How Does Foam Rolling Work? And Why “SMR” Should be Called “SMT”

Today, I’m going to share a discussion on Facebook that I recently had with Todd Hargrove and Greg Lehman. I’m not always confident with my understanding of things, but I’ve developed great “go-to guys” over the years when I’m seeking answers in various topics, and Todd and Greg are well-versed in areas pertaining to manual therapy.

I lift weights every day with a ton of strong dudes. Nearly all of them foam roll. I foam roll and use the stick and a lacrosse ball too. Are we all just a bunch of dumb meatheads falling prey to The Placebo Effect? Or is there more to foam rolling than meats the eye? Are we changing mechanical properties in the fascia? Or are there other mechanisms at play?

Over the past decade, strength coaches have come up with a number of potential mechanisms to explain how and why foam rolling is working. Though these theories made sense at the time, most of them are now outdated. I hope you appreciate the conversation.

foam rolling

BRET

Hey Todd and Greg, I want to write a blogpost about “How Foam Rolling Works” and pretty much repeat what Todd wrote about DNIC. I’m going to link to blogposts that you have written. But I wanted to ask you all whether or not you think there’s any merit in Schleip’s thoughts here:

http://www.thebodymechanic.ca/2012/10/28/fascial-neurobiology-an-explanation-for-possible-manual-therapy-treatment-effects/

And, do each of you agree that DNIC makes the most sense in regards to how foam rolling works? Thank you very much for your time, Bret

TODD

Hi Bret, I think there is some merit in Schleip’s ideas, and I discussed them briefly in my paragraph titled “4. Does Foam Rolling Work by Proprioceptive Stimulation?” My answer is that stimulation of mechanoreceptors is probably part of the story, but I think DNIC is a better explanation.

Someone pointed out in the comments to my post that Schleip has new proposed mechanism – something like squeezing water from a sponge. (See the comment by Margy) I never looked into it, but I noticed Chaitow referenced it recently in an FB post.

BRET

Thanks Todd! Greg, I would appreciate your thoughts. All of my lifting partners swear that foam rolling has made their muscles more pliable over time. I’m inclined to think that they’re full of it and that they’re just imagining things, but if Schleip’s theory is correct then it could make sense.

GREG

Two thoughts:

1. I would guess there is a transient increase in stretch tolerance and ROM after foam rolling. Your friends might then go train a little easier at end ROM and it is this new training and confidence at end ROM that ends up increasing their extensibility or comfort with new ROMs.

2. Pain reduction: I would not put this solely on DNIC. People will certainly report pain relief without having to mash the shit out of their tissues. I would guess that the pain relief mechanism is the same as every other pain relief mechanism from manual therapy or movement. Meaning we probably don’t know but its a lot of little things that deal with the resolution of our pain output. This could be all the non-specific effects we talk about: fuzzy homunculus, refreshing the sensory cortex, beliefs about treatment and satisfying an expectation, paying attention to the area etc. If someone can tell me what manual therapy does then we can probably say that that is what foam rolling does.

I certainly don’t think scar tissue or mechanical adhesions are being removed.

As for long-term changes I suppose it is possible that the tissue might change via mechanotransduction if the load is consistent and frequent over time. I don’t know why this would make some more pliable it seems just as likely to make the tissue more robust.

Sorry, no good answers there.

TODD

BTW, Chaitow recently referenced Schelip’s research on water extrusion, which I haven’t read. Here’s a good quote, which supports my idea that if foam rolling has any benefit, it is temporary, but opens up a “window of opportunity”:

“Schleip and Klingler observe temporary easing of stiffness after water is extruded from fascial tissues, returning to stiffness as it is resorbed (after 20-30 minutes)…this window of reduced stiffness offers chance for mobilization etc, but does not seem to account for sustained reduction in stiffness.”

BRET

Let’s try to form a current consensus between us:

Theories that are out are:

1. Pizoelectricity – liquid crystals spark and realign tissues

2. Thixotropy – fluid-like flow from agitation

3. Fuzz – unsolidification of loose connective tissue

4. Scar tissue and adhesion removal – breaking down scar tissue and removing adhesions

5. Trigger point therapy – releasing trigger points

6. Myofascial meridians – affecting one part of the body’s fascia impacts the whole chain

But still on the plate are:

1. Increased stretch tolerance – transient decrease in stretch-related pain sensation

2. DNIC – pain distraction

3. Placebo effect – believing makes it real

4. Refreshing the somatosensory cortex – clearing pain-related “defaults” in the brain/body

5. Proprioceptive stimulation – transient decrease in muscle tone due to mechanotransduction

6. Spongy window – dehydrating tissue followed by a subsequent rehydration, with a window of opportunity in between

Are these correct?

