The Effect of Foam Rolling for Three Consecutive Days on Muscular Efficiency and Range of Motion

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.

Comparison of acute and prolonged effects of short-term foam rolling and vibration foam rolling on the properties of knee extensors

Recently, Foam Rolling (FR) and Vibration Foam Rolling (VFR) have attracted attention in sports and rehabilitation fields. Previous studies have shown that FR and VFR acute interventions effectively increase the range of movement (ROM) and decrease tissue hardness. For application to sports and rehabilitation, it is necessary to compare the acute and prolonged effects of short duration FR and VFR. Therefore, this study aimed to compare and investigate the acute and prolonged (15 minutes) effects of short duration (30-s) FR and VFR interventions on knee extensors. The subjects were 14 male university students (22.4 ± 1.0 years old), in which the knee extensors of the dominant leg were tested. In a cross-over trial, 30-s of FR or VFR were performed with 2-s rolling of the anterior thigh (15 rolls). The frequency of VFR was 35 Hz. Measurements included knee flexion ROM, pain pressure threshold (PPT), tissue hardness, and countermovement jump height. The results of this study showed no interaction effects for all variables, but main time effects were observed for knee flexion ROM, PPT, and tissue hardness. Post-hoc tests showed that knee flexion ROM increased up to 10 minutes after the intervention. PPT significantly increased, and tissue hardness significantly decreased up to 15 minutes after intervention. This study showed that 30-s FR and VFR interventions effectively increased ROM, PPT, and decreased tissue hardness. The effects were prolonged up to 10-15 minutes after the intervention. The results of this study show no advantage of VFR over FR with acute short-term interventions.

Acute Effects of Short-Term Massage Procedures on Neuromechanical Contractile Properties of Rectus Femoris Muscle

Background and Objectives: In many sports, maintaining muscle work at an optimal level despite fatigue is crucial. Therefore, it is essential to discover the most efficient way of recovery. This study aimed to evaluate and compare the acute effects of four different recovery methods on muscle neuromechanical properties. Materials and Methods: The research was conducted using a randomized, quasi-experimental, repeated-measures design. Fourteen healthy and active male students of the Faculty of Sport and Physical Education (age 25.1 ± 3.9 years) were included in this study. The tensiomyography was used to evaluate muscle responses after four different types of short-term recovery methods (passive rest, percussive mechanical, vibro-mechanical, and manual massage) on the rectus femoris muscle on four occasions: baseline, post fatigue, post recovery and prolonged recovery. Results: The ANOVA revealed that muscle fatigue decreased maximal vertical muscle displacement (Dm) and muscle contraction time (Tc) in post fatigue compared to the baseline. The most important finding shows that only the vibro-mechanical massage resulted in an increase in Tc in the prolonged recovery compared to the post fatigue (p = 0.028), whereas only manual massage showed no differences in Dm from the baseline in post-recovery (p = 0.148). Moreover, both manual and vibro-mechanical massages increased Dm and Tc in prolonged recovery, indicating no differences from the baseline (all p > 0.05), thus showing signs of muscle recovery. Percussion mechanical massage and passive rest did not show indices of muscle recovery. Conclusions: Manual massage could induce immediate positive changes in Dm by reducing muscle stiffness. In addition, vibro-mechanical and manual massage improved muscle tissue by rapidly returning Dm and Tc values to baseline at prolonged recovery measurement (5 min after the fatigue protocol). These findings can benefit sports practitioners, and physical therapists in developing the best recovery method after muscle fatigue.

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.

