Pain pressure threshold of a muscle tender spot increases following local and non-local rolling massage

Acute self-myofascial release modulates cardiac autonomic function and hemodynamic parameters at rest and reduces cardiovascular stress reaction

PURPOSE

Self-myofascial release (SMR) is a form of self-massage aiming to release tension, improve blood flow, and alleviate muscle soreness. This study aimed to determine whether a single session of SMR could impact cardiovascular parameters at rest and during a cold pressor test (CPT).

METHODS

Twenty male participants (aged 26 ± 2 years) underwent a 20-min SMR and a 20-min seated control condition (CON) on two separate test days in a randomized order. Peripheral and central blood pressure (BP), total peripheral resistance (TPR), pulse wave velocity (PWV), heart rate (HR), root mean square of successive RR interval differences (RMSSD), and the quotient of low-frequency power and high-frequency power (LF/HF) were measured both at rest and during a CPT before (t0), 2 min (t1), and 20 min (t2) after the SMR and CON.

RESULTS

Time × condition interactions could be detected for peripheral and central diastolic BP, TPR, HR, and RMSSD. Following the SMR, peripheral diastolic BP, central diastolic BP, TPR, and RMSSD were reduced, while HR was increased compared to the CON. Regarding the CPT time × condition interactions could be detected for peripheral, and central diastolic BP, with lower values after SMR.

CONCLUSION

The results of the present study suggest that a single bout of SMR confers favorable cardiovascular benefits in healthy normotensive individuals. Furthermore, SMR can attenuate the hemodynamic reactivity to a stress test. Future research should address whether regular SMR leads to chronic adaptations similar to regular, moderate aerobic exercise, massage therapy, and static stretching.

Effects of foam rolling on hamstrings stiffness in damaged and non-damaged muscle states

Introduction: The aim of this study was to examine the effects of foam rolling (FR) on hamstring muscles stiffness in both non-damaged and exercise-induced muscle damage (EIMD) states, using shear wave ultrasound elastography to measure changes in shear modulus. Methods: Fourteen healthy adults (25.5 ± 4.7 years) participated in a within-participant repeated measures design, with a 2-minute FR intervention applied on one leg and contralateral leg serving as a control. The damaging protocol encompassed maximal eccentric knee extensions performed on an isokinetic dynamometer and the Nordic hamstring exercise, consisting of 3 sets of 10 and 6 repetitions, respectively. Measurement were taken at baseline and then 1 h, 24 h and 48 h after the damaging protocol. Results: The results indicated no significant time × leg interaction for shear modulus in biceps femoris, semimembranosus, and semitendinosus muscles in both non-damaged and damaged states. Notably, there was a significant increase in biceps femoris (p = 0.001; η2 = 0.36) and semitendinosus (p < 0.001; η2 = 0.44) shear modulus after EIMD, but no significant differences were found between the FR and control leg, which was also the case for muscle soreness, range of motion, and passive resistive torque (p = 0.239-0.999 for interactions). Discussion: The absence of significant changes post-FR intervention suggests a limited role of short-duration FR in altering muscle stiffness during recovery from EIMD. These findings contribute to the understanding of FR's role in muscle recovery. Although this was not directly investigated, our results suggest a predominance of central mechanisms rather than direct mechanical modifications in muscle properties. This research highlights the necessity for additional investigations to explore how FR interventions influence muscles in different states and to elucidate the mechanisms underlying these influences.

Effects of Percussive Massage Treatments on Symptoms Associated with Eccentric Exercise-Induced Muscle Damage

Percussive massage (PM) is an emerging recovery treatment despite the lack of research on its effects post-eccentric exercise (post-EE). This study investigated the effects of PM treatments (immediately, 24, 48, and 72 h post-EE) on the maximal isometric torque (MIT), range of motion (ROM), and an 11-point numerical rating scale (NRS) of soreness of the nondominant arm's biceps brachii from 24-72 h post-EE. Seventeen untrained, college-aged subjects performed 60 eccentric elbow flexion actions with their nondominant arms. Nine received 1 minute of PM, versus eight who rested quietly (control [CON]). In order, NRS, ROM, and MIT (relative to body mass) were collected pre-eccentric exercise (pre-EE) and after treatment (AT) at 24, 48, and 72 h post-EE. NRS was also collected before treatment (BT). Electromyographic (EMG) and mechanomyographic (MMG) amplitudes were collected during the MIT and normalized to pre-EE. There were no interactions for MIT, EMG, or MMG, but there were interactions for ROM and NRS. For ROM, the PM group had higher values than the CON 24-72 h by ~6-8°, a faster return to pre-EE (PM: 48 h, CON: 72 h), and exceeded their pre-EE at 72 h by ~4°. The groups' NRS values did not differ BT 24-72 h; however, the PM group lowered their NRS from BT to AT within every visit by ~1 point per visit, which resulted in them having lower values than the CON from 24-72 h by ~2-3 points. Additionally, the PM group returned their NRS to pre-EE faster than the CON (PM: BT 72 h, CON: never). In conclusion, PM treatments may improve ROM without affecting isometric strength or muscle activation 24-72 h post-EE. Although the PM treatments did not enhance the recovery from delayed onset muscle soreness until 72 h, they consistently provided immediate, temporary relief when used 24-72 h post-EE.

Self-Massage Acute Effects on Pressure Pain Threshold, Muscular Electrical Activity, and Muscle Force Production: A Systematic Review and Meta-Analysis

ABSTRACT

Furlan, MR, Machado, E, Petter, GdN, Barbosa, IM, Geremia, JM, and Glänzel, MH. Self-massage acute effects on pressure pain threshold, muscular electrical activity, and muscle force production: a systematic review and meta-analysis. J Strength Cond Res 38(3): 620-635, 2024-Self-massage (SM) is often used in physiotherapy and sports training programs. However, the SM acute effects on pressure pain threshold (PPT), muscle electrical activity (MEA), and muscle force production remain unclear. A meta-analytical review was performed to verify the SM acute effects on neuromuscular responses in healthy adults or athletes. The review (CRD42021254656) was performed in the PubMed, Web of Science, and Embase databases. A synthesis of the included studies was performed, and both the risk of bias and the evidence certainty level were assessed through the PEDro scale and Grading of Recommendations Assessment, Development, and Evaluation approach, respectively. Nineteen studies were included, 5 evaluated the PPT, 7 the thigh muscles' MEA, and 15 the lower-limb strength. The SM application induces moderate increases in quadriceps' PPT (5 studies; standardized mean difference [SMD]: 0.487; 95% CI 0.251-0.723; p < 0.001; I2 = 0%). We found no SM effects on the hamstrings and plantar flexors' MEA. Also, we observed small increases in knee extensors' concentric torque (2 studies; SMD: 0.288; 95% CI 0.088-0.489; p = 0.005; I2 = 0%), without effects in isometric muscle strength, eccentric torque, and rate of force development. Grading of recommendations assessment, development, and evaluation analysis showed high and low certainty levels for the SM effects on quadriceps' PPT and muscle strength, respectively. Self-massage pressure-volume application seems to be a determining factor in inducing changes in these parameters, and it may vary among the treated muscles, where a higher pressure-volume application is required for increasing knee flexors and plantar flexors' PPT and strength. Thus, new studies with better methodological quality should be performed to strengthen this evidence.

The Acute Effect of Percussive Massage Intervention with and without Heat Application on Plantar Flexor Muscles' Passive and Active Properties

Recently, percussive massage (PM) intervention using a handheld percussive massage device, namely a massage gun, has been used as an easy way to perform vibration functions. Additionally, a product has been developed that allows PM intervention and heat application to be performed simultaneously. Thus, this study aimed to compare the acute effects of PM intervention with and without heat application on dorsiflexion (DF) range of motion (ROM), passive stiffness, and muscle strength in the gastrocnemius muscle. Fifteen healthy young men (20.9 ± 0.2 years) participated in this study. We measured the DF ROM, passive torque at DF ROM (an indicator of stretch tolerance), passive stiffness, and maximum voluntary isometric contraction (MVIC) torque of the plantar flexor muscles before and immediately after 120 seconds PM intervention with and without heat application. The results showed that PM intervention with and without heat application significantly increased DF ROM and passive torque at DF ROM and decreased passive stiffness, not MVIC torque. These results suggest that PM intervention increased ROM and decreased passive stiffness regardless of the presence or absence of the heat application.

Enhance range-of-motion and hypotensive effect in elderly submitted to three manual therapy techniques: Cross-over study

The present study has two objectives: 1) to verify the effect of Maitland mobilization, manual massage (MM), and static stretching (SS) on the acute range-of-motion (ROM) responses, over 30 min, in the elderly; 2) to verify the effect of Maitland's mobilization, MM, and SS on blood pressure (BP) responses, over 60 min, in the elderly. Sixteen inactive elderly men were recruited. After familiarization, all subjects performed the experimental conditions throughout four remaining sessions. Each session included two baselines ROM measures in randomized order. After baseline, participants completed the control group, Maitland, MM, and SS conditions and retesting immediately (Post-0) e again throughout 30-min following intervention. All conditions increased ankle, hip, and shoulder ROM for at least 10-min post-intervention. Systolic BP hypotensive effects were found for all experimental protocols when compared to baseline values. In conclusion, it was observed that Maitland, MM, and SS conditions enhance ROM and promote hypotensive effect post-intervention. These results have a practical prescription and rehabilitation implications and may be used in the elderly population, since a movement limitation can be treated by global interventions in a non-limited, as well as promoting cardiovascular protection through the hypotensive effects in the same experimental session.

