First, some praise for the device that's become a staple of every runner’s self-help/torture plan: It’s very nice. You can’t hurt yourself with a foam roller. Sure, you could lie on a sore spot until you bruise, but that’s about the worst thing that will happen, says Barb Hoogenboom, a professor in Grand Valley State University’s clinical doctorate of physical therapy program. “The bigger problem,” she says, “is that foam rolling is putting a Band-Aid on a problem that you haven’t found the cause of yet.”
Take a common running ailment: the screaming mad IT band that causes pain on the outside of the knee. Usually, a runner’s first inclination is to attack the pain by rolling the IT band, and keep running as usual. But more often than not, the problem isn't the IT band itself. If pain persists longer than a day or two, Hoogenboom says, “the root cause is probably more about muscular imbalances rather than just a sore muscle.”
That means your IT band might hurt because it connects to a weak muscle. Or because your large, prime muscles are weak. “If your butt’s not doing its job, the little guys are going to have to take over,” Hoogenboom says. “The tensor fasciae latae is attached to the IT band. If it gets overused, it can get tight and irritable, and then it makes the illiotibial band get tight. Something that’s underused can cause something else to be overused.”
An all-over strengthening routine could help stave off injuries due to weak muscles. But there’s a greater question you may need to ask yourself in order to heal. In the case of the IT-band scenario, you need to question why you're underusing your butt. In the case of all other nagging injuries, why aren’t you using certain muscles that you should be?
“That’s the million-dollar question,” Hoogenboom says. The answer is neuromuscular imbalances—when your muscles and the central and peripheral nervous systems that drive them don’t communicate properly. Like when your body decides to recruit the little tensor fascia latae instead of your big butt to assist hip movement.
Researchers are currently debating whether a pattern of movement—like sitting at your desk all day—causes the imbalances, or whether inherent imbalances cause poor movement patterns. We do know that if you’ve been injured in the past, and you have chronic pain somewhere other than your injury site, chances are you’ve changed how you move to favor the body parts that weren’t injured. That doesn’t necessarily mean your performance will suffer, says Hoogenboom. But the new pattern could cause pain in places that has little to do with the source of the pain. To leave an injured glute alone, for example, you might’ve started over-recruiting your tensor fascia latae, which is now causing your IT pain.
A good therapist will not only diagnose your problem, but will also “keep people cognizant of their potential imbalances so they can fix themselves or cut things off at the start if they start having problems again,” Hoogenboom says.
Many runners Hoogenboom sees know when something is wrong that can’t be rolled out. But it often takes a professional who knows what proper movement patterns look like to tell you what you’re doing wrong—and a willingness to stink at your sport for a while as you train yourself to move properly again with strength and movement exercises prescribed by a therapist.
She’s not against your foam roller. “It can be very helpful after a hard workout for soreness,” she says. “But if everything were foam-rollable, physicians, athletic trainers, personal trainers—we’d all be out of business.” And those guys aren’t going anywhere.