Effects of roller massager on muscle recovery after exercise-induced muscle damage

Using multi-channel near-infrared spectroscopy to assess the effect of cupping therapy on the spatial hemodynamic response of the biceps muscle: A preliminary study

BACKGROUND

The local hemodynamic response after cupping therapy has been considered as a contributing factor for improving muscle tissue health; however, the effects of cupping pressure and duration on the spatial hemodynamic response have not been investigated.

OBJECTIVE

The objective of this study was to investigate the hemodynamic response inside and outside the cupping cup under various pressures and durations of cupping therapy.

METHODS

A 3-way factorial design with repeated measures was used to investigate the main and interaction effects of the location (areas inside and outside the cup), pressure (-225 and -300 mmHg) and duration (5 and 10 min) on the hemodynamic response of the biceps muscle. A functional near-infrared spectroscopy was used to assess hemodynamic changes in 18 participants.

RESULTS

A significant three-way interaction of the location, pressure, and duration factors was observed in oxyhemoglobin (p= 0.023), deoxy-hemoglobin (p= 0.013), and blood volume (p= 0.013). A significant increase was observed in oxyhemoglobin, blood volume, and oxygenation compared to pre-cupping (p< 0.05) in the area outside the cup.

CONCLUSION

Our findings indicate that an appropriate combination of cupping pressure and duration can effectively affect the spatial hemodynamic response of the biceps.

Acute effects of foam roller or stick massage on indirect markers from exercise-induced muscle damage in healthy individuals: A systematic review and meta-analysis

BACKGROUND

This systematic review and meta-analysis examined the effects of foam roller or stick massage performed after exercise-induced muscle damage protocols on indirect markers of muscle damage compared to a non-intervention control group in healthy individuals.

METHODS

PubMed, Biblioteca Virtual em Saúde, Scopus, Google Scholar, and Cochrane Library database were searched in August 2, 2020, with last update on February 21, 2021. Were included clinical trials involving healthy adult individuals who received foam roller/stick massage versus a non-intervention group and evaluated indirect markers of muscle damage. Risk of bias was assessed by the Cochrane Risk of Bias tools. Standardized mean differences with 95% confidence intervals were used to measure the foam roller/stick massage effect on muscle soreness.

RESULTS

The five included studies investigated 151 participants (136 men). Overall, the studies presented a moderate/high risk of bias. A between-groups meta-analysis showed no significant difference between massage and non-intervention control groups on muscle soreness immediately after (0.26 [95%CI: 0.14; 0.65], p = 0.20), 24 h (-0.64 [95%CI: 1.34; 0.07], p = 0.08), 48 h (-0.35 [95%CI: 0.85; 0.15], p = 0.17), 72 h (-0.40 [95%CI: 0.92; 0.12], p = 0.13), and 96 h (0.05 [95%CI: 0.40; 0.50], p = 0.82) after an exercise-induced muscle damage protocol. Moreover, the qualitative synthesis showed that foam roller or stick massage had no significant effect on range of motion, muscle swelling, and maximal voluntary isometric contraction recovery.

CONCLUSION

In conclusion, the current literature appears to not support the advantage of foam roller or stick massage to improve recovery of muscle damage indirect markers (muscle soreness, range of motion, muscle swelling, and maximal voluntary isometric contraction) compared to a non-intervention control group in healthy individuals. Furthermore, due to the heterogeneity of the methodological designs among the included studies, making it difficult to compare the results. In addition, there are not enough high-quality and well-designed studies on foam roller or stick massage to draw any definite conclusions.

REVIEW PROTOCOL NUMBER

The study was pre-registered in the International Prospective Register of Systematic Review (PROSPERO) on August 2, 2020, with last update on February 21, 2021. Protocol number: CRD2017058559.

The Effects of Massage Therapy on Sport and Exercise Performance: A Systematic Review

BACKGROUND

A massage is a tool that is frequently used in sports and exercise in general for recovery and increased performance. In this review paper, we aimed to search and systemize current literature findings relating to massages' effects on sports and exercise performance concerning its effects on motor abilities and neurophysiological and psychological mechanisms.

METHODS

The review has been written following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines. One hundred and fourteen articles were included in this review.