Effectiveness of instrument assisted soft tissue mobilization versus foam rolling on trigger point release in calf muscles

BACKGROUND

Instrument assisted soft tissue mobilization and foam rolling are two techniques that have been proven effective in treating Myofascial Trigger Points, irrespective of the type of trigger point. However, little is known about the comparative effectiveness of Instrument assisted soft tissue mobilization and foam rolling. This study proposed to evaluate the effectiveness of either technique on plantar flexors trigger points, ankle dorsiflexion, and lower limb power present in the calf muscles in non-symptomatic patients.

METHOD

Forty-two subjects with bilateral calf muscle tightness, at least one trigger point in the calf muscle, and fulfilling the inclusion criteria were randomly assigned to either of the groups. Group A was treated for gastrocnemius and soleus trigger points using Instrument assisted soft tissue mobilization and Group B was treated using the Foam Rolling method. Treatment was given every alternate day, a total of 3 sessions. Subjects were evaluated on 1st and 3rd sessions for pre-post differences of ankle dorsiflexion Range of motion in weight bearing and non-weight bearing position, pressure pain threshold for gastrocnemius trigger point 1(G1), 2(G2), and soleus point 1(S1) on both sides, and lower limb power.

RESULT

Within group analyses, both groups had shown statistically significant results for all parameters except gastrocnemius trigger point 2 of foam rolling. For between group comparison foam rolling had a statistically significant result in non-weight bearing ankle dorsiflexion range of motion.

CONCLUSION

Both Instrument assisted soft tissue mobilization and Foam rolling were equally effective for treating calf trigger points. But foam rolling was more effective in improving ankle dorsiflexion range of motion.

Effect of a massage chair (BFM-M8040) on neck and shoulder pain in office workers: A randomized controlled clinical trial

Background

With the increasing work-related musculoskeletal disorders, neck and shoulder pain among office workers has also increased. That said, this randomized controlled trial aimed to seek the potential effects of a massage chair (BFR-M8040) on neck and shoulder pain among office workers.

Methods

This was conducted at the Wonkwang University Gwangju Medical Center from April 2022 to December 2022. Sixty adult participants were randomly allocated. The mean age of male participants was 39.63 ± 8.09 years while female participants was 43.52 ± 8.27; women participated the most (86.67%). The control group received basic physical treatments, including a 10-min heat treatment for deep regions and a 10-min hot pack for the areas on the neck and shoulder of the complained discomfort. The experimental group received the same treatment as the control group and added 20 min of the electric massage chair's PEMF Neck Mode (XD module 3) (BFR-M8040, Bodyfriend Co., Ltd.). The participants received treatments twice per week. The primary outcome was measured using the numerical rating scale and the Korean version of the neck disability index. And the secondary outcome was measured using pressure pain threshold, range of motion, the Korean occupational stress scale, the Korean version of the Euro-quality of life-5 dimension, and safety evaluation.

Results

Fifty-eight participants completed a 6-week follow-up and analyzed (29 in the control group and 29 in the experimental group). There was a significant decrease in the experiment group in both scales for primary outcome measures. For secondary outcome measures, statistically significant increases were observed in pressure pain threshold. The experimental group only showed a slight increase in the quality-of-life measures. There were no reported adverse events.

Conclusion

The benefit of using a massage chair (BFR-M8040) was verified to alleviate neck and shoulder pain among office workers; future studies could involve participants from other countries for further investigation.

Recovery Effects of Foam Rolling on Psychophysiological Responses in Thai National Male Ice Hockey Players

We examined the short-term effects of foam rolling (FR), dynamic stretching (DS), and passive rest (PR) following simulated ice hockey exercise (IHE) on heart rate (HR), blood lactate (BL), leg choice reaction time (CRTleg), rating of perceived exertion (RPE), and global rating of change (GRC) in elite ice hockey players. The study followed a randomized cross-over design. Fifteen national male ice hockey players were assigned to the FR, DS, or PR interventions for 10 mins following 35- min of simulated IHE. HR and BL were obtained at 0-, 5- and 10-min post-intervention. CRTleg and RPE were assessed pre-and post-intervention. GRC was evaluated post-intervention. The PR decreased HR faster than the DS at 5-min of post-treatment. Whereas the FR and DS reduced BL levels faster than the PR at 5- and 10-min post-treatment. There was no difference in CRTleg among the FR, DS, and PR. The FR had lower RPE scores compared to the DS and PR post-treatment. As perceptual aspects, the FR was the most preferred treatment by ice hockey athletes. The FR and DS exerted more beneficial effects on BL but not on HR by the passive rest. The FR showed the most effective treatment on the psychological demands by improving RPE and perceptual responses over the DS and PR. Thus, the FR could be used as a choice for post-game recovery treatment on improving physiological and perceptual responses following an intense match-play in ice hockey players.

Corticospinal excitability and reflex modulation in a contralateral non-stretched muscle following unilateral stretching

PURPOSE

Muscle stretching effect on the range of motion (ROM) and force deficit in non-stretched muscle, and the underlying mechanisms, is an ongoing issue. This study aimed to investigate crossover stretching effects and mechanisms on the plantar flexor muscles.

METHODS

Fourteen recreationally active females (n = 5) and males (n = 9) performed six sets of 45-s static stretching (SS) (15-s recovery) to the point of discomfort of the dominant leg (DL) plantar flexors or control (345-s rest). Participants were tested for a single 5-s pre- and post-test maximal voluntary isometric contraction (MVIC) with each plantar flexor muscle and were tested for DL and non-DL ROM. They were tested pre- and post-test (immediate, 10-s, 30-s) for the Hoffman (H)-reflex and motor-evoked potentials (MEP) from transcranial magnetic stimulation in the contralateral, non-stretched muscle.

RESULTS

Both the DL and non-DL-MVIC force had large magnitude, significant (↓10.87%, p = 0.027, pƞ2 = 0.4) and non-significant (↓9.53%, p = 0.15, pƞ2 = 0.19) decreases respectively with SS. The SS also significantly improved the DL (6.5%, p < 0.001) and non-DL (5.35%, p = 0.002) ROM. The non-DL MEP/MMax and HMax/MMax ratio did not change significantly.

CONCLUSION

Prolonged static stretching improved the stretched muscle's ROM. However, the stretched limb's force was negatively affected following the stretching protocol. The ROM improvement and large magnitude force impairment (statistically non-significant) were transferred to the contralateral muscles. The lack of significant changes in spinal and corticospinal excitability confirms that the afferent excitability of the spinal motoneurons and corticospinal excitability may not play a substantial role in non-local muscle's ROM or force output responses.

The contralateral effects of foam rolling on range of motion and muscle performance

A single bout of foam rolling (FR) can acutely increase joint range of motion (ROM) without detrimental effects on subsequent muscle performance. Similarly, long-term FR training can increase ROM, while muscle performance seems to be unaffected. Although the acute and long-term effects of FR on the treated muscle are understood, the impact of FR on the contralateral side is not well known. Therefore, this scoping review aims to summarize the current evidence on the acute and long-term effect of FR on the ipsilateral limb on ROM and muscle performance (i.e., maximum force, rate of force development, jump height) for the contralateral (non-treated) limb. Potential explanatory mechanisms are also discussed. There is evidence that a single bout of FR on the ipsilateral limb increases ROM of the contralateral limb; however, evidence is limited for long-term effects. The most likely mechanism for contralateral ROM increases is a reduced perception of pain. With regard to isolated muscle contractions, no changes in muscle performance (i.e., maximum voluntary isometric contraction, maximum voluntary dynamic contraction) were found in the contralateral limb after a single bout of FR on the ipsilateral limb. Notably, only one study reported large impairments in rate of force development of the contralateral limb following FR on the ipsilateral leg, possibly due to decreased motor unit recruitment. Furthermore, to date there are only two studies examining the long-term FR training of the ipsilateral limb on performance (i.e., maximal strength and jump performance) which reported moderate improvements. Although, trivial to very large changes on a variety of parameters were found in this study, the functional and practical relevance of our findings should be interpreted with caution.

Sensorimotor, cognitive and affective behavior according to perceived level of disability in patients with chronic low back pain: an observational cross-sectional study

OBJECTIVES

The aim was to evaluate the influence of the level of disability on sensorimotor and psychological variables in nonspecific chronic low back pain (NCLBP).

METHODS

A cross-sectional observational study was performed with 90 participants, divided into one group with NCLBP (60 participants) and one asymptomatic group (30 participants). Symptomatic participants were divided into a "major" or "minor" disability group using the Roland Morris Disability Questionnaire score, resulting in two groups of 30 participants. All participants completed a series of self-administered questionnaires and performed sensorimotor tests.

RESULTS

There were no statistically significant differences in the sensorimotor variables except in pain intensity, which was greater in the NCLBP group with high lumbar disability. There were statistically significant differences between the symptomatic groups in the degree of self-efficacy, pain catastrophism and kinesiophobia.

CONCLUSIONS

Patients with NCLBP and high levels of disability present greater pain intensity and significantly poorer results in psychological variables compared with those with NCLBP and low levels of disability. In contrast, there were no differences for sensorimotor variables between the patients with NCLBP and high levels of disability and those with low levels of disability.

Comparative Effectiveness of Gua Sha, Cryostretch, and Positional Release Technique on Tenderness and Function in Subjects with Plantar Fasciitis: a Randomized Clinical Trial

Background

Plantar fasciitis (PF) can be treated effectively with manual techniques like cryostretch (CS) and the positional release technique (PRT). Although Gua Sha (GS) has been suggested in the literature for PF, its efficacy has not been studied in the research.

