Panel Discussion: What effect do you believe foam rolling has on fascia?
Much attention has been given to fascia, but what affect can we have with self-administered techniques using foam rolls, softballs, tennis balls, the stick, and Trigger Point Performance tools.
For examples of the techniques I am referring to check out these articles
Moderated by Brent Brookbush DPT, PT, MS, PES, CES, CSCS, ACSM H/FS
This Panel Discussion was originally posted on my facebook page - https://www.facebook.com/brent.brookbush - on February 8th, 2014
Barbie Collins I rely on my foam roller daily. Otherwise my massage bill would be outrageous
February 8 at 9:20am
Brent Brookbush Nice Barbie Collins… although I would love to hear about the various protocols and techniques individuals like yourself are using, I really want to hear about why you think it is effective.
Just to get things off to a bit of a start… I am going to say that I do not thing foam rolling has much of an affect on fascia at all. Your thoughts?
February 8 at 10:03am
Barbie Collins Especially for areas like the IT band that get tight on dancers and are difficult to stretch/relax, I feel like my foam roller can get in there more effectively. Maybe it's in my head but I feel like it's saving my knees.
February 8 at 10:08am
Barbie Collins As for how often, I slow roll each body part 10 times after a workout or class at the end of the day. If I feel tight I may do some shoulder opening exercises on it before an upper body workout as well
February 8 at 10:10am
Rob Fluegel Barbie, since the ITB is not a muscle, it can't really get tight. I think you are probably releasing the lateral quad using the foam roller.
February 8 at 10:13am
Brent Brookbush That's the direction I want to head Rob Fluegel… what are we doing with the foam roll? Can we really affect fascia? Compressing muscles seems to be more likely. As far as the ITB… I have to agree with Rob on this one Barbie Collins
February 8 at 10:14am
Barbie Collins Yes, that area, plus the glutes. Oh so tight lol
February 8 at 10:14am
Brent Brookbush Probably, not your glutes either Barbie Collins… never met anyone with a tight glute max; however, I have met more than a few with a tight piriformis.
February 8 at 10:16am
Rob Fluegel Sorry, just a pet peeve of mine regarding people very often talking about stretching their ITB when it's not contractile.
February 8 at 10:16am
Gary Miller My thoughts are that for almost 10 years I have used foam rolling on the young and old including myself and there has been debate that it actually changes fascia but it works and has always worked! No one I have ever know to use it as prescribed has said it doesn't at the very least help their mobility and performance. The one thing I will say I question as a possible myth but it would be cool if it were actually proven was the use of foam rolling help with the reduction of cellulite! I know people everywhere would jump on it more…lol again at the end of they day I am a believer and will never stop prescribing it or doing it myself!
February 8 at 10:16am
Barbie Collins My apologies for generalizing- you know what I'm saying.
February 8 at 10:18am
Rob Fluegel I think it does help with mobility and performance because I think you are increasing muscle play which then increases mobility and performance.
February 8 at 10:20am
Barbie Collins What do you think would best/better for healthy fascia? Certain exercises? Supplements? Hydration?
February 8 at 10:22am
Brent Brookbush Hey kats, I posted this in another discussion on foam rolling. It's an excerpt from one of my articles… thought you might appreciate, given our discussion on the ITB. Rob Fluegel, Barbie Collins and Gary Miller
Excerpt from my article on the Tensor Fasciae Latae
"Often, reference is made to release and stretching (specifically foam rolling) of the iliotibial band. As connective tissue the ITB is non-contractile and slow to adapt. Although we may feel that the iliotibial band is taught, adaptive shortening of this tissue is far less likely than the iliotibial band being pulled taught by overactive musculature, or being pulled taught by the relative position of the hip and knee. Before implicating the iliotibial band as the cause of pain and dysfunction it is worth assessing the muscles that invest in the iliotibial band, specifically the TFL. From the standpoint of practice, muscle tissue adapts faster and generally has a larger capacity for change than connective tissue.
Further, CONNECTIVE TISSUE CANNOT DEVELOP TRIGGER POINTS OR TENDER POINTS. Trigger points are a muscle tissue phenomena, not a connective tissue phenomena. When an individual uses a foam roll, medicine ball, or a manual therapist uses pressure to relieve tender areas in the “ITB”, it actually the vastus lateralis that is being affected. As discussed above, this can have a positive effect on mechanics and the relative tension of the ITB, but it is not the ITB that is being affected directly. Long story short… there is nothing wrong with the technique, but the rationale is inaccurate."
Tensor Fasciae Latae (TFL) | Brent Brookbush
brentbrookbush.com
Tensor Fasciae Latae (TFL)Posted on December 19, 2012 by admin Human Movement Sc…See More
February 8 at 10:22am
Donna Clinton The techniques you have shown really have a positive long lasting effect. They have helped me immeasurably. Foam rolling I use to get quick temporary release. And there is definitely a noticeable rise in diabetes, arthritis (even in younger population) cardiac disease, fibromyalgia and even MS, I believe foam rolling has its limitations
February 8 at 10:25am
Brent Brookbush That is a great question Barbie Collins, I am going to go ahead and nix the supplements and water on the basis of "which supplements?" and the relative hydration of fascial tissue not likely being affected by the amount you consume on an hourly basis, possibly only affected in cases of pretty severe dehydration.
There are manual techniques directed at fascia, but this is why I posted this… These manual techniques are not easily replicated on one's self. That does not mean that foam rolling does not work, or that fascia is not important.
I personally believe that fascial work with a manual therapist is of great benefit, and that foam rolling is an important technique for reducing trigger-points and hypertonicity in muscles.
February 8 at 10:27am
Barbie Collins And what of claims of glucosamine chondroitin on joint tissues? Snake oil? My dad swears by it but I wonder how much is mental vs actually doing anything for the joints.
February 8 at 10:31am
Donna Clinton Actually, for me there is something to the glucosamine chondroitin. I have taken it, then been off for months and I did feel better with it. Although I must point out that for every 1 pound loose it will take about 4 pounds of pressure off the knee and about 5 to 6 lbs of pressure off the hip joints. If I gain even a few pounds, I feel worse. The best way to go for me is to keep myself at the proper weight
February 8 at 10:39am
Brent Brookbush Hey Barbie Collins… there is no doubt that placebo works , especially when it comes to joint pain. The research on glucosamine is all over the place, and I think the effect of placebo has much to do with it.
