Self-Myofascial Release (SMR) routine for the legs
The following article is part of the TotalMSK Coronavirus (covid-19) home survival pack, which is a series of guides covering various aspects of having to live under a lock-down. This particular article looks at self-myofascial release techniques to help reduce leg tension from prolonged sitting or working at home (see home working computer setup guide). Equally, these techniques are a useful way of self-maintaining one's legs after physical activity, such as running. As a runner, musculoskeletal professional, soft-tissue therapist and educator, the author has developed these self-maintenance leg routine techniques over many years. These techniques have proved highly effective, in part because the author understands how one can use these tools to apply specific myofascial release techniques in a self-treatment context. Although these techniques work exceptionally well on the legs, they are not suitable for other areas of the body. There are occasions where treatment using myofascial release techniques may not be suitable or advisable (contraindicated). Contraindications can be global, meaning that a method should not be used at all or local, meaning it might be possible to apply a technique to some areas of the body but not others. Before commencing with any fitness or stretching activities and particularly self-myofascial release techniques, one should be sure it is safe. Hence, if one has any contraindications to massage or myofascial release techniques, then self-treatment using the methods listed in the article is not advisable. If in doubt, speak to a suitably qualified professional and get advice before commencing with any of these self-treatment methods. Also, it is advisable to read the more general article on Self-Myofascial Release (SMR) for legs if one has not already done so. Equally, as with any form of soft-tissue stretching tissues should be suitably warmed up before attempting to apply any stretch, especially in the case of self-myofascial release techniques. This article follows on from two previous articles about "Self-Massage Foam Rollers - Myofascial Release" and "Self Trigger Point Therapy (TPT) and Massage Balls". The previous two articles covered essential aspects about the origins of the massage techniques these self-treatment products aim to replicate, along with some of the common mistakes when using them. Myofascial release techniques can prove very effective in treating some forms of chronic pain. However, chronic pain often requires a multifaceted treatment approach, and it may not be feasible or safe to apply self-myofascial release techniques effectively, (see the article on Chronic Pain for further details on aspects of such conditions and treatment).
SMR tools and techniques
There are many popular videos on social media demonstrating self-myofascial release techniques. It is important to remember that anybody can make and post videos on social media, regardless of their training, education and even understanding of basic anatomy, physiology and the basis of myofascial release techniques. Equally, it is important to understand there are many different myofascial release techniques. In essence, myofascial release techniques are like "tools" in the therapists "toolbox". Part of the therapist skill lies in knowing when to or not to apply a specific "tool" in any given situation. Many of the social media videos demonstrate the use of individual "tools", such as foam rollers, massage balls, spiky massage balls etc. being used to treat the entire body. Unfortunately, there is no one "tool" fits all, and this is why soft tissue therapists learn multiple techniques. Furthermore, not only does each "tool" have limitations even in a trained therapist context, but even more so in a self-treatment context. Applying, techniques correctly and effectively in self-treatment context can be challenging due to physical positioning and the effect this has on tissues under treatment and elsewhere. Hence, it makes sense to utilise different "tools" or self-myofascial release techniques for different situations. It is best not to assume that just because a technique works well in one area that it will work well on other areas of the body, though people always seem tempted to try. Even with the author's knowledge, there are many areas of the body that he cannot treat in a self-treatment context. As good as self-maintenance can be, sometimes we need a little outside and professional help, and it is essential to understand that. This article and the other related ones involve the use of a "massage stick or stick roller" and a "spiky massage ball". One can easily apply these techniques to the quadriceps, hamstrings and calf muscles. However, the methods are only likely to have a limited effect on deep tissues. One of the best things about these techniques is that the necessary tools are relatively inexpensive and quite small, unlike a foam roller.