Objective

To determine and compare the effectiveness of GS, CS, and PRT in subjects with PF in terms of pain intensity, pain pressure threshold, and foot function.

Methods/Design

Thirty-six patients with PF (n=36) were randomly allocated to three study groups (12 in each group)-group GS, group CS, and group PRT, respectively.

Settings

A randomized clinical trial was conducted at physiotherapy OPD in a tertiary health center.

Participants

Subjects of all genders with plantar fasciitis of the age group 20-60 years. Thirty-six subjects with plantar fasciitis out of whom 12 were males and 24 females. There were no dropouts in this study.

Intervention

The interventions included the Gua Sha technique (1 session), the cryostretch technique with a frozen tennis ball (3 sessions), and the positional release technique (7 sessions), along with common exercises for all three groups.

Outcome Measures

Pain intensity, foot functions, and pain pressure threshold were assessed using the Numerical Pain Rating Scale, Foot Function Index, and pressure algometer, respectively, on day 1 (pre-intervention) and day 7 (post-intervention).

Results

Between-group analyses showed that group GS was more effective than CS and PRT for pain (p=.0001), group CS was more effective than GS and PRT for foot function (p=.0001) whereas group PRT was more effective than GS and CS for pain pressure threshold (p=.0001).

Conclusion

Although all three groups showed improvement, Gua Sha was superior in terms of reducing pain, cryostretch for improving foot functions, and PRT for reducing tenderness. The interventions used in this study are cost-effective and have proved to be simple and safe techniques.

Acute Effect of Short Intensive Self-Myofascial Release on Jump Performance in Amateur Athletes: A Randomized Cross-Over Study

Searching for effective methods to maximize physical performance that can be utilized during warm-ups is challenging in modern sports. This study aimed to investigate the effect of a short and intensive self-myofascial release (SI-SMR) on jumps in amateur, collegiate athletes. The study sample consists of 30 subjects with an average age of 21.8 years. The tests conducted included a squat jump (SJ), countermovement jump (CMJ), and drop jump (DJ). In the first week, half of the participants performed a standardized warm-up with additional short (15 s per lower limb muscle group) and intensive (20 reps/15 s) SMR and then performed jump tests. The other half performed a standard warm-up. The following week the groups switched interventions. The results revealed a tendency for all jump test parameters (height, force, and power), the reactive strength index, and stiffness to improve with SI-SMR, but the differences were small and insignificant. A dependent t-test for paired samples revealed that only SJ height improvement (+0.96 ± 2.63 cm) reached statistical significance (p = 0.04), but the small ES (ES = 0.14) could have attenuated this result. When a two-way mixed ANOVA was applied, the differences were insignificant. SI-SMR was ineffective in the direct improvement of jump performance. Although SI-SMR had no adverse effects, athletes should focus on specific preparations for sports competitions instead of using an SI-SMR protocol.

Effect of manual physical therapy on sleep quality and jaw mobility in patients with bruxism: A biopsychosocial randomized controlled trial

This study aimed to investigate the effects of deep-stripping and trigger-point pressure release massage on the Pittsburgh Sleep Quality Index (PSQI), jaw mobility, and pressure pain threshold (PPT) of masticatory muscles in patients with sleep bruxism. A randomized controlled trial was conducted among 45 patients diagnosed with sleep bruxism. The patients were randomly assigned to three groups. Group I was the control group and included five men and 10 women; Group II was the deep-stripping massage group, which included two men and 13 women; and Group III was the pressure release group, which involved four men and 11 women. Patients were tested two times, before and after 6 weeks. Group I received transcutaneous electrical nerve stimulation and passive stretching; Group II received a deep-stripping massage; and Group III received a trigger-point pressure release massage. Findings revealed significant improvements in PSQI (p = 0.0001), jaw opening (p = 0.0001), jaw protrusion (p = 0.0001), jaw left lateral movement (p = 0.004), jaw retraction (p = 0.0001), right temporalis PPT (p = 0.0001), left temporalis PPT (p = 0.0001), right master PPT (p = 0.001), left master PPT (p = 0.001), right lateral pterygoid PPT (p = 0.001), left lateral pterygoid PPT (p = 0.001), right digastric muscle PPT (p = 0.001), and left digastric muscle PPT (p = 0.001) in the post-test condition in Group II compared with Group I and Group III. Deep-stripping massage improved PSQI, jaw mobility, or PPT of the masticatory muscles compared with trigger-point pressure release massage and traditional treatment techniques in patients with sleep bruxism.

Effect of Acute Self-Myofascial Release on Pain and Exercise Performance for Cycling Club Members with Iliotibial Band Friction Syndrome

Cycling is a popular sport, and the cycling population and prevalence of related injuries and diseases increase simultaneously. Iliotibial band friction syndrome is a common chronic overuse injury caused by repetitive knee use in cycling. Self-myofascial release using foam rollers is an effective intervention for this syndrome; however, studies reporting positive results on self-myofascial release in cycling are limited. Therefore, this study investigated the effect of self-myofascial release on pain and iliotibial band flexibility, heart rate, and exercise performance (cadence, power, and record) in adult male cyclists with iliotibial band friction syndrome. We evaluated the pain and exercise ability of the control (n = 11) and self-myofascial release (n = 11) groups before and after cycling twice. Significant differences were observed in the pain scale, the iliotibial band flexibility, and cycling pain and power. The posterior cadence of the self-myofascial release group was 3.2% higher than that of the control group. The control group's record time increased by 74.64 s in the second cycling session compared to the first cycling session, while that of the self-myofascial release group decreased by 30.91 s in the second cycling session compared to the first cycling session. Self-myofascial release is effective in relieving pain and may improve cycling performance by increasing the iliotibial band flexibility.

Effects of different intermittent pneumatic compression stimuli on ankle dorsiflexion range of motion

Despite substantial evidence of the effectiveness of intermittent pneumatic compression (IPC) treatments for range of motion (ROM) improvement, little evidence is available regarding how different IPC stimuli affect ankle dorsiflexion (DF) ROM. This study aimed to investigate the effects of different IPC stimuli on the ankle DF ROM. Fourteen, university intermittent team sport male athletes (age: 21 ± 1 year, height: 1.74 ± 0.05 m, body mass: 70.9 ± 7.7 kg, body fat percentage: 14.2 ± 3.6%, body mass index: 23.5 ± 2.5 kg/m²; mean ± standard deviation) completed four experimental trials in a random order: 1) no compression with wearing IPC devices (SHAM), 2) the sequential compression at approximately 80 mmHg (SQUEE80), 3) the uniform compression at approximately 80 mmHg (BOOST80), and 4) the uniform compression at approximately 135 mmHg (BOOST135). For the experimental trials, the participants were initially at rest for 10 min and then assigned to either a 30-min SHAM, SQUEE80, BOOST80, or BOOST135. Participants rested for 20 min after IPC treatment. The Weight-Bearing Lunge Test (WBLT), popliteal artery blood flow, pressure-to-pain threshold (PPT), muscle hardness, heart rate variability, and perceived relaxation were measured before (Pre) and immediately after IPC treatment (Post-0) and 20 min after IPC treatment (Post-20), and the changes in all variables from Pre (Δ) were calculated. ΔWBLT performance, ΔPPT, and Δperceived relaxation in all IPC treatments were significantly higher than those in SHAM at Post-0 and Post-20 (p < 0.05). ΔPopliteal artery blood flow in BOOST80 and BOOST135 was significantly higher than that in SHAM and SQUEE80 at Post-0 (p < 0.05). ΔMuscle hardness and Δheart rate variability did not differ significantly between trials. In conclusion, IPC treatments, irrespective of applied pressure and mode of compression, increased ankle DF ROM. This resulted from decreased pain sensitivity (i.e., increased PPT). In addition, high inflation pressure and frequency did not provide additional benefits in increasing ankle DF ROM.

Comparison between 6-week foam rolling intervention program with and without vibration on rolling and non-rolling sides

PURPOSE

The chronic effects of unilateral foam rolling (FR) or FR with vibration (VFR) intervention on the rolling and non-rolling sides (cross-education effects) are still unclear. Thus, this study aimed to investigate the effects of unilateral 6-week FR or VFR intervention on ankle dorsiflexion range of motion (DF ROM), muscle stiffness, and muscle strength in both rolling and non-rolling sides.

METHODS

Thirty healthy young men were randomly allocated into the FR (n = 15) or the VFR intervention group (n = 15). Participants performed three sets of unilateral FR or VFR interventions for 60 s of the calf muscles twice/week, for 6 weeks. DF ROM, gastrocnemius muscle stiffness, and maximal voluntary isometric contraction (MVIC) torque were assessed in the rolling and non-rolling sides before and after the intervention.

RESULTS

The DF ROM increased significantly (p < 0.05) to the same extent in the FR and VFR intervention groups on both rolling (FR: d = 0.58, VFR: d = 0.63) and non-rolling (FR: d = 0.39, VFR: d = 0.50) sides. Similarly, the passive torque at DF ROM increased significantly (p < 0.05) to the same extent in the FR and VFR intervention groups on both rolling (FR: d = 0.85, VFR: d = 0.77) and non-rolling (FR: d = 0.76, VFR: d = 0.68) sides. However, there were no significant changes in muscle stiffness and MVIC after FR and VFR interventions on both the rolling and non-rolling sides. FR and VFR interventions could increase the ROM in both the rolling and non-rolling sides but could not change muscle stiffness and strength.