RESULTS

The data revealed that massages, in general, do not affect motor abilities, except flexibility. However, several studies demonstrated that positive muscle force and strength changed 48 h after the massage was given. Concerning neurophysiological parameters, the massage did not change blood lactate clearance, muscle blood flow, muscle temperature, or activation. However, many studies indicate pain reduction and delayed onset muscle soreness, which are probably correlated with the reduction of the level of creatine kinase enzyme and psychological mechanisms. In addition, the massage treatment led to a decrease in depression, stress, anxiety, and the perception of fatigue and an increase in mood, relaxation, and the perception of recovery.

CONCLUSION

The direct usage of massages just for gaining results in sport and exercise performance seems questionable. However, it is indirectly connected to performance as an important tool when an athlete should stay focused and relaxed during competition or training and recover after them.

Pain-Pressure Threshold Changes throughout Repeated Assessments with No Sex Related Differences

Algometers are commonly used to measure the pain-pressure threshold (PPT) in various tissues, such as muscle, tendons, or fascia. However, to date, it is not clear if the repeated application of a PPT assessment can adjust the pain thresholds of the various muscles. Therefore, the purpose of this study was to investigate the repeated application of PPT tests (20 times) in the elbow flexor, knee extensor, and ankle plantar flexor muscles in both sexes. In total, 30 volunteers (15 females, 15 males) were tested for their PPT using an algometer on the respective muscles in random order. We found no significant difference in the PPT between the sexes. Moreover, there was an increase in the PPT in the elbow flexors and knee extensors, starting with the eighth and ninth assessments (out of 20), respectively, compared to the second assessment. Additionally, there was a tendency to change between the first assessment and all the other assessments. In addition, there was no clinically relevant change for the ankle plantar flexor muscles. Consequently, we can recommend that between two and a maximum of seven PPT assessments should be applied so as not to overestimate the PPT. This is important information for further studies, as well as for clinical applications.

Soreness or sng: a common symptom with differential clinical impact from pain in degenerative lumbar spine diseases

INTRODUCTION

Soreness is a common complaint in patients who receive lumbar spine surgery (LSS) for degenerative lumbar spine diseases (DLSD). However, soreness is not assessed independently and its impacts on outcomes of LSS remains largely unknown. Sng(pronounced sә-ng, ) in Chinese language is the word with the closest meaning to soreness, and Chinese-speaking people naturally use sng to describe their non-pain 'soreness' symptom. This study was aimed to investigate the prevalence and impacts of soreness or sng on outcome of LSS by introducing Visual Analogue Scale (VAS) of sng on back and leg.

MATERIALS AND METHODS

This prospective cohort study recruited patients who receive LSS for DLSD. Participants completed the patient-reported outcome measures at 1 week before and 1 years after LSS. The patient-reported outcome measures included (1) VAS for back pain, leg pain, back sng and leg sng, (2) Oswestry Disability Index (ODI) and (3) RAND 36-item Short Form Health Survey. The minimal clinical important difference (MCID) of ODI and physical component health-related quality of life (HRQoL) was used.

RESULTS

A total of 258 consecutive patients were included and 50 dropped out at follow-up. Preoperatively, the prevalence of sng was comparable to pain both on back and leg; postoperatively, the prevalence of sng was higher than pain. Leg and back sng were associated with preoperative and postoperative mental HRQoL, respectively. The reduction of sng on back and leg were significantly less than pain postoperatively. Leg sng was the only symptom independently associated with attaining MCID.

CONCLUSION

Soreness or sng should be assessed independently from pain in patients receiving LSS for DLSD because soreness or sng had substantial clinical impacts on the outcome of LSS.

Effects of Foam Rolling Duration on Tissue Stiffness and Perfusion: A Randomized Cross-Over Trial

