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Wellness 101

Understanding what causes pain is the key to unlocking which therapeutic process is best suited for you.

Pain Massage Foam Rolling Application

Understanding Pain

Why Do I Hurt?

Pain can feel different for everyone but there are some similar qualities in types of pain that are beneficial to be aware of.

The context of the current pain you are experiencing is very important. Have you ever felt this pain before? Are you doing something that you have done a million times and it has never hurt like this? Do you have health insurance? Has your doctor recently told you to be careful so you don’t hurt your back? Many things and current life situations can affect the pain you are experiencing. While some of these questions may initially sound silly, the human brain is incredibly complex and it is able to consider all of these things in the subconscious mind while you are going on about your day. For example, if you recently lost your job, and therefore your health insurance, you might maximize the severity of your pain without even realizing it.

Types of Pain

Why Do I Hurt?

Pain can feel different for everyone but there are some similar qualities in types of pain that are beneficial to be aware of.


An ache is a dull, sustained pain. An ache is usually a signal from your body telling you that it doesn’t like what has been happening and that you could benefit to move. An example is the feeling of low back pain you may experience toward the end of a long day in the office. The human body was designed to move. If you don’t move enough it will tell you, and it is usually in the form of an ache.

Severe Pain

Severe pain is less common than people think. This is the type of pain that’s worse than anything imaginable and would cause you to seek immediate emergency room attention. It is important to remember that people have different pain thresholds and the same severity of pain may feel different to two individuals.

Acute Pain

Acute pain is usually much more specific and occurs as a direct result of trauma. An ankle sprain is an example of acute pain. Acute pain is actually a form of protection. Your body is signaling you to cease movement in that area so that it can heal.

Where Is The Pain?

A Closer Look At Chronic Pain

Pain is a warning signal from the body. It is much like the “check engine” light on the dashboard of your car. The check engine light is there to tell you that you have an issue that needs to be resolved. Many people take the warnings of the human body as “non-threatening” and either ignore the warning or try to cover it up with over-the-counter medicine. Unfortunately, this leads to chronic pain more times than not. Once pain is experienced, you should stop what you are doing and determine the source.

Foot Pain

Foot pain is very common and for good reason. The foot is one of the most sensitive areas of the body and we tend to beat them up on a daily basis. Most people wear shoes that are too tight or too narrow, that have an elevated heel, or an overly cushioned sole, all of which can affect the positioning and dull the senses in the foot. This decrease in stimulus can cause the muscles within the foot to become weak or dysfunctional and eventually affect our stability. Chronic conditions such as plantar fasciitis, heel pain and tight calves often start as adaptations to prolonged imbalances within the foot.

Knee Pain

Knee pain is one of the most common types of pain people deal with. Although nothing is really “simple” when it comes to the human body, the knee joint is a rather simple joint. Most knee pain is not caused by the knee, it is caused by either the hip or ankle not moving properly, and the knee being the joint between them that pays the price. The best areas to foam roll when you have knee pain are the calves, the quads, and the hips.

Lower Back Pain

Low back pain is the most common type of pain and is a leading cause of disability all over the world. Going back to the ankle and the hip … if these two areas don’t move and stabilize appropriately then the low back can pay the price. Additionally, poor posture and sitting too much lead not only to hips that don’t move correctly, but also to numerous muscles in and around the trunk becoming weak and unable to provide support. To best address low back pain, rolling the hips and upper back is recommended to restore proper motion.

Shoulder Pain

Up to 25% of the population deals with shoulder pain, but most times the pain does not come from a direct injury to the shoulder. Shoulder problems are usually a result of something else in the body that is not moving or stabilizing the way it should. The best areas to foam roll are the chest, the upper back, and the side with the lats.


How Can I Create Change?

Most of us associate massage with pure relaxation and the release of tension in the muscles. But massage is so much more...

When muscles and surrounding tissue get stuck, the body is actually laying additional tissue down and forming a scar. We are probably aware of the scar that forms on the outside but a very similar response occurs on the inside. Therefore, during a deep tissue massage the therapist is actually breaking the bond of the scar tissue.

According to a 2011 study in the “Journal of Alternative and Complementary Medicine,” in deep-tissue massage, the manipulation of muscle tissue causes an immediate reduction by about 18 percent of the hormone arginine vasopressin, a hormone that restricts blood vessels and raises blood pressure. This reduction initiates what is known as the "relaxation response," a mechanical response that encourages circulation, enhances the delivery of oxygen and lowers blood pressure. Additionally, massage initiates a reduction of the stress hormone cortisol, thus creating feelings of relaxation.

