In order to better understand just what myofascial release is supposed to do for you, a working knowledge of fascia itself is a necessity. According to Rob Wilson in his article "Foam Rollers Don't Work: Understanding Myofascial Release," "fascia is the basic term used to describe the connective tissues of the body." He likens this fascia to the stuff that covers the different compartments of a T-bone steak before you cook it. However, my physical therapist likened fascia to shrink wrap that covers all structures in the body. To continue further with the analogy, when you develop a muscle knot, which is not a literal one, the fascia in that area bunches up, much like shrink wrap. Tissues then cannot glide smoothly when trapped by bunched-up fascia. As a result, you develop pain and compensatory movement patterns, which only leads to more pain since all of our muscles are designed to function in specific ways.
For example, your transverse abdominus, which is the deepest layer of your abdominal muscles, is supposed to support your spine. However, for me, my rectus abdominus was acting as my spine's support. This resulted in poor spinal stability. However, you wouldn't know I had an unstable spine because I was able to always keep my back neutral, but I also had to grip my core unusually hard to achieve this. The rectus abdominus is only supposed to function for forward flexion. My obliques were also involved in providing spinal stability--and that's not what they're used for, either! To summarize, I had a lot of muscles firing that weren't supposed to be firing, and a lot of muscles firing too late that were supposed to be firing immediately. You can then see why this would result in trigger points and pain.
At first, trying to figure out the dysfunction of my hip was a complete experiment. Since my hip problem could not show up on neither an x-ray nor MRI, my therapist had to rely solely on palpating all of my painful spots. It was like putting a puzzle together. She knew my hip joint was not sitting properly in my hip, as my hip bones were not even. Over time through several appointments, several sessions of massage, and several sessions of palpating, did she begin to really understand the whole picture. She had already originally concluded that the only way to get my hip joint to sit properly in my socket was by smoothing out all of this bunched-up fascia in all of the areas that were tender. But then she also realized I had to re-train my muscles so that they were working how they're supposed to. This is where I began to take matters into my own hands outside of our sessions.
While the deep-tissue massages I received during therapy were absolutely helpful, she could only massage the areas I was able to pinpoint. On my own, I found more tender areas that did not elicit the same pain signals other areas did, but nonetheless contributed to the overall poor mechanics of my hip. I then began to realize that the way I previously tried to implement self-mysofascial release with a foam roller was all wrong. I'd spend minutes rolling out my IT band, only to come away with just a tiny bit of relief. However, by sitting that tender area on a golf ball for five minutes--super painful, might I add--I finally found the relief I'd been seeking all along. I then took this golf ball to all of the tender areas on me, finally releasing all of this bunched-up fascia so that I could then implement corrective exercise to restore proper functioning of my hip. I still have to use the golf ball, but I know it's a process. After all, I've had this issue for years, so fixing this problem is not going to happen overnight. However, the difference is incredibly noticeable. I can squat more now than I did prior to the injury. I can stand and walk for long periods without developing any nagging pain. I can now sink into my left hip without feeling tension. And it's all because of self-myofascial release.
My story is crucial to understanding that the only way to release fascia is to put continual pressure on a point of adhesion. Quickly rolling back and forth over a painful area may elicit some relief, but it's like trying to smooth shrink wrap with a rolling pin. But if you put enough pressure on that shrink wrap, you can break through it.
So what are the different tools that can be used for self-myofascial release? Do you have to use a foam roller? Do you even have to use a golf ball?
Let me start by saying that self-myofascial release is absolutely painful, but hurt does not always equal harm. You must push through the pain; however, you can control the degree of pain with the various self-myofascial tools out there.
You can use a foam roller, a lacrosse ball, a golf ball, a rolling pin, and a variety of other implements. I chose a golf ball because it's hard; its small size means I can better pinpoint areas of tenderness. Even so, using a golf ball is for those who are able to tolerate the pain. There are less painful means.
Foam rollers are great for large muscle groups. As you can see from the foam rollers pictured above, these too are used for those who are able to tolerate pain or who need more aggressive release because they have a lot of muscle tissue to work through. There are foam rollers that do not have these ridges, of course. They are simply compact foam with pockets of air that allow for some give in individuals new to self-myofascial release. These particular rollers also range in degrees of firmness. I have a black one that's firmer than the blue-and-white one at my gym. A tennis ball can also provide this same give for those who want to hone in on a specific area, like a tender area on a forearm or upper back.
When you're foam rolling or doing self-myofascial release with some other implement, find an area that feels tender. Once you've found that area, you simply pin that area down and hold it for about 60-90 seconds. You can also use the foam roller to help soften things up before going in with more aggressive methods. It's okay to roll around just a little bit, but you primarily want to keep that spot still so that the pressure can smooth out the adhesion.
Sometimes it's difficult to tell if you were able to eliminate the adhesion. If it's an area that you can't easily stretch to test it, all you can do is wait for a day or two to see if that area is still tender. If it's no longer tender, then you've smoothed out the fascia. If, however, the area can be stretched, you'll know the myofascial release has worked when you no longer feel tension in that area. You may feel some soreness in that area the following day, but that is completely normal. For more stubborn muscles, like your piriformis, you may have to work on that area for a few days. You'll especially have to give that point of tenderness a few days if you've had it for a while.
Even after you've rid yourself of the pain, you need to ask yourself what led to the problem in the first place and then go in and try to correct it. Did you develop pain in your low back because of improper squatting form? Deadlifting form? Sitting hunched over at your desk all day? Not maintaining proper posture? Getting rid of the pain is great, but unless you fix what caused the pain in the first place, it is likely to return.