Effects of Self-Myofascial Release on Athletes' Physical Performance: A Systematic Review

Therapists and strength and conditioning specialists use self-myofascial release (SMR) as an intervention tool through foam rollers or massage rollers for soft tissue massage, with the purpose of improving mobility in the muscular fascia. Moreover, the use of SMR by professional and amateur athletes during warm-ups, cool downs, and workouts can have significant effects on their physical performance attributes, such as range of motion (ROM) and strength. The purpose of this study was to analyse the literature pertaining to these types of interventions and their effects found in different physical performance attributes for athletes. A systematic search was carried out using the following databases: PUBMED, ISI Web of Science, ScienceDirect, and Cochrane, including articles up to September 2023. A total of 25 articles with 517 athletes were studied in depth. SMR seems to have acute positive effects on flexibility and range of motion, without affecting muscle performance during maximal strength and power actions, but favouring recovery perception and decreasing delayed-onset muscle soreness. Some positive effects on agility and very short-range high-speed actions were identified, as well. In conclusion, although there is little evidence of its method of application due to the heterogeneity in that regard, according to our findings, SMR could be used as an intervention to improve athletes' perceptual recovery parameters, in addition to flexibility and range of motion, without negatively affecting muscle performance.

Acute Effects of Different Foam Roller Intervention Techniques on Knee Extensors

The usefulness of Foam Roller (FR) even without a rolling stimulus (e.g., static compression with or without dynamic joint movements) has been recently demonstrated; however, the different effects of these methods remain unclear. Thus, this study aimed to compare and investigate the effects of such FR intervention methods on knee extensors. The dominant knee extensors of 20 male university students were investigated using the following four conditions: control (CON), FR with rolling (FR_rolling), FR with static compression (FR_SC), and FR with static compression + dynamic movement of the knee joint (FR_DM). FR_SC was intervened to compress the muscle belly of the knee extensors. FR_DM involved knee flexion and extension while maintaining the FR_SC condition. Knee flexion ROM, pain pressure threshold (PPT), tissue hardness, and countermovement jump (CMJ) height were outcome variables; they were compared before and immediately after the intervention. The results of this study showed that knee flexion ROM was significantly (p < 0.01) increased in FR_rolling (d = 0.38), FR_SC (d = 0.28), and FR_DM (d = 0.64). Tissue hardness was significantly (p < 0.01) decreased in FR_rolling (d = -0.55), FR_SC (d = -0.28), and FR_DM (d = -0.42). A main effect of time (p < 0.01) was observed in knee flexion ROM, PPT, and tissue hardness, but no change in CMJ was observed. The results of this study suggested that clinicians and athletes could choose any method they like as a warm-up routine.

Stretching and Releasing of Iliotibial Band Complex in Patients with Iliotibial Band Syndrome: A Narrative Review

Iliotibial band syndrome (ITBS) is one of the most common overuse syndromes causing knee pain; it is especially prevalent in runners and also common in cyclists, rowers, and field athletes, with occasional cases occurring in non-athletes too. ITBS symptoms can negatively affect not only knee function, but also mental and physical aspects of health-related quality of life. Although various conservative treatment options have been investigated and discussed, there is still no consensus on a standard of care for ITBS. Moreover, the literature on the etiology and risk factors of ITBS, which could help in selecting appropriate treatment methods, is conflicting and inconclusive. The role of individual treatment modalities such as stretching and releasing techniques has not been extensively studied and remains unclear. In this article, we will critically review the available evidence for the benefits of ITB stretching and "release" methods in the treatment of ITBS. In addition to the direct evidence (clinical studies examining the effects of ITB stretching and other methods that purportedly stretch or "release" the ITB), we present several additional lines of reasoning that discuss the rationale for ITB stretching/releasing in terms of the etiology of ITBS, the mechanical properties and behavior of the ITB, and the risk factors for ITBS development. We conclude that the current literature provides some evidence for the inclusion of stretching or other "release" methods in the early rehabilitation of ITBS. Long-term interventions typically include ITB stretching; however, it remains unclear to what extent stretching within a multimodal treatment actually contributes to resolving the symptoms. At the same time, there is no direct evidence to suggest that stretching and "release" methods have any negative effects.

Alternative Flexibility Training

Over the last approximately 20 years, research has reported on performance impairments following prolonged durations of static stretching. This has led to a paradigm shift towards dynamic stretching. There has also been a greater emphasis using foam rollers, vibration devices, and other techniques. Recent commentaries and meta-analyses suggest that stretching need not be listed as a fitness component as other activities such as resistance training can provide similar range of motion benefits. The commentary aims to review and compare the effects of static stretching and alternative exercises for improving range of motion.

Effects of Different Recovery Modalities on Delayed Onset Muscle Soreness, Recovery Perceptions, and Performance Following a Bout of High-Intensity Functional Training

The purpose of this study was to investigate the effects of the foam rolling technique and static stretching on perceptual and neuromuscular parameters following a bout of high-intensity functional training (HIFT), which consisted of 100 pull-ups, 100 push-ups, 100 sit-ups, and 100 air squats (Angie benchmark) in recreationally trained men (n = 39). Following baseline measurements (Feeling Scale, Visual Analogue Scale, Total Quality Recovery, Sit-and-Reach, Countermovement Jump, and Change-of-Direction t-test), the volunteers performed a single bout of HIFT. At the end of the session, participants were randomly assigned to one of three distinct groups: control (CONT), foam rolling (FR), or static stretching (SS). At the 24 h time-point, a second experimental session was conducted to obtain the post-test values. The level of significance was set at p < 0.05. Regarding power performance, none of the three groups reached pretest levels at 24 h point of the intervention. However, the CONT group still showed a greater magnitude of effect at the 24 h time-point (ES = 0.51, p ≥ 0.05). Flexibility presented the same recovery pattern as power performance (post × 24 h CONT = ES = 0.28, FR = ES = 0.21, SS = ES = 0.19). At 24 h, all groups presented an impaired performance in the COD t-test (CONT = ES = 0.24, FR = ES = 0.65, SS = ES = 0.56 p ≥ 0.05). The FR protocol resulted in superior recovery perceptions (pre × 24 h TQR = ES = 0.32 p ≥ 0.05). The results of the present study indicate that the use of FR and SS exercises may not be indicated when aiming to restore neuromuscular performance following a single bout of HIFT. The use of the FR technique during the cooldown phase of a HIFT session may be helpful in improving an individual's perception of recovery.