February 8 at 10:39am
Donna Clinton Look at the techniques Brent has here. They get rid of the debris around the joints
February 8 at 10:50am
Brent Brookbush I don't know that I would make that claim Donna Clinton… I think what you are actually feeling when you foam roll is a decrease in activity of muscles that have become over-active due to postural dysfunction, which in-turn reduces tension and forces applied to joints.
February 8 at 11:00am
Brent Brookbush Here's another snippet from that same conversation, and an excerpt from another article on my thoughts on fascia -
I think that we must be careful in assuming that all fascia is dense with receptors, as all fascia and muscles do not display equivalent amounts of receptor density. Here is another excerpt from my article on the Biceps Femoris
- where I address some of what you are talking about:
My Fascial Hypothesis:
Large fascial sheaths not only play a role in the transmission of mechanical force, but may also play a role in dictating the function of muscular synergies. This is likely caused by reducing or increasing tone of invested musculature via reflex arcs formed between mechanoreceptors imbedded in the connective tissue and the attached musculature. In this way my view of fascia differs slightly from noted expert on the subject Tom Myers. I think of these large fascial sheaths (specifically the thoracolumbar fascia, iliotibial band, and abdominal fascial sheath) as natures “mother board.” A place for mechanical information to be communicated to the nervous system for more efficient recruitment of the muscular system. Despite having a slightly different philosophy it does not change the fact that fascia plays an important communicative role in the human body and we have Tom Myers to thank for his work.
Facial Integration:
Sacrotuberous Ligament:
The long head of the biceps femoris runs nearly continuous with the sacrotuberous ligament transferring mechanical force to the sacrum and SI joint. Further the fascial connection from sacrotuberous ligament to lumbosacral fascia may hint at a synergistic relationship between the biceps femoris and lumbar extensors mediated by mechanoreceptors within this fascial sheath. Functionally, this appears to be the case, as those with an under-active gluteus maximus often rely on biceps femoris activity and an increase in lumbar extension to compensate during gate. It is my opinion, that this relationship is a solid rationale for adding the lumbar extensors to the deep longitudinal subsystem.
Iliotibial Band and Lateral Inter-muscular Septum:
The iliotibial band (and lateral intermuscular septum which invests in to the ITB) creates a complicated network that invests in several structures:
Lateral retinaculum and the patellar tendon
The lateral collateral ligament at the knee
Fibular head
Anterior tibiofibular ligament
Biceps femoris tendon:
The potential communicating synergies that may arise from this fascial network are staggering and could be the subject of an article unto themselves. To date, the most useful idea to arise from my personal consideration of this relationship has been the relationship between the iliotibial band and tibial external rotators. The iliotibial band may acts as a communicating medium for these muscle, contributing to over-activity in not one, but all of these structures. The external rotation force and posterior glide of the proximal fibular head also has significant implications in ankle mechanics.
Biceps Femoris | Brent Brookbush
brentbrookbush.com
Biceps FemorisPosted on January 18, 2013 by admin Human Movement Science & Funct…See More
February 8 at 11:01am
Maggie Stephens Avidly following this discussion. Fitness instructor since the mid 80s, but haven't taught for 2 years now due to neck strain. Weekly physio is helping (though oh so slow!) trying to self-work on upper back tightness and trigger points. So, bought my first foam roller (and manual) a week ago. Hence the interest.
February 8 at 11:04am
Donna Clinton Oh Brent Brent Brookbush I didn't mean the foam roll techniques. Sorry didn't express myself well
February 8 at 11:17am
Rebbecca Hoffman Following. Not a professional, but an interested massage therapist and crossfitter. I am mixed about the application of foam rolling without supervision from above, as the average person does not know why a certain area is 'tight' in the first place. Most of the time, it is a stabilization, and in my anecdotal observations, as soon as that area is utilized/activated once again, it tightens back up.
Yet when it does work and stay loose, why does it work? I am thinking more a nervous system release than anything, especially for those who obtain pleasure from discomfort or have a high pain tolerance.
February 8 at 11:26am
Melinda Reiner Question is, can you isolate ITB from underlying vastus lateralis? When lateral structures are tight, use of rolling (I believe) affects not only neuromuscular input, but also the c-fibers that control pain.
February 8 at 11:41am
Rebbecca Hoffman I do not know the answer to the second, but on the first, if you roll with a golf ball, you can eventually work your way to ungluing the ITB from the Vast. Lat. It tends to be very painful, and very hard for a person to do themselves. You would also need to separate it from lateral hamstrings to get the best benefit.
February 8 at 11:52am
Brent Brookbush Hey Rebbecca Hoffman and Melinda Reiner,
I have to get back to our original point… is foam rolling a fascial technique?
The answer is most likely NO. What we affect with a foam roll or any compression technique is likely muscle, specifically triggerpoints and receptors that result in autogenic inhibition. To melinda's point we may have some affect on c-fibers, noci-ceptors and other interstitial nerve fibers that control pain.
You cannot separate the ITB from the Vastus Lateralis with compression… all you end up doing is mashing them together. There are techniques to start improving the glide between the vastus lateralis, lateral intermuscular septum and the ITB, but these are manual techniques that require a shear force.
It's fun with functional anatomy and physics - total geek-out!
February 8 at 12:05pm
Ryan Crandall If one feels the need to constantly foam roll, I believe said person is doing something wrong. I use the foam roller (or tennis ball etc) only on occasion and as a tool for a novel stimulus thru the skin which can allow muscle to relax via the parasympathetic side of the autonomic nervous system. The IT band is supposed to be tight. Fascia is a piece of the puzzle but overrated at the moment. Wanna feel better and "looser"? Meditate or try Tai Chi, slackline, or take a 3d Yoga class.
February 8 at 3:28pm
Rob Hooper I'm actually giving a presentation on the mechanism of foam rolling in regards to its effect on ROM next week. There isn't much high level evidence published yet, but what I have found suggests that the pressure from foam rolling is too diffuse to target trigger points. The literature says foam rolling warms the fascia, which makes it more fluid-like, more pliable, and can also break up adhesions between fibrous layers. Take note that these studies were not designed to determine the mechanism, and that these are suggestions put forward by the authors. There is also a study that suggests improved arterial function due to foam rolling, which would presumably result in better muscle function.
February 8 at 12:21pm
Brent Brookbush Hey Ryan Crandall,
I hate to do this, but there seem to be some flaws in your statement. #1 - How does a foam roll affect the parasympathetic system? #2: The IT Band is not a muscle #3 - a fail to see how meditation will cause changes in muscle length and activity #4 - If you foam roll over-active muscles and correct posture you can foam roll everyday, but this requires assessment.