Massage Stick - Stick Roller
There are many forms of massage sticks or stick rollers, much like there are foam rollers. Some of the massage stick rollers are flexible, some have neoprene over the rollers, some are rock hard, and others have different sized and moveable rollers. Personally, the author prefers a relatively non-flexible and straightforward massage stick roller. Be warned if you have hairy legs and use the massage stick roller on bare skin, as some products have tightly packed individual rollers which can pull the hair out of your legs (the author knows from experience). Foam rollers and massage sticks have a lot in common, in that they both try to replicate petrissage massage, which includes squeezing and stripping actions. Massage training teaches massage therapists to apply these actions towards the heart, as the stripping actions push blood flow through tiny one-way valves within the veins. Varicose veins are an excellent example of what happens when these miniature one-way valves within the veins become damaged. It is possible to treat the quadriceps muscles very effectively with a massage stick, as it is possible to treat soft tissues in a relaxed or semi-relaxed state. Usually, if one were trying to treat the quadriceps with a foam roller, then this would involve laying in prone (face down) position and tends to result in the quadriceps being under tension. Logically, a massage therapist would not attempt to perform a "stripping" type technique on the quadriceps of somebody who was tensing them, as it would be particularly painful.
Spiky Massage Balls
As with the foam rollers and massage stick rollers, there are many varieties and shapes of spiky massage balls. Some spiky balls have cone-shaped spikes, others have cylindrical ones and massage balls come in a variety of sizes, shapes and levels of firmness. The author tends to use a firm and roughly 8cm diameter spiky massage ball and with cone-shaped spikes. Such a design works well for applying a "myofascial tissue lock", which is relevant in a self soft tissue release context. There are many videos on social media of people using spiky massage balls in what appears to be some form of trigger point therapy. The following link has more details on what myofasical trigger points (TrPs) are and their relevance. Even just placing a normal massage ball in an area of pain and then applying loads of bodyweight pressure to the tissues is only likely to result in further tissue trauma, possible bruising and further symptom irritation. Employing the same method with a spiky massage ball makes even less sense, though a spiky massage ball can be useful for soft tissue release (STR). Self soft tissue release (SMR) uses the spiky massage ball in a completely different way to trigger point therapy (TPT). Soft Tissue Release works by creating a musculocutaneous soft tissue lock and then applying a form of either active or passive stretch to the tissues under treatment. It is possible to use the spikes on the massage ball to achieve a similar musculocutaneous soft tissue lock and in a self-treatment context.
The following four guides explain how to use the techniques discussed above, and their creation came about through the authors, combined knowledge, experience and pushing his own body to the limits. It is personnel preference as to whether one starts by treating the upper legs or lower legs first. However, that said if the author was beginning his self leg treatment routine on the upper legs, then he would do the entire upper legs before the lower legs. Equally, if starting on the lower legs (calves), it is worth treating the Gastrocnemius before the Soleus, as is explained in the articles.
The article was written by Terry Davis MChiro, BSc (Hons), Adv. Dip. Rem. Massag., Cert. WHS.
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About the Author
As of December 31st 2020, the author chose to leave the Chiropractic profession. He no longer works as a Chiropractor and works as a Myotherapist in Morningside, Brisbane. The author possesses an unusual background for somebody who trained as a Chiropractor (McTimoney). His education, training, and practical experience span over two decades and relate to both health's physical and mental aspects. He has also needed to push his own body and mind to the limits of physical and psychological endurance as part of his time serving in Britain's elite military forces. His education includes a bachelor of science degree in Business Management, with a specialisation in psychology and mental health in the workplace, an Integrated Masters in Chiropractic, MChiro and a multitude of soft-tissue therapy qualifications (see the about section for more details). His soft tissue qualifications range from certificate level right through to a BTEC Level 5 Advanced Diploma in Clinical Sports and Remedial Massage Therapy. Terry also has extensive experience in security, work, health and safety and holds relevant certifications. He has also taught as a senior course coach at Advanced Diploma level (Myotherapy / Musculoskeletal Therapy) in Australia, both theoretical and practical aspects including advanced Myofascial Release Techniques and has certification in training and assessment. Terry will have taught many of the first students to train as Myotherapists in Brisbane. Terry's combination of knowledge through education, training, elite military service, and personal injury history has paid dividends for the consumers he sees and has treated over the last 15 years. He has extensive experience treating chronic pain and work and sports-related musculoskeletal injuries. Terry is still very active and enjoys distance running, kayaking, mountain biking and endurance-type activities.