CONCLUSIONS

The results showed that it is not necessarily needed to perform VFR to increase ROM in the long term.

Effects of Self-myofascial Release Instruments on Performance and Recovery: An Umbrella Review

INTRODUCTION

Currently, the use of self-myofascial release (SMR) instruments is not uncommon in our society, especially in sports. The most common SMR instruments are foam rollers, roller massagers, and balls. Regardless of the instrument used, the main objectives are to enhance performance and recovery. Nevertheless, many studies point out that there is still a lack of robust scientific evidence documenting the exact mechanisms that explain its true effects, therefore some authors affirm that the reported benefits are anecdotal in nature.

OBJECTIVE

This overview aims to summarize, from systematic reviews, the effectiveness of SMR instruments on performance and recovery.

MATERIAL AND METHODS

This study followed the PRISMA principles. Systematic reviews were found on the electronic databases according to an established P (healthy active individuals) I (SMR using instruments) C (other treatment, placebo, sham, or no treatment) O (performance and recovery) S (systematic reviews) search strategy. Additionally, methodological analysis was performed using R-AMSTAR.

RESULTS

Initially, it was found 15 systematic reviews. However, after methodological analysis, only 7 systematic reviews had sufficient quality to be included. From those, it was found that SMR using instruments is beneficial to enhancing short-term flexibility-related and recovery-related outcomes. Inconstant data was reported in muscular-related outcomes. Nevertheless, beyond pain during SMR, no major adverse effects were found. Different effects between time, pressure and other instrument characteristics were also found.

CONCLUSION

SMR using instruments can be a safe intervention used in sports to enhance performance and recovery from previous training/competition or between matches.

Pain and electromyography reduction cause of sitting upright posture, frequent break, eye rest and self-stretching during smartphone usage

BACKGROUND: Prolonged use of the smartphone causes neck and shoulder pain. However, no study has yet evaluated the effects of sitting upright, combined with frequent breaks, eye rest and self-stretching on pain and EMG during smartphone use. OBJECTIVES: The purpose of the study was to compare pain and muscle activity between the control group (rest only) and the intervention group (rest combined with correct posture, eye rest and self-stretching) in smartphone use for 41.30 minutes. METHOD: Forty-four healthy females aged 18–25 years old were recruited and randomly divided into two groups. The body pain chart and Visual Analog Scale (VAS) were used to evaluate pain. Electromyography (EMG) was used to measure muscle activity of Cervical Erector Spinae (CES) and Upper Trapezius (UT) muscles. RESULTS: The results showed that overall pain and neck pain in the control group increased significantly after smartphone use for 20 min and continually increased to 41.30 minutes (p < 0.05). Overall pain and neck pain in the intervention group was significantly lesser than control group after smartphone use for 41.30 minutes (p < 0.05). In the control group, EMG of CES at 41.30 minute was significantly higher than that of at 0 min (p < 0.05). There was no significant difference in EMG of UT between the two groups. CONCLUSION: Conclusion smartphone user in the interventional group reported less pain when compared to control group after Smartphone use for 41.30 minutes. Therefore, the user aged 18–25 years should have a rest combined with correct posture, eye rest and self-stretching to prevent neck pain during prolonged smartphone use.

Comparison of the Acute Effects of Foam Rolling with High and Low Vibration Frequencies on Eccentrically Damaged Muscle

Previous research has shown that vibration foam rolling (VFR) on damaged muscle shows greater improvement in muscle soreness and range of motion (ROM) compared with foam rolling (FR) without vibration. However, the effect of frequency in VFR on muscle soreness and loss of function caused by damaged muscles is unknown. The purpose of this study was to compare the acute effects of 90-s low-frequency (LF)- and high-frequency (HF)-VFR intervention on ROM, muscle soreness, muscle strength, and performance of eccentrically damaged muscle. Study participants were sedentary healthy adult volunteers (n = 28) who performed a bout of eccentric exercise of the knee extensors with the dominant leg and received 90-s LF-VFR or HF-VFR intervention of the quadriceps 48 h after the eccentric exercise. The dependent variables were measured before the eccentric exercise (baseline) and before (pre-intervention) and after VFR intervention (post-intervention) 48 h after the eccentric exercise. The results showed that both LF-VFR and HF-VFR similarly (p < 0.05) improved the knee flexion ROM (11.3 ± 7.2%), muscle soreness at palpation (-37.9 ± 17.2%), and countermovement jump height (12.4 ± 12.9%). It was concluded that it was not necessary to perform VFR with a high frequency to improve muscle soreness and function.

Chronic and Residual Effects of a Two-Week Foam Rolling Intervention on Ankle Flexibility and Dynamic Balance

Background

Foam rolling has been shown to acutely improve joint range of motion (ROM). However, limited knowledge exists on the chronic and residual effects. The primary purpose of this study was to examine the chronic and residual effects of a 2-week roller–massager intervention on ankle dorsiflexion ROM and dynamic balance.

Methods

Forty-two participants (24.3 ± 2.5 years, 33 males, 9 females) were randomly assigned to either roller-massage (RM) or control group (= no intervention). Ankle ROM was assessed with the weight-bearing lunge test (WBLT) and dynamic balance with the Y-Balance test for both limbs. The RM group was instructed to roll their calf muscles for three sets of 60 s per leg on 6 days a week over 2 weeks. Acute effects were measured during baseline testing for dorsiflexion ROM and dynamic balance immediately after foam rolling. Chronic and residual effects were measured 1 day and 7 days after the intervention period. Multivariate ANOVA was performed for post-hoc comparisons to determine acute, chronic, and residual effects.

Results

Significant acute and chronic foam rolling effects (p <0.05) were found for ankle dorsiflexion ROM. The chronic increase in ROM slightly decreased 7 days post-intervention but remained significantly above baseline (p < 0.05). Regarding dynamic balance, there were no acute but chronic (p < 0.05) and residual (p < 0.05) effects.

Conclusion

Using a roller–massager for a 2-week period chronically increases ROM and dynamic balance. These increases are still significant 7 days post-intervention emphasizing the sustainability of foam rolling effects.

Myofascial Treatment Techniques on the Plantar Surface Influence Functional Performance in the Dorsal Kinetic Chain

Prior studies have shown that self- and manual massage (SMM) increases flexibility in non-adjacent body areas. It is unclear whether this also influences performance in terms of force generation. Therefore, this study investigated the effect of SMM on the plantar surface on performance in the dorsal kinetic chain. Seventeen young participants took part in this within-subject non-randomized controlled study. SMM was applied on the plantar surface of the dominant leg, but not on the non-dominant leg. A functional performance test of the dorsal kinetic chain, the Bunkie Test, was conducted before and after the intervention. We measured the performance in seconds for the so-called posterior power line (PPL) and the posterior stabilizing line (PSL). The performance of the dominant leg in the Bunkie Test decreased significantly by 17.2% from (mean ± SD) 33.1 ± 9.9 s to 27.4 ± 11.1 s for the PPL and by 16.3% from 27.6 ± 9.8 s to 23.1 ± 11.7 s for the PSL. This is in contrast to the non-dominant leg where performance increased significantly by 5.1% from 29.7 ± 9.6 s to 31.1 ± 8.9 s for the PPL and by 3.1% from 25.7 ± 1.5 s to 26.5 ± 1.7 s for the PSL. SMM interventions on the plantar surface might influence the performance in the dorsal kinetic chain.

The Effect of Static Compression via Vibration Foam Rolling on Eccentrically Damaged Muscle

Previous research has shown that vibration foam rolling (VFR) on damaged muscle can result in improvements in muscle soreness and range of motion (ROM). Furthermore, static compression via VFR (i.e., VFR without rolling) can increase the ROM and decrease the muscle stiffness of non-damaged muscle. Therefore, it is likely that static compression via VFR on eccentrically damaged muscle can mitigate muscle soreness and the decrease in ROM, and the decrease in muscle strength. The purpose of this study was to investigate the acute effects of a 90 s bout of VFR applied as a static compression on an eccentrically damaged quadriceps muscle, measuring ROM, muscle soreness, muscle strength, and jump performance. This study was a single-arm repeated measure design. Study participants were sedentary healthy male volunteers (n = 14, 20.4 ± 0.8 years) who had not performed habitual exercise activities or any regular resistance training for at least 6 months before the experiment. All participants performed a bout of eccentric exercise of the knee extensors with the dominant leg and then received a 90 s bout of static compression via VFR of the quadriceps 48 h after the eccentric exercise. The knee flexion ROM, muscle soreness at palpation, and countermovement jump height were measured before the eccentric exercise (baseline), before (pre-intervention) and after the VFR intervention (post-intervention), and 48 h after the eccentric exercise. The results showed that the static compression via VFR significantly (p < 0.05) improved the knee flexion ROM (6.5 ± 4.8%, d = 0.76), muscle soreness at palpation (-10.7 ± 8.6 mm, d = -0.68), and countermovement jump height (15.6 ± 16.0%, d = 0.49). Therefore, it can be concluded that static compression via VFR can improve muscle soreness and function.

Pain pressure thresholds in children and adolescents with idiopathic chest pain

OBJECTIVES

The pathophysiology of idiopathic chest pain remains unclear. Studies evaluating pain pressure thresholds in other idiopathic pain syndromes have revealed pain sensitivity in both affected and unaffected areas. The present study aimed to evaluate thoracic and extrathoracic pain pressure thresholds and their correlation with patients' pain characteristics and quality of life.

