For reference, according to Family
Practice Notebook, normal hip flexion (with
the patient supine) is 110 to 120 degrees and
normal hip extension (patient on their side) is
10 to 15 degrees.
Cons: It would have been beneficial
if the researchers included an additional
intervention of, for example, static stretching
for comparison. Although we may have been
harbouring reservations about the potential
overuse of foam rollers, the fact is that
the majority of stretching we see is being
performed without these devices. Based
upon the findings of this study, perhaps they
should be using them after all (as should we!)
While there is some contention about this
point, care should be taken when performing
foam roller type activities to apply high levels
of pressure only when rolling in the direction
towards the heart. This applies to other
similar aggressive massage-type activities
as well. The reason being that there are
valves in the veins throughout the body,
including for example in the legs, but also
in other muscles and extremities. These
valves allow blood to move back towards
the heart without falling due to gravity.
There is some claim that rolling with intense
pressure against these valves (i.e. away
from the heart such as down the arms or
legs) could rupture them. While this is not
life threatening, it is biomechanically non-
optimal to have damaged these valves and
could lead to unappealing vein formations
(blood pooling, varicose veins). While there
is some argument about this, particular care
46 | NETWORK SPRING 2017
It is satisfying t o see such results being achieved
through the use of equipment that is available at
most fitness training facilities
should be taken at areas where there is not significant musculature
protecting these veins/valves, such as in the back of the knee, or the
inside of the elbow. It should also be noted that the research by Dr’s
Monteiro and colleagues took no such precaution. We disagree in
general with their claim that use of a massage stick would provide
less pressure than a foam roller and due to its small radius and
ridged structure would advise even greater caution. This would
particularly be the case when used by a personal trainer on a client
that is smaller or less muscular than themself. Foam rolling is often
conducted without awareness of this potential damage; however, we
have seen enough evidence to advise taking this precaution.
A recent review of the literature by DeBruyne and colleagues in
the Journal of Sport Rehabilitation (2017, 26:94-100) concluded that
a roller massager should be used, although they do agree that the
longer duration may provide the greatest benefits to flexibility and
potentially injury reduction.
Associate Professor Mike Climstein, PhD FASMF FACSM FAAESS is one of
Australia’s leading Accredited Exercise Physiologists and researchers. He is
director of chronic disease rehabilitation at Vale Medical Practice.
[email protected]
Joe Walsh, MSc is a sport and exercise scientist. As well as working for
Charles Darwin and Bond Universities, he is a director of Fitness Clinic in Five
Dock, Sydney. fitnessclinic.com.au