February 8 at 12:23pm
Brent Brookbush Hey Rob Hooper,
Be real careful using suggestions from authors… their opinions mean little more than our opinions, unless the study was specifically designed to confirm their notions.
February 8 at 12:25pm
Rob Hooper Agreed, and that's why I pointed that out in the post, and mentioned the lack of high level evidence. This where expert opinion seems to lie, but there has not been much in the way of scientific research to determine what the mechanism is. So I guess the real answer is that we just don't know.
February 8 at 12:29pm
Brent Brookbush Quite possibly true Rob Hooper - nice thoughts.
February 8 at 12:31pm
Melinda Reiner Brent, agree with your response to my comment…like minds think alike…exactly what my point originally was. Agree that no fascial changes, but neural effects may contribute to subjective feedback from clients/patients.
February 8 at 12:54pm
Joe Burt I think there is value in using a foam roller to affect fascia. Rolling slowly and using finely-tuned directional changes only and also on an individualized basis. Basically using the roller to shift fascial planes in a favored direction. However, it will never be as specific as hands on work and is often used inappropriately (too fast, no regard to direction, etc). Now even if this doesn't work for changing underlying fascia (which will be tough to ever know for sure), it will have the side effect of hydrating tissues and stimulating nerve endings. And like Mike Boyle says, if we find out foam rolling isn't effective, it's only 5 minutes of the workout that we were "wasting".
February 8 at 12:57pm
Anthony Carey If fascia is continuous through, around and between muscles-how are you differentiating what is effected? Especially with something as broad as a foam roller? And is the tool being held in place, longitudinally rolled, horizontal cross friction, etc? Each motion effecting different receptors. And how did you get to those structures? Through the skin. Let's be careful with generalizations across the board.
February 8 at 1:23pm
Leslie Minetree Freeland I rely on my Yoga Tune-Up Balls. I studied under Jill Miller the creator of them and became a practitioner 2 years ago. They have literally saved me in so many ways. I was having difficulty deep breathing when I started my triathlon training 2 years ago, especially while running. My feet and hands would actually go numb as well. I went to a weekend session in NY with Jill to study. When I returned home within 1 week I shaved off 2 minutes off my mile!!! I could breathe and my extremities no longer went numb. My back would snap, crackle, and pop (lol) for about a week as I was breaking up the superficial fascia. Now running is one of favorite things to do. They have helped me with headaches, TMJ, and breaking up scar tissue after my FAI hip surgery with a labrum tear. I only use the foam roller to lengthen out the muscles after I break up the fascia with my Yoga Tune-Up balls. There is absolutely no way the foam roller can get to the fascia properly!
February 8 at 1:29pm
Jinny McGivern With respect to actual technique, are more individuals rolling structures over the foam roll or using it as a tool for static release?
February 8 at 1:36pm
Brent Brookbush Hey Anthony Carey,
I think you both add and make my point for this not being a "fascial technique." From what I have seen this technique has the largest impact on outcomes by imparting direct compression on tender points, improving muscle tonicity and movement patterns when appropriate assessment is used to determine over-active structures. Now, the changes in muscular tonicity may have long-term effects on fascial length which may lead to adaptation over time, and their may be some benefit to fascia at the acute point as it is deformed and stretched around the roll, ball, etc….
The point that drives me nuts, is that foam rolling is often thought of as a purely fascial technique, and vague theories on fascia are used to dictate exercise selection and practice. I don't think this is helpful.
If you and I are using a "mixed bag" approach to the effects of foam rolling I have a suspicion, even if through pure trial and error, that we will end up using very similar techniques despite the fact that we have never worked together or met for that matter.
February 8 at 2:08pm
Brent Brookbush Great question Jinny McGivern,
Do we roll back and forth, or stay still on tender points… what are everyone's thoughts?
February 8 at 2:09pm
Leslie Minetree Freeland Roll back and forth is my preference in regards to the foam roller. Even though that is not what I have been taught through NASM.
February 8 at 2:13pm
Rebbecca Hoffman I want to say that it depends on the person and the point Brent Brookbush. Sometimes rolling produces more effect, while other times breathing into it and letting it sink works better.
What exactly is the tender point that they are holding? A 'trigger' point? An adhesion? If we knew that, the answer would be more clearer.
February 8 at 2:21pm
Anthony Carey Brent Brookbush, I complete get your point. As all things fitness, attempts to better understand one concepts are done at the exclusion of the interdependency of the systems. Here is a slide from a presentation I did at the ACE Symposium almost 2 years ago:https://www.facebook.com/photo.php?fbid=10152860607410026&set=pb.201571125025.-2207520000.1391887362.&type=3&theater
Photo
Timeline Photos
A slide from Anthony Carey's presentation at the ACE Symposium yesterday: To Ro…See More
By: Function First
February 8 at 2:25pm
Brent Brookbush Really nice Anthony Carey… love it.
February 8 at 2:27pm
Maurice D. Williams Interesting topic to say the least ladies & gents. From my very limited knowledge of fascia & SMR, I'd have to agree with Anthony Carey. If SMR is designed to target "trigger points", knots, etc. In our muscles and fascia surrounds those very same muscles, then how can we say for sure that the fascia isn't being affected? I'd would have to base my opinion on experience with myself and clients. SMR has been tremendously helpful professionally and ppersonally, so I do believe that it has on affect on the fascia. Brent Brookbush: do u have research that says fascia isn't affected?
February 8 at 2:55pm
Ryan Crandall Brent. That was a typo. I did not mean to say the IT band was a muscle obviously it's not. Touch can affect the autonomic nervous system. Meditation (as you know) has a list of benefits, including a "relaxing" effect on muscle tone. Moving meditation has this effect and it's damn powerful.
I believe most massage techniques (including foam rolling )work through the nervous system and it's not as mechanical as we think, so I agreed with u there.
February 8 at 3:27pm
Tony Susnjara I had two thoughts - first was similar to Anthony Carey - if we took a cross section of say a thigh, we'd see the femur, thigh muscles, blood vessels, nerve tissue, lymph ducts and of course the various forms of connective tissue etc. And all of these would work together synergistically and also with the whole body. So the first question I would ask is how this whole system is effects by an intervntion.What would be the effect on local circulation? What about neurologically? How will the GTO's or muscle spindles respond? What about the structural elements of the muscle tissue? The fibres themselves? These are still objective, physical structures, Anthony also mentions subjective ones such as client expectations so that is another range of factors.