Types of Massage

Understanding the basic types of massage, and how they work, will lead to a better understanding of foam rolling.

Deep massage

As the name implies, a deep tissue massage is intended to get to the layers of muscle and tissue that are deep, or closer to the bone. Deep tissue massage is great to help relieve chronic muscle tensions. Due to repetitive movements that occur for many years and the overall lifestyle of many people, the different layers of tissue can begin to get stuck together. If it stays this way for too long, it must be broken up or “released”.


Active Release Technique (commonly called ART) is a form of manual therapy that is incredibly effective. The therapist builds compression and applies tension into a specific muscle as the patient moves through a range of motion. ART is similar to a deep tissue massage in that scar tissue, adhesions and hydrogen bonds get broken up.


Graston Technique differs from some of the others because it is an instrument assisted method, meaning the therapist uses a stainless steel tool. The tool allows the therapist to be very specific, which makes this another effective method of muscle and tissue work. Again, the skilled clinician is using the tool while the patient is encouraged to participate in therapeutic exercises that serve to increase mobility through the tissues.


SMR—Self-myofascial release (SMR) is a form of self-massage that is designed to replicate the common technique a therapist would use called myofascial release. Myofascial release occurs when a therapist uses their hands to apply pressure into the body while using a traction or pulling technique. The therapist might hold that pressure for up to two minutes in some cases.

Myofascial Release

Why Does Body Work Hurt?

Understanding the basic types of massage, and how they work, will lead to a better understanding of foam rolling.

Myofascial release can often lead to pain and discomfort due to compression into the connective tissues. This is similar to the pain that occurs at times during a massage. Most of us have experienced some soreness when pressure is put on tender muscles and tense areas. Many of these receptors have become desensitized over the years with the muscles being consistently tense. Many times just a small amount of extra pressure can increase discomfort. You can think of foam rolling the same way … when you compress sensory receptors, it can feel uncomfortable.

TriggerPoint suggests using pain as your guide. Foam rolling can be uncomfortable, but should not be painful. The best way to tell the difference is whether or not you can breathe comfortably as you roll. If it hurts too badly, regress. 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).

It’s important to remember that foam rolling is not “causing” the pain, foam rolling is “removing” the pain, and once you begin to roll regularly, and react to your body’s feedback, it can be enjoyable and satisfying.

Foam Rolling

Why Should I Roll?

Foam rolling keeps fascia healthy by circulating fresh, oxygenated blood through soft tissue for better movement and recovery.

The act of foam rolling involves using body weight pressure across a cylindrical object in an effort to change the tissues.

Foam rolling can be used to induce a variety of changes in the tissue, depending on the application of use. One method is to simply use body weight to apply compression forces into a particular area.

When compression is applied, blood meant for particular tissues will first be obstructed, and when the pressure is removed, nutrient rich blood will rush to the area to begin the healing process. 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.

Foam Rolling

Keeping soft tissue healthy means it will have optimum elasticity, allowing you better range of motion.

People have been practicing foam rolling in different ways, shapes and forms for many years, but in terms of testing the science behind it, it’s still a fairly new modality. Following are some studies we’ve identified that we feel are useful in helping to explain the physiological benefits a bit better.

Increasing Range of Motion

In 2012 researcher Graham MacDonald and colleagues studied the effect of foam rolling on knee joint range of motion and the muscular force at the knee and published their findings in the “Journal of Strength and Conditioning Research”. The researchers took measurements of two groups, one who foam rolled and one who did not, at different time intervals. They found no significant difference in muscle force, but they did note a significant increase in range of motion. The researchers concluded that two 1-minute bouts of foam rolling proved to be statistically significant in increasing range of motion without decreasing muscle force.

In a 2014 study published in the “Journal of Sports Rehabilitation” researchers found that foam rolling followed by static stretching was the most effective at increasing hip range-of-motion. The study participants were divided up into three groups and randomly assigned to either foam rolling, static stretching, or both. The participants performed 3 sets of 1 minute of foam rolling with a 30 second break in between, 3 sets of static stretches holding each stretch for 1 minute with a 30 second break in between, or the group that was assigned to both performed both. Researchers concluded that all group increased hip range-of-motion, but the group that performed both increased the most. The practical application of this research suggests that if participants have time to perform both then do so.

Foam Rolling

Increasing Flexibility

According to a 2013 study published in the “International Journal of Sports Physical Therapy”, 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.