METHODS

This cross-sectional, single-blind, controlled study included children and adolescents with idiopathic chest pain. The patients' pain characteristics, including their symptom duration, type of pain, mean pain intensity, mean duration of painful periods, pain frequency, and Pediatric Quality of Life Inventory Child Version scores, were assessed by a paediatric cardiologist via a face-to-face interview. Pain pressure thresholds were measured using an algometer by an algologist who was blinded to the study groups.

RESULTS

There was a statistically significant difference in pain pressure thresholds in the trapezius; supraspinatus; thoracic 2, 4, and 10 areas; deltoid; and tibia between the patient and healthy control groups. In the patient group, while there was a positive correlation between the mean all-region pain pressure thresholds and age (p = 0.047, r = 0.235), there was no correlation between pain pressure thresholds and symptom duration, pain intensity, and quality of life.

CONCLUSION

The present study is the first step towards investigating probable pain sensitivity mechanisms in children and adolescents with idiopathic chest pain. We noted lower thoracic and extrathoracic pain pressure thresholds in children and adolescents with idiopathic chest pain than in healthy controls.

Pain threshold in selected trigger points of superficial muscles of the back in young adults

BACKGROUND

Monitoring of pain threshold is the basis for verification of the effectiveness of therapy or assessment of the patient's condition. This study aimed to determine the pain threshold of selected superficial muscles of the back taking into account trigger point activity in young and healthy males and females, with the evaluation of intrarater reliability of algometric measurements.

MATERIAL AND METHODS

The study examined 30 young adult participants (15 males and 15 females) aged 26.23 ± 3.21, and BMI of 23.80 ± 3.43. The Pain Test FPX Algometer (Wagner) was used for the study. Trigger points on the levator scapulae and trapezius muscles (superior and inferior portion) on both sides were examined. It was also verified whether the trigger points studied are active or inactive. Furthermore, an author's survey questionnaire was used.

RESULTS

Within the trigger points of the right (p = 0.04) and left (p = 0.02) superior trapezius muscle and the left (p = 0.04) levator scapulae muscle, the pain threshold values were higher in the male group. There was a statistically significantly higher number of active trigger points in the female group compared to that in the male group (2.49 ± 1.51 vs. 1.07 ± 1.16, respectively), p = 0.01. For all muscles tested, mean pain threshold values were significantly higher for inactive trigger points. A greater number of active trigger points is associated with lower pain thresholds at these points (left: the superior trapezius, r = -0.597, the inferior trapezius, r = -0.609; the levator scapulae, r = -0.746; right: the superior trapezius, r = -0.610, the inferior trapezius, r = -0.604; the levator scapulae, r = -0.747). The evaluation of the intrarater reliability showed excellent agreement between the first and second measurements, ICC > 0.987 for all examined trigger points.

CONCLUSIONS

(1) Women who reported pain more than once a week in the studied muscles showed a greater number of active trigger points. (2) A greater number of active trigger points in female is related to a lower pain threshold (which is associated with greater pain sensitivity) in female than in male. (3) A sample size of 30 people seems sufficient to detect variations in the pain threshold at active and inactive trigger points of selected back muscles, especially when the frequency of occurrence of both types of points is comparable.

The Iliotibial Band: A Complex Structure with Versatile Functions

The development of a pronounced iliotibial band (ITB) is an anatomically distinct evolution of humans. The mechanical behaviour of this “new” structure is still poorly understood and hotly debated in current literature. Iliotibial band syndrome (ITBS) is one of the leading causes of lateral knee pain injuries in runners. We currently lack a comprehensive understanding of the healthy behaviour of the ITB, and this is necessary prior to further investigating the aetiology of pathologies like ITBS. Therefore, the purpose of this narrative review was to collate the anatomical, biomechanical and clinical literature to understand how the mechanical function of the ITB is influenced by anatomical variation, posture and muscle activation. The complexity of understanding the mechanical function of the ITB is due, in part, to the presence of its two in-series muscles: gluteus maximus (GMAX) and tensor fascia latae (TFL). At present, we lack a fundamental understanding of how GMAX and TFL transmit force through the ITB and what mechanical role the ITB plays for movements like walking or running. While there is a range of proposed ITBS treatment strategies, robust evidence for effective treatments is still lacking. Interventions that directly target the running biomechanics suspected to increase either ITB strain or compression of lateral knee structures may have promise, but clinical randomised controlled trials are still required.

Cross-education effect of vibration foam rolling on eccentrically damaged muscles

OBJECTIVES

Previous studies showed that vibration foam rolling (VFR) on damaged muscles improves muscle soreness and range of motion (ROM). VFR intervention can also increase the ROM and pain pressure threshold (PPT) in the non-rolling side, known as a cross-education effect. However, this is not clear for the non-rolling side. Therefore, this study aimed to investigate the cross-education effects of VFR intervention on ROM, muscle soreness, and PPT in eccentrically damaged muscles.

METHODS

Participants were sedentary healthy male volunteers (n=14, 21.4±0.7 y) who performed eccentric exercise of the knee extensors with the dominant leg and received 90-s VFR intervention of the quadriceps at the nondamaged side 48 h after the eccentric exercise. The dependent variables were measured before the exercise (baseline), before (preintervention), and after VFR intervention (postintervention) 48 h after the eccentric exercise. The Bonferroni post hoc test was used to determine the differences between baseline, preintervention, and postintervention.

RESULTS

Results showed that the VFR intervention on the nondamaged side 48 h after the eccentric exercise improved significantly (p<0.05) the knee flexion ROM, muscle soreness at palpation, and PPT compared to baseline.

CONCLUSION

VFR intervention on the nondamaged side can recover ROM and muscle soreness in eccentrically damaged muscles.

Sex Differences in the Mechanical and Neurophysiological Response to Roller Massage of the Plantar Flexors

Self-massage using foam rollers, sticks, or balls has become a popular technique to enhance joint range of motion (ROM). Although increases are reported to be larger in females than males, the mechanisms of this observation are unclear. The present study aimed to investigate the effect of roller massage (RM) on ROM, passive tissue stiffness, and neurophysiological markers as a function of sex. Males (n = 15, 22.8 ± 2.9 yrs.) and females (n = 14, 21.1 ± 0.7 yrs.) performed three 60-second bouts of calf RM. Outcomes assessed pre-, and post-intervention included passive dorsiflexion (DF) ROM, passive tissue stiffness, passive torque, DF angle at the first stretch sensation, shear elastic modulus, and spinal excitability. DF ROM (+35.9 %), passive torque at DF ROM (+46.4 %), DF angle at first stretch sensation (+32.9 %), and pain pressure threshold (+25.2 %) increased in both groups (p<.05) with no differences between males and females (p > 0.05). No changes were observed for passive stiffness, shear elastic modulus, and spinal excitability (p > 0.05). Roller massage may increase ROM independently of sex, which, in the present study, could not be ascribed to alterations in passive stiffness or neurophysiological markers. Future studies may further elucidate the role of sensory alterations as possible factors driving RM-induced changes in flexibility.

Positional release therapy and therapeutic massage reduce muscle trigger and tender points

OBJECTIVE

To determine if positional release therapy (PRT) or therapeutic massage (TM) was more effective in the treatment of trigger and tender points in the upper trapezius muscle.

BACKGROUND

Trigger points in the upper trapezius muscle are common and can be painful. Trigger points are commonly treated using TM however, PRT is a novel treatment that deserves further investigation.

METHODS

Sixty healthy male (24) and female (36) participants, (age = 27.1 ± 8.8 years, wt = 75.2 ± 17.9 kg, ht = 172.8 ± 9.7 cm) presenting with upper trapezius pain and a trigger point were recruited and randomized into either the TM or PRT group. Upper trapezius trigger points were found via palpation. Pain level was evaluated using a visual analog scale (VAS) and pain pressure threshold (PPT) was assessed using a pressure algometer. Muscle thickness was measured by B-mode ultrasound, while muscle stiffness was measured by shear-wave elastography (SWE). Participants were measured at baseline, posttreatment and again 48 h later.

RESULTS

Both treatments were effective in treatment of pain and muscle stiffness. Although no statistical group differences existed, treatment using PRT showed decreased pain averages and decreased pressure sensitivity at both post treatment, and 48 h later. Neither treatment was able to maintain the reduced muscle stiffness at the 48-h measure in males.

CONCLUSION

Both treatments showed a significant ability to reduce pain and acutely decrease muscle stiffness. Although not statistically different, clinically PRT is more effective at decreasing pain, and decreasing pressure sensitivity. Neither treatment method produced a long lasting effect on muscle stiffness in males.

Acute Effects of Foam Rolling on Hamstrings After Half-Marathon: A Muscle Functional Magnetic Resonance Imaging Study

Purpose: Foam rolling (FR) is widely used for post-exercise muscle recovery; yet, the effects of FR on skeletal muscle inflammation and microvascular perfusion following prolonged exercise are poorly understood. We aim to address the gap in knowledge by using magnetic resonance imaging (MRI) T2 mapping and intravoxel incoherent motion (IVIM) sequences to study the acute effects of FR on hamstrings following half-marathon running in recreational runners.