February 8 at 3:53pm
Dom Nicoletta On actual fascia directly- none.
Indirectly through the nervous system- some
February 8 at 4:01pm
Michael Zweifel Does foam rolling effect fascia? We'll that depends on the area of the body and duration of work, but most likely not. Might have an acute effect but doubt it chronically, especially in the manner most use foam rolling. Also every part of the body has different fascia in terms of density and thickness, so rolling May have effect every part differently.
Even Thomas Myers has said massage and foam rolling doesn't really change fascia, it's more of a proprioceptive , sensory effect.
February 8 at 4:01pm
Tony Susnjara The second thing is that there seems to be this belief - that I had myself, that you simply roll a body part and there is a cause and effect. Since then I have made freinds with Angelo Castiglione with whom I've had extensive discussions about these subjects. What I have learned is that rolling is not rolling. There are an entire range of variables that can be controlled and exectured in a particular way. Maybe Angleo will joiin in th discussion but from what I understand, there can be more or less optimal sequences or should I say pathways to follow when rolling and I think he typically start with the feet because as I understand it - "all roads lead to Rome" Another varibale is pressure. Too much and you activate the stretch reflex and TURN ON the bits that you're trying to turn off to improve extensibility of soft tissue - note that is a neurological not fascial consideration. There is timing or duration of applying pressure and when to roll? Do you roll before training or competing if you're an athlete? Or after? So a whole range of variables need to be considered in a holistic way.
February 8 at 4:04pm
Tony Susnjara Dom and Michael, what's your basis for saying there is no effect on fascia? Is there research that says this is the case? I'd be interested in seeing what you're referring to. Were they looking at a continuous course of applying rollers in a systematic way?
February 8 at 4:07pm
Kenneth E. Hoover I'm going to keep it simple. Circulation. I might get bold and throw vascular elasticity out there with it, but Circulation, and the subsequent anything else that may be impacted by oxygen. Now, as a disclaimer I'll have to say "done properly. at the right time, right pressure, with all controllable variables controlled, GOOD GRIEF GUYS! It's SMR! Going back to "Circulation" and someone is going to tell me that is not fascia…..
February 8 at 4:16pm
Tony Susnjara I spoke to an educator who teaches dry needling and I asked him how it works. He said that they do not know but the theory is that when you needle a trigger point, you deactivate the stretch reflex, the muscle relaxes, takes pressure off the blood vessles and allows more blood to flow. What he said that they can measure is a reducation of inflammatory markers or indicators in the region.
February 8 at 4:22pm · Like · 2
Michael Zweifel Here are some links to study's
February 8 at 9:33pm
Michael Zweifel Certain regions of fascia are too dense and thick to change -http://www.jaoa.org/content/108/8/379.short A major aspect of fascia is that it’s highly proprioceptive. There are ten times more sensory nerve endings in fascia than muscle and they are constantly monitoring changes in tension, joint position, rate of movement, and pressure - ://www.fasciaresearch.com/online-courses/online-courses/InnervationExcerpt.pdf
Three-Dimensional Mathematical Model for Deformation of Human Fasciae in Manual Therapy
Context: Although mathematical models have been developed for the bony movement …See More
February 8 at 9:39pm
Bernadette Ricci If you roll back and forth, doesnt it just excite the pain receptors more doing the opposite of what you really want? Holding on the tender spot for a minimum of 30 seconds or until you found a release is what I thought. Is there something I am missing? Brent Brookbush
February 8 at 9:51pm
Tony Susnjara Michael, is that saying that the roller + body weight cannot be exerting enough force to deform the fascia? Would be interesting to see how much force is needed and how much force is generated. Also to compare that to various forms of stretching etc.
February 8 at 10:07pm
Tony Susnjara stretching doesn't seem to exert much force either but it seems to result in plastic deformation when repeated at the appropriate intensity and over time. As I understand it, muscle tissue is extensible and fasica is elastic and resists stretching so if the fascia does not adapt the joint ROM will not change
February 8 at 10:16pm
Jason Erickson Going back to the first post for a moment:
"New Panel Discussion: What affect do you believe foam rolling has on fascia?
Much attention has been given to fascia, but what affect can we have with self-administered techniques using foam rolls, softballs, tennis balls, the stick, and Trigger Point Performance tools."
All of these are tool-assisted methods of applying external force to soft tissues. Foam rolling with a standard roller applies a diffuse pressure over a broad swath of tissue. As the size of the contact surface becomes smaller, the potential relative force (in lbs/square inch) increases. The density/hardness of the contact surface, the manner of force application (laying on it, pressure applied with hands, leaning against it, etc.), and the relative stability of the contact surface (mobile/non-mobile) are also important variables.
Then we have the soft tissues: skin, fascia, muscle, tendons, ligaments, blood vessels, and nerves throughout. No matter where we apply pressure, we are applying an external force to at least five of those: skin, fascia, blood vessels, nerves, and at least one other. The force applied with the tools noted above is most effective when bone is on the other side of the soft tissues. This brings in the relative position and shape of the underlying bone(s) as an important factor. From what I've seen, most applications of those tools apply pressure at/near a perpendicular angle to the plane of the underlying bony surface(s), resulting in compression of the soft tissues. In most cases, the soft tissues remain static during the force application.
On the other hand, many forms of "fascial" massage/bodywork are much less dependent upon the position/angle of the underlying bone. From my massage studies and practice, the angle of pressure application with my hands is oblique or parallel to the underlying bony surface(s). This results in a "stretching"/"spreading"/"lengthening"/whatever-you-wanna-call-it of the soft tissues. Sometimes this is combined with passive movement, sometimes with active movement of the targeted tissues.
Therefore I suspect that the mechanism(s) of change in these tool-assisted methods may be different from the mechanism(s) of change in many manual methods… though there may be some commonalities.
We might also consider manual methods such as pin-and-stretch, Active Release Technique (a trademarked form of pin-and-stretch), certain Rolfing/Structural Integration methods, etcetera, that apply a compressive force to soft tissues, and then actively move those soft tissues. There are now some tool-assisted methods (using "Voodoo Bands" and similar compressive wraps) that compress soft tissues and then actively move them. I wonder if those methods are more suggestive of the mechanisms of action of the tool-assisted methods noted by Brent.
How do the various soft tissues respond to compression, individually and in combination with one another? Perhaps we will benefit from understanding that before looking at any specific method(s).