Additionally, a 2014 study published in “Fascia Science and Clinical Applications” found that using self-myofascial release techniques on the bottom of both feet immediately increased hamstring and low back flexibility. The experimental group rolled the arch of the foot for two minutes, by applying as much pressure as they could to the ball. After two minutes, the group re-tested flexibility by performing a sit-and-reach test. On average, the participants increased the sit-and-reach by 2 inches. This proved to be significant as it was an immediate result that incorporated no traditional stretching.

Foam Rolling

Effects on Pre Exercise

Delays Onset Muscle Soreness

In a 2013 study published in "Medicine and Science in Sports and Exercise," Graham MacDonald and fellow researchers found that foam rolling after exercise may speed up recovery following maximum intensity exercise. In this study participants performed 60 seconds of foam rolling following one repetition maximum training. When these participants were compared to the group that did not foam roll, it was found while both were sore, the foam rolling groups soreness peaked much sooner than the non-foam rolling group. 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 speed up the recovery process allowing more frequent exercise sessions.

Foam Rolling

Effects on Post Exercise

Delays Onset Muscle Soreness

A chronically tense muscle can pull a joint out of proper alignment and result in other tissues become compressed. For example, a common problem in the lower body is known as Piriformis Syndrome. This is when a muscle in the hips known as the pirifomis becomes tense and will compress the large nerve that runs from the low back all the way down to the foot known as the sciatic nerve. This pain is usually the result of the muscle imbalance in the hips. Although, it all the time so it is beneficial to speak with your doctor before simply assuming it is a muscle imbalance issue.


Myofacial Compression Techniques

Increase tissue length, tolerance and elasticity so that you can move and perform better.

A pivot is a motion that has been a staple in many massage therapy techniques. While it appears to be a simple rolling of the tool over the tissue, it involves maintaining compression and performing small side-to-side rotation motions. The tool is designed to grip the clothing or the skin and slowly work deeper, layer by layer to have the maximum effect of the targeted area. The goal is to move the muscle and tool at the same time and not to simple work over the top of the skin.

Another effective method of MTrP treatment, which is an indirect technique, is Myofascial Release. Myofascial release applies a stretch to the tissue housing the MTrP. As the stretch is held, the tissue is elongated and the MTrP can be released. This method is described as being healthy subjective to the clinician providing the technique.

TriggerPoint™ has developed a unique set of foam rolling modalities that we call Myofascial Compression Techniques. Together, these innovative and different methods of foam rolling will help you fill your toolbox of self-care and recovery.

By performing Myofascial Compression Techniques, tissue tolerance will increase as length tension relationships and elasticity are restored, resulting in enhanced mobility and improved overall biomechanics.

A myofascial trigger point (MTrP) was defined by Drs. Travell and Simons and published in “Myofascial Pain and Dysfunction: The Trigger Point Manual” as “a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule”. The release of myofascial trigger points (MTrPs) can involve a variety of different techniques. One effective method is Trigger Point Pressure Release. This technique is performed by applying and sustaining light pressure on an area containing an MTrP. The pressure is held until a noticeable “release” is felt. This process can be repeated throughout a range of motion, until there is no longer pain associated with the movement. If the technique is too aggressive, it could further aggravates the MTrPs.

Moving & Performing Better

Getting Started with MCT

Pre-Gen: Pre Exercise

Foam rolling prior to working out (Pre-Gen Rolling) serves as an important component of the dynamic warm-up process by preparing the tissues for the upcoming demand. Spending 5-10 minutes foam rolling prior to your workout increases blood flow, allowing the connective tissue fibers to slide more freely, thus preventing some of the movement compensations that could be occurring. Furthermore, in Pre Gen Rolling, elasticity and proper length-tension relationships are restored, allowing muscles to produce the greatest amount of force with the least amount of energy cost during exercise. This results in optimal performance, decreased injury, and quicker recovery.

Pre-Gen Rolling

  • Increases tissue tolerance for less chance or injury
  • Optimizes length-tension relationship for performance
  • Delays the onset of fatigue
  • Increases flexibility and range of motion
  • Increases force output
  • Decreases heart rate

Moving & Performing Better

Getting Started with MCT

Re-Gen: Post Exercise

Foam rolling can also serve as an effective cool-down method upon completion of exercise. Post workout foam rolling is more of a therapeutic approach than pre workout rolling. In this case, it’s used more as a total body flushing method to help promote circulation of metabolic wastes. This will accelerate the recovery process and restore the muscles and tissue. This process should be slow and systematic, taking approximately 10 minutes to flush out the entire body.

Re-Gen Rolling

  • Flushes the tissue
  • Creates pliability
  • Accelerates recovery
  • Reduces DOMS
  • Prevent the formation of trigger points
  • Prevent muscle imbalances