Self-Massage Techniques for the Management of Pain and Mobility With Application to Resistance Training: A Brief Review

ABSTRACT

MacLennan, M, Ramirez-Campillo, R, and Byrne, PJ. Self-massage techniques for the management of pain and mobility with application to resistance training: a brief review. J Strength Cond Res 37(11): 2314-2323, 2023-Fascial restrictions that occur in response to myofascial trigger points (MTrP), exercise-induced muscle damage (EIMD), and delayed onset of muscle soreness (DOMS) cause soft tissue to lose extensibility, which contributes to abnormal muscle mechanics, reduced muscle length, and decrements in joint range of motion (ROM) and actively contributes to musculoskeletal pain. Resistance training and in particular, weightlifting movements have unique mobility requirements imperative for movement efficacy and safety with ROM restrictions resulting in ineffective volume and intensity tolerance and dampened force output and power, which may lead to a failed lift or injury. Self-massage (SM) provides an expedient method to promote movement efficiency and reduce injury risk by improving ROM, muscular function, and reducing pain and allows athletes to continue to train at their desired frequency with minimal disruption from MTrPs-associated adverse effects. Thus, the aim of this review was to determine the efficacy of various self-massage tools in managing pain and mobility and to explore the potential benefits of SM on resistance training performance. Many SM devices are available for athletes to manage ROM restrictions and pain, including differing densities of foam rollers, roller massagers, tennis balls, and vibrating devices. To attenuate adverse training effects, a 10-to-20-minute bout consisting of 2-minute bouts of SM on the affected area may be beneficial. When selecting a SM device, athletes should note that foam rollers appear to be more effective than roller massagers, with vibrating foam rollers eliciting an increased reduction to pain perception, and tennis balls and soft massage balls were shown to be efficacious in targeting smaller affected areas.

The immediate effects of foam rolling of the hamstrings muscle group on the contractile properties of the knee muscles in football players

INTRODUCTION

Excessive amounts of intense training, without adequate recovery time, can overload the musculoskeletal, immune, and metabolic systems, resulting in a potentially negative effects on later exercise performance. During the competitive period, the ability to recover after intense training and competition is an important factor of success in soccer. The purpose of this study was to determine the effect of hamstring foam rolling on the knee muscle contractile properties in soccer players, after a sports-specific load.

METHODS

20 male professional soccer players were included and contractile properties of the biceps femoris, rectus femoris, vastus medialis and vastus lateralis muscles were measured with tensiomyography, before and after a Yo-Yo interval test and after 5 × 45 s of hamstring foam rolling. Additionally, active and passive knee extensibility before and after the intervention were measured. A mixed linear model was performed to determine the differences between the mean values of the groups. The experimental group performed foam rolling, while the control was resting.

RESULTS

Five repetitions of 45 s of hamstring foam rolling had no statistically significant effect (p > 0.05) on any of the measured muscles following the Yo-Yo interval test or foam rolling intervention. There were no statistically significant differences in delay time, contraction time and maximum muscle amplitude between groups. Active and passive knee extensibility did not differ between groups.

DISCUSSION AND CONCLUSION

It seems that foam rolling does not affect mechanical properties of the knee muscles or hamstring extensibility in soccer players, after a sports-specific load.

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.

Foam Rolling Acute Effects on Myofascial Tissue Stiffness and Muscle Strength: A Systematic Review and Meta-Analysis

ABSTRACT

Glänzel, MH, Rodrigues, DR, Petter, GN, Pozzobon, D, Vaz, MA, and Geremia, JM. Foam rolling acute effects on myofascial tissue stiffness and muscle strength: a systematic review and meta-analysis. J Strength Cond Res 37(4): 951-968, 2023-Foam rolling (FR) is widely used in rehabilitation and physical training. However, the effects of FR on myofascial tissue stiffness and muscle strength remain unclear. This study aimed to perform a systematic review with meta-analysis of trials that tested the FR acute effects during warm-up on the myofascial tissue stiffness and muscle strength in healthy adults or athletes. This systematic review (CRD42021227048) was performed according to Cochrane's recommendations, with searches performed in PubMed, Web of Science, Embase, and PEDro databases. Syntheses of included studies' data were performed, and the PEDro scale was used to assess the methodological quality of the studies. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluations approach. Twenty included studies assessed trunk and thigh fascial tissue stiffness, and thigh and calf muscle stiffness, whereas muscle strength was assessed in the knee extensors and flexors, and plantar flexors muscles. Qualitative analysis showed decreases in fascial ( n = 2) and muscle ( n = 5) stiffness after FR. However, the meta-analysis showed no effects of FR on myofascial tissue stiffness. Both qualitative and quantitative analyses showed no effects of FR on isometric muscle strength, eccentric torque, and rate of force development. However, the knee extensor concentric torque increased after FR. Foam rolling increases the knee extensor concentric torque, but it does not acutely change the myofascial tissue stiffness and isometric muscle strength. However, evidence of these studies provides low certainty to state that FR does not change these parameters. Therefore, high methodological quality studies should be performed to better ascertain the effects of FR on the myofascial tissue stiffness and muscle strength.