A 1-Week Comprehensive Foam Rolling Intervention Program Can Improve Knee Pain but Not Muscle Function and Range of Motion in Patients with Total Knee Arthroplasty

We investigate the effect of a 1-week comprehensive foam rolling (FR) intervention program on knee pain, range of motion (ROM), and muscle function in patients with TKA.Thirty patients with TKA were randomly allocated to FR (n = 15) or control (n = 15) groups. The control group received only regular physical therapy. Patients in the FR group performed the FR intervention in addition to their regular physical therapy twice daily from postoperative weeks two to three (60 s × 3 repetitions × 2 times/day × 6 days: total = 2160 s). Pain score, knee flexion and extension ROM, muscle strength, walking function, and balance function were measured before and after the FR intervention. From the second to third postoperative weeks, there were significant improvements in all variables, and the reduction in pain score at stretching was significantly greater in the FR group (-26.0 ± 1.4; p < 0.05) than in the control group (-12.5 ± 1.9). However, there was no significant difference in changes in the other variables except for the pain score at stretching between FR and control groups. A 1-week comprehensive FR intervention program in patients with TKA could reduce pain scores at stretching without a synergistic effect on physical function, i.e., walking speed, balance function, and muscle strength of the knee extensors muscles.

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.

Acute Effects of a Single-Session of Full-Body Foam Rolling on Heart Rate Variability

Background

Self-myofascial release has been demonstrated to increase relaxation and improve blood flow, yet it is unknown if it can elicit an acute effect on heart rate variability (HRV).

Purpose

This study aimed to determine if a single-bout of foam rolling could increase parasympathetic activity as measured by HRV.

Methods

Twenty (20) participants volunteered and their baseline HRV was assessed using a finger sensor while lying supine, and then a second measure was recorded with them sitting upright with feet on the ground. This study utilized a practical HRV collection method designed for use in the field settings, and the data is recorded in arbitrary units (A.U.). Participants then oscillated on a closed-cell cylindrical foam roller using their body weight on the triceps surae, hamstrings, quadriceps, lumbar spine, and pectoral muscles each for 60 sec. Participants first massaged the right limb and then repeated on the matching muscle group on the left before continuing to the next region. Follow-up HRV measurements were recorded using the same procedures.

Results

Paired samples t tests assessing pre- and post-foam–rolling HRV measures in supine and seated positions revealed no difference between supine measures (p = .05, d = 0.21), nor the seated measures (p = .27, d = 0.17) among all participants. When sexes were analyzed separately, males showed a significant decrease in HRV in supine positions (p = .03, d = 0.33), but females did not (p = .55, d = 0.09).

Conclusions

The single bout of foam rolling on large muscle groups did not increase parasympathetic activity as hypothesized. Males and females responded differently in supine positions, but no difference was present in seated positions across sexes. The task of self-massage may have prevented the anticipated response from the massage. Further research should investigate if passive massage is more effective on HRV response.

Does the Self-Myofascial Release Affect the Activity of Selected Lower Limb Muscles of Soccer Players?

Myofascial therapy has already become one of the basic forms of treatment of the locomotor system. One form of the therapy is Self-Myofascial Release, in which external force is applied to the body with the help of special rollers (foam rolling, FR). The aim of the study was to investigate the direct effect of Self-Myofascial Release of hamstring muscles using a foam roller on the bioelectric activity of selected muscles (biceps femoris and gluteus maximus) during squats. The study involved 40 male soccer players, who were randomly divided into two groups: experimental and control. The tests used did not show significant differences in the analyzed variables before the experiment (baseline measurement p > 0.05), while significant intergroup differences appeared for subsequent measurements, both for reference MVC values (p < 0.01 - for % gluteus maximus MVC, p < 0.001 - for % biceps femoris MVC) and for raw EMG values (p < 0.01 gluteus maximus and p < 0.001 - for % 0.0001 for biceps femoris). The use of self-myofascial release within the hamstring muscles leads to changes in the electrical potential of the muscles of the lower limb.

Chronic Effects of Foam Rolling on Flexibility and Performance: A Systematic Review of Randomized Controlled Trials

The purpose of this study is to review the existing literature on chronic effects of foam rolling (FR) on flexibility and performance. Electronic databases were searched during January 2022 for topics related to FR. Included studies met the following criteria: (a) peer-reviewed articles written in English; (b) FR intervention of at least four weeks; (c) non-motorized FR device during intervention; (d) randomized controlled trial with existence of a control group; and (e) any lower body parameter related to flexibility, recovery, and performance. Nine studies met that criteria. Results revealed that chronic FR demonstrated conflicting results for improvement of flexibility. On the other hand, a majority of the articles in this review showed no beneficial effects of FR on performance. Lastly, the effect of FR on recovery is unclear. These findings suggest the need for further studies to establish the consensus about the long-term application of FR in flexibility, recovery, and performance.

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 Effects of a Self-Myofascial Release Program on Isokinetic Hamstrings-to-Quadriceps Strength Ratio and Range of Motion of the Knee Joint Among Athletes With Hamstring Shortness

CONTEXT

Range of motion (ROM) and muscular strength are the main factors that affect athletic performance. Self-myofascial release is a flexibility technique, which is used to inhibit overactive muscle fibers.

OBJECTIVE

To investigate the effects of the 8-week self-myofascial release on the isokinetic hamstrings-to-quadriceps strength ratio (H/QRatio) and the ROM of the knee joint among male athletes with the hamstring shortness.

