Foam roller, massage gun, trigger point ball, oh my!

In recent years there has been a huge growth in popularity of different items for self-massage or trigger point release. The foam roller has been around for a long time, and people have been digging tennis balls into sore muscles for ages, but now we have massage guns, foam rollers that vibrate, chirp wheels, and beyond! I frequently have clients, friends, and family alike asking me if they “work”. My answer to that is (as my answer to most questions frequently is) - IT DEPENDS. Let’s first talk about what the research says.

First up is massage guns. These became popular over the past several years as a lot of affordable options hit the market. Therabody first released Theragun in 2016 at a fairly steep price point, but as of today you can get an off-brand massage gun on Amazon for $19.99. As with anything new, there isn’t a whole lot of research available. What I did find was evidence of increased flexibility and reduced delayed onset muscle soreness. That increase in flexibility is only short-term, meaning it lasts for a little while immediately after using the device. (As with any change in range of motion, in order to keep that “new” range you have to target strengthening in that range- but that’s another post for another time.) Massage guns also can be helpful in reducing perception of pain, which makes them useful in rehabilitation from injury. What a massage gun does not do is increase muscle force or output. It actually doesn’t affect muscle force or output at all, so using one as a component of a warm-up for increased blood flow and acute increase in range of motion may be a good idea.

In less positive news, I also did find some case reports of injury that occurred due to inappropriate use of massage guns. One study discussed a vertebral artery dissection in a young woman who was using a massage gun repetitively to her neck. Although this sounds terrifying, it was from improper use of the device. Another case report described in eye injury in a man that was using a massage gun around his eye for headaches. It is also not recommended to use a massage gun on your face. I think we will be seeing more evidence come out about massage guns in the coming years, so stay tuned.

Now to foam rollers. There are a few more studies available here since they have been around longer. The evidence shows improved flexibility, not unlike the massage gun, but also improved tissue stiffness. Another study found foam rolling actually superior to static stretching, which shouldn’t be too much of a surprise if you’ve been following me. In terms of prevention of delayed onset muscle soreness, studies show that foam rolling is better than nothing for improved symptoms, but not better than any other intervention.

In terms of massage balls, there unfortunately is mostly bad news in the research. There was a case study reporting sciatic nerve injury in the glute. In my opinion something like this should be avoidable. With any self-massage technique, you should cease treatment with onset of numbness or tingling. In order to really injure a nerve you have to feel that onset of numbness/tingling/shooting pain and then keep going. If you feel that and stop, you will not cause permanent injury.

So what does all of this mean? All of these methods of self-massage or myofascial release have the ability to increase blood flow and warm-up the tissues. There is evidence in support of both massage guns and foam rollers in terms of increasing flexibility in the short term as well as reducing delayed onset muscle soreness. This is all great! If you’ve been following me for a while you likely know that I’m not the biggest fan of static stretching. It doesn’t have great evidence for much other than making you a little weaker in the short term, so while I don’t think it’s necessarily bad, I don’t think it provides much benefit either. If you’re feeling “tight” or having pain in a muscle, any of these above techniques are a great option. It’s of course important to perform them safely. Avoid rolling over bony prominences, especially repeatedly. This will likely only irritate the tissues more. Also, I feel like this should go without saying but just in case- if you feel any kind of shooting pain, numbness, or tingling- STOP! Never lean into anything that feels nerve-y. We also need to learn more about safety with massage guns, but for now it appears that as long as you stay below the neck, you should be good. I would venture to say staying away from the spine in general is wise. As always, if you have any doubt, contact your PT. Happy rolling!