to be effective at reducing sensitivity in individuals with neck and upper back pain in an at-home program (Hanten et. al, 2000). In addition, studies by Hou et. al (2002) suggest compression can help to decrease pain. By decreasing pain and increasing the quality of the muscle, there will be more range of motion at each joint which will lead to more efficient movement.

The type of foam roller chosen would depend

on a variety of factors. The less dense rollers

will work the area closer to the surface while

the more dense rollers will work the deeper

tissues (Curran, Fiore, & Crisco, 2008).

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When and why did foam rolling begin?

While there is no specific date on when foam rolling began, it is speculated to have become popularized around the mid 1990’s in physical therapist clinics. There is no shortage of data on the benefits of massage and pain relief, as well as, massage and increased athletic performance. In the 1984 Summer Olympics, Sports Massage was made available for the first time (Beck, 2010). Since then, massage has been part of every Summer and Winter Olympics, as well as integrated into the training modali-ties of most of the professional athletic teams. Serious athletes from a variety of sports would seek out the services of skilled massage therapist to help maintain the highest level of perfor-mance while addressing the myriad physical and sometimes emotional conditions that accompany the sport.

All of the factors above (increasing importance, assisting devices, popularity, quickness, and cost) combined to create a “perfect storm” for finding a way to provide massage to everyone. In the mid to late 1990’s Dr. Michael Clark, of the National Academy of Sports Medicine began to incorporate foam rolling into his practice and finally released his first book, Integrated Training for the New Millennium in 2000, which introduced foam rolling to the public for the first time.

In addition, early in the twentieth century, advancing technology and the introduction of electric devices began to get introduced into massage therapy. These vibrating devices were much more effective at changing the tissue and saved the therapists hands, which allowed for more work to be done. In 1985, David Palmer introduced chair massage into the therapeutic world. This in-novation brought massage out of the clinic and made it practical to use in public, with the client fully clothed (Beck, 2010). In the 1990’s the popularity of massage became increasingly popular, scientific research began to support massage, and it was no lon-ger about the mystical Eastern Medicine techniques. In fact, in 1997, Americans spent more than $27 billion on complementary alternative medicine and exceeded the out-of-pocket expendi-tures for all U.S. hospitalizations. Massage was listed as the third most common alternative modality (Eisneberg et. al, 1998).

First patent released on a tool designed for self massage.

Summer OlympicsEgyptian tomb depicts two men having work done on their feet and hands- thought to be massage.

3RD Most CommonAlternativeMassage was listed as the third most common alternative modality (Eisneberg et. al, 1998).

BC 2330 1928 1984 1997

Massage made avail-able for athletes.

Tomb of Physician

These days it’s easy to see foam rollers throughout gyms, physi-cal therapy clinics, chiropractic clinics, as well as on the sidelines of professional sports teams, the Olympics, and any other place people are active or injured. Everyone should be doing some-thing to influence better movement and better biomechanics. Foam rolling before a workout is a great way to increase circula-tion, increase range of motion, and get the body better prepared for the demands of the workout, without a decrease in perfor-mance (MacDonald et. al, 2011). In addition, Brooks, Woodruff, Wright, and Donatelli (2005) found that massage after fatigue increased performance of the forearm muscles. In a compari-son between static stretching and foam rolling before isometric strength and jump height, the foam rolling group was found to have increased their performance (D’Amico & Morin, nd). While the mechanism of this result is not completely understood, it is thought that the total body act of foam rolling serves as a suffi-cient warm-up, increasing total body circulation and prepping for movement.

“Post exercise massage has

been found to reduce soreness

without changing the ability of

the muscle to function”

(Hilbert, Sforzo & Swensen, 2002)

If an individual sits, walks, runs, lifts or breathes, they are a candidate for foam rolling.

Who uses foam rolling?