DESIGN

A randomized controlled trial.

SETTING

Research laboratory.

PARTICIPANTS

Twenty-four college-aged male athletes with hamstring shortness were selected for this study and were randomly assigned to a foam rolling group (FOAM, n = 12) and a control group (n = 12).

INTERVENTIONS

Participants in the FOAM group performed supervised self-myofascial release program 3 times per week for 8 weeks. The control group received no intervention.

METHODS

Data were analyzed via 2-way repeated-measure analysis of variance at the significance level of .05.

MAIN OUTCOME MEASURES

ROM and the H/QRatio at the velocities of 60°/s, 120°/s, and 180°/s were measured by an isokinetic dynamometer.

RESULTS

The results of 2-way repeated-measure analysis of variance demonstrated that hamstring ROM increased in FOAM group (P = .001). No significant changes were found in H/QRatio after self-myofascial release for FOAM group (P ≥ .05).

CONCLUSIONS

When compared with other methods of stretching, self-myofascial release with foam rolling may be beneficial in increasing ROM without decreasing H/QRatio in people with the hamstring shortness.

The Influence of Self-Myofascial Release on Muscle Flexibility in Long-Distance Runners

During long-distance running, athletes are exposed to repetitive loads. Myofascial structures are liable to long-term work, which may cause cumulating tension within them. The aim of this study was to evaluate the acute effect of self-myofascial release on muscle flexibility in long-distance runners. The study comprised 62 long-distance, recreationally running participants between the age of 20 and 45 years. The runners were randomly divided into two groups: Group 1 (n = 32), in which subjects applied the self-myofascial release technique between baseline and the second measurement of muscle flexibility, and Group 2 (n = 30), without any intervention. The self-myofascial release technique was performed according to standardized foam rolling. Assessment of muscle flexibility was conducted according to Chaitow's proposal. After application of the self-myofascial release technique, higher values were noted for the measurements of the following muscles: piriformis, tensor fasciae latae muscles and adductor muscles. Within the iliopsoas and rectus femoris muscles, lower values were observed in the second measurement. These changes were statistically significant (p < 0.05) within the majority of muscles. All these outcomes indicate improvement related to larger muscle flexibility and also, an increase in range of motion. In the control group (Group 2), significant improvement was observed only in measurements for the iliopsoas muscles. The single application of self-myofascial release techniques with foam rollers may significantly improve muscle flexibility in long-distance runners. Based on these results, the authors recommend the self-myofascial release technique with foam rollers be incorporated in the daily training routine of long-distance runners, as well as athletes of other sport disciplines.

Acute Effect of Vibration Roller With and Without Rolling on Various Parts of the Plantar Flexor Muscle

A single use of a vibration foam roller likely increases the range of motion (ROM) without decreasing muscle strength and athletic performance. However, to date, no study compared the effects of a vibration roller with and without rolling on various parts of the plantar flexor muscle. Therefore, this study aimed to compare the effects of the vibration foam roller with rolling or without rolling at the muscle-tendon junction (MTJ) or the muscle belly on dorsiflexion (DF) ROM, passive torque at DF ROM, shear elastic modulus, muscle strength, and jump performance. Fifteen healthy young males performed the following three conditions: (1) vibration rolling over the whole muscle-tendon unit, (2) static vibration on muscle belly, and (3) static vibration on MTJ for three-set 60-s vibration in random order. In this study, DF ROM, passive torque, shear elastic modulus, muscle strength, and single-leg drop jump were measured before and immediately after the interventions. The DF ROM and passive torque at DF ROM were increased after all three conditions, whereas the shear elastic modulus was decreased after vibration rolling and static vibration on the muscle belly, but not following static vibration of the MTJ. In addition, there were no significant changes in muscle strength and jump performance in any group. Our results showed that vibration with rolling or static vibration on muscle belly could be effective to improve ROM and muscle stiffness without adverse effects of muscle strength and athletic performance.

Acute Effects of Gastrocnemius/Soleus Self-Myofascial Release Versus Dynamic Stretching on Closed-Chain Dorsiflexion

CONTEXT

Limited ankle dorsiflexion (DF) range of motion has been correlated with decreased flexibility of the gastrocnemius/soleus complex. Decreased ankle DF range of motion can lead to an increase in lower-extremity injuries, for example, acute ankle sprains, Achilles tendinopathy.

OBJECTIVE

The purpose of this study was to determine whether a single application of the intervention to the gastrocnemius/soleus complex via multidirectional self-myofascial release using a foam roller, multiplanar dynamic stretch performed in downward dog, or a combination of both techniques acutely improved ankle DF.

DESIGN

Subjects were assigned to groups via random card selection. Investigators provided verbal cues as needed to yield correct performance of interventions. Both interventions were performed twice for 1 minute using a dynamic walking rest of 30.48 m at a self-selected pace between interventions. Statistical analyses were completed using a 1-way analysis of variance, at α level ≤ .05.

SETTING

A convenience sample study.

PARTICIPANTS

A total of 42 asymptomatic physical therapy students (18 females and 24 males) with mean age of 26.12 (4.03) years volunteered to participate.

INTERVENTIONS

Multidirectional self-myofascial release using a foam roller, multiplanar dynamic stretch performed in downward dog, or a combination of both techniques.

MAIN OUTCOME MEASURES

Weight-bearing right ankle DF measurements were recorded in centimeters using a forward lunge technique (intraclass correlation coefficient = .98, .97, and .96).

RESULTS

Data analysis revealed no significant difference between the 3 groups in all pre-post measurements (P = .82). Mean (SD) measurements from pretest to posttest for myofascial release, dynamic stretching, and combination interventions were 0.479 (0.7) cm, 0.700 (0.7) cm, and 0.907 (1.4) cm, respectively.

CONCLUSION

Until further studies are conducted, the selection of technique to increase ankle DF range of motion should be based on each individual patient's ability, preference, and response to treatment.