The Reliability of Transcranial Magnetic Stimulation-Derived Corticomotor Inhibition as a Brain Health Evaluation Tool in Soccer Players

Background

The suitability of corticomotor inhibition and corticospinal excitability to measure brain health outcomes and recovery of sport-related head impact (concussion and subconcussion) depends on good inter-day reliability, which is evaluated in this study. Transcranial magnetic stimulation (TMS) reliability in soccer players is assessed by comparing soccer players, for whom reliability on this measure may be reduced due to exposure to head impacts, to generally active individuals not engaged in contact sport.

Methods

TMS-derived corticomotor inhibition and corticospinal excitability were recorded from the rectus femoris muscle during two testing sessions, spaced 1–2 weeks apart in 19 soccer players (SOC—age 22 ± 3 years) and 20 generally active (CON—age 24 ± 4 years) healthy volunteers. Inter-day reliability between the two time points was quantified by using intra-class correlation coefficients (ICC). Intra-group reliability and group differences on actual measurement values were also explored.

Results

Good inter-day reliability was evident for corticomotor inhibition (ICC_SOC = 0.61; ICC_CON = 0.70) and corticospinal excitability (ICC_SOC = 0.59; ICC_CON = 0.70) in both generally active individuals and soccer players routinely exposed to sport-related head impacts. Corticomotor inhibition showed lower coefficients of variation than excitability for both groups (Inhib_SOC = 15.2%; Inhib_CON = 9.7%; Excitab_SOC = 41.6%; Excitab_CON = 39.5%). No group differences between soccer players and generally active individuals were found on the corticomotor inhibition value (p > 0.05), but levels of corticospinal excitability were significantly lower in soccer players (45.1 ± 20.8 vs 85.4 ± 6.2%Mmax, p < 0.0001). Corticomotor inhibition also showed excellent inter-rater reliability (ICC = 0.87).

Conclusions

Corticomotor inhibition and corticospinal excitability are stable and maintain good degrees of reliability when assessed over different days in soccer players, despite their routine exposure to head impacts. However, based on intra-group reliability and group differences of the levels of excitability, we conclude that corticomotor inhibition is best suited for the evaluation of neuromuscular alterations associated with head impacts in contact sports.

Methodical approaches to determine the rate of radial muscle displacement using tensiomyography: A scoping review and new reporting guideline

Tensiomyography is a non-invasive method to assess skeletal muscle contractile properties from the stimulated radial displacement. Many studies have used the rate of displacement (Vc) as an indirect measure of muscle contraction velocity. However, no standardised methodical approach exists to measure displacement and determine Vc. This review aimed to provide an overview of concepts to determine Vc and measurement protocols to foster the development of a standardised methodical approach. This review followed the Preferred Reporting Items for Systematic Reviews and meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guideline. Systematic searches were performed within five electronic databases and additional sources. The included 62 studies reported 10 different concepts to determine Vc, which we summarised in three groups. The determination concepts differed mainly regarding time intervals during the contraction phase considered and criteria used to define these intervals. Essential information on the equipment and raters, measurement setup, electrical stimulation procedure, and data analysis were frequently not reported. In conclusion, no consensus on how to determine Vc existed. Incomplete reporting of measurement protocols hindered study comparison, which obstructs developing a standardised approach. Therefore, we propose a new guideline for reporting measurement protocols, which covers the 1) equipment and rater, 2) measurement setup, including positioning of the subject, sensor and electrodes, 3) electrical stimulation, including initial stimulation amplitude, increment, and endpoint, and 4) data analysis, including selection criteria and number of analysed signals and a definition of derived parameters.