What else is in, or out?

Should self-myofascial release be given a new name? If so, what 3 letter acronym?

GREG

With #3. Placebo isn’t really the right word. Use it. But clarify that there are really effects behind it. Expectation and satisfying that expectation being one of them. I don’t know this stuff off the top of my head but that paper by A Louw on A neuroscience approach to low back pain in athletes would probably touch on it.

But honestly, if we solve why manual therapy works then I bet we can say why foam rolling helps with pain.

TODD

Hi Bret, those look good. Here are a few comments, each of which are pretty trivial.

First, in reference to the meridians idea, I would not disagree that causing structural changes to the fascia in one area would have mechanical effects in another area. I just disagree with the idea that foam rolling could affect the fascia.

Second, I might somehow combine numbers four and five of the second list. In other words, the effects on the somatosensory cortex are due mostly to proprioceptive stimulation.

Third, the “window of opportunity” applies to more than just the sponge. It would also apply to any other mechanisms (e.g. DNIC) which would create temporary benefits in mobility or pain reduction.

Fourth, I haven’t read anything at all about the water/sponge theory so I have no idea whether it “holds water.” Ouch!

Oh, and in regard to your question about the term “myofascial release”, I don’t like that term at all as applied to foam rolling or any manual technique. It is describing a theoretical and implausible mechanism of effect, as opposed to the actual technique.

Therefore, it’s confusing and causes people to assume that when you are foam rolling, you are releasing fascia, even though there are many other ways that foam rolling might cause changes to your movement that have nothing to do with fascia.

Calling foam rolling MFR is like calling sit ups “ab shredding.”

BRET

Awesome stuff guys! So it should be called…..wait for the drumroll…..Self Manual Therapy (SMT)?

TODD

SMT sounds great. That way, no one will be confused about what you are taking about.

OTHER ARTICLES ON THE TOPIC

If you find this interview to be interesting, here are some more links you can check out:

Paul Ingraham on trigger points

Todd Hargrove on the mechanisms of how foam rolling works (and how it doesn’t work)

Greg Lehman on fascia science

Todd Hargrove on fascia

Alice Sanvito on how we can’t stretch fascia

Paul Ingraham on fascial neurobiology

Chris Beardsley summarizing current research on foam rolling

foam rolling

30 Comments

  • Sam says:

    Hi bret,
    I use tennis ball message for piriformis syndrome, and it really works.

  • Dixon says:

    Man, Ive been using foam rolling and other stretches for my Piriformis and I really feel like it helps..when I miss I can really tell a difference..even if I still do the stretches but miss the foam rolling I still feel a difference.

  • ANdy says:

    Cheers Bret for taking the time to talk this stuff through and good use of go to guys rather than running off at half-cock. Sweet summary.

    ANdy

  • Derrick Blanton says:

    Question for the panel:

    How adaptable are the physical properties of tendons in response to external pressure, and friction?

    i.e., Is it plausible that various types of manual therapy, ex. cross friction from a more severe implement, such as a chain, could potentially effect a structural adaptation of the tendon?

    Spitballing here, I think here of martial artists, walking on their knees to toughen up connective tissue, Muay Thai fighters toughening up their shins to withstand enormous blows, etc. Possibly, we can also physically work to remodel the tendon? Or not, I don’t know!

    On the topic du jour, I find SMR to be very effective, and I hypothesize that it is primarily a neurological effect, a form of operant conditioning. But whatever the mechanism, it has been a blessing for me!

    Of course, this may depend on what the source of pain and immobility is, and the causes for that can be many.

    Great discussion!

    • Derrick Blanton says:

      Some SMR classical conditioning as well?

      The muscles do seem to reflexively relax under the correct dose of painful pressure, too much, and there can be a seizing up. And yet there does seem to be a progressively more conscious voluntary effect to the ‘learning’.

      Almost like right in that grey area between reflex and volition, which makes it all the more difficult to pin down.

      • Trev says:

        “How adaptable are the physical properties of tendons in response to external pressure, and friction?”