Total Training Volume and Muscle Soreness Parameters Performing Agonist or Antagonist Foam Rolling between Sets

Background: Foam rolling (FR) has become very popular in recent years; however, the practice of FR between sets of resistance training (RT) for the lower limbs needs further examination. Purpose: Therefore, the purpose of the present study was to examine the effect of FR for the agonists (quadriceps) and antagonists (hamstrings) between multiple sets of the leg extension on repetition maximum performance (RM), fatigue resistance index (FRI), and muscle soreness (MS). Study design: Quasi-experimental clinical trial. Methods: Twenty trained men participated in this study (30.35 ± 6.56 years, 1.77 ± 0.05 cm, 87.70 ± 7.6 kg) and attended seven sessions with 48 h between sessions, (one familiarization session; two 10-RM test and retest sessions; and four experimental sessions). The four experimental sessions were performed in random order and included: agonist foam rolling (AFR), antagonist foam rolling (ANTFR), agonist/antagonist foam rolling (A/ANTFR), and traditional control (TP, without foam rolling). All sessions consisted of three sets for maximal repetitions with a 10-RM load for the leg extension. In the AFR and ANTFR sessions, there was a 120 s rest interval between sets, during which FR was done for the agonists or antagonists, respectively. In the A/ANTFR protocol, there was a 120 s rest interval between sets, during which FR was done for the agonists and antagonists. In the traditional protocol (TP), there was a 120 s passive rest interval between sets. Results: Regarding the total training volume (TTV), significant differences were noted between sessions (F_3,57 = 11.014; p = 0.0001). The AFR, ANTFR, and A/ANTFR sessions had significantly higher TTV versus the TP (p < 0.05). Regarding the FRI, significant differences were noted between sessions (F_3,57 = 2917, p = 0.042). A significantly higher fatigue index was shown for the ANTFR and AFR sessions versus the TP (p < 0.05). Regarding the total number of repetitions, significant differences were noted between sessions (F_3,57 = 11.086, p = 0.0001). The total number of repetitions was significantly higher in the A/ANTFR, ANTFR, and AFR versus the TP session (p < 0.05). MS was significantly lower in the A/ANTFR, ANTFR, and AFR sessions versus the TP session (p < 0.05). Conclusion: In conclusion, foam rolling between sets for the agonist or antagonist separately or in succession, resulted in greater neuromuscular performance and higher fatigue indices, as well as reducing the perception of acute muscle soreness.

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

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

The Immediate Effects of Self-Myofacial Release on Flexibility, Jump Performance and Dynamic Balance Ability

Self-myofascial release (SMR) is a popular method to potentially increase the compliance and extensibility of the fascia and reduce muscle stiffness. The purpose of this study was to examine the acute effects of posterior muscle chain SMR on flexibility, vertical jump performance and balance ability. Eighteen young participants volunteered to take part in this crossover design study. They performed two self-massage sessions in randomized order separated by at least one week. One session consisted of posterior muscle chain SMR whereas the other one was performed on the upper limbs as a control intervention (CON). Flexibility was measured with the Toe Touch Test (TTT), Weight-Bearing Lunge Test (WBLT), and Straight Leg Raise Test (SLR). Jump performance was evaluated during a squat jump, a counter movement jump and a stiffness jump. Dynamic balance ability was assessed through the Star Excursion Balance Test. All these variables were measured before and after each intervention. A significant increase in flexibility (+3.5 ± 1.8 cm, +1.6 ± 1.0°, and +7.7 ± 4.0° for the TTT, WLBT, and SLR, respectively, p < 0.003) and balance performance (4.8 ± 3.9 cm, p < 0.003) was observed following SMR intervention compared to CON. Conversely, jumping performance was unchanged in both groups. SMR improves joint flexibility and dynamic balance ability.

INFLUENCE OF AN ACUTE BOUT OF SELF-MYOFASCIAL RELEASE ON KNEE EXTENSION FORCE OUTPUT AND ELECTRO-MECHANICAL ACTIVATION OF THE QUADRICEPS

Background

In contrast to static stretching (SS), previous research has demonstrated increases in flexibility after an acute bout of self-myofascial release (SMR) without any subsequent decreases in force output. Previous research has utilized measures of surface electromyography (sEMG) and mechanomyography (MMG) to examine the influence of SS on the electrical and mechanical processes of muscle activation, respectively. However, there is a lack of research examining the potential changes in electro-mechanical muscle activation post-SMR.

Purpose

To examine the influence of SMR, via an acute bout of foam rolling (FR) to the vastus lateralis (VL), on the expression of knee extension force output and the inter-muscular electro-mechanical activation of the quadriceps musculature.

Study Design

Randomized crossover trial.

Methods

Twenty (10 males, 10 females) recreationally-active participants with prior FR experience completed both SMR and control (CON) testing protocols during separate testing sessions that were conducted in a randomized order 48 hours apart. During the SMR protocol, participants performed 3 sets of 60 seconds of FR over the VL portion of their quadriceps musculature, with 60 seconds of rest between sets. During the CON protocol, participants quietly sat upright for 10 minutes. Peak knee extension force output -(Force_peak) data, as well as sEMG and MMG data from the VL and the rectus femoris (RF) were collected during maximal voluntary isometric contractions (MVICs) before and after both testing protocols. Root mean square sEMG and MMG amplitudes were calculated to represent electro-mechanical muscle activation of the VL (VL-sEMG_RMS, VL-MMG_RMS) and RF (RF-sEMG_RMS, RF-MMG_RMS) musculature.

Results

Repeated measures analyses of variance (RM ANOVAs) identified a significant (p < 0.05) increase in Force_peak within the SMR protocol among males, but no change among females. No statistically significant changes in any electro-mechanical muscle activation measures were identified pre-to-post-SMR within either sex.

Conclusion

In contrast to the SS literature body, these results suggest that SMR does not influence the electro-mechanical aspects of muscle activation during MVICs. These results provide support for the absence of decreases in force output post-SMR, but further examination regarding the potential muscle mass influence of SMR on electro-mechanical muscle function remains warranted.