Despite its beneficial effects on flexibility and muscle soreness, there is still conflicting evidence regarding dose-response relationships and underlying mechanisms of foam rolling (FR). This study aimed to investigate the impact of different FR protocols on tissue perfusion and tissue stiffness. In a randomized crossover trial, two FR protocols (2x1 min, 2x3 min) were applied to the right anterior thigh of twenty healthy volunteers (11 females, 25 ± 4 years). Tissue perfusion (near infrared spectroscopy, NIRS) and stiffness (Tensiomyography, TMG and Myotonometry, MMT) were assessed before and after FR application. Variance analyses revealed a significant interaction of FR duration and tissue perfusion (F_[1,19] = 7.098, p = 0.015). Local blood flow increased significantly from pre to post test (F_[1,19] = 7.589, p = 0.013), being higher (Δ +9.7%) in the long-FR condition than in the short-FR condition (Δ +2.8%). Tissue stiffness (MMT) showed significant main effects for time (F_[1,19] = 12.074, p = 0.003) and condition (F_[1,19] = 7.165, p = 0.015) with decreases after short-FR (Δ -1.6%) and long-FR condition (Δ -1.9%). However, there was no time*dose-interaction (F_[1,19] = 0.018, p = 0.895). No differences were found for TMG (p > 0.05). FR-induced changes failed to exceed the minimal detectable change threshold (MDC). Our data suggest that increased blood flow and altered tissue stiffness may mediate the effects of FR although statistical MDC thresholds were not achieved. Longer FR durations seem to be more beneficial for perfusion which is of interest for exercise professionals designing warm-up and cool-down regimes. Further research is needed to understand probable effects on parasympathetic outcomes representing systemic physiological responses to locally applied FR stimulations.

Selective Effects of Manual Massage and Foam Rolling on Perceived Recovery and Performance: Current Knowledge and Future Directions Toward Robotic Massages

Manual massage and foam rolling are commonly used by athletes for warm-up and recovery, as well as by healthy individuals for well-being. Manual massage is an ancient practice requiring the intervention of an experienced physiotherapist, while foam rolling is a more recent self-administered technique. These two topics have been largely studied in isolation from each other. In the present review, we first provide a deep quantitative literature analysis to gather the beneficial effects of each technique through an integrative account, as well as their psychometric and neurophysiological evaluations. We then conceptually consider the motor control strategies induced by each type of massage. During manual massage, the person remains passive, lying on the massage table, and receives unanticipated manual pressure by the physiotherapist, hence resulting in a retroactive mode of action control with an ongoing central integration of proprioceptive feedback. In contrast, while performing foam rolling, the person directly exerts pressures through voluntary actions to manipulate the massaging tool, therefore through a predominant proactive mode of action control, where operations of forward and inverse modeling do not require sensory feedback. While these opposite modes of action do not seem to offer any compromise, we then discuss whether technological advances and collaborative robots might reconcile proactive and retroactive modes of action control during a massage, and offer new massage perspectives through a stochastic sensorimotor user experience. This transition faculty, from one mode of control to the other, might definitely represent an innovative conceptual approach in terms of human-machine interactions.

The effect of foam rollers of varying densities on range of motion recovery

OBJECTIVE

This study aimed to compare the effect of different density foam rollers on range of motion recovery.

METHOD

Ten active men completed two, 3-day trials in random order. During the experimental trials, all participants performed 2 min of foam rolling (FR) using a medium-density (medium trial) or hard-density (hard trial) foam roller on the right posterior thigh after completing the 90-min Loughborough Intermittent Shuttle Test (LIST). The hip joint range of motion (ROM), muscle hardness, and muscle soreness were assessed before and after the LIST and at 0 min, 20 min, 60 min, 24 h, and 48 h after FR intervention. Serum creatine kinase (CK) concentrations were assessed before the LIST and at 60 min, 24 h, and 48 h after FR intervention. The contralateral leg in each trial was used as a control.

RESULTS

The ROM at 0 min, 20 min, 60 min, 24 h, and 48 h after FR intervention were higher in the right leg (the massage leg) than in the left leg (the contralateral leg) (p < 0.05). In the right leg, the ROM at 0 min after FR intervention was higher than after the LIST (p < 0.05). There were no significant differences between the medium and hard trials for ROM. Muscle hardness, muscle soreness, and serum CK concentration were not affected by FR.

CONCLUSION

FR has a positive effect on ROM recovery. Moreover, the two roller densities provided similar ROM recovery.

The effects of foam roll on perceptual and performance recovery during a futsal tournament

