If you’ve ever suffered from knee pain, odds are that someone has told you to foam roll. Since overly-tight fascia is a common cause of knee woes, people often think that rolling back and forth on your IT band or along your calves can help loosen things up and bring relief.
But it turns out, Julia Blackwell, a fascia release expert, says this approach is often ineffective at actually loosening up that fascia and, you know, decreasing your pain. However, there are other ways to use a foam roller to relieve knee pain—they might feel a little more intense, but they only take 10 minutes or so to do.
First things first: What is fascia?
Blackwell describes fascia as the biological “fabric” (or connective tissue) that holds everything in the body together.
“One of my favorite analogies is to imagine fascia like plastic wrap that wraps around every single thing within us. It encases every muscle fiber, muscle group, ligament, tendon, bone, nerve, blood vessel, and organ,” says Blackwell. “This plastic wrap organizes our body into the shape, structure, and texture we see in the mirror.”
Blackwell says that the amount of mobility afforded by our fascia is largely dictated by the extracellular fluid within it. “Think of it like oil between all those layers of plastic wrap,” she says. “This fluid nourishes our cells, hydrates all our tissues, allows muscles and joints to glide, and even absorbs impact. Healthy fascia hydrated by the extracellular fluid is key for feeling young, moving easily, and living life without aches and pain.”
So, how can fascia lead to knee pain?
According to Blackwell, issues begin to arise when certain areas of our fascia become restricted and dehydrated. With knee pain specifically, there are several potential reasons why the fascia can become unhealthy:
Underuse: “Working at a desk and simply living in modern culture has landed this as the most common culprit; there are truly so few of us that are moving the way our bodies were intended!” says Blackwell.
Overuse: We tend to be repetitive in our movement patterns—and in our choices of workouts. Blackwell says that running and squatting, in particular, tend to tighten fascia around the knees over time.
“Through either of those causes, that critical hydration of extracellular fluid gets pushed out and our ability to absorb impact and have our knee joint glide easily becomes directly affected,” says Blackwell. “What this ends up feeling like is stiff, achy, and painful knees.”
How can foam rolling help?
Blackwell, who offers free foam rolling routines at movementbyjulia.com, says that even if your knees have been achy for a long time, the good news is that it is possible to restore the health of your fascia. A comprehensive approach, using compression, cross-fibering, and active movement can help to re-introduce hydration and space.
“Through compression, we encourage a massive fluid exchange when we release the pressure—goodbye inflammation and hello blood flow!” Blackwell says. “We can do this with a standard foam roller.”
She further explains that foam rolling can activate our fasciacytes, which are cells within the fascia that stimulate the production of hyaluronic acid (HA)—a critical component of extracellular fluid that acts like grease for our joints.
But here’s the thing: Blackwell says that the normal back-and-forth foam rolling with the “grain” of the muscle that we usually do is actually ineffective at stimulating the fasciacytes to produce the lubricating HA. They are only activated through cross-fibering, or going against the direction of the muscle fibers. “So this is likely the reason you’ve been unable to find lasting relief with only rolling up and down your muscle,” says Blackwell.
The final piece of the puzzle is actively moving through a range of motion to signal to our nervous system that it’s safe to move that way. “While all these separate parts can give you some results, the magic is in the simultaneous combination!”
How to properly use a foam roller for knee pain
There are three moves Blackwell recommends doing with the foam roller to help lubricate the fascia in order to decrease knee pain. With each, she says to remember to breathe consistently throughout. And she adds: “If it feels tender, know that that is simply a signal that the fascia is dehydrated here and that it will become less intense over time as your fascia becomes healthier.”
Sitting on the floor, place your left calf muscle on top of your roller. Start on the upper calf, but stay at least two inches below the knee joint.
Cross your right leg over the top of the left to add more compression.
Slowly point and flex your toes from the ankle. Take your time and move through the maximum range of motion possible. Do 10 reps.
Next, slowly circle your ankle. Roll the entire shin/ankle complex, so when you roll your toes to the inside, you turn your whole leg to the inside as well, then as you roll your toes to the outside, roll your whole leg to the outside, so that you get ultimate cross-fibering on the calf. Do five circles in each direction.
Repeat on the other leg.
Come into a forearm plank position with both of your quads (front thigh muscles) on your roller. Start on the lower quads, but at least two to three inches above the knee.
Flex your toes, and slowly bend your knees back towards your butt like you’re doing a hamstring curl.
Once you get to 90 degrees, slowly straighten your legs back out.
Repeat two more times.
Then, bend your knees back to 90 degrees again and begin rocking your heels from side to side for the cross-fibering action.
Slowly move your heels from side to side 10 times, remembering to breathe deeply. Avoid engaging your lower back.
Rest for 15 to 30 seconds and then repeat this technique on a slightly different spot of your quads one more time for maximum effect.
“This one can be a bit intense the first few times, so if you want to make this easier, wrap your roller in a yoga mat to add padding,” suggests Blackwell.
Come down into a side plank position with the roller on the side of your left thigh about three inches above the knee joint. Place your right foot on the ground in front of you for stabilization.
Flex your left toes and slowly bend your knee back towards your butt like you’re doing a hamstring curl.
When you get back to 90 degrees, slowly straighten back out. Repeat one more time.
On your third time bending your knee back, pause at 90 degrees and then lift your heel gently towards the ceiling and then down towards the floor.
Rock up and down three times and then come off the roller.
Repeat on the right leg.
Blackwell says it’s safe to perform these foam rolling movements for your knees every day, or you can do them every other day if you experience any soreness after releasing fascia with this technique. “Soreness is rare, but I always recommend honoring your body if it’s asking for an extra day to integrate and recover,” she says.
If you’ve mainly been experiencing knee pain during exercise, she recommends doing these moves as part of your warm-up. But a word of warning: “This method of rolling can be a bit more intense than standard rolling back and forth. However, it’s so effective that you can spend less time on your roller and experience faster and more lasting results.”