Effects of foam rolling on performance

For years the majority of the benefits of foam rolling stemmed from research based on massage. While the effects of foam roll-ing may be very similar to massage, the “self- application” aspect of myofascial release could make a significant difference in the changes in the soft tissue. In the past five years the research on foam rolling has increased due to the growing popularity of mas-sage and a paradigm shift towards realizing the lasting benefits of consistent soft tissue work. While the results of foam rolling have varied, collectively, it appears to be beneficial to foam roll before and after exercise.

towards realizing the lasting benefits ork. While the results of foam rolling appears to be beneficial to foam roll

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Additionally, Miller (2006) investigated whether foam rolling would increase range of motion in hamstrings compared to a control group which simply maintained normal activity. The foam rolling group performed three sessions of foam rolling per week for eight weeks. This study revealed that that three sets of 1-minute spent rolling the hamstring over the eight weeks significantly increased both the dominant and non-dominant leg hamstring flexibility (Miller, 2006).

A 2013 study by Healy, was focused on whether or not foam rolling would affect athletic performance in comparison with holding a plank for 30 seconds. The movements examined were an isometric squat, assessment of jump height, and an an agility drill. The researchers concluded that while there was no significant difference in the performance tests, there was a significant difference in the time to fatigue. The subjects that participated in the 30 second plank fatigued quicker than the foam rolling group. The conclusion was that foam rolling does not have detrimental effects on performance, and is used as part of one’s warm-up (Healy, 2013).

Pre-Exercise

Foam Rolling Warm-Up Delays Onset of Fatigue

The researchers tested 17 subjects looking at flexibility, muscle activation, maximum voluntary isometric contraction, knee flexion torque, evoked twitch force, and electromechanical delay before and after four different interventions of hamstring foam rolling. The study concluded that foam rolling pre-exercise was effective at increasing flexibility measured by a sit and reach assessment, with no detriment to the force production of the hamstrings (Sullivan, 2013).

Foam Rolling Increases Flexibility

Similarly, in 2012, MacDonald studied the effect of foam rolling on knee joint range of motion and the muscular force or rate of force development. The researchers found no significant difference between muscle force, rate of force development or muscular activation between the foam rolling group and the group who did not foam roll. But, they noted there was a significant increase in range of motion of the knee joint with the foam rolling group. The researchers therefore concluded that two 1-minute bouts of foam rolling proved to be statistically significant in increasing range of motion without decreasing production of muscular force or rate of force development (MacDonald, 2012).

Foam Rolling Increases Range of Motion

Effects of foam rolling on performance

Shortly after the 2012 study, MacDonald and fellow researchers followed up with a study to assess delayed on-set muscle sore-ness in physically active individuals. The 2013 study found that following up one repetition maximum testing with 60 seconds of foam rolling, the subjects had reduced muscle soreness and in-creased extensibility in the quadriceps group (MacDonald, 2013). In addition, the researchers found that thigh girth and maximum voluntary isometric contraction during knee extension were not affected. The conclusion was that foam rolling as part of a cool down could reduce the negative effects of delayed onset muscle soreness while not having a negative effect on results or perfor-mance, thus allowing more frequent exercise sessions.

In an undated article, D’Amico and Morin compared foam rolling to static stretch as part of a method to increase tissue extensi-bility and joint range of motion. Static stretching is commonly used as part of cool down to help restore proper muscle length and prevent muscle soreness. When one set of a 90 second bout of foam rolling was compared to three sets of 30 second static stretches, the results proved to have no significant difference. Therefore, the authors concluded that both static stretching and foam rolling significantly improved joint range of motion. This would suggest that foam rolling is as effective as static stretch-ing as part of cool down following exercise.

Rolling out is a perfect complement

to stretching and even a possible

replacement to simply forcing ad-

ditional length to muscles; added

flexibility is created through natural

tissue relaxation and can minimize

discomfort of common soreness.

Post-Exercise

Myofascial release can often lead to pain and discomfort due to com-pression into the connective tissues. Reason for this could be the Myofascial Trigger Points (MTrPs), knots or “adhesions” within the tissue compressing onto the surrounding sensory receptors and firing off a response that elicits the sensation of pain. The pain felt should be labeled more as discomfort, so as not to provoke a protective response in the body. When the pain becomes too much the body will respond with an autonomic nervous system reflex, which can activate a protec-tive mechanism (Benarroch, 2001).

If any of these responses become evident, then the individual should decrease the compression. This can be achieved by either applying less pressure or increasing the surface area of the device used (rolling on a larger or softer roller). Due to the fact that everyone interprets pain differently, Trigger Point PerformanceTM suggest the use of the adapted version of the Faces Pain Scale (FPS) as described in Pain, in 2001. (Hicks, Baeyer, Spafford, Korlaar, & Goodenough, 2001).