Methods: Sixteen healthy recreational marathon runners were recruited. After half-marathon running, FR was performed on the hamstrings on the dominant side, while the other limb served as a control. MRI T2 and IVIM scans were performed bilaterally at baseline (pre-run), 2–3 h after running (post-run), immediately after FR (post-FR0), 30 min after FR (post-FR30) and 60 min after FR (post-FR60). T2, a marker for inflammatory edema, as well as IVIM microvascular perfusion fraction index f for biceps femoris long head (BFL), semitendinosus (ST) and semimembranosus (SM) were determined. Total Quality Recovery (TQR) scale score was also collected.

Results: Both T2 and f were higher at post-run compared to pre-run in all hamstrings on both sides (all p < 0.05; all d > 1.0). For the FR side, T2 decreased, and f increased significantly at post-FR0 and post-FR30 compared to post-run in all muscles (p < 0.05; all d > 0.4) except for f at BFL and SM at post-FR30 (both p > 0.05), though f at BFL was still marginally elevated at post-FR30 (p = 0.074, d = 0.91). Both parameters for all muscles returned to post-run level at post-FR60 (all p > 0.05; all d < 0.4) except for T2 at SM (p = 0.037). In contrast, most MRI parameters were not changed at post-FR0, post-FR30 and post-FR60 compared to post-run for the control side (p < 0.05; d < 0.2). TQR scores were elevated at post-FR0 and post-FR30 compared to post-run (both p < 0.05; both d > 1.0), and returned to the post-run level at post-FR60 (p > 0.99; d = 0.09). Changes in TQR scores compared to post-run at any time points after FR were correlated to T2 for ST at post-FR30 (r = 0.50, p = 0.047) but not T2 for other muscles and any changes in f values.

Conclusions: Hamstrings inflammatory edema and microvascular perfusion were elevated following half-marathon running, which were detectable with MRI T2 mapping and IVIM sequences. FR resulted in acute alleviation in inflammation and greater microvascular perfusion; however, the effects seemed to last only for a short period of time (30–60 min). FR can provide short-term benefits to skeletal muscle after prolonged running.

Menthol-Based Topical Analgesic Induces Similar Upper and Lower Body Pain Pressure Threshold Values: A Randomized Trial

CONTEXT

Both health professionals and consumers use menthol-based topical analgesics extensively for the temporary relief of pain from musculoskeletal ailments or injury. However, there are no reports of differences in the pain pressure threshold (PPT) or the relative effectiveness of topical analgesics to reduce pain in the upper and lower body muscles and tendons. The objective of this study was to investigate whether differences existed in PPT and relative pain attenuation associated with a menthol-based topical analgesic over a variety of upper and lower body muscles and tendons.

DESIGN

Randomized allocation, controlled, intervention study.

METHODS

Sixteen participants (10 females and 6 males) were tested on their dominant or nondominant side. The order of specific muscle/tendon testing was also randomized, which included upper body (middle deltoid, biceps brachii, and lateral epicondylar tendon) and lower body locations (quadriceps, hamstrings, gastrocnemius, lumbosacral erector spinae muscles, and patellar and Achilles tendons). The PPT was monitored before and 15 minutes following the application of a menthol-based topical analgesic.

RESULTS

A menthol-based topical analgesic increased PPT (decreased pain sensitivity) overall (P = .05; 11.6% [2.4%]; d = 1.05) and PPT was higher (P < .0001; 31.5%-44.2%; d = 1.03-1.8) for lower versus upper body locations.

CONCLUSIONS

Health professionals and the public can be assured of similar reductions in pain sensitivity independent of the location of application of a menthol-based topical analgesic.

Downhill Running Impairs Activation and Strength of the Elbow Flexors

ABSTRACT

Brandenberger, KJ, Warren, GL, Ingalls, CP, Otis, JS, and Doyle, JA. Downhill running impairs activation and strength of the elbow flexors. J Strength Cond Res 35(8): 2145-2150, 2021-The purpose of this study was to determine if knee extensor injury induced by 1 hour of downhill running attenuated force production in the elbow flexors. Subjects completed either downhill running for 1 hour (injured group; n = 6) or sedentary behavior (control group; n = 6). Strength and voluntary activation (%VA) were measured by isometric twitch interpolation of the elbow flexor and knee extensor muscles at the following time points in relation to the injury: before injury (Pre), after injury (Post), 24 hours after injury (24Post), and 48 hours after injury (48Post). Mean (±SE) knee extensor strength was significantly reduced (53.5 ± 9.9%) Post and remained reduced at 24Post and 48Post in the injury group. Knee extensor muscle twitch strength was reduced Post and 24Post after the downhill run (p < 0.022). Elbow flexor muscle strength was significantly reduced Post (13.2 ± 3.9%) and 24Post (17.3 ± 4.0%). Elbow flexor muscle twitch strength was not significantly different at any time point. Elbow flexor muscle %VA was not significantly reduced compared with Pre, at Post (16.2 ± 5.1%), 24Post (20.9 ± 6.7%), or 48Post (12.9 ± 4.5%). A 1-hour downhill run significantly injured the knee extensors. The elbow flexor muscles remained uninjured, but strength of these muscles was impaired by reduced %VA. These data suggest muscle injury can lead to prolonged strength deficits in muscles distant from the injury and should be accounted for when scheduling training that may lead to delayed-onset muscle soreness.

Acute Effect of Different Duration of Foam Rolling Protocols on Muscle Thickness, Pain Pressure Threshold, and Volume Load on Multiple Sets of Knee Extension

Previous studies investigated the effects of foam rolling (FR) on measurements of strength and power. However, the acute effect of FR on muscle thickness (MT) and pressure pain threshold (PPT) after multiple sets of resistance exercise remains to be elucidated. The aim of the present study was to examine the effect of one and three minutes of quadriceps FR on muscle thickness (vastus lateralis [VL] and rectus femoris [RF]), pain threshold (VL and RF), and total load lifted (TLL) on multiple sets of knee extension. Nine resistance-trained men (age: 24.8 ± 5.2 years; height: 177 ± 7 cm; total body mass 77.7 ± 6.2 kg) participated the study. MT, PPT, and performance on multiple sets of knee extension were compared after performing passive recovery (CON), one minute (FR1), or three minutes of FR (FR3). A similar total training load among experimental conditions was observed. There was a greater increase on VL muscle thickness after FR3 when compared to CON and FR1. In addition, there was an increase on rectus femoris PPT two minutes post FR3, with no differences between conditions. These results indicate that longer duration FR-protocol may acutely increase muscle thickness of the vastus lateralis muscle without negatively affect the TLL and PTT.

Local and Non-local Effects of Foam Rolling on Passive Soft Tissue Properties and Spinal Excitability

In sports and clinical settings, roller massage (RM) interventions are used to acutely increase range of motion (ROM); however, the underlying mechanisms are unclear. Apart from changes in soft tissue properties (i.e., reduced passive stiffness), neurophysiological alterations such as decreased spinal excitability have been described. However, to date, no study has investigated both jointly. The purpose of this trial was to examine RM’s effects on neurophysiological markers and passive tissue properties of the plantar flexors in the treated (ROLL) and non-treated (NO-ROLL) leg. Fifteen healthy individuals (23 ± 3 years, eight females) performed three unilateral 60-s bouts of calf RM. This procedure was repeated four times on separate days to allow independent assessments of the following outcomes without reciprocal interactions: dorsiflexion ROM, passive torque during passive dorsiflexion, shear elastic modulus of the medial gastrocnemius muscle, and spinal excitability. Following RM, dorsiflexion ROM increased in both ROLL (+19.7%) and NO-ROLL (+13.9%). Similarly, also passive torque at dorsiflexion ROM increased in ROLL (+15.0%) and NO-ROLL (+15.2%). However, there were no significant changes in shear elastic modulus and spinal excitability (p > 0.05). Moreover, significant correlations were observed between the changes in DF ROM and passive torque at DF ROM in both ROLL and NO-ROLL. Changes in ROM after RM appear to be the result of sensory changes (e.g., passive torque at DF ROM), affecting both rolled and non-rolled body regions. Thus, therapists and exercise professionals may consider applying remote treatments if local loading is contraindicated.

The Immediate Effects of Foam Rolling and Stretching on Iliotibial Band Stiffness: A Randomized Controlled Trial

BACKGROUND

Iliotibial Band Syndrome (ITBS) is a common clinical condition likely caused by abnormal compressive forces to the iliotibial band (ITB). Stretching interventions are common in ITBS treatment and may predominantly affect tensor fascia latae (TFL). Another ITBS treatment is foam rolling, which may more directly affect the ITB. Shear wave ultrasound elastography (SWUE) measures real-time soft tissue stiffness, allowing tissue changes to be measured and compared.

PURPOSE

To examine effects of foam rolling and iliotibial complex stretching on ITB stiffness at 0˚ and 10˚ of hip adduction and hip adduction passive range of motion (PROM).

STUDY DESIGN

Randomized controlled trial.

METHODS

Data from 11 males (age = 30.5 ± 9.0 years, Body Mass Index (BMI) = 27.8 ± 4.0) and 19 females (age = 23.5 ± 4.9, BMI = 23.2 ± 2.1) were analyzed for this study. Subjects were randomly assigned to one of three groups: control, stretching, and foam rolling. Shear wave ultrasound elastography measurements included ITB Young's modulus at the mid-thigh, the distal femur and the TFL muscle belly. ITB-to-femur depth was measured at mid-thigh level. Hip adduction PROM was measured from digital images taken during the movement.

RESULTS

No significant interactions or main effects were found for group or time differences in ITB Young's modulus at the three measured locations. The ITB stiffness at the mid-thigh and distal femur increased with 10° adduction, but TFL stiffness did not increase. A main effect for adduction PROM was observed, where PROM increased 0.8˚ post-treatment (p = 0.02).