The present study investigated the efficacy of recovery by foam rolling (FR) on performance, psychological, and physiological parameters of futsal players in a simulated futsal tournament. In this randomized controlled trial design, four youth teams from Iran's national premier league participated in a simulated futsal tournament (five days, three matches). Sixteen youth futsal players from two teams (age: 19.1 ± 1.3 years old) were randomly distributed into two groups: (i) passive recovery (PR); and (ii) FR recovery. The FR recovery protocol consisted of five repetitions of 40 s separated by 20 s of rest on calf, quadriceps, hamstrings, and gluteus muscles 5 min after each match. The other group rested passively during the same period. The Yo-Yo intermittent recovery level 2, repeated sprint ability, vertical jump, and PRO agility tests were assessed pre- and post-tournament. Also, Hooper index (HI) and blood lactate concentrations were measured throughout matchdays. Data were analyzed by a repeated measure ANOVA and ANCOVA. Substantial improvements in HI on the second (ES:0.6) and third (ES:0.4) matchdays and faster lactate removal on the third (ES:0.3) matchday were observed in the FR group when compared to the PR group (p<0.05). Although FR recovery was slightly beneficial when compared to PR attenuated decrements in aerobic (-1.6%vs-9.7%) and anaerobic performance (-4.5%vs-1.3%), vertical jump (-1.6%vs-3.0%), and change of direction (-2.1%vs-4.3%), these effects were not statistically significant (p>0.05). The finding showed using FR during compact competitions expedites physical performance recovery, increases blood lactate clearance and leads to regenerate psychological characteristics. Therefore, along with other desirable recovery strategies, the use of FR could be recommended in short-term compacted futsal tournaments.

Rolling massage acutely improves skeletal muscle oxygenation and parameters associated with microvascular reactivity: The first evidence-based study

Although it has been claimed that rolling massage (RM), may lead to improvements in skeletal muscle oxygenation, metabolism, blood flow, and vascular function, scientific evidence has not yet been provided. Thus, the current study investigated the effects of 30 s and 2 min of RM on forearm muscle oxygenation, parameters associated with oxidative metabolism, and microvascular reactivity as well as brachial artery endothelial function. Forearm skeletal muscle parameters were assessed in 12 healthy young men (26 ± 6 yrs) using near-infrared spectroscopy (NIRS) combined with a 5-min vascular occlusion test. Additionally, brachial artery endothelial function was simultaneously assessed by measuring the relative change in brachial artery diameter normalized to the hyperemic blood flow (Normalized %FMD). These measurements were performed before and after the RM interventions performed on the anterior forearm muscles. Forearm muscle oxygenation increased after 30 s of RM (62 ± 7 to 71 ± 11%; p = 0.02) while there was no change from baseline to post-intervention after 2 min of RM. No change was observed for oxidative metabolism, however, the significant main effect (p = 0.02) for NIRS-derived reperfusion slope (%·s^-1) indicated that microvascular function improved after both 30 s (2.30 ± 0.5 to 2.61 ± 0.70%·s^-1) and 2 min of RM (2.33 ± 0.4 to 2.60 ± 0.85%·s^-1). The lack of significant effects of RM on Normalized %FMD suggest that the RM did not acutely improve brachial artery endothelial function. These findings provide, for the first time, evidence that RM improves skeletal muscle oxygenation and parameters associated with microvascular reactivity. Additionally, RM increased brachial artery blood flow, but not upstream brachial artery endothelial function.

The effects of one session of roller massage on recovery from exercise-induced muscle damage: A randomized controlled trial

Background/objective

Roller massage has become a popular intervention in sports settings in order to treat muscle soreness and stiffness, as well as improving post-exercise recovery, although there is limited evidence for these assumptions. Therefore, the purpose of this study was to evaluate the effects of a single session of roller massage, applied with a controlled force after an exercise-induced muscle damage protocol, on muscle recovery.

Methods

A randomized controlled study was performed using a repeated-measures design. Thirty-six young men completed four sets of six eccentric actions of elbow flexors at 90°/s with a 90s rest interval between sets. Participants were randomly assigned into one of three groups: 1) Roller massage (n = 12), 2) Sham (n = 12), and 3) Control (n = 12). Maximal isometric voluntary contraction (MIVC), delayed-onset muscle soreness (DOMS), range of motion (ROM), and muscle thickness were measured at baseline, and at 24, 48, and 72 h post exercise.

Results

There was no significant group by time interaction for MIVC (p = 0.090) and ROM (p = 0.416). Also, although there was a significant group by time interaction for muscle thickness (p = 0.028), post hoc test did not find significant difference between groups (p > 0.05). DOMS was recovered at 72 h for roller massage (p < 0.001) and control (p < 0.001) groups, while the Sham group did not recover from DOMS across 72 h (p < 0.001). There was also no significant difference between groups in DOMS at any time (p > 0.05).

Conclusions

A single session of roller massage applied on elbow flexors had no effect on recovery of MIVC, muscle swelling, ROM and DOMS.