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.

Effects of Diacutaneous Fibrolysis on Passive Neuromuscular Response and Mechanosensitivity in Athletes with Hamstring Shortening: A Randomized Controlled Trial

Introduction. Diacutaneous Fibrolysis is defined as specific instrumental intervention to normalize function in the musculoskeletal system. It is considered a treatment method for the mechanical alterations of the locomotor system, and it is widely used in sports for therapeutic and preventive purposes. Despite the clinical benefits observed in different musculoskeletal conditions, the action mechanism of diacutaneous fibrolysis remains uncertain. There are no studies evaluating the neuromuscular response on the posterior muscular chain of the lower extremity in athletes, where overload, stiffness, and injury incidence are high. Objective. To evaluate the immediate, and 30 min post treatment effects of a single diacutaneous fibrolysis session on passive neuromuscular response and mechanosensitibity on hamstring and gluteus in athletes with shortening. Design. A randomized within participant clinical trial. Methods. Sixty-six athletes with hamstring shortening were included (PKE < 160). The lower limbs were randomized between the experimental limb and control limb, regardless of dominance. A single session of diacutaneous fibrolysis was applied to the posterior gluteus maximus, biceps femoris, and semitendinosus of the experimental lower limb whereas the control limb was not treated. Viscoelastic muscle properties (myotonometry), contractile muscle properties (tensomiography), and mechanosensitivity (algometry) were tested before treatment (T0), after treatment (T1), and 30 min post treatment (T2). Results. Regarding viscoelastic properties, in the intra-group analysis we found statistically significant differences in the experimental limb at T1, decreasing muscle stiffness in gluteus maximus (p < 0.042), in biceps femoris (p < 0.001) and in semitendinosus (p < 0.032). We also observed statistically significant differences in Tone decrease (p < 0.011) and relaxation increase (p < 0.001) in biceps femoris. At T2, the decrease in stiffness in all tested muscles was maintained (p < 0.05). There were statistically significant inter-groups differences in stiffness on gluteus (p < 0.048) and biceps femoris (p < 0.019) and in tone on biceps femoris (p < 0.009) compared to the control limb. For contractile properties, we only found statistically significant differences on maximal radial displacement (Dm) in gluteus, both control and experimental at T2 (p < 0.05) and in biceps femoris control (p < 0.030). No changes were found in the mechanosensitivity. Conclusions. A single session of diacutaneous fibrolysis produces changes in some parameters related to viscoelasticity properties of the biceps femoris and gluteus. There were no changes on contractile properties on semitendinosus. Only small changes on the contractile properties on the gluteus maximus and biceps femoris were found. No effect was found on the mechanosensitivity of the posterior chain muscles in athletes with hamstring shortening.

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.

Immediate effects of myofascial release on neuromechanical characteristics in female and male patients with low back pain and healthy controls as assessed by tensiomyography. A controlled matched-pair study

BACKGROUND

Low back pain (LBP) is a major health issue in most industrialised countries. Lumbodorsal fascia has been advocated as a potential source of pain in the lumbopelvic region. Myofascial release constitutes a manual therapeutic approach focussing on the restoration of altered soft tissue function. No previous study has focused on quantifying neuromechanical effects of myofascial release on LBP patients through tensiomyography. The purpose of this study was to quantify immediate neuromechanical alterations of myofascial release on patients with LBP and healthy controls through tensiomyography parameters.

METHODS

The participants' (n = 30) bilateral lumbar erector spinae muscles were assessed via tensiomyography before and after a 6-min myofascial release treatment of the lumbodorsal fascia to evaluate the muscles' mechanical characteristics. Subjects with LBP (n = 15) were eligible to partake if they reported having had LBP for most days in the past 12 weeks. Muscle displacement (Dm [mm]), velocity of contraction (Vc [mm/s]), and lateral symmetry (Ls [%]) were assessed through tensiomyography testing.