Level of Evidence

2c.

Immediate effect of foam roller on pain and ankle range of motion in patients with plantar fasciitis: A randomized controlled trial

Background:

Stretching has been proven to be effective on pain and range of motion (ROM) in patients with plantar fasciitis. Despite recent gain in popularity and the proposed theories of effectiveness of foam roller, there is a lack of literature on the effect of foam rolling on plantar fasciitis.

Objective:

The objective of this study was to compare the effects of foam rolling and stretching on pain and ankle ROM in patients with plantar fasciitis.

Methods:

A total of 50 participants were included and randomly allocated to the stretching and foam roller groups. Visual analog scale (VAS), pressure pain thresholds (PPTs) for gastrocnemius, soleus and plantar fascia and weight-bearing lunge test (WBLT) measurements were recorded at baseline and immediately after treatment.

Results:

Within-group analysis has shown there is a statistically significant difference (p<0.001) in all the outcome measures in both foam roller and self-stretching groups. The between-groups analysis showed no statistical significance difference in VAS, plantar fascia PPT and WBLT parameters (with p-values of 0.171, 0.372 and 0.861, respectively); however, significant differences were found in gastrocnemius PPT (p=0.029) and soleus PPT (p=0.013).

Conclusion:

It was seen that both stretching and foam rolling techniques helped in reducing pain and increasing the ROM. However, the effectiveness of foam roller was superior to stretching in terms of increase in PPTs at gastrocnemius and soleus.

Clinical Trial Registration No:

CTRI/2018/01/011398.

Name of registry:

The Clinical Trials Registry — India (CTRI); https://ctri.nic.in.

Acute Effects of Dynamic Stretching Followed by Vibration Foam Rolling on Sports Performance of Badminton Athletes

Dynamic stretching (DS) is performed to increase sports performance and is also used primarily for transiently increasing range of motion (ROM). Recently, vibration foam rolling (VFR) has emerged. Its underlying concept is that it combines foam rolling techniques with local vibration to improve ROM and muscular activation concurrently. This crossover study investigated the effects of DS or DS followed by VFR (DS + VFR) during warm-ups on flexibility, muscle stiffness, power, and agility of the lower limbs in badminton athletes. Forty badminton players performed DS or DS + VFR as warm-up exercises on two occasions in a randomized order. The target muscle groups were the bilateral shoulder, anterior and posterior thigh, posterior calf, and lower back. Main outcome measures: The primary outcome was knee range of motion (ROM), and the secondary outcomes were muscle stiffness, lower limb power (countermovement jump [CMJ]), and agility. Results indicated that the protocols improved performance. DS increased knee flexion ROM (% change = 1.92, ES = 0.3, p = 0.033), CMJ height (% change = 5.04, ES = 0.2, p = 0.004), and agility (% change = -4.97, ES = 0.4, p < 0.001) but increased quadriceps muscle stiffness (% change = 3.74, ES = 0.3, p = 0.001) and increased gastrocnemius muscle stiffness (% change = 10.39, ES = 0.5, p = 0.001). DS + VFR increased knee extension ROM (% change =2.87, ES = 0.4, p = 0.003), reduced quadriceps muscle stiffness (% change = -2.79, ES = 0.3, p = 0.017), CMJ height (% change = 2.41, ES = 0.1, p = 0.037), and agility (% change = -4.74, ES = 0.2, p < 0.001). DS + VFR was not significantly superior to DS, except for muscle stiffness reduction. Taken together, we suggest that practitioners consider DS as a first line of warm-up exercise to increase ROM, CMJ height, and agility in athletes. Moreover, the addition of VFR to DS results in a large reduction of muscle stiffness, potentially reducing the risk of sports injury. Athletes, coaches and athletic professionals may consider them when selecting effective warm-up practices to augment athletic performance.

Pilot Study

BACKGROUND

The prevalence of neck pain is on the increase. A sedentary life style, poor ergonomics in the workplace and in daily life, and stress all contribute to neck overload. The aim of this study was to assess the efficacy of a single session of a Fascial Distortion Model (FDM) intervention combined with foam rolling in patients with cervical spine overload.

MATERIAL AND METHODS

The study enrolled 90 patients, who were randomized to an FDM group, a foam rolling group (who exercised with a Duoball against a wall) and a control group, of 30 patients each. Mobility was measured with a digital inclinometer, pain intensity was assessed with a VAS scale and (upper and middle) trapezius tone was evaluated by sEMG. These measurements were carried out twice in each group and analysed in Matlab and Statistica 13.

RESULTS

Both groups subjected to a therapeutic intervention (FDM and foam rolling) reported a significant reduction in neck pain intensity and improved cervical spine mobility (p&lt;0.01). The control group did not demonstrate changes in mobility or pain intensity. The resting trapezius tone did not change in any of the groups. Conclusions, 1. A single session of FDM therapy can effectively reduce and eliminate cervical spine pain, which may be of use in work-site rehabilitation. 2. Single sessions of FDM and foam rolling can effectively improve neck mobility in patients with cervical spine overload. 3. There is a rationale for conducting further prospective randomized studies of larger samples to assess the duration of the beneficial effects of both therapies and determine an optimum session frequency.