        Given that the tensile strength of tendons is, I think, something like 4000psi, probably not very. Actually, I should phrase that as a question. Since I learned how strong connective tissues are I’ve wondered how anyone can claim to stretch their IT band for example. The muscle seems like the more pliable substance here, so aren’t we just breaking up the little self-defensive contractions that occur in it when we roll/prod/needle?

    • Todd says:

      Hi Derek,

      Good questions.

      The tissues of the body are definitely adaptable in general: stressing them will cause microdamage that will cause them to grow more resistant to that particular form of stress. This is the SAID principle (or, with specific regard to bones and tendons, Wolff’s Law and Davis’ Law.)

      So if you’re continually compressing a certain bone, it will get harder and denser in that area. If you’re always stressing a certain tendon or ligament, it will get stronger.

      However, I doubt that foam rolling creates the intensity or duration of stress on connective tissues that would cause an adaptation. And I doubt that any such adaptations would be useful for anything other than bearing the specific stress of the rolling.

      I have heard that martial artists deliberately stress their bones to make them harder. I don’t know how much work they require to do this, but I would guess that its more intense and prolonged than 30 seconds a day on the foam roller.

      I also know that Graston and instrument assisted soft tissue techniques deliberately create minor injury to tissues, to promote inflammation. But the idea there is not so much to toughen up the tissues through adaptation, but to promote healing.

      • Hannes says:

        I’ve heard that tennis players have thicker and more dense radius and ulna on their dominant side compared to the other one. So changes do probably occur in bone with external stressors. I’ve been led to believe that structural change to bone is best accomplished with rapid shock-absorption, like a kick on the shins or a tennis serve.
        If the same is true for tendons is not as clear, to my mind, tendons react to load in the direction of the fibers, not as much with external pressure or perpendicular load. I would probably say that much of the toughening is do to pain inhibition. That is also seen in endurance athletes!

    • Joshua Naterman says:

      Tendons adapt to mechanical stress, similarly to how muscles do. The more you load a tendon, the thicker it gets. Manual techniques won’t reproduce this effect, but it is 100% possible to damage a tendon (or muscle, ligament, etc) with excessive pressure. The small surface area of a finger, elbow, or a massage/Gua Sha type tool can be high enough to actually cause a crush injury, just as if you dropped a heavy weight on it.

      Virtually all of our musculoskeletal tissues are dependent on physical stresses to provoke adaptation. The bones respond to compressive forces by developing thicker, denser Haversian systems in the direction of the applied force, so repeatedly kicking very heavy (and sufficiently hard) bags will thicken the bones specifically in the areas of impact. Walking on your knees won’t toughen connective tissue so much as it will promote calcification of the patellar tendon and the development of a collagen pad over the area. If you are smart enough to use a sufficiently (but not overly) padded surface you shouldn’t have to worry about calcification, but doing that on concrete can cause some problems. I used to fight Muay Thai, and we never did that. We had a series of progressively denser heavy bags that we kicked, punched, kneed, and elbowed for such purposes. I also went a step further and implemented a simplistic Iron Body routine that I adapted from what I had learned about Shaolin methodology, and it worked exceedingly well.

      As for muscle pliability, if you check the available literature you will find that patients under anesthesia have impeccable flexibility, and even after immense range of motion work in the unconscious state, they wake up with zero soreness or injury. This proves experimentally what we already know from the structure of skeletal muscle: Our range of motion is not limited by the tissue itself, but rather by how our bodies have been ‘taught’ to use the tissue. The contractile components of skeletal muscle can stretch to 3x its resting length (not the shortened length at the end of a contraction, but the length at which the muscle spends the most time. Think “anatomical position”). In the human body, we never even come close to that kind of excursion, or range of motion. We are designed to never be able to approach those limits. I have mentioned flexibility because you, like everyone else who tries it, will notice that you are more flexible and feel ‘looser’ after a manual therapy session. Stretched muscles also have this looser, softer tissue quality to them, as well as greater voluntary range of motion, which suggests a very similar underlying mechanism is at work in each case.

      What I think is happening is a complex reflex feedback system between the various afferent fibers and the motor groups that they either directly or indirectly influence, as well as existing motor patterns and their influence on how our bodies are forced to carry tension as a result of said patterns. In short, we have an immense number of motion, length, and tension sensors in our joints, muscle tissue, and tendons. All of these are connected to nerves that have to pass through the fascia, often several layers in order to reach their target cells. Based on the observations of Golgi Tendon Organ reflexes, I think it is fair to speculate that the compressive forces on the nerve fibers from fascial tension during a length change send signals that trigger reflexive contractions that limit the range of motion. Just like the GTO reflex can be trained to tolerate much higher forces before kicking in, I think that this is part of what is happening in our muscles. I think that all of the reflexes we have are being trained all the time, based on our usage and lifestyles, and that this is what controls quite a lot of conscious range of motion and tissue quality. If we manually compress a nerve, we know it can lower the amplitude of the EMG signal downstream. Why would compression from fascia be any different?