February 9 at 2:07am
Tony Susnjara Interesting insights Jason. What do you think of using balls along the lines of Yamuna Body Rolling? There are a wide variety of massage techniques. The fibres can be compressed, stretched longitudinally and also transversely - deep transverse friction is an attempt to separate structures and since the Yamuna method is on a ball as opposed to a roller, it can work on multiple planes, it's also a great core workout as often the torso needs to be supported and often, the soft tissues are rolled in a lengthened position so the method combines pressure + stretching.
February 9 at 2:18am
Jason Erickson Tony, I have a Yamuna ball and the book on the Yamuna method. I've tried it. I'd lump that into the same list with the methods Brent proposed for discussion, for the reasons noted in my prior post. It's primarily a method of applying compressive force, though you are correct in stating that movement can be used to permit a form of "stretching" or "frictioning" of various tissues, though I feel these are secondary to the compression.
What do you mean when you say, "it can work on multiple planes", and how does that differ from what is possible with a roller?
How is the "core workout" aspect relevant to this discussion? Is it just an added benefit, or something else?
How does the "pressure + stretching" of ball rolling differ from the other methods I mentioned? Other than the nature of the contact surface, is there anything else that makes it unique from the various "compress-and-move" methods?
February 9 at 2:42am
Jason Erickson It should be noted that any method of applying compressive force can be modified by adding active/passive movement.
February 9 at 2:45am
Tony Susnjara Firstly, the core thing - it was just one of the things that struck me when I tried the method. The two things about the balls + method that I found different where that the tissues were often rolled while in a lengthened positition - while stretched - I found this quite an intense sensation, very deep relatively to when the tissues were not under stretch. The second thing about the ball was that it could move across the myofascia, both just along it - so the obective is to separate fibres relative to each other. From how it was explained to me, there was an emphasis on rolling the tendons as well - as an area of focus - don't know if that means much but overall, as a method and product, if felt quite differnet to a foam roller.
February 9 at 2:52am
Ryan R. Fairall Hi All. I'm a PhD Candidate (ABD) in Movement Science and I'm actually doing my dissertation research on the acute effects of using SMR (just using that name because of prior research and the use of it in the field) with a lacrosse ball and static stretching on GH IR ROM, strength and throwing velocity in overhead athletes with a really common movement impairment called GIRD (> 20 deg less IR in throwing arm vs. non-throwing). From prior research, it seems like the exact mechanisms of this technique aren't really fully understood, but because my research is looking at acute effects (quickest and most feasible way to finish my degree) I am attributing the effects of the actually SMR more to autogenic inhibition rather than histological changes to the actual myofascial structure. That I think the stretching changes. My pilot study yielded the following results:
February 9 at 9:39am
Ryan R. Fairall Oops hit enter… ROM: SMR +3.5 deg, SS +8.5 deg, SMR+SS +9.5 deg, strength: no sig change within or bw conditions, EMG during strength: no sig change within or bw conditions, throwing velo: no sig change within or bw conditions. So using 8 subjects (repeated measures), I found that IR sig improved with all conditions (good thing) while performance measures didn't sig change (good thing). So not exactly sure on the original question on how it effects the fascia, but the point of my babbling is that it looks like SMR and SS works at improving ROM and that hopefully decreases these athletes' risks of injuries associated with GIRD without having them throw slower. Have to collect from 4 more people for my full study, but plan to see the same results. Sorry for the long message guys. PS: I assumed actually rolling over the area causing friction and heat is what causes changes in the fascial tissue, but I think manual therapists have a better idea on that.
February 9 at 9:51am
Brent Brookbush Really great post Jason Erickson,
Thank you so much for adding such a long, well-written, well thought out post.
To your point: At this point in my experience and education I believe that most self-administered techniques are in fact better taught as "compression" techniques and likely have a larger effect on muscle than fascia. Manual techniques that use an oblique or parallel force (such as massage, pin and stretch, IASTM) probably has a largest effect on fascia. With that being said, a muscular model of impairment is probably a better predictor of effective self-administered release techniques, and fascial models should probably be considered more for dictating manual therapy.
February 9 at 10:21am
Brent Brookbush Hey Ryan R. Fairall,
Great study, I would be curious to see what the carry over from session to session was between each group. I have hypothesized that releasing before static stretching would result in better carry over (48,72, or 96 hours later) when compared to static stretching alone.
February 9 at 10:27am
Ryan R. Fairall Thanks, I agree 100% Brent. I only did acute effects cause I want to get finish the degree ASAP. I'd love to do future research when I work at a university looking at the effects of the interventions over time (e.g. X times per week for X weeks). It seems like there are a lot of theories out there on the mechanisms of SMR/foam rolling, but really all I care about as a practitioner is if it actually works. But hey, that's where research comes in…evidence-based practice right? ;)
February 9 at 10:44am
Ryan R. Fairall Just a comment on if the ITB can be lengthened…stumbled upon this article a few years ago when researching the topic.http://www.ncbi.nlm.nih.gov/pubmed/11994795
Quantitative analysis of the relative … - PubMed - NCBI
PubMed comprises more than 23 million citations for biomedical literature from M…See More
February 9 at 2:54pm
Jason Erickson Ryan, how are you ruling out histological changes to the underlying myofascial strustures? Also, by autogenic inhibition, are you referring to a specific inhibitory feedback loop, or all inhibitory feedback loops combined? Do you plan to include any discussion of the psychosocial aspects of the inhibition, or will you only mention the biomechanical aspects?
February 9 at 3:02pm
Rob Fluegel Ryan, I don't have time right now to access the article above but I would have to question if the researchers were actually measuring true ITB length.
Their conclusion on the Abstract states: "Adding an overhead arm extension to the most common standing ITB stretch may increase average ITB length change…"
Has anatomy changed since I've been in school (besides them now calling the peroneals the fibularis)? How does one stretch a lower extremity structure by adding upper extremity movement?
It is my belief that the ITB can not be stretched because it is a tendon. If tendons stretched we would not be able to propel ourselves forward.
February 9 at 3:10pm
Ryan R. Fairall Hey Jason. Well since it's acute effects I'm concluding that the improvements in ROM are more likely due to neurological adaptations, rather than actual changes in the soft tissue structures. Like Brent mentioned, in a study measuring changes over time, adaptations may be more due to changes in the tissue. But hey, like I said, I care more about does it change rather than the how or why it changes.
February 9 at 3:13pm
Jason Erickson Good catch, Rob. I agree. There are mechanisms that can explain the observed changes. Attributing them to length changes in the ITB indicates some sloppy thinking about A&P. It would have been better had they noted the change in performance without attempting to explain it.