An Acute Bout of Self-Myofascial Release Does Not Affect Drop Jump Performance despite an Increase in Ankle Range of Motion

This study examined the acute effects of self-myofascial release plus dynamic warm up versus dynamic warm up alone on ankle range of motion and drop jump performance. Twenty-five recreationally active participants (male: 16, female: 9) were randomly assigned into a foam rolling (FR) or a dynamic warm up group (CON) (age: 22.8 ± 3.9 years, body mass 75.9 ± 13.2 kg, stretch stature: 174.1 ± 10.1 cm). In a randomised crossover design, each participant completed two experimental sessions that were separated by seven days. Ankle range of movement was assessed while using a weight-bearing lunge test and drop jump performance was recorded via bilateral force plates. Following a 5 min cycle, the foam rolling group undertook self-myofascial release to the lower limb and thoracic/lumbar regions, followed by a dynamic warm up. The control group undertook the same initial warm up plus the dynamic exercises. The level of significance was set at p ≤ 0.05. There was a significant increase (p < 0.001) in ankle range of motion immediately after the warm up for both groups (pre CON: 37.5 ± 5.31, post CON: 39.8 ± 5.76; pre FR 38.7 ± 7, post FR: 40.3 ± 7.3 deg). No significant difference was found between the conditions (p > 0.05). There were no significant differences for any indices of jump performance (p > 0.05). Based on these results, foam rolling plus dynamic exercises does not appear to impair or enhance drop jump performance, despite the increases in ankle range of movement.

Protective Effects of Foam Rolling against Inflammation and Notexin Induced Muscle Damage in Rats

It is known that high-intensity exercise can cause inflammation and damage in muscle tissue, and in recent years, physical therapists and fitness professionals have begun to use foam rolling as a recovery method to improve performance. Despite the lack of basic science studies to support or refute the efficacy of foam rolling, the technique is very widely used in the sports world. In this respect, we investigated whether foam rolling could attenuate muscle damage and inflammation. Female Wistar rats were assigned to control (C), foam rolling (FR), notexin without foam rolling (N) and notexin with foam rolling (NFR) groups. A 4.5 x 2 cm foam roller was used to massage their hind legs (two 60-second repetitions twice a day for 3 days). Motor function tests (Balance Beam Test and Grip strength) were used. We detected an increase in time and foot faults when crossing a beam in the N group compared to C and FR rats. In contrast, a significant decrease was detected in both tests in NFR compared to N rats. Muscle power was measured with a grip strength test and better performance was detected in NFR rats compared to N rats. Furthermore, an increase of pro-inflammatory proteins was noted in the N group, while there was a decrease in the NFR group. On the contrary, an increase in PPAR-γ (anti-inflammatory protein) in the NFR group compared to the N group demonstrates the anti-inflammatory properties of the foam rolling technique. In summary, applying foam rolling after damage has benefits such as an increase in anti-inflammatory proteins and a reduction of pro-inflammatory proteins, resulting in muscle recovery and better performance.

Roller Massage: A Descriptive Survey of Allied Health Professionals

BACKGROUND

In sports medicine, the interprofessional care of athletes has become a frequent practice. This type of care often involves different interventions used among professionals. One common intervention prescribed is roller massage (RM) or self-myofascial release. The trends in the use of RM among allied health professionals are nonexistent. The surveillance of such responses has not been documented.

PURPOSE

To survey and document responses in the knowledge, clinical application, and use of RM devices among allied health professionals in the United States.

DESIGN

Cross-sectional descriptive survey study.

METHODS

A 20-question survey was sent to allied health professionals including physical therapists, athletic trainers, and fitness professionals. The survey covered topics such as demographics, beliefs about RM, preferred devices, exercise prescription, and client education.

RESULTS

One thousand and forty-two professionals (N = 1042) completed the survey. Most respondents believed that RM decreases pain (82%) and increases mobility (76%). A high percentage use a foam roller in their practice (81%), recommend a full-size foam roller (49%), and believe the medium density (48%) is the most effective. A high proportion of respondents prescribe RM for injury treatment (69%) and for preexercise and postexercise (61%). They also recommend rolling daily for 30 seconds to 2 minutes per muscle group (33%) at a self-paced cadence (46%). A high percentage of respondents use patient-reported outcomes (74%), joint range of motion (49%), and movement-based testing (48%) to measure effects of RM. Eighty-seven percent use live instruction to educate clients, and 88% believe there is a gap in the research.

CONCLUSION

The results of this survey document responses in the use of RM among allied health professionals. The reported responses provide insight into how professionals are using RM as an intervention and the potential gaps between the research and professional practice. Future studies are needed to further validate these findings.

Acute Effect of 2 Self-Myofascial Release Protocols on Hip and Ankle Range of Motion

CONTEXT

Self-myofascial release (SMR) is an intervention popularly used by rehabilitation, fitness, and sports professionals to improve recovery and performance. In SMR, the athlete/patient applies pressure to the muscle and fascia using various tools, such as balls, rods, foam rolls, and massagers.

OBJECTIVE

This study aimed to evaluate the acute effect of 2 SMR protocols (short term and long term) of the posterior thigh and calf muscles on hip and ankle range of motion (ROM) in physically active men.

PARTICIPANTS

A total of 14 adult males (24.9 [3.2] y, 77.2 [13.2] kg, and 1.75 [0.06] m) who exercise regularly (at least twice a week, 45 min per session) participated in this study.

INTERVENTIONS

Participants performed a short-term SMR protocol (2 × 10 repetitions, SSMR) and a long-term SMR protocol (2 × 20 repetitions, LSMR) of the posterior thigh (using a foam roller) and calf (using a massage stick) muscles in counterbalanced order, on 2 different days with a 48-hour interval.

MAIN OUTCOME MEASURES

Ankle dorsiflexion and hip-flexion ROM, evaluated at 5 moments: pre- and post-SSMR, pre- and post-LSMR, and in the control condition, which was always performed at the first visit.

RESULTS

The SMR promoted significant gains for both dorsiflexion (F_1,13 =202.67, P < .001, ηp2=.94 ) and hip flexion (F_1,13 = 66.46, P < .001, ηp2=.84 ), regardless of the protocol and limb analyzed. The average increase for both limbs corresponded, approximately, to 11% for ankle dorsiflexion and to 6% for and in hip flexion.

CONCLUSIONS

The results suggest that SMR of the posterior thigh and calf muscles acutely increases the ROM of both hip flexion and ankle dorsiflexion and that duplicating the SMR volume from 10 to 20 repetitions per set seems not to promote additional gains.

