Foam Roller Technique Training - Part 2

In Part 1, we discussed basic Feldenkrais principles, how to choose the correct roller for your client, reviewed one supine exercise and discussed the effectiveness of using the roller for spinal stabilization exercises. In Part 2, we will review the importance of proprioceptive training and neuromuscular re-education exercises that can be done on the roller.

Proprioception

Proprioception is the ability of the body to sense movement and spatial relationships within the body. Joint dysfunction is often associated with functional deficits in the neurological area. For example, after spraining an ankle, someone may complain that things do not feel the same even though the ligaments have healed properly. This may be due to decreased proprioception in the ankle. When the body loses normal sensory input from the muscles and joints, normal neuromuscular function in that area is also lost. This is due to lack of information about joint position, movement and the resulting reflexes. To prevent re-injury to this area, the body often contracts the surrounding muscles to restrict the ROM. This further increases the lack of normal neuromuscular function and sensation in the area.

Small amplitude, low speed, reversible movements permit internal self monitoring. These movements increase the use of the body’s internal proprioceptors and decrease the dependence on the trainer, mirrors and other external monitors. A joint in its neutral position has the most potential for normal ROM. When the joint is displaced from its mechanically best position, it is at a mechanical disadvantage. Proprioception is often dysfunctional as well as altered kinesthetic awareness.

When considering spinal movements, it’s important to note that different sections of the spine have different ROM. Decreased ROM or hypomobility in one spinal segment will result in increased ROM in the adjacent segments. To train the spinal muscles to protect the hypermobile range of motion, the opposing muscle group must increase its sensitivity to stretch during eccentric work. If the body cannot sense when the joint is approaching its end range, the muscles will not receive the message to contract to protect the hypermobile joint. Closed kinetic chain exercises can help to increase the amount of proprioception.

Working on the roller in the supine position facilitates spinal proprioception. The contact of the roller against the spine offers more kinesthetic information than is typically available in the sitting or standing position. As the erector spinae relax, the multifidi can move the spinal segments through the small amplitude, low speed, reversible movements that facilitate increased proprioception. In addition to enhanced kinesthetic awareness, there can also be increased spinal ROM in hypomobile segments as the erector spinae relax.

Roller Exercises in Supine

Figure 1	Figure 2	Figure 3

For supine exercises, have the client position on the roller and warm up with the exercises discussed in Part 1. Practice combining movements or decreasing the base of support as the client becomes more adept at balancing. For example, lift the opposite arm and leg at the same time (see Figure 1 above). Then try the other side. Again, most clients will be better at one side than the other. Repeat the easier combination until the client gets a sense of what muscles she uses, what muscles she doesn't use and where she shifts her weight. Then try the other side using the information gained while working on the easier combination. Typically, the client does not adjust her weight in the same manner before she lifts the arm and leg on the other side. She can feel how her spine accommodates to the movement differently from one side to the other. Again, the manner she chooses as the easiest is the best one for her.

For enhanced proprioception, it is critical that the clients rely on their internal sensors rather than the personal trainer. The trainer should cue clients to help them find the best options rather than give concrete examples. Ask clients where, how and when they shift their weight on the easier combination. Once they are aware of this shift, have them try to mirror these shifts on the other side to see if the resulting movement is easier. They will have a better sense of using their internal monitors to answer these questions than if the trainer says something like "Put 50 percent of your weight on this body part at this particular moment in time." Using the unconscious brain to control this complex task will be more difficult if the cueing tends to engage the conscious brain, which likes to think things through rather than sense what is correct.

Other supine exercises include lifting one leg, holding it up and then lifting the other leg up so that only the arms are touching the ground (see Figure 2). Be sure to raise and lower one leg at a time to avoid potential injury to the back. As the client progresses, you can place the arms closer to the roller or the legs closer together to decrease the base of support. You can place both legs on an exercise ball. You can have the client place one or both arms across their chest as they alternate lifting legs (see Figure 3).

Neuromuscular Re-education

Begin with the safest and simplest exercises before progressing to the more complicated, functional ones. The personal trainer should make sure proper body mechanics are used by the client before progressing to aggressive strengthening programs. Using proper body mechanics is one way of ensuring proper firing sequence of the stabilizers and prime movers. Strengthening without using proper body mechanics predisposes the client to future injuries from degenerative changes, altered joint proprioception and muscle imbalances.