February 9 at 3:15pm
Ryan R. Fairall Hi Rob, from what I remember the researchers used ultrasound to measure the length of the ITB. As far as lifting the same arm up overhead, I think that as more to do with the lateral tilting of the pelvis and how that effects the muscles that lead into the ITB. Personally, I like the doing that when doing a stretch for the TFL. Luckily I still have access to full articles, so it you want it I can download it and email it to you.
February 9 at 3:18pm
Tony Susnjara Rob, why can't tendons be stretched and what are tendons anyway? Aren't they the all the fascial sheaths that run through the belly of the muscle coming together and then connecting to a bone? Tendons adapt to forces, get stronger, hypertrophy, can become more or less extensible over time.
February 9 at 3:23pm
Tony Susnjara Wouldn't the inclusion of the arm movement have to do with the fact that fascia is continuous?
February 9 at 3:21pm
Kyle Stull Gentlemen, in regards to that study, they simply measured adduction at the hip. Which, as we know, includes many things in addition to the IT Band. In fact, the researchers say "One of the limitations of this study was that we did not
directly measure ITB length". That is taken directly from the discussion section.
February 9 at 3:31pm
Ryan R. Fairall Yeah, I tend to agree Tony.
February 9 at 3:34pm
Rob Fluegel I do think that the arm movements are likely affecting the fascia and the muscles that lead into the ITB as Ryan said above. I believe that that is part of the basis for Gary Gray's "True Stretch" apparatus and his idea of "tweaking" the stretch by adding trunk and/or arm movements. Which brings me back to my question of if the researchers were truly measuring ITB length or something else. Again, I haven't read the article yet.
February 9 at 3:36pm
Rob Fluegel ^ but Kyle I guess did. So then why call the article the effectiveness of 3 different ITB Stretches when that is not what they measured.
February 9 at 3:38pm
Maurice D. Williams We certainly know that through fascia, the upper body connects to the lower body. If you look @ the posterior oblique system (POS), then we know that the lats connect contrallaterally to the glutes through the thoracolumbar fascia. As a result, by adding in some upper body movement, one can indeed affect the lower body.
February 9 at 3:40pm · Like
Rob Fluegel Tony, no I don't think that tendons stretch. I believe that the adaptations to stress, hypertrophy, etc are secondary to the cellular makeup of the tendon. If your Achilles Tendon stretched when your gastroc contracted, you wouldn't be able to walk.
February 9 at 3:44pm
Rob Fluegel Agreed Maurice, like I said and what has been concluded from that study, the researchers did not actually measure true ITB length.
February 9 at 3:46pm
Kyle Stull Rob, thats a great question. One of the beauty's of research perhaps?
February 9 at 3:46pm
Ryan R. Fairall Im trying to remember, I thought they used ultrasound to measure the thickness of the ITB, but I'll have to download the article again to check.
February 9 at 3:53pm
Kyle Stull They used markers placed on iliac crest and around the knee. As I mentioned a moment ago, the researchers stated themselves that they were not able to look only at the ITB, and must take into consideration the contribution of the glutes and TFL (which is more than likely where the changes occurred).
February 9 at 3:56pm
Tony Susnjara Rob, tendons have to stretch in order to function - exactly as you've described - so maybe I need to clear up the context of that. Tendons supply elastic energy and so does the fascia - it stretches and recoils because it is ELASTIC. However it is made up of the same collagen fibers, ground substance and fibroblast cells the fascia in the belly of a muscle. It is adaptable just like any other tissue but I think it adapts far more slowly and to a lesser degree that other tissues. I've practiced yoga for a long time and martial arts and have developed a product with which I do a single leg deadlift variation that really hits the hamstring origin via a full ROM eccentric load - after that exercise, you feel like you bone has been stretched - the DOMs are very intense. I'm not saying that the goal is to overstretch the tendons as then as you say, they would loose their elastic recoil and capacity to store and release energy but I can't understand why, if connective tissue generally adapts to stress why tendons would be any different.
February 9 at 3:59pm
Ryan R. Fairall Good chat guys. Great points. These are real brains at work;)
February 9 at 4:42pm
Ryan R. Fairall Oops my bad guys and girls. Its been a few years since I read these articles. I'm pretty sure this was the one I meant to post. Sorry again for the confusion. iPhone is not the best for searching for articles. Love to hear thoughts?
http://www.ncbi.nlm.nih.gov/m/pubmed/17023254/
Assessment of stretching of the ilioti… - PubMed - NCBI
To assess stretching of the iliotibial tract with Ober and modified Ober tests, …See More
February 9 at 5:45pm
Kyle Stull Ryan, thanks for re-sending the study. I do find this one more interesting. They noticed deformation of the ITB during the stretch (Obers Test). I can't see anywhere in the study that they even attempted to measure the actual length of the ITB, though and whether or not that it increased. Anyway, interesting read. Thanks again!
February 9 at 7:53pm
Ryan R. Fairall Hey Kyle, Nah, looked like they measured just the width. Im guessing they were going on the theory that the more the tendon stretches length wise the more the width decreases. Which makes sense, like stretching a rubberband.
February 9 at 8:09pm
Kyle Stull It does make sense, and I agree with their thought process. They just need to see if any of though changes were maintained.
February 9 at 9:11pm
Brent Brookbush You kats are amazing Ryan R. Fairall, Kyle Stull, Tony Susnjara, Rob Fluegel and Jason Erickson for really taking this discussion to a whole new lever. Love the research posted.
I did think of one thing to add to the discussion between Rob and Tony,
Do you think that the adaptation to stretch may have something to do with the type of connective tissue we are trying to affect?
For example,
Loose connective tissue (areolar, adipose and reticular)
Dense connective tissue (regular, irregular, elastic)
Ligaments and other forms of dense regular connective tissue, with a relatively low percentage of elastin may be limited in their capacity to adapt to forces by increasing in total length (and for the reasons Rob stated… what would be the long-term effect of muscle tonicity over a lifetime on tendon length).
I agree with Rob Fluegel in the sense that I think ligaments may stretch in response to force, but with a relatively high threshold to length change and almost no capcity to adaptively lengthen - achilles tendon ruptures resulting from a history of limited dorsiflexion might be an example of this.
We have to consider how we wish fascia to adapt. Is it really length change, or is it an improvement in tissue quality, including optimal alignment of collagen and elastin, reduction in adhesion, and potentially sensitivity of embedded mechanoreceptors.