The Acute Effects of Foam Rolling on Fatigue-Related Impairments of Muscular Performance

The purpose of this study was to examine the effects of self-myofascial release (MFR) via foam rolling immediately following strenuous activity on acute fatigue-related impairments of muscular performance. Healthy male (n = 16) and female (n = 9) subjects visited the laboratory three separate times. During visit 1, subjects were familiarized with performance testing procedures and the foam rolling and fatigue protocols. For visits 2 and 3, subjects were (T1) assessed for vertical jump height, velocity, and power and dynamic reaction time (DRT). Subjects then performed the exercise fatigue protocol, followed by either a foam rolling treatment (MFR) or seated rest (CON). Immediately after, subjects repeated the performance tests (T2). CON resulted in a greater percent decline from T1–T2 for average power (p = 0.03), average velocity (p = 0.02), and peak power (p = 0.03) than the MFR treatment. No between-treatment differences were detected for %∆ vertical jump height (p = 0.14) or DRT (p = 0.20). According to magnitude-based inference analysis, MFR is likely beneficial in attenuating fatigue-induced kinematic decrements (i.e., power and velocity). Based on magnitude-based inference analysis, MFR is “possibly beneficial” with respect to mitigating acute fatigue-related impairment of jump height and dynamic reaction time. Results demonstrate the plausible short-term benefits of foam rolling on muscular performance decrements associated with acute muscular fatigue from exercise.

FOUR WEEKS OF ROLLER MASSAGE TRAINING DID NOT IMPACT RANGE OF MOTION, PAIN PRESSURE THRESHOLD, VOLUNTARY CONTRACTILE PROPERTIES OR JUMP PERFORMANCE

BACKGROUND

Roller massagers are popular devices that are used to improve range of motion (ROM), enhance recovery from muscle soreness, and reduce pain under acute conditions. However, the effects of roller massage training and training frequency are unknown.

PURPOSE

The objective was to compare two different roller massage training frequencies on muscle performance.

STUDY DESIGN

Randomized controlled intervention study.

METHODS

Twenty-three recreationally active university students were randomly allocated to three groups: control (n=8;), rolling three (3/W; n=8;) and six (6/W; n=7) times per week for four weeks. The roller massage training consisted of unilateral, dominant limb, quadriceps and hamstrings rolling (4 sets x 30 seconds). Both legs of participants were tested pre- and post-training for active and passive hamstrings and quadriceps range of motion (ROM), electromyography (EMG) activity during a lunge movement, unilateral countermovement jumps (CMJ), as well as quadriceps and hamstrings maximum voluntary isometric contraction (MVIC) forces and electromechanical delay. Finally, they were tested for pain pressure threshold at middle and distal segments of their quadriceps and hamstrings.

RESULTS

There were no significant training interactions for any measure with the exception that 3/W group exhibited 6.2% (p=0.03; Effect Size: 0.31) higher CMJ height from pre- (38.6 ± 7.1 cm) to post-testing (40.9 ± 8.1 cm) for the non-dominant limb.

CONCLUSIONS

Whereas the literature has demonstrated acute responses to roller massage, the results of the present study demonstrate no consistent significant training-induced changes. The absence of change may highlight a lack of muscle and myofascial morphological or semi-permanent neurophysiological changes with rolling.

LEVELS OF EVIDENCE

2c.

THE EFFECTS OF AN ACUTE BOUT OF FOAM ROLLING ON HIP RANGE OF MOTION ON DIFFERENT TISSUES

BACKGROUND

Foam Rolling (FR) has steadily gained in popularity as an intervention to increase range of motion (ROM) and reduce pain. It is believed that FR can remove restrictions due to fascial adhesions, thus improving ROM. FR has been proposed as a means to increase ITB length as a means to achieve these outcomes. Previous research has focused on the effects of FR over both muscle and fascia tissue together. However, no studies have examined the effects of FR over fascial tissue not containing muscle.

PURPOSE

The purpose of this study was to compare the acute effect of a single bout of foam rolling (FR) over the Iliotibial Band (ITB) compared to FR over the gluteal muscle group on hip adduction passive range of motion (PROM).

METHODS

Twenty-seven participants were recruited for the study. Each participant performed three sessions: FR over tissue devoid of muscle, the ITB (PFR), FR over contractile tissue, the gluteal muscles (AFR), and a session without FR (control) in a randomized order. Hip adduction PROM was measured in a pre-post manner for each session.

RESULTS

Results of the repeated measures ANOVA showed a significant interaction across session and time (F_{(2, 25)} = 25.202, p < 0.001, ηp2 = 0.502, 1 - β = 1.000). Post-hoc analysis showed the AFR post-test measure was significantly different from both control (p < 0.001) and PFR counterparts (p < 0.001). FR over the gluteal muscle group lead to a 14.8% improvement in hip adduction ROM, with PFR only a 2% improvement.

CONCLUSION

A single bout of FR over a myofascial group appears to increase PROM in healthy young adults, whereas FR over the ITB itself (primarily fascial tissue) does not. This suggests the conventional theory behind FR may need to be reevaluated.

LEVEL OF EVIDENCE

Level 1B, laboratory study, repeated measures design.

Comparison of vibration rolling, nonvibration rolling, and static stretching as a warm-up exercise on flexibility, joint proprioception, muscle strength, and balance in young adults

Warm-up is an essential component for optimizing performance before an exercise session. This study investigated that the immediate effects of vibration rolling (VR), nonvibration rolling (NVR), and static stretching as a part of a warm-up regimen on the flexibility, knee joint proprioception, muscle strength, and dynamic balance of the lower extremity in young adults. Compared with the preintervention, VR induced the range of motion of knee flexion and extension significantly increased by 2.5% and 6%, respectively, and isokinetic peak torque and dynamic balance for muscle strength and dynamic balance increased by 33%-35% and 1.5%, respectively. In the three conditions, most outcomes between VR and NVR were comparable; however, the participants had a significantly higher knee joint reposition error after NVR than after VR, indicating that NVR would have a hampering knee joint proprioception effect. In particular, compared with static stretching, VR significantly increased the quadriceps muscle strength by 2-fold and dynamic balance by 1.8-fold. These findings suggest that athletic professionals may take VR into account for designing more efficient and effective preperformance routine to improve exercise performances. VR has high potential to translate into an on-field practical application.