Effects of Foam Rolling as a Recovery Tool in Professional Soccer Players

Rey, E, Padrón-Cabo, A, Costa, PB, and Barcala-Furelos, R. Effects of foam rolling as a recovery tool in professional soccer players. J Strength Cond Res 33(8): 2194-2201, 2019-Foam rolling (FR) is a common strategy used after training and competition by players. However, no previous studies have assessed the effectiveness of FR as a recovery tool in sports populations. The aim of this study was to examine the effectiveness of FR (20 minutes of FR exercises on quadriceps, hamstrings, adductors, gluteals, and gastrocnemius) and passive recovery (20 minutes sit on a bench) interventions performed immediately after a training session on Total Quality Recovery (TQR), perceived muscle soreness, jump performance, agility, sprint, and flexibility 24 hours after the training. During 2 experimental sessions, 18 professional soccer players (age 26.6 ± 3.3 years; height: 180.2 ± 4.5 cm; body mass: 75.8 ± 4.7 kg) participated in a randomized fully controlled trial design. The first session was designed to collect the pretest values of each variable. After baseline measurements, the players performed a standardized soccer training. At the end of training unit, all the players were randomly assigned to the FR recovery group and the passive recovery group. A second experimental session was conducted to obtain the posttest values. Results from the between-group analyses showed that FR had a large effect on the recovery in agility (effect sizes [ES] = 1.06), TQR (ES = 1.08), and perceived muscle soreness (ES = 1.02) in comparison with the passive recovery group at 24 hours after training. Thus, it is recommended that soccer coaches and physical trainers working with high-level players use a structured recovery session lasting from 15 to 20 minutes based on FR exercises that could be implemented at the end of a training session to enhance recovery between training loads.

A Meta-Analysis of the Effects of Foam Rolling on Performance and Recovery

Foam rolling is thought to improve muscular performance and flexibility as well as to alleviate muscle fatigue and soreness. For this reason, foam rolling has become a popular intervention in all kinds of sport settings used to increase the efficiency of training or competition preparation as well as to speed post-exercise recovery. The objective of this meta-analysis was to compare the effects of foam rolling applied before (pre-rolling as a warm-up activity) and after (post-rolling as a recovery strategy) exercise on sprint, jump, and strength performance as well as on flexibility and muscle pain outcomes and to identify whether self-massage with a foam roller or a roller massager is more effective. A comprehensive and structured literature search was performed using the PubMed, Google Scholar, PEDro, and Cochrane Library search engines. Twenty-one studies were located that met the inclusion criteria. Fourteen studies used pre-rolling, while seven studies used post-rolling. Pre-rolling resulted in a small improvement in sprint performance (+0.7%, g = 0.28) and flexibility (+4.0%, g = 0.34), whereas the effect on jump (-1.9%, g = 0.09) and strength performance (+1.8%, g = 0.12) was negligible. Post-rolling slightly attenuated exercise-induced decreases in sprint (+3.1%, g = 0.34) and strength performance (+3.9 %, g = 0.21). It also reduced muscle pain perception (+6.0%, g = 0.47), whereas its effect on jump performance (-0.2%, g = 0.06) was trivial. Of the twenty-one studies, fourteen used foam rollers, while the other seven used roller massage bars/sticks. A tendency was found for foam rollers to offer larger effects on the recovery of strength performance (+5.6%, g = 0.27 vs. -0.1%, g = -0.01) than roller massagers. The differences in the effects between foam rolling devices in terms of pre-rolling did not seem to be of practical relevance (overall performance: +2.7 %, g = 0.11 vs. +0.4%, g = 0.21; flexibility: +5.0%, g = 0.32 vs. +1.6%, g = 0.39). Overall, it was determined that the effects of foam rolling on performance and recovery are rather minor and partly negligible, but can be relevant in some cases (e.g., to increase sprint performance and flexibility or to reduce muscle pain sensation). Evidence seems to justify the widespread use of foam rolling as a warm-up activity rather than a recovery tool.

The Parameters of Foam Rolling, Self-Myofascial Release Treatment: A Review of the Literature

Self-myofascial release (SMR) is a well-known and popular therapy. Its growing popularity is based on high effectiveness and availability. However, there is a lack of agreement about which parameters should be used to optimize the effects of the therapy. The purpose of this review is to critically select and assess current literature and ascertain the values of the follow­ing parameters: (1) therapy duration, (2) volume of applied pressure, (3) speed and (4) frequency of roll, (5) type of roller, (6) the number of treatment applications during one session, (7) the duration of intervals between applications that yield the best results in terms of soft tissue.

