Foam rolling - pros and cons.
Oh, what a complex topic. Lets try and keep it simple though. Foam rolling (FR) seems common with both the average joe trying to alleviate pain as well as athletes trying to improve performance. Like so many things in life the answers regarding foam rolling and if it would be a good choice for you or not lies in the intended purpose.
A meta-analysis is a study of multiple studies in an effort to find out the average amongst many studies and is proposed to provide more accurate information based on numbers and probability across multiple studies, not just one. A meta-analysis of the effects on FR on performance and recovery apparently did show some favorable results, at least in elite athletes. Of note though, was the mechanism was poorly understood and some of it could very well just be the belief that it was helping (Placebo effect).
So what's the issue? Well if there is one, it's in how people are using FR. Many people are trying to resolve injuries and pain using FR. While apparently there may be some benefit to FR for performance, I question the application to someone with pain. You probably would like to know why.
For starters, pain is often there for a reason. Most commonly because of tissue damage or excessive loads on tissues. Keep in mind that pain can also be referred pain, ie. the pain generator is not the actual site of the pain. So that pain down the outside of your leg that you think is your ITB (Illio-tibial band) may in fact be referred pain from a lumbar (low back) issue. Trying to alleviate pain without truly understanding why it's there can potentially cause more damage. At the very least it involves you using a potentially painful technique that will have no effect at all, and worse yet might actually cause damage. The same rings true with tightness. The brain is smart and it will employ tightness to alter or limit joint motion to protect tissue or joints. So consider that your FR plan may actually be taking away the very protection your body just implemented to protect you.
So lets lay it out (simplistically)
May alleviate tightness
May improve flexibility (for a very short duration - like 10 minutes)
May alleviate post workout soreness
May enhance recovery
May improve performance (slightly)
May take away tightness, the very protection your body deemed necessary
May actually cause tissue damage (from loss of short term protection by your body and potentially because
the mechanisms are not fully understood and it is after all painful
May prevent or delay you from getting proper care to resolve the issue
May alleviate pain, but only temporarily leaving you to do it day after day, after day
So where does that leave us? Well I guess it depends where you started. In my opinion, if you are a high level athlete trying to improve your performance and recovery, there may be some value to foam rolling. However, if you are trying to resolve pain I personally would encourage you to re-evaluate your choice. There are usually more complex mechanisms occurring that cause pain than just a tight tissue. Watching YouTube and Podcasts will only take you so far. There are many subtleties to treating pain that often do not get conveyed. You need to see someone like a PT with skills that can evaluate you first, and then develop a plan. The evaluation is paramount. Choose someone with good experience.
I have seen many patients trying (without success) to resolve pain via foam rolling. I'm not saying that some people don't have success. I am saying that in my experience professionally I have seen more people miss that mark than hit it. Maybe that's because the people that it works for never make it to my office, I don't know. The ones I've seen had minimal results or no results at all. So, if you are going to try FR, my recommendation would be that if your issue is not better in a lasting manner within a week or two seek out a professional opinion. There are most likely a lot better thangs you could do with your time than painfully rolling around on a foam roll with little else in return.