ACUTE EFFECTS OF DIFFERENT ANTERIOR THIGH SELF-MASSAGE ON HIP RANGE-OF-MOTION IN TRAINED MEN

BACKGROUND

Self-massage is a ubiquitous intervention similar to massage, but performed by the recipient him- or herself rather than by a therapist, most often using a tool (e.g., foam roller, roller massager). Self-massage has been found to have a wide range of effects. It is particularly known for increasing flexibility acutely, although not always. The variability of the results in previous studies may potentially be a function of the tool used. Recent findings also suggest that self-massage exerts global effects. Therefore, increased flexibility should be expected in the areas adjacent to the ones treated.

PURPOSE

To investigate the acute effects of foam rolling and rolling massage of anterior thigh on hip range-of-motion (ROM) - i.e., hip extension and hip flexion - in trained men.

METHODS

Eighteen recreationally active, resistance trained males visited the lab on two occasions over a 4-day period separated by at least a day. Each session included two baseline ROM measures of passive hip flexion and extension taken in a randomized fashion. Recording of baseline measures was followed by the intervention of the day, which was either foam rolling or rolling massage of the anterior thigh as per randomization. Immediately post intervention, passive hip flexion and hip extension ROM were reassessed. In order to assess the time course of improvements in ROM, hip flexion and hip extension ROM were reevaluated at 10, 20, and 30 minutes post-intervention.

RESULTS

Hip flexion and hip extension ROM increased immediately following both interventions (foam rolling or roller massager) and remained increased for 30 minutes post intervention. Foam rolling was statistically superior in improving hip flexion and hip extension ROM immediately post intervention. However, immediately post-intervention was the only time point that measurements exceeded the minimum detectable change for both interventions.

CONCLUSION

Both foam rolling and rolling massage appear to be effective interventions for improving hip flexion and extension ROM when applied to the anterior thigh, but the observed effects are transient in nature.

LEVEL OF EVIDENCE

2b.

The Effect of Foam Rolling on Recovery Between two Eight Hundred Metre Runs

With the increased popularity of foam rolling as a means of recovery, it is important to establish the exact manner in which the practice is useful. The purpose of this study was to examine the impact of foam rolling on recovery between two 800 m runs. Sixteen trained males (mean ± sd; age, 20.5 ± .5 yr; average 800 m treadmill run time, 145.2 ± 1.8 s) participated in the study, using a randomized, crossover design. The subjects completed two 800 m runs on a treadmill, separated by a 30 min rest, during which time a foam rolling protocol or passive rest period was performed. The speed of each run was as fast as possible. Subjects had access to speed controls, but were blinded to the actual speed. Blood lactate concentration and V.CO2 were measured prior to and following each run. Stride length, 800 m run time, and hip extension were measured during each run. V.CO2, stride length, 800 m run time, and hip extension were not significantly different between conditions (p > .05). For blood lactate, no statistical interaction was found between condition and time (p > .05). Foam rolling between two 800 m runs separated by 30 min performed by trained male runners does not alter performance.

ACUTE EFFECTS OF DIFFERENT SELF-MASSAGE VOLUMES ON THE FMS™ OVERHEAD DEEP SQUAT PERFORMANCE

BACKGROUND

The Functional Movement Screen (FMS™) is a battery of tests designed to assess movement competency; the overhead deep squat test, specifically, has been shown to be an accurate predictor of overall FMS™ scores. Self-massage (SM) is a ubiquitous warm-up utilized to increase joint range of motion and, therefore, may be effective for improving performance of the overhead deep squat test.

PURPOSE

To examine how different doses (30, 60, 90, and 120 seconds) of SM of different areas of the body (plantar fascia, latissimus dorsi, and lateral thigh) affects the score obtained on an overhead deep squat test.

METHODS

Twenty recreationally active females were recruited to be tested on four occasions: sessions one and two consisted of baseline testing, session three consisted of SM applied to the lateral thigh, and session four consisted of SM applied to the lateral torso and plantar fascia.

RESULTS

In all SM conditions, at least 90 seconds was required for a change in deep squat score from baseline; therefore, it is concluded that SM the lateral torso, plantar fascia, and lateral thigh for 90 seconds or more are effective interventions for acutely improving overhead deep squat scores.

CONCLUSION

Self-massage appears to be an effective modality for inducing acute improvements in the performance of the FMS™ overhead deep squat in all conditions tested.

LEVEL OF EVIDENCE

2b.

The Effect of Foam Rolling Duration on Hamstring Range of Motion

Musculoskeletal health benefits from flexibility training and maintaining a functional, or sport specific, range of motion is important to one's overall fitness. Commercial foam rollers are commonly used in gyms, therapy clinics and homes, yet data are lacking on the optimal rolling duration and effect on range of motion.

PURPOSE

The purpose of this study was to examine the effect of varied durations of a commercial foam roller treatment on hamstring range of motion.

METHODS

The knee extension range of motion of 33 college aged men and women (age= 20±1.5y, mass= 72.2±10.8 kg) was assessed after a short (2 sets of 10s) and long (4 sets of 30s) duration of hamstring self-administered myofascial release using a commercial foam roller. A one way ANOVA was performed to compare the mean knee extension angle for each condition to baseline measures.

RESULTS

Results indicated that neither the short duration (67.30 ± 10.60 deg) nor long duration (67.41 ± 10.81 deg) rolling condition produced significant increases in knee extension compared to baseline (67.70 ± 9.90 deg).

CONCLUSION

Self-administered foam rolling for a total duration of up to 2 minutes is not adequate to induce improvements in knee joint flexibility. Contributing factors may include the amount of pressure imparted by the commercial roller as well as duration of treatment.