      In fact, if you look at EMG response to stretching protocols, you will find very specific inhibitory effects associated with each protocol. Excessive pressure on a muscle can also cause acute inhibition, which would explain why SMR/SMT type modalities make it easier to achieve a certain range of motion, and teach the body to carry tension differently over time. We already know that we are not changing internal structures, which was an earlier idea of what was causing the change in tissue quality.

      Finally, we know that the human body learns from its experiences, from squat form to throwing a ball to being able to touch one’s toes. What was once difficult, or impossible, eventually becomes no big deal if sufficient practice takes place.

      Together as a body of evidence, this strengthens my belief that this reflex re-education is a major part of what is happening to our muscular tissues during manual therapy and stretching.

      There’s also the idea that our fascia is a separate communications network, a biological liquid crystal (which does exist, and has been studied as a wet collagen matrix… sound familiar?), but I don’t think there’s enough evidence to start making very many claims in this area yet.

      Thoughts?

  • David King says:

    Hi Bret,

    We have a massage chair here where I am staying. It is a device that runs down the upright of a chair. So that when you sit on it, your back is hard up against it. It is composed of balls that move and rotate. I can tell you that it is pretty powerful. It runs for 15 min I believe. One day after training I was particularly sore. I used that chair four times one day and I think twice the next day. Just twice because my back had been bruised the day before with this machine. I few days later I was still very sore and tired so I went for a massage. I can tell you, that it was night and day. You could feel the muscles release during the massage.

    So this device isn’t a roller but I think it is the same thing. I know a lot of people say rolling works but I don’t believe it for a second.

  • Susan says:

    You all are making some pretty interesting points, but the person who is the expert on this by far is Sue Hitzmann. MELTing your connective tissue is the way to go. You shouldn’t have to cause pain to relieve pain. That’s absurd.

  • Mathiah says:

    Bret,

    If foam rolling left a window where there was more ROM tolerance/greater ROM, then couldn’t any long term improvements in ROM or stretch ability be based on the possibility that if you then use the ROM that is gained after foam rolling, you would then cause an adaptation based on that ROM which would strengthen your body’s ability to get into said ROM over time?

    So then it would work in the same way that doing Good Mornings increases your Hamstring’s strength in the stretched position?

    • Rob Panariello says:

      Hi Derek,

      As Todd has pointed out with regard to both osseous and soft tissue structures, Wolff’s law and Davis’ law define the principles of the adaption of these anatomical structures to stress. We know that the areas of bone with muscle attachments have a greater density than other areas due to the stress applied by contracting muscles at these attachment sites. High levels of applied (and sometimes inappropriately directed) stress are also responsible for bone spurs, callouses on our hands and feet, etc. We also know through Hans Selye’s General Adaptation Syndrome (GAS) that a specific level of appropriate stress is required to disrupt the homeostasis of the body for a supercompensation event to occur. This supercompensation event prepares the body in the event this same high level of applied stress is repeated. This is one reason why adaptation (physical improvement/enhancement) occurs.

      As Trev has stated, I have been witness to some who claim that that foam rolling will also stretch the ITB, as I personally am of the opinion this does not occur. There was a time where the ITB was utilized as an ACL graft during ACL reconstruction knee surgery to restore the stability of the knee. If the ITB stretched out with the application of foam rolling, if you think of the knee stresses that occur with running, jumping, and cutting, etc., how could this anatomical structure possibly be utilized to restore knee stability after an individual disrupted their ACL?

      Empirically many who foam roll feel the benefits of performing this exercise. What actually (specifically) occurs to produce these benefits, I’m not quite sure that anyone truly knows.

      Just my opinion.

      Rob Panariello

      • Derrick Blanton says:

        Great perspectives, Todd, Trev, and Rob! Thank you, gentleman.

        A couple of thoughts:

        I personally have found foam rolling to be a bit like trying to boil water with a Crock Pot. Moderately useful as a preliminary technique, but the stove or microwave just works better for the task at hand!