CONCLUSION

A single episode of stretching and foam rolling does not affect short-term ITB stiffness. The lack of ITB stiffness changes may be from an inadequate intervention stimulus or indicate that the interventions have no impact on ITB stiffness.

LEVELS OF EVIDENCE

1b.

Time Course of Acute Hip Adduction Range of Motion Changes Following Foam Rolling

BACKGROUND

With the increased popularity of foam rolling (FR), it is important to establish the exact manner in which the practice is useful.

PURPOSE

The purpose of this study was to examine the impact of FR the iliotibial (IT) band on hip adduction range of motion (ROM) and the short-term time course of any ROM changes that may occur.

METHOD

In a within-subject design, 34 subjects (21 female, 13 male) (female mean age 24.67 ± 8.6 yrs, height 161.4 ± 9.8 cm, mass 67.3 ± 12.3 kg; male mean age 22 ± 2.5 yrs, height 170.2 ± 8.2 cm, mass 76.3 ± 21.9 kg) underwent a baseline Ober's test to measure hip adduction ROM prior to the FR and control conditions. Subjects rolled the lateral portion of each thigh for 3 bouts of 20 seconds. A tempo of 3 seconds down and 3 seconds up the leg was maintained across FR bouts. A 5-minute walk served as the control condition. The Ober's test was repeated at less than 1 minute, 3 minutes, 10 minutes, 15 minutes, and 20 minutes following the FR bouts and the control to assess changes in hip adduction ROM over time. A blinded clinician conducted the Ober's test. A two-way analysis of variance was used to assess differences by condition and time.

RESULTS

No differences in hip adduction ROM were found at baseline between FR and CON within subjects (27.9 cm ± 7.5 vs. 27.7 cm ± 6.6, p > .05). Ober's test ROM was significantly greater in FR compared to CON immediately post-treatment (24.2 cm ± 6.3 vs. 28.2 cm ± 6.3, p = .00, d = .59), and 3 minutes post (24.6 cm ± 7.6 vs. 28.3 cm ± 5.9, p = .00, d = .56). No differences were observed 10 minutes post, 15 minutes post, or 20 minutes post FR or CON (p > .05).

DISCUSSION

Compared to walking, FR the IT band significantly increased hip adduction ROM as measured by the Ober's test. These increases appear to dissipate between 3 and 10 minutes post-FR.

CONCLUSION

An acute bout of 3 sets of 20 seconds of FR may be effective for transiently increasing ROM. Whether these short-term increases have implications for chronic flexibility changes is unclear.

LEVEL OF EVIDENCE

2.

Acute Effects of Foam Rolling on Cycling Performance: A Randomized Cross-Over Study

Acute foam rolling protocols may increase range of motion without a negative impact on muscle performance. The main purpose of the present study was to investigate the acute effects of foam rolling on cycling performance (mean power and maximal power), affect and perceived exertion. A secondary aim was to assess the effect of foam rolling on post-exercise muscle soreness. In a random order, ten recreationally trained cyclists (age: 26 ± 5 years; height 1.76 ± 0.06 m; total body mass 78.3 ± 19.8 kg; cycling experience: 5.6 ± 5.3 years; 4.1 ± 1.3 cycling sessions per week and 1.4 ± 1.4 strength sessions per week) were submitted to the following experimental conditions (separated by one week) before performing a three-minute, all-out cycling test: foam rolling or control. During foam rolling protocol, participants were instructed to roll back and forth on one leg and to place the opposite leg crossed over, from the proximal to the distal portion of the rectus femoris and vastus lateralis during one set of sixty seconds for each muscle group. Feeling scale (10 min pre and post-test), CR-10 scale of perceived exertion (ten-minute post-test), pressure pain threshold (pre and 24 h post-test) and mean/maximal power were assessed. No significant differences were observed between conditions for mean and maximal power, affect, perceived exertion, and pressure pain threshold (all p > 0.05). In conclusion, a pre-exercise acute session of self-myofascial release does not improve performance and post-exercise muscle soreness of recreationally trained cyclists.

A psychophysical study comparing massage to conditioned pain modulation: A single blind randomized controlled trial in healthy participants

INTRODUCTION

Pain-inducing massage results in greater pain inhibition than pain free massage, suggesting a mechanism dependent on conditioned pain modulation (CPM). The purpose of this study was to test the hypothesis that pain inducing massage produces similar magnitude of reduction in pain sensitivity as a cold pressor task and that baseline conditioned pain modulation efficiency predicts pain inducing massage related hypoalgesia.

METHODS

Sixty healthy participants were randomly assigned to receive either pain inducing massage to the neck, cold pressor task to the hand, or pain free massage to the neck. Participants also underwent pre and immediate post-intervention quantitative sensory testing. A repeated measures ANCOVA determined between group differences in pain sensitivity changes.

RESULTS

Pain inducing massage used as a conditioning stimulus resulted in comparable experimental pain sensitivity changes as a cold pressor task (p > 0.05). Pain intensity during the intervention demonstrated a weak correlation (r = 0.20, p = 0.12) with changes in pain sensitivity at a remote site. Individuals with an efficient CPM at baseline who received the pain inducing massage displayed greater increases in pressure pain threshold compared to individuals with a less efficient CPM indicating the potential benefit of treatment stratification by mechanism.

CONCLUSION

Although pain inducing massage resulted in less self-reported pain than a cold pressor task, both resulted in similar magnitude of the CPM response, suggesting shared underlying mechanisms. Understanding mechanisms of interventions can move us closer to mechanistic based treatments for pain which is consistent with a personalized medicine approach to care.

Evaluating the effects of embedded self-massage practice on strength performance: A randomized crossover pilot trial

Background

Self-administered massage interventions with a roller massager are commonly used as part of warm-ups and post-workout recovery routines. There is yet no clear consensus regarding the practical guidelines for efficient embedded interventions.

Objectives

The present randomized crossover pilot trial aimed at examining the effects of a rolling intervention with a roller massager embedded within the rests periods of a resistance training protocol. The rolling intervention targeted quadriceps muscles.

Setting

Participants (n = 14) performed two resistance training protocols expected to elicit momentary muscle failure. The protocol consisted in 10 sets of 10 rest-pause repetitions of back squats, with a poundage set up at 50% of the maximal one-repetition. Two min were allocated to recovery between sets. During the recovery periods, participants completed a rolling routine with a roller massager for 60 s (Roller-massager), or underwent passive recovery (Control). The total workload, concentric power, thigh circumference rate of perceived exertion (RPE) and delayed onset of muscle soreness (DOMS) from 24 h to 120 h after completion of the protocol were the dependent variables.

Results

Roller-massager was associated with a reduction in total workload (-11.6%), concentric power (-5.1%) and an increase in perceived exertion compared to Control (p < 0.05). Roller-massager was also associated with reduced thigh circumference after the resistance training protocol, indicating reduced muscle swelling, and reduced DOMS 24 h to 120 h post-workout (p < 0.001).

Conclusion

These findings support that embedded rolling with a roller massager hinders performance and increases effort perception. Embedded interventions may not be suitable during conditioning periods designed to maximize training intensity.

Effects of Myofascial Self-Release on Range of Motion, Pressure Pain Threshold, and Hamstring Strength in Asymptomatic Individuals: A Randomized, Controlled, Blind Clinical Trial

CONTEXT

Myofascial self-release is performed using a roller to exert pressure on the soft tissues and to promote effects similar to those of traditional massage. However, there is no standardization regarding its application, mainly in relation to time.

OBJECTIVE

To evaluate the effects of myofascial self-release with a rigid roller on range of motion (ROM), pressure pain threshold (PPT), and hamstring strength in asymptomatic individuals following 2 different times of intervention.

DESIGN

Randomized, controlled, blind, clinical trial comparing preintervention and immediately postintervention within 2 groups.

SETTING

Institutional physiotherapy clinic.

PARTICIPANTS

A total of 40 university students (18-30 y), who had no symptoms, participated.

INTERVENTION

Foam roller for 30 seconds and 2 minutes for group 2.

MAIN OUTCOME MEASURES

Hamstring PPT, knee-extension ROM, and peak knee-flexion torque measured before and immediately after the intervention.

RESULTS

Both groups experienced a statistically significant increase in ROM compared with baseline (30 s and 2 min for group 2 P < .024). There were no statistically significant differences comparing peak knee-flexion torque or PPT.

CONCLUSIONS

Hamstring myofascial self-release using a roller for 30 seconds or 2 minutes produced an increase in ROM in healthy individuals. PPT and peak knee-flexion isometric torque showed no effects.

Manual Therapies for Posterior Thigh Muscles Enhanced Ten-Repetitions Maximum Test Performance and Hip Flexibility in Young Soccer Players

This study investigated how different manual therapies applied to the posterior thigh muscles affect the ten-repetitions maximum performance test (10 RM) and hip flexion range-of-motion among young soccer players. Seventeen non-professional male soccer players performed the 10RM and range of motion pre-testing, and, in separate laboratory visits, they underwent three different experimental activities presented to each participant in a randomized order: (a) rest control activity with no intervention, (b) manual massage, and (c) muscle energy. Comparing pre-testing performances to repeated tests after each intervention condition, participants increased their maximum load lift on the 10-repeitions maximum test following manual massage and muscle energy interventions (p < 0.05), but not following the control condition. They also increased their hip range-of-motion on flexibility testing following manual massage and muscle energy (p < 0.05), but not following the control condition. Thus, both manual massage and muscle energy therapies applied to the posterior thigh were beneficial to performance. This finding has clear implications when preparing athletes for competition.