February 10 at 12:17am
Jason Erickson "We have to consider how we wish fascia to adapt. Is it really length change, or is it an improvement in tissue quality, including optimal alignment of collagen and elastin, reduction in adhesion, and potentially sensitivity of embedded mechanoreceptors."
Is it actually fascia that we need to adapt?
February 9 at 10:51pm
Jason Erickson How would you stimulate adaptation of fascia without also stimulating adaptive responses in other tissues?
I don't think it can be done.
Since fascia generally adapts to patterns of movement/use, perhaps we should stop worrying about "adapting the fascia" and go back to improving the client's patterns of movement/use. We are unlikely to see any fascial adaptations that are inconsistent with those, barring pathological conditions.
February 9 at 10:55pm
Brent Brookbush Great points Jason Erickson,
I would say that regardless of the technique we are using the goal should always be to improve movement patterns. Although this post was originally intended to shed some light on the likely adaptation to self-administered techniques, and from my perspective the fact that "foam rolling" is likely best used as a static compressive technique to affect muscle tissue… there are several manual techniques that are specific to fascia. I have currently been integrating active release technique and Graston (Instrument Assisted Soft Tissue Mobilization) into my practice. These techniques are very specific to adaptations in fascial layers; however, at this point I have not found effective techniques that could be taught to a client/patient for a home exercise/self-administered program.
My thinking at this point, is these are good additions to a model that already includes the more influential techniques used to target joint mobility and the muscular system. Thoughts?
February 10
Tony Susnjara I personally think there are some deeper philosophical questions that it would be helpful to answer. I have practiced 3 different styles of yoga and 3 different style of martial arts. What I realised is that each style adheres to a worldview that limits it range of expression and each has its own values and priorities. I also expect the scientific and empirical worldview simply discounts possibilities that it would never even think to consider. In 1999 I wrote a 5000 word paper titled Dense Connective Tissue, Structure, Function and Plasticity. I focused on DCT because it seemed to be the most important limiting factor in improving ROM. At the same time, I looked at the role of the muscle spindles and GTO's and the muscle fibres themselves. So I always think of all the elements involved in the process. In terms of a limiting paradigm, in my yoga practice, I have held a passive forward bend stretch for 15 minutes, a downward dog for half an hour, thoracic extension over a prop for 20 minutes. Such techniques are practiced on a regular basis. This is one of many ways to practice yoga, you can also practice dynamically and actively but statically and also all in combinations of approaches. My point is - does anyone research the effects of these forms of stretching? It's outside of the paradigm of the mainstream scientific community. There are other approaches that are outside of the mainstream paradigm that if tested or researched could produce results that change the paradigm. Here is a logical thought experiment. A young man has fallen from his motorbike and broken his ankle and damaged his Achilles tendon. His ankle is put in a brace - what position should they brace it in? If they brace it in a shortened position, the tendon will adapt and if they brace it in a lengthened position, the tendon will also adapt. There are African tribes that triple the length of their neck - I don't recommend it but my point it - apply enough force over a long enough time and the tissues will adapt - including the bones. Here is another example. Years ago, I had a terrible sinus problem. It made me feel nauseous, dizzy, like throwing up. I went for x-rays and they said??? is this neoplasia? Then a CT scan and they asked the same question - then an MRI which showed no tumours but it was still perplexing because the bones were growing in an abnormal way. In the end an ENT worked it out. One of my sinus cavities had completely closed itself off from the outside world. It then created a vacuum. Over an extended period of time, the suction of the vacuum pulled on the bones and caused the new cells to be laid down in an abnormal manner. Did you get that? The suction of the closed sinus cavity changed the shape of the bones around my sinus cavity. I assume you have all heard about Wolf's Law - if bone can change shape, why not tendon? From personal experience, I think that all tissues in the body are far more adaptable than the scientific community considers them to be.
February 10 at 2:59am
Brent Brookbush Great post Tony Susnjara,
I don't think anyone is denying the adaptability of tissue in this post; but I do think there is reason to deny certain practices as effective for having a positive affect on fascial tissue. While the techniques may not be dangerous, any ineffective technique has the potential to waste time that could be spent on effective practices. This in turn effect outcomes and quality of life for those under our care. As I have mentioned before… in practice I am searching for the Holy Grail…. The first time, long-term fix to perfect, every time. In essence, the perfect session. It is going to take a ton of refinement to approach this goal, and in regards to this post… we should not be afraid to cast aside a body of work to replace it with something more effective.
February 10 at 10:55am
Tony Susnjara I think we agree on that Brent in terms of effective vs ineffective techniques. I think my point is that it is possible to have never been exposed to certain techniques and to have never applied them and never tested them and then to draw conclusions about what is and is not possible but with a limited tool box.
What kind of parameters do you put around the duration of a stretch, the intensity of a stretch and the repetition of that stretch? I know that in yoga, dance, gymnastic etc. they go way beyond what is considered normal practice in the fitness or physical therapy worlds. I knew someone who had chronic inflammation of the Achilles - he got relief from going to see his physical therapist who stretched and massaged and mobilised his calves and Achilles but then it just came back again. He was about to book in for surgery which totally shocked me. Have you ever tried stretching I asked him? And his physio and doctor had never suggested it to him?
I think of it this way, you can gradually, over a long period of time, take a deconditioned person and build them up to complete a full marathon. So who is measuring mobility in the same way? Are scientists going into a laboratory, applying a force to a tissue once and then based on that one test saying whether something is or is not possible?
Just like running, people build up a tolerance to stretching. In the beginning, they are often so hypertonic, their stretch reflex is so hypersensitive, it's equivalent to someone running 500 m before they fatigue. And over time, with repetition, you can build up just about any capacity.
Twice now I've said no to clinical trials on the freeFORM Board because I could see from a mile away that researches were asking all the wrong questions and I did not need to go through the process to know what the outcome would be. They would have gone ahead and set up faulty experiments and they would have walked away with a piece of paper saying “clinical trial “and "evidence based research" and lots of people would have read it and nodded their heads when before it even happened, I was shaking mine.
It's not that I think I'm so smart or anything like that, it's that I come from outside the paradigm and then I step into it and see what those inside it cannot - and of course, it works both ways,and there has to be so many things that I cannot see but I am ready to redraw my map at anytime as I have done repeatedly over the years.
February 10 at 3:39pm
Jason Erickson Tony, you make some good points about researchers needing to ask the right questions. If you study the published research, you will see that there is a lot of data, and that it does tend to specify differences in the characteristics of different groups studied.