FINDINGS

Statistical analyses revealed a significant increase for velocity of contraction in the right (p = .021) and left (p = .041) lumbar erector spinae for the subjects with LBP but not for the healthy controls (both p > .14).

INTERPRETATION

We suggested that myofascial release alters neuromechanical characteristics in subjects with LBP. Tensiomyography may be implemented in clinical settings to monitor intervention effects of the myofascial system, especially the tensiomyography parameter velocity of contraction.

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.

Sex-Based Differences in Tensiomyography as Assessed in the Lower Erector Spinae of Healthy Participants: An Observational Study

BACKGROUND

Although there is mounting evidence on sex-linked differences in paraspinal muscle function, it is unknown whether sex-based variations in mechanical and contractile characteristics of the lumbar erector spinae (LES) can be monitored noninvasively in healthy participants at rest using tensiomyography (TMG).

HYPOTHESIS

Sex-specific effects in muscle displacement (Dm) and velocity of muscle deformation (Vd) will be observed via TMG assessed in the LES.

STUDY DESIGN

Observational study.

LEVEL OF EVIDENCE

Level 3.

METHODS

LES response was measured in a relaxed state in 40 healthy adults (20 females). Possible differences between the conditions were investigated using mixed-model analyses of variance. Two-stage hierarchical linear regression analyses were performed to predict the outcome of TMG Dm and Vd based on participant sex.

RESULTS

There were significant main effects of sex with large effect sizes for both TMG parameters, resulting from lower mean values in women compared with men (Dm, P < 0.01; Vd, P < 0.01). In contrast, neither the main effect of side (left vs right LES) nor the interaction between the side and sex reached significance (all P > 0.3). Introducing the sex variable in stage 2 of the regression analyses significantly improved the prediction of the TMG parameters (all ∆R² ≥ 0.18; all P < 0.01; all f² ≥ 0.29).

CONCLUSION

Sex-based differences in muscle stiffness and contractile characteristics could be observed by TMG on LES muscles in healthy individuals at rest. The data suggest that these disparities are not exclusively attributable to anthropometric measures but may be linked to intrinsic sex-based differences in skeletal muscle characteristics.

CLINICAL RELEVANCE

We recommend implementing TMG in a clinical setting using the obtained results as a basis to factor for the patient's biological sex when assessing effects of therapeutic/exercise regimens aiming at the optimization of myofascial tissue regeneration and performance.

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.

Acute Effects of Tissue Flossing on Ankle Range of Motion and Tensiomyography Parameters

CONTEXT

Recently, a few papers have suggested that tissue flossing (TF) acutely improves range of motion (ROM) and neuromuscular performance. However, the effects of TF on muscle contractile properties are yet to be defined.

OBJECTIVE

To investigate the acute effects of TF on ankle ROM and associated muscle gastrocnemius medialis displacement and contraction time assessed with tensiomyography.

DESIGN

Crossover design in a single session.

SETTING

University laboratory.

PARTICIPANTS

Thirty recreationally trained volunteers (age 23.00 [4.51] y).

INTERVENTION

Active ankle plantar flexion and dorsiflexion were performed for the duration of 2 minutes (3 sets, 2-min rest between sets), while a randomly selected ankle was wrapped using TF elastic band (BAND) and the other ankle served as a control condition (CON).

MAIN OUTCOME MEASURES

Participants performed an active ankle plantar flexion and dorsiflexion ROM test and muscle gastrocnemius medialis tensiomyography displacement and contraction time measurement pre, 5, 15, 30, and 45 minutes after the floss band application.

RESULTS

There were no statistically significant differences between BAND and CON conditions (active ankle plantar flexion ROM: P = .09; active ankle dorsiflexion ROM: P = .85); however, all ROM measurements were associated with medium or large effect sizes in favor of BAND compared with CON. No significant changes were observed in the tensiomyography parameters.