The Effects of a Preconditioning Rolling Session on Subsequent Eccentric Exercise-Induced Muscle Damage

West, JT, Miller, WM, Jeon, S, and Ye, X. The effects of a preconditioning rolling session on subsequent eccentric exercise-induced muscle damage. J Strength Cond Res 34(8): 2112-2119, 2020-The aim of this study was to examine the effects of a preexercise unilateral quadriceps muscle rolling intervention on subsequent ipsilateral (IPSI) or contralateral (CTRA) knee extension eccentric exercise-induced muscle damage. Twenty-seven healthy volunteers (14 men) underwent an eccentric exercise protocol (6 sets of 10 repetitions with 75% of the maximal isometric strength) with a single-leg knee extension machine. Before the eccentric exercise, the subjects were randomly assigned to either (a) IPSI group: rolling the ipsilateral knee extensor muscles, (b) CTRA: rolling the contralateral muscles, or (c) Control: sitting for 6 minutes (same duration as the rolling intervention protocol) relaxed. The muscle soreness, passive knee extension range of motion, and knee extension isometric strength were measured before, immediately, 24 hours, and 48 hours after exercise. The magnitudes of the range of motion decrement were attenuated in both the IPSI (p = 0.031) and CTRA (p = 0.014) groups 24 hours after the eccentric exercise, when compared with the control. Isometric strength (p = 0.783) and muscle soreness (p = 0.586) responses were not significantly different among the 3 groups (time points and sexes merged). Additionally, women displayed an overall faster recovery than men in isometric strength (p = 0.001) and muscle soreness (p = 0.024), evidenced by the measurements at 48 hours after exercise. Our study suggests that unilateral quadriceps rolling intervention before high-intensity muscle-damaging exercise has a beneficial effect on maintaining range of motion in both the ipsilateral and contralateral muscles.

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.

Foam rolling during a simulated half-time attenuates subsequent soccer-specific performance decrements

The passive nature of the half-time period with soccer/football can result in second-half performance decrements. As foam rolling (FR) can increase range of motion, neuromuscular efficiency, and enhance arterial function, the inclusion of FR during half-time may attenuate performance decrements. The objective of this acute study was to compare FR versus passive recovery during a simulated half-time period on simulated second-half soccer pass, sprint performance as well as quality of recovery. Thirteen male soccer players simulated a soccer match by performing two bouts of 15 × 20 m sprints with 30-s rest intervals. The bouts were separated by 10-min with either a passive recovery or they performed five FR exercises on both legs for 45-s each with 15-s rest. Tests were conducted before and following the simulated half-time period and consisted of Total Quality of Recovery (TQR), Loughborough Soccer Pass Test (LSPT), blood lactate (LAC), and sprint velocity of the simulated soccer match. Heart rates (HR) were recorded at the end of each test session and each sprint. Results showed no significant changes between conditions for TQR, LSPT, LAC and HR. However, while all sprint speed measures (mean, best of 15 sprints and mean of the first 5 sprints) significantly decreased with the passive condition, no decrement was noted with all sprint measures with the FR condition; there was only a significant (p = 0.001; d = 0.63) 2.1% decrease with the mean of the first 5 sprints. In conclusion, there is some evidence that FR may be beneficial to attenuate sprint speed impairments.

Comparative Effectiveness of Thai Herbal Formula (Thor-Ra-Nee-San-Tha-Kat) Versus Naproxen for Chronic Myofascial Pain: A Pilot Randomized-Controlled Trial

Background: Myofascial pain syndrome (MPS) is a painful musculoskeletal condition. The prevalence of MPS ranges from 5.9% to 38.7% in the general population. "Thor-ra-nee-san-tha-kat" (TRK) is a traditional formula included in the Thailand National List of Essential Medicines for the treatment for muscle pain caused by abdominal rigidity and for severe constipation. Objectives: The authors employed a pilot single-blind, randomized-controlled trial to compare the effectiveness of TRK and naproxen for the treatment of chronic upper trapezius MPS. Materials and Methods: Seventy-six male and female subjects, ages 25-55 years, who met the inclusion criteria were equally randomized into two groups to receive either two 500 mg capsules of TRK once daily before bed or two 250 mg naproxen tablets twice a day after meals for 14 days. Subjects assessed their level of pain using the numerical rating scale. Cervical range of motion (CROM) was determined using a goniometer, and pressure pain threshold (PPT) was assessed using an algometer. Adverse drug reactions were recorded and all items were compared within and between groups, before and after treatment. Results: The results revealed that patient pain scores after 14 days of treatment were much improved with mean differences exceeding the reference minimum clinically important difference (MCID) in both groups. However, the changes in CROM and PPT values were small and did not surpass their respective reference MCIDs except for the right lateral bending CROM for naproxen treatment. The adverse drug reactions were mild, with watery stools reported by 47% of patients in the TRK-treated group and constipation reported by 24% of those in the naproxen group. Conclusion: The administration of TRK formula for 14 days was safe and as effective as naproxen at providing short-term relief of pain in patients with chronic upper trapezius pain.

Effectiveness of the PROMUFRA program in pre-frail, community-dwelling older people: A randomized controlled trial

This study evaluated the effect of PROMUFRA program on physical frailty, kinanthropometric, muscle function and functional performance variables in pre-frail, community-dwelling older people. Participants (n = 50, 75 ± 7 years) were randomly assigned to two groups: intervention group (IG), and control group (CG). The IG performed multi-component exercise program, focused on high-intensity resistance training (HIRT) combined with self-massage for myofascial release (SMMR) for 12 weeks (2 d.wk^-1). Two measurements were performed, at baseline and post-3 months. Participants (n = 43) were analyzed and significant differences were found in group-time interaction for muscle mass (p = 0.017), fat mass (p = 0.003), skeletal muscle mass index (p = 0.011), maximum isometric knee extension (p = 0.042), maximum dynamic knee extension (p = 0.001), maximum leg press (p < 0.001), Barthel Index (p = 0.039) and EuroQol 5-dimensions-3-levels (p = 0.012). We conclude that PROMUFRA program is an effective training method to achieve healthy improvements for the pre-frail community.

Foam Rolling Prescription: A Clinical Commentary

Behm, DG, Alizadeh, S, Hadjizadeh Anvar, S, Mahmoud, MMI, Ramsay, E, Hanlon, C, and Cheatham, S. Foam rolling prescription: a clinical commentary. J Strength Cond Res 34(11): 3301-3308, 2020-Although the foam rolling and roller massage literature generally reports acute increases in range of motion (ROM) with either trivial or small performance improvements, there is little information regarding appropriate rolling prescription. The objective of this literature review was to appraise the evidence and provide the best prescriptive recommendations for rolling to improve ROM and performance. The recommendations represent studies with the greatest magnitude effect size increases in ROM and performance. A systematic search of the rolling-related literature found in PubMed, ScienceDirect, Web of Science, and Google Scholar was conducted using related terms such as foam rolling, roller massage, ROM, flexibility, performance, and others. From the measures within articles that monitored ROM (25), strength (41), jump (41), fatigue (67), and sprint (62) variables; regression correlations and predictive quadratic equations were formulated for number of rolling sets, repetition frequency, set duration, and rolling intensity. The analysis revealed the following conclusions. To achieve the greatest ROM, the regression equations predicted rolling prescriptions involving 1-3 sets of 2-4-second repetition duration (time for a single roll in one direction over the length of a body part) with a total rolling duration of 30-120-second per set. Based on the fewer performance measures, there were generally trivial to small magnitude decreases in strength and jump measures. In addition, there was insufficient evidence to generalize on the effects of rolling on fatigue and sprint measures. In summary, relatively small volumes of rolling can improve ROM with generally trivial to small effects on strength and jump performance.

Effects of Self-Massage Using a Foam Roller on Ankle Range of Motion and Gastrocnemius Fascicle Length and Muscle Hardness: A Pilot Study

Context: Several studies have reported that self-massage using a foam roller (FR) increased joint range of motion (ROM) immediately. However, the mechanism of increasing ROM by the FR intervention has not been elucidated. Objective: To clarify the mechanism by investigating properties and morphological changes of muscles targeted by the FR intervention. Design: An interventional study. Setting: An athletic training laboratory. Participants: Ten male college volunteers with no injuries in their lower limbs (mean [SD]: age 23.8 [3.2] y, height 173.2 [4.9] cm, weight 69.5 [8.6] kg). Intervention: The FR intervention on the right plantar flexors for 3 minutes. Main Outcome Measures: Maximum ankle ROM, muscle hardness, and fascicle length of the gastrocnemius muscle at the neutral (0°), maximum dorsiflexion, and maximum plantar flexion positions. All measurements were conducted before (PRE) and after (POST) the FR intervention. Results: Dorsiflexion ROM increased significantly at POST (PRE: 13.6° [8.0°], POST: 16.6° [8.4°]; P < .001), although plantar flexion ROM did not change significantly between PRE and POST (PRE: 40.0° [6.1°], POST: 41.1° [4.9°]). There was no significant difference in muscle hardness and fascicle length between PRE and POST in any of the angles. Conclusions: Dorsiflexion ROM increased significantly by the FR intervention in the present study; however, muscle hardness and fascicle length did not change. FR may affect not only the muscle but also the fascia, tendon, and muscle-tendon unit. The FR protocol of the present study can be applied in clinical situations, because it was found to be effective to increase ROM.