The authors launched their research in May 2018. The search strategy included the electronic databases EBSCOhost and PubMed. The following inclusion criteria were assessed:

- English language, high quality manuscripts (evaluation in PEDro scale)

- at least one of the groups using the foam roller, tennis ball or the stick to fascial release

- basic parameters of therapy described.A total 55 articles met the inclusion criteria. Patients can usually withstand a maximum tolerable pressure for 30-120 seconds, repeated 1-3 times, separated by 30 seconds of rest. The intensity of a single rolling movement should be moderate, and the movement should last about 3 seconds. Keeping the roller on particularly sensitive areas is recommended to release tension and enhance blood perfusion.Currently, there is no consensus on an optimal FR programme. However, there is a tendency to use SMR tools with a physiol­ogy-based method to enhance therapeutic efficiency.

Short-Term Effects of Rolling Massage on Energy Cost of Running and Power of the Lower Limbs

PURPOSE

Self-myofascial release (SMFR) is a type of self-massage that is becoming popular among athletes. However, SMFR's effects on running performance have not yet been investigated. The aim of this study was to evaluate the effects of SMFR on the cost of running (Cr). In addition, the authors evaluated the effects of SMFR on lower-limb muscle power.

METHODS

Cr and lower-limb muscle power during squat jump (SJ) and countermovement jump (CMJ) were measured before (PRE), immediately after (POST), and 3 h after (POST 3h) an SMFR protocol (experimental condition). In the control-condition testing session, the same measurements were performed without undergoing the SMFR protocol. Experimental and control conditions were tested in a randomized order.

RESULTS

Cr at POST trended to increase compared with PRE (+6.2% [8.3%], P = .052), whereas at POST 3h, Cr was restored to PRE values (+0.28% [9.5%], P = .950). In the experimental condition, no significant effect of time was observed for maximal power exerted during SJ. By contrast, maximal power exerted during CMJ at POST and at POST 3h was significantly higher than that observed at PRE (+7.9% [6.3%], P = .002 and +10.0% [8.7%], P = .004, respectively). The rate of force development measured during CMJ also increased after SMFR, reaching statistical significance at 200 ms from force onset at POST 3h (+38.9%, P = .024).

CONCLUSIONS

An acute use of foam rollers for SMFR performed immediately prior to running may negatively affect endurance running performance, but its use should be added before explosive motor performances that include stretch-shortening cycles.

Roller massage decreases spinal excitability to the soleus

Roller massage (RM) interventions have shown acute increases in range of motion (ROM) and pain pressure threshold (PPT). It is unclear whether the RM-induced increases can be attributed to changes in neural or muscle responses. The purpose of this study was to evaluate the effect of altered afferent input via application of RM on spinal excitability, as measured with the Hoffmann (H-) reflex. A randomized within-subjects design was used. Three 30-s bouts of RM were implemented on a rested, nonexercised, injury-free muscle with 30 s of rest between bouts. The researcher applied RM to the plantar flexors at three intensities of pain: high, moderate, and sham. Measures included normalized M-wave and H-reflex peak-to-peak amplitudes before, during, and up to 3 min postintervention. M-wave and H-reflex measures were highly reliable. RM resulted in significant decreases in soleus H-reflex amplitudes. High-intensity, moderate-intensity, and sham conditions decreased soleus H-reflex amplitudes by 58%, 43%, and 19%, respectively. H-reflexes induced with high-intensity rolling discomfort or pain were significantly lower than moderate and sham conditions. The effects were transient in nature, with an immediate return to baseline following RM. This is the first evidence of RM-induced modulation of spinal excitability. The intensity-dependent response observed indicates that rolling pressure or pain perception may play a role in modulation of the inhibition. Roller massage-induced neural modulation of spinal excitability may explain previously reported increases in ROM and PPT.

NEW & NOTEWORTHY Recent evidence indicates that the benefits of foam rolling and roller massage are primarily accrued through neural mechanisms. The present study attempts to determine the neuromuscular response to roller massage interventions. We provide strong evidence of roller massage-induced neural modulation of spinal excitability to the soleus. It is plausible that reflex inhibition may explain subsequent increases in pain pressure threshold.