        (This seems to depend on how tightly bundled up the muscle is, i.e. desperate times call for desperate measures!)

        I had already gone to a hard PVC pipe through self experimentation, when Kelly Starrett began demonstrating more aggressive forms of SMR involving a barbell, and other hard implements. These techniques worked even better, for me at least.

        Now I realize this idea of purposely provoking pain seems to rub many the wrong way. In this sense, I would compare more aggressive forms of SMR to eccentric exercise modalities for tendinitis/tendinosis. Painful, but effective.

        Something was going on, and I struggled to wrap my mind around what. The best that I could come up with was this, and this is just theory, obviously:

        When you challenge a “trigger point” or musculotendinous knot, and this means the tendon as well, with direct, or frictional pressure, the nervous system learns that resisting the force increases the pain. Relaxing the tension causes the pain to relent.

        Now is this a reflexive, or a learned response? I don’t know!

        RE: the ITB, can you stretch it, I agree with you guys, probably not pliable. Certainly you can certainly stretch the TFL, and glute on the other side.

        Perhaps the tendon “communicates” with the muscle, and this is another way the nervous system gets the memo, to turn down the volume. It is an “impolite request”!

        Science takes time, experiments take time, studies slowly and patiently isolate variables, and things don’t get resolved in one hour, ala “Mythbusters”. So maybe one day, we will find out more definitively about this SMR effect.

  • Mike says:

    Bret,

    Here is the reference for an article that relates well to this discussion in that it summarizes some of the current best evidence regarding manual therapy mechanisms:

    Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther. 2009 Oct;14(5):531-8.

    All the best,

    Mike

  • Yamuna Zake says:

    Foam rolling is being used primarily because it has been marketed to all of you in the fitness world. We began using very specific sized balls with specific weights, resistance and intensity to reorganize the body, stimulate bone, align the bone and muscles, to free restrictions of all kinds, and to teach anatomy to the people using this. Yamuna Body Rolling is highly organized and works the body anatomically. It works by first stimulating the bone at the site of muscle origins. Next it works the tendons, and then the muscle bodies, toward the muscle insertions. You do not roll up and down or randomly where pain or tightness is. You work with the natural order of the anatomy. In this way, people get results. The body understands the work being done to it. The body corrects. It is not a temporary relief. A foam roller can never get into the detail of the body. It can not target specific muscles. Yes, maybe it can work the piriformis, but that is only one muscle in a group of muscles. It is never the problem. It is not designed to problem solve anatomy. It is a temporary quick relief that does not re-educate the neuro- muscular system. The Yamuna work helps people to problem solve and self cure. It is based on pure anatomy. If people take the seconds to foam roll, they should try taking a few more minutes and learn their anatomy.

    • Trev says:

      Hi Yamuna. I haven’t heard of bone stimulation through rolling before and can’t find any mention of it through search. Could you explain this please?

      • Yamuna Zake says:

        Direct bone stimulation, means weight bearing into your bone. Any muscle that has any attachment to the bone automatically begins to respond. Beyond the foam roller we work with balls to get the detail of the anatomy. We work where the end on attaches to the bone. This gives healthier length tone and function o the muscle rathe than random rolling up and down repeatedly

  • Conrad says:

    This is great! Thanks for facilitating this Bret! I’m looking forward to going through some of the additional links you have provided.

    Clinically, it’s difficult to communicate about soft tissue stuff with clients because saying, “I don’t know” how or why this works doesn’t always go over the best.

    Reading the scientific literature about scar tissue pretty quickly shows that most of the language used talking about soft-tissue work is mis-guided at best.

    The following paper was fairly enlightening on understanding some of the foundational components on the topic: Hardy MA, The Biology of Scar Formation. Phys Ther 69:1014-1024, 1989.
    http://www.ncbi.nlm.nih.gov/pubmed/2479956

  • Carl Valle says:

    A lot of soft tissue diagnostics tools are available to validate change with other data to confirm if something is working. Very easy to rehash anatomy books but it would be great to see someone show changes over weeks with their clients with some evidence.