Discomfort vs. Pain when foam rollingIt is important to identify the difference between mild to moderate discomfort imposed by the foam roller and pain that would indicate something is wrong, inducing protective response. If the individual feels shooting or piercing pain then compression should be stopped immediately and the placement of the roller should be adjusted. If after adjusting the roller the pain is not relieved then seek the advice of a licensed practitioner for further evaluation.

0 2 3 4 6 7 95 8 101

MILD (Green) MODERATE (Yellow) SEVERE (Red)

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Un

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ble

Dis

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Annoying

Uncomfortable

Intense

Agonizing

None

Understanding pain, breathing & hydration

This could result in • Increased heart rate• Visible sweating• Increased respiratory rate or breath holding• Increased tension through the muscular system• Decreased ability to induce myofascial release

Keys to Successful MCT

When performing releases, tender spots can be targeted by hold-ing static compression on the area for 20 to 30 seconds. Pre-workout foam rolling is used to stimulate blood flow and prepare the body for movement. Post-workout and restorative foam rolling should be performed with concentrated, slow, controlled movement and breathing.

Progression & Regression Self-Myofascial Release Scale

Breathing

Proper breathing is one of the most important, yet most over-looked aspects of everyday function. Breathing is controlled by the autonomic nervous system which means that it is not some-thing that one has to think about every time a breath is taken. Due to this, the basic aspect of inhaling and exhaling begins to become influenced by outside factors and can become dysfunc-tional.

Breathing dysfunction has been noted to be a factor in almost everyone who has to deal with stressful situations on a regu-lar basis. Hodges, Heijnen, and Gandevial (2001) have shown that within inner cities there exists a large amount of breathing dysfunction and imbalances, such as upper chest breathing and chronic hyperventilation. Upper chest breathing is notoriously observed as a stress response. The associated biomechanical dysfunction is the inability of the primary respiratory muscles to function properly. This leads to the wrong muscles providing the support, such as the pectorals (specifically pectoralis minor), psoas, and trapezius muscles. In a study by Chaitow, Bradley & Gilbert (2002) chronic low back sufferers benefited as much from practicing proper breathing as they did from physical ther-apy in the first 6 weeks. The breathing not only helped with pain, but also served to reduce long term stress.

Ask the client to stand in proper alignment. Feet pointing straight

with neutral hips.

Instruct them to take deep nasal breaths (in through the nose) and exhale out of the

mouth.

The hand on the abdomen should move first, and the most.

The hand on the chest should move only minimally.

This Diaphragmatic or “Belly Breathing” serves as a relaxation technique to help reduce stress, helps deal with pain or discomfort associated with foam rolling and leads to better results.

Have them place one hand on their chest and the other on their

abdomen.

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Carney, Cuddy & Yap (2010) suggest that humans express power through open, expansive postures, and they express powerlessness through closed, contractive postures. The au-thor’s research stated that an individual’s posture can have a significant impact on hormone levels in as little as two minutes. They demonstrated that the powerless posture would decrease testosterone (associated with confidence) by 15% and would in-crease cortisol (stress) by 10%. They showed that the powerful posture had the opposite effect, increasing testosterone by 25% and decreasing cortisol by 20%. This information is significant because pain and injury can have a lasting effect on behavior.

Empowerment

Hydration

According to Jéquier & Constant (2009), depending on the persons age, water can make up anywhere from 50 to 75% of body weight. These authors also conclude that water has many roles, including regulating temperature, lubricating the lungs and skin, controlling blood pressure and transporting nutrients, oxygen and waste. Electrolytes are critical for optimal perfor-mance and health maintenance.

Hayes, Naylor & Egger (2012) stated that, although the brain has no pain receptors, neural sensitization from the body tissues is often converted to the sensation of pain. This suggests that the Central Nervous System is simply reactive to the information coming into it. Although pain and depression can be a biological condition, in many cases it is simply a reflection of our habits, which are represented by our postures. If an individual can move confidently with a healthy body, then they are much more likely to have a healthy mind.

The How to apply the Programming for Pre Workout

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MCTTM ReleasesPractical Application