CONCLUSIONS

The results of this study suggest that TF applied to the ankle is a valid method to increase ROM and at the same time maintaining muscular stiffness.

The Evidence for Common Nonsurgical Modalities in Sports Medicine, Part 1: Kinesio Tape, Sports Massage Therapy, and Acupuncture

There are a number of nonsurgical modalities used by athletes in attempts to improve performance or prevent, treat, and rehabilitate musculoskeletal injuries. A concise review of available evidence on common nonsurgical modalities used today is necessary so that practitioners may appropriately counsel patients.

Foam Rolling and Muscle and Joint Proprioception After Exercise-Induced Muscle Damage

CONTEXT

Foam rolling (FR) is considered an effective postexercise modality for reducing delayed-onset muscle soreness and enhancing recovery of muscle function. However, the effects of FR on muscle and joint proprioception have not been investigated.

OBJECTIVE

To examine the effects of FR on muscle and joint proprioception after an intense exercise protocol.

DESIGN

Controlled laboratory study.

SETTING

University-based laboratory.

PATIENTS OR OTHER PARTICIPANTS

A total of 80 healthy, physically active male students were randomly assigned to either the FR (n = 40; age = 22.8 ± 3.3 years, height = 176.4 ± 5.3 cm, mass = 74.2 ± 6.4 kg) or passive-recovery (PR; n = 40; age = 23.0 ± 3.2 years, height = 178.1 ± 5.5 cm, mass = 74.6 ± 6.2 kg) group.

INTERVENTION(S)

Participants in both groups performed 4 sets of 25 repetitions of voluntary maximal eccentric contractions at 60°/s from 20° to 100° of knee flexion to induce exercise-induced muscle damage. The exercise was followed by either PR or 2 minutes of FR immediately (1 hour) and 24, 48, and 72 hours postexercise.

MAIN OUTCOME MEASURE(S)

Muscle soreness, pressure-pain threshold, quadriceps-muscle strength, joint position sense, isometric force sense, and threshold to detect passive movement at baseline and immediately, 24, 48, and 72 hours postexercise after FR.

RESULTS

Foam rolling resulted in decreased muscle pain, increased pressure-pain threshold, improved joint position sense, attenuated force loss, and reduced threshold to detect passive movement compared with PR at 24 and 48 hours postexercise.

CONCLUSIONS

Foam rolling postexercise diminished delayed-onset muscle soreness and improved recovery of muscle strength and joint proprioception. These results suggested that FR enhanced recovery from exercise-induced damage.

DURATION OF MYOFASCIAL ROLLING FOR OPTIMAL RECOVERY, RANGE OF MOTION, AND PERFORMANCE: A SYSTEMATIC REVIEW OF THE LITERATURE

BACKGROUND

Knowledge of the body's response to and recovery from exercise is rapidly increasing. State-of-the-art equipment and facilities allow recreationally active adults to seek innovations to enhance performance and shorten recovery time. Myofascial rolling (MR) is a relatively new practice, providing acute benefits for muscle pain and range of motion (ROM). However, there is no consensus on optimal MR duration.

PURPOSE

The purpose of this systematic review is to determine the optimal MR duration using a foam roller or a roller massager for muscle pain, ROM, and athletic performance via qualitative review.

STUDY DESIGN

Systematic Review of the Literature.

METHODS

A systematic search was conducted using PubMed, EMBASE, EBSCOHost and PEDro (July 2018). Twenty-two studies met the inclusion criteria and were appraised using the PEDro scale. Studies were grouped by outcome measure, with a total number of subjects of n = 328 for pain/soreness, n = 398 for ROM, and n = 241 for performance. Heterogeneity of data prohibited a formal meta-analysis: studies were manually reviewed and classified as providing evidence for benefit of MR (i.e., significant positive effect) or not (i.e., null or negative effect) for each of the studied outcomes.