Also, would you mind breaking your posts into paragraphs. It is difficult to read such large blocks of unbroken text. On a computer, hold down as you press the "Enter" key when you want to move your cursor to the next line. When done with your post, just hit the "Enter" button as usual and it will be posted.
February 10 at 3:36pm
Tony Susnjara thanks Jason, you learn something new every day
February 10 at 3:40pm
Brent Brookbush Hey Tony Susnjara,
I actually cover many of your questions about stretching in my book "Fitness of Fiction" - I know you have seen some of my snippets. When you look at all the research you start to see trends… for example, 30 seconds or more is more consistently effective than stretches held for less than 30 seconds. There is no additional benefit holding a stretch for longer than 2 minutes. Stretching up to two times a day increases gains, but no additional gains are likely to be made after 6 weeks, further, a tight muscle is likely to increase in length more than a muscle that exhibits no restriction.
I would post this research I am alluding to, but I literally cite 143 references in that chapter.
13 hours ago
Angelo Castiglione Thanks Brent Brookbush for the post and thanks Tony Susnjara for the mention. Some truly incredible discussion and fantastic input from everyone!
Now in the work that I do using a hands off approach to soft tissue, predominately using a systemised approach I've developed to foam rolling, using order of exercise, intensity and speed of application as crucial elements to what I consider to be effective foam rolling, the information we have on fascial lines is the closest to understanding the global changes that take place with the way I foam roll and the incredible instant changes which take place EACH time, not occasionally, but each and every time consistently.
However, it is fair to say that I really don't know what is taking place within the soft tissue, but as Ryan R. Fairall also mentions, I'm not so concerned with WHAT is happening, but more so on making changes to help those I work with. I prefer to spend time getting the desired results, than wondering why I'm getting them. In time it will be revealed with more research.
Now even before I knew who Tom Myers was, I had been using foam rollers for years and getting results and not really understanding why it was so. Then when I finally discovered Tom Myers and the Fascia Research Society and sat through all the conferences, I started putting some of the pieces together as to what was/could be happening with foam rolling.
Now in regards to static stretching, I personally don't do a single static stretch and nor do I recommend it to others either as I get incredible results in improving ROM and eliminating pain without it so I do not allocate any time whatsoever to it when I can invest my time in much more effective systemised foam rolling techniques which give incredible value for time.
11 hours ago
Tony Susnjara Nice to have you in the conversation at last Angelo Castiglione
9 hours ago
Tony Susnjara Brent Brookbush I wouldn't have time to read any research on the figures and protocols you mentioned above right now but it's definitely of interest and not having read it, I'd be cautious to comment specifically on what they've said and having said that, it sounds perfectly reasonable and I'd have no reason to question in.
The thing I would add is a question on the subjects and I would assume that they were chosen at random? And here is my fundamental point - STRETCHING IS A SKILL and you get better at it over time.
I assume that this fact is not considered in the research and if the research shows that tendons do not stretch, have they looked at the possibility that chronic adaptions over an extended period of time by someone who stretches in a particular way or is the research based on someone who doesn't stretch often, doesn't know how to stretch and so on. It would be like studying a sedentary person and extrapolating the result and saying that the marathon runner will generate the same result. Some people can run fast and far, some can lift very heavy things and testing a trained person as opposed to an untrained person is very different.
8 hours ago
Tony Susnjara //www.youtube.com/watch?v=tE8uvlJqA1s
Ashtanga Yoga Demo with Kino at AYC Toronto 2012
This video was taken Friday night during my workshop at AYC Toronto in 2012 and …See More
8 hours ago · Like · Remove Preview
Brent Brookbush Thanks for your insights Angelo Castiglione. I believe the why as more implications of the muscles, lines or structures that we wish to foam roll, than whether or not foam rolling is effective. I personally use static stretching with great success, but the implementation is very specific and based on thorough evaluation.
7 hours ago
Brent Brookbush Hey Tony Susnjara,
I hear you on having the time to read research. It's a tough thing to make time for, especially in light of it often taking dozens of research studies to answer the questions we wish to have answered.
I am not sure why you would want to stretch tendons when muscular adaptation would seem to have a larger impact on performance. I agree that stretching is a skill, but we still need to base our practice on the recommendations implied by research.
7 hours ago
Brent Brookbush Most importantly, a big thank you to Anthony Carey, Tony Susnjara, Angelo Castiglione, Rob Fluegel, Jason Erickson, Kyle Stull, Ryan R. Fairall, Maurice D. Williams, Barbie Collins, Gary Miller, Donna Clinton, Rebecca Rebbecca Hoffman, Maggie Stephens, Melinda Reiner, Dom Nicoletta, Leslie Minetree Freeland, Jinny McGivern, Michael Zweifel, Bernadette Ricci, Leslie Minetree Freeland, Rob Hooper and Joe Burt
You made this the biggest "Panel Discussion" I have ever hosted. I hope you kats found it as informative as I did. I will be adding this to the archive of discussions at7 hours ago
Melinda Reiner You rock!
7 hours ago
Tony Susnjara Yep I agree on that issue as to whether or not you want to stretch tendons - and I would say that it depends on the context. My comments were more about what is and isn't possible and also the problems inherent and invisible in evidence based research.
There will be times when it is beneficial to stretch tendons - because these is a going to be a more or less optimal tone, elasticity and extensibility of tissues for different contexts. My basic theory is that we live in a hypertonic society and we don't know it. Often I take people through a systematic, carefully aligned, holistic yoga based stretch routine, I then put an eye pad on their eyes and talk them through some breathing and relaxation and the effect in the beginning can be SHOCKING because they have an experience which contrasts how much physical, mental and emotional tension they carry around all day and they don't even know it because it is normal to them.
And traditional cultures were far more mobile than what we are, they often sat of the floor and had open hips and their normal everyday lives involved what we would call stretching. So industrialisaton reduced the normall ranges of motion.
about an hour ago
Maggie Stephens Phew! It's been tough trying to keep up with you all during this discussion - that'll be your discussion by the way, I was merely an onlooker! Huge respect and admiration to the contributors. Loved the debate/perspectives, but most of all I've learnt a huge amount. Thank you M x
6 hours ago
Anthony Carey Epic post!
5 hours ago
Brent Brookbush Your insights were well appreciated, as well as your significant reach and influence among human movement professionals Anthony Carey. I look forward to more discussions in the future.
5 hours ago
Anthony Carey Thanks Brent Brookbush. Meaningful, respectful discussions such as those in this post helps us all. Kudos to all who contributed.