  • kerry says:

    Hi Bret may I ask an unrelated question with regards to the mighty hip thrust? When one preforms this exercise are we supposed to squeeze the gluts to make the pelvis posterior tilt then drive up with the gluts and then at the top keep squeezing to maintain the posterior tilt and pivot from the upper back and drop the pelvis back down all the while maintaining the pelvis in the posterior tilted position? So basically do we pivot from the upper back a frozen posterior tilted pelvis up and down? This is what I got from watching an instructional Video it seem to work and I do not get a sore lumbar but just wanted to check before i ruin my spine , Cheers Kerry

  • Dave says:

    Great article and discussion! However, I just have to point out that SMT = Spinal Manipulation Therapy among a lot of manual therapists (PT’s) out there. I prefer soft tissue mobilization (STM) mysef, which is a medically acceptable term.

    • Yamuna Zake says:

      Remember, structure rules function. You can work soft tissue all day, but if bone is misaligned and /or arthritic, you must work to realign and soften the brittleness in bone before soft tissue work can be truly successful.

  • anonymous says:

    Sorry to be a troll but self manual therapy sounds like what my girlfriend and i do when go away to different colleges hahaha.

    This was very informative, ive had a convo telling someone that foam rolling doesnt do any myofacial release and he came back at me with “well thats just cause people do it wrong”.

    I really enjoyed “Why foam rolling is NOT Myofascial Release ” by Andreo Spina

  • Hey Guys, At this point the research has not made any real clear sense of why SMR (SMT) does much in terms of any chronic or real change in any tissue system. After reading Chris’ summation of Schelip’s research (I quoted it below) this may be all we may need to or ever understand about SMT: “You may have influenced the viscoelastic properties of tissue (a short term change) but more dominantly you have convinced the nervous system to let you move farther, with greater ease or with greater strength.” Stimulation of the somatosensory cortex is temporary and provides ‘the window of opportunity’ to possibly accomodate and influence ‘better’ movement. In other words…Foam roll and grab some end ranges and that maybe as good as it gets. Tissue that is ‘mechanically’ locked up (due to SAID or whatever) will probably remain locked up no matter how much we try and roll ‘it’ out. A properly influenced nervous system can be masterful in ‘hiding’ poor tissue health.
    BTW…Damn, All of you are freakin’ wicked smart…I have to do a better job of keeping up with Bret & Chris’ S&CR

  • Paige says:

    I prefer a hand held muscle roller so i can bring it with me to the gym, i got a great deal on a golf ball muscle roller which i absolutely love!!
    http://zzathletics.com/Golf-Ball-Muscle-Roller-Massager-GBMR1.htm

  • tom jennings says:

    Great points. I like the term SMT vs, SMR but unfortunately so many people recognize the SMR term that it may be difficult to change. Agree that there really are probably several factors affecting any changes. Thanks for the information.

  • Michael Brynkus, MSc says:

    If self-myofascial release (lacrosse ball, rumble roller etc..) doesnt relieve muscle tension. Then how can I get rid of my chronically tight and painful IT bands and quads which are must likely causing me patellofemoral pain. I have been doing glute, core and VMO activation for awhile now with only mild benefits.

  • Henk says:

    I know this is a long shot but I presume someone with an answer might see this. I’m a huge proponent of SMT and I could write almost an endless list detailing how I have benefitted from SMT. Also all the other people I know and who have tried SMT have given positive feedback about the “method”. I use rumble roller and lacrosse ball with my SMT as those tools can find sweet spots from everybody’s body no matter the age, gender, body composition, activity level etc. Though today I came across of person who couldn’t get anything out from SMT. She couldn’t feel any kind of “good pain”, didn’t have tight spots or anything in her body no matter from where she tried to relieve the tension and how hard she used the lacrosse ball on herself. What’s odd about the situation is that she usually can’t even go through a gentle massage session without complaining about pain and notifying the masseur that he is using too much force on her body. Could there be something wrong with her body as she couldn’t find any kind of sweet spots no matter how hard she tried? I’m not saying one has to be in agony for SMT to work but I find it odd that person who usually is so tense that you can’t lay a finger on her can now literally sit, lay etc. on a lacrosse ball without feeling a thing. She hasn’t done any kind of work on her body for months – be it exercising, SMT, getting a massage etc. – and she works in a physically demanding job so one could presume that some SMT is needed but no. Would it be possible that her lack of muscle mass and extremely high BF level (50+ %) both play a part in the problem? That her tight muscles and sweet spots can’t be found under the fat layer that easily? Or could it be due to something else? Any ideas what might be the cause are highly appreciated.

  • Fred Barbe says:

    Funny, I know we were not 100% sure, but I didn’t know there were still so many possibilities. I’m glad I got to know who your guests are!

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