Figure 4	Figure 5

Exercising on unstable surfaces like rollers or balls allows the client to avoid using habitual movement patterns. It helps clients focus on the quality of their movements versus the quantity. Performing standard exercises while using the roller as an unstable surface should not be used as a strengthening technique. However, it is an excellent way to ensure the client is using proper body mechanics before practicing the movement with standard weight training techniques. Examples where using the roller can enhance traditional strengthening exercises include abdominal crunches (see Figure 4 above), push ups (see Figure 5) and squats. When working on shoulder stabilization, a fit client could perform a push up with both hands on a long roller. A more advanced participant could do push ups with each hand on separate short rollers.

Standing on the Roller

Precautionary Note: Standing on the roller is a higher risk exercise that will require additional training for clients. If they perform this series of exercises with their shoes off, they will usually enhance the proprioceptive information coming from their feet. They will stand so that the roller is placed in the arch of the foot. For some clients, this position may be uncomfortable so you can have them stand on a half roller, wear their shoes or take frequent breaks.

Figure 6	Figure 7

First have the client stand on the roller while she is holding onto a stable object such as another roller standing on end (see Figure 5). Tell her to step off of the roller immediately if she feels she is losing her balance. Make sure she knows how to step forward and backward off of the roller. The risk of injury is higher in the standing position than in the other positions. You will need to closely monitor and cue your clients to ensure they are performing the exercises safely and to ensure they are following the basic Feldenkrais principles.

As the client becomes comfortable standing on the roller, ask her to lift one arm up and then place it back down on the stable object she is using for balance. Eventually, she should progress to where she feels comfortable standing without holding onto anything. Then have her practice lifting one arm up and then the other (see Figure 7). Then with both arms by her side, try lifting one knee and then the other. As the client learns to balance, you will see small amplitude, low speed, reversible movements using her postural muscles. If you see a lot of large movements through the spine and arms, the client is not following the basic Feldenkrais principles. If you see her using excessive arm movement, have her hold onto a ball while balancing. This will enhance the use of other muscles to balance since the arms will be preoccupied.

Squats and Lunges

Figure 8	Figure 9

Once your client can perform the standing movements, she can practice performing squats while standing on the roller. The client usually has more difficulty on the concentric phase of the exercise as she goes from a squatting position to standing. Encourage her to move slowly so she can determine how to properly shift her weight while maintaining her balance. Once she can perform the squat properly, have her pick up a light object in front of her. An easy way to help her monitor her progress is to have her lift a full roller that is standing on end in front of her (see Figure 8). As she becomes more proficient, she will be able to grab the roller at a level that is closer to the floor.

By teaching proper squat technique with this method, the client is able to perform traditional training methods for strengthening in the squat position with improved body mechanics. After the client has mastered the squat on one long roller (see Figure 9), you can have her perform squats from two short rollers to increase the difficulty of this exercise. Highly skilled participants can also try lunges while standing on one or two rollers. These are higher risk exercises that are not appropriate for the general population.

By using the rollers for the fitness population, a personal trainer can help clients of all fitness levels make gains in balance, stabilization, proprioception and neuromuscular re-education. Using the roller gives clients a way to pursue enhanced performance without constant wear and tear on their muscles and joints. It allows personal trainers to work with the general population on more functional goals such as posture and proper body mechanics. Both inexpensive and portable, the rollers can enhance your success as a personal trainer.

References:

1. Alon, R. Mindful Spontaneity: Lessons in the Feldenkrais Method. Berkeley, CA: North Atlantic Books. 1996
2. Cronin, W. M. “Proprioception Phenomenon.” Advance for Directors in Rehabilitation. June 2000. Pp. 67-68.
3. Feldenkrais, M. Awareness Through Movement: Health Exercises for Personal Growth. San Francisco, CA: Harper & Row Publishers. 1977.
4. Grimsby, O. “Scientific-Therapeutic-Exercise-Progressions” Presentation at the Combined Sections Meeting in New Orleans. 1994
5. Parker, Ilana. Functional Exercise Program. Course manual. San Francisco, CA.
6. Porterfield, J. A., DeRosa, C. Mechanical Low Back Pain: Perspectives in Functional Anatomy. Philadelphia, PA: W. B. Saunders Company. 1991
7. Sullivan, P. E., Markos, P. D., Minor, and M. A. D. an Integrated Approach to Therapeutic Exercise: Theory and Clinical Application. Reston, VA: Reston Publishing Company. 1982