Never use a foam roller all over the body. In fact, you should limit your rolling to the soft tissues of the body with a focus on the muscles. Here is an email from a reader who hurt something while foam-rolling his leg near the iliotibial band (ITB).
Stew, I think I hurt my knee foam-rolling. I immediately stopped and could feel my knee starting to swell up. Now it just feels stiff with a bit of instability. It only hurts when I do certain motions but don’t want to test it because the pain feels like a knife to the knee. I was rolling my ITB, but anytime I did a roll, it felt uncomfortable on the inside of my knee like it was being pulled from rolling. I am seeing a doctor tomorrow. Any suggestions on working around it? Jason.
Jason, good question. Sorry to hear about the aching knee after your stretching and foam-roll session. Before we discuss ways to work around this ache, let’s talk about some dos and don'ts with foam rolling.
I love the foam roller and refer to it as my poor man’s masseuse; however, it does have some limitations. I am not a doctor and will not give any medical advice here, but you should focus on only muscle massage when using the foam roller.
If you have sore muscles, the foam roller is a way to address the pain and offer some temporary relief to the muscles throughout the body. However, you must be careful around joints as the meniscus, ligaments and underlying bursa sacs can be aggravated by rolling.
With the knee, hip and IT band, getting too close to the joint can cause these tissues to receive pressure from the weight of your body on the roller. As you roll the side of the leg and the corresponding front and back of the leg, you will encounter other muscles, tendons and ligaments.
It is likely you rolled across the connective tissues of the sartorius muscle and tendons. There are also bursa sacs along those connective ends of that muscle that may have caused your inner-knee pain even though you were rolling the outside of the knee. There is a long muscle that reaches from the inside of the knee, across the front of the leg and into the outside of the hip near the ITB.
Sometimes the foam roller can cause inflammation if you are sore already. If you created inflammation, then were on your feet for a large part of the following day, that inflammation can flow toward the knee and even make it stiff and painful to move. Gravity can do that with inflammation, so keep the knee elevated whenever possible.
It may hurt for a few days or even a week or more before you can do much with the knee, so running, leg exercises or even biking may be off the list. You may be able to swim if you do small flutter kicks for propulsion instead of large scissor or breaststroke kicks. Another option to consider if kicking hurts is to use leg buoys to place between your legs so you can avoid kicking altogether. Just use your arms to swim while the buoys keep your legs from sinking while you swim to get some cardio and upper body activity.
Replace any leg days with core and non-impact cardio work that does not involve significant knee bending. Elliptical machines can be an option if you do not want to get in the pool with the arm pull workouts. Keep your upper-body days the same but take out any cardio work unless it doesn’t cause any pain to the leg.
When using the foam roller or stretching, focus on the gluteus medius and gluteus maximus as well as the tensor fascia latae as exercises to assist with IT band pain. Do this instead of cranking down the foam roller on the IT band or trying to stretch it. The IT band is near impossible to stretch anyway, but all the muscles around it are fair game.
Stew Smith is a former Navy SEAL and fitness author certified as a Strength and Conditioning Specialist (CSCS) with the National Strength and Conditioning Association. Visit his Fitness eBook store if you’re looking to start a workout program to create a healthy lifestyle. Send your fitness questions to email@example.com.
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