RESULTS

The most evidence-based benefit of MR is the alleviation of muscle soreness; seven of eight studies assessing pain/soreness resulted in a short-term reduction, and a minimum dose of 90 seconds per muscle appeared beneficial. While ten of 17 studies involving ROM showed acute improvements, the results were inconsistent and highly variable. No significant effects on performance were detected.

CONCLUSION

Available data indicate that MR for 90 seconds per muscle group may be the minimal duration to achieve a short-term reduction in pain/soreness, with no upper limit found. Results do not support increases in chronic ROM or performance, and data are insufficient to provide a conclusive recommendation for impacting acute ROM. The heterogeneity of the literature highlights the need for additional research to determine optimal dose of MR.

LEVEL OF EVIDENCE

2a- (Systematic Review with heterogeneity).

Unilateral hamstring foam rolling does not impair strength but the rate of force development of the contralateral muscle

BACKGROUND

Self-administered foam rolling (SAFR) is an effective massage technique often used in sport and rehabilitation settings to improve range of motion (ROM) without impairing the strength performance. However, the effects of unilateral SAFR on contralateral non-intervened muscle's rate of force development (RFD) are unknown. Therefore, the purpose of this investigation was to examine the acute effects of unilateral hamstrings SAFR on the contralateral limb flexibility, the isometric strength, and the RFD parameters.

METHODS

Thirty-four subjects (21 women) completed two separate randomly sequenced experimental visits, during which the control (rested for 10 min) or ten, 30-second SAFR were performed with the dominant hamstring muscle group. Before (Pre) and after (Post) the interventions, the contralateral hip flexion passive ROM, the maximal explosive isometric strength of the contralateral knee flexors with the corresponding prime mover muscles' surface electromyographic (EMG) amplitude were measured. Separate two-way (time ×intervention) repeated measures analyses of variance (ANOVAs) were used to examine the potential changes of the dependent variables.

RESULTS

The SAFR significantly improved the contralateral limb ROM (Pre vs. Post: 68.3 ± 21.0 vs. 73.2 ± 23.2 degrees, p < 0.001; d = 0.22). No change was found for the contralateral isometric strength or the maximal EMG amplitude. For the RFD parameters, the percent changes of the RFDs for the first 50, 100, and 200 ms of the maximal explosive isometric contraction were -31.2%, -16.8%, and -10.1%, respectively, following the unilateral SAFR, relative to the control condition. In addition, the decrement of the first 50-ms RFD reached statistical significance (p = 0.007; Cohen's d = 0.44).

CONCLUSION

Ten sets of 30-second unilateral hamstring SAFR improved the ROM of the non-intervened contralateral limb, but decreased its ability to generate force, especially during the early phase (e.g., 50 ms) of the maximal explosive contraction.

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.

Foam Rolling of the Calf and Anterior Thigh: Biomechanical Loads and Acute Effects on Vertical Jump Height and Muscle Stiffness

When considering the scientific lack concerning the execution and acute effects and mechanism of foam rolling (FR), this study has evaluated the biomechanical loads by the force-time characteristics during two popular FR exercises. Additionally, the acute effects of FR on jump height and muscular stiffness were simultaneously assessed. Within a randomized cross-over design, 20 males (26.6 ± 2.7 years; 181.6 ± 6.8 cm; 80.4 ± 9.1 kg) were tested on different days pre, post, and 15 and 30 min after three interventions. The interventions consisted of a FR procedure for the calf and anterior thigh of both legs, 10 min ergometer cycling, and resting as a control. Stiffness was measured via mechanomyography at the thigh, calf, and ankle. The vertical ground reaction forces were measured under the roller device during FR as well as to estimate jump height. Within the FR exercises, the forces decreased from the proximal to distal position, and were in mean 34 and 32% of body weight for the calves and thighs, respectively. Importantly, with 51 to 55%, the maxima of the individual mean forces were considerably higher. Jump height did not change after FR, but increased after cycling. Moreover, stiffness of the thigh decreased after FR and increased after cycling.