Introduction
For centuries, people believed that the structure of the human body depended only on skin and bones, yet in the 19th century, fascia was discovered and soon linked to the movement system performance. Fascia constitutes a sheet of connective tissue in the human body which forms under the skin and attaches, envelopes, and separates muscles, bones, and other organs (Stecco as cited in Lesondak, 2017). This structure, especially when tense, often becomes a source of pain, which led to the establishment of the myofascial release therapy, aiming to provide relief. Foam rolling (FR) is one of the most widespread myofascial therapy techniques, which involves applying mechanical pressure to a target area using a foam roller to alleviate soreness, tightness, and inflammation of the fascia. This method is particularly popular among sports physicians who employ it in a variety of settings, including pre-exercise, to increase training efficiency and performance of athletes, and post-exercise, to facilitate the recovery process. Although FR generally does not improve sprint, jump, and muscle endurance, studies show that it has a positive impact on flexibility, range of motion and can be used as a pain relief technique.
Flexibility and Range of Motion (ROM)
Flexibility is a vital factor in the performance of any person engaged in sports activities. Various changes and fluctuations in flexibility may lead to abnormalities in the musculoskeletal system, which in turn may cause injuries. The use of foam rolling is considered to be one of the ways to improve the condition of athletes’ muscles, fascia, and ligaments both before and after exercise. For example, one study was conducted to determine if a foam roller had any significant impact on the hamstring muscle group’s flexibility after six days of use as a post-exercise solution. Mohr, Long, and Goad (2014) found that “foam rolling the hamstrings muscle group before static stretching would be appropriate in noninjured subjects who have less than 90° of hamstring ROM” (p. 298). Similar findings were reported by Junker and Stöggl (2015), who tested a 4-week training program using the foam roll technique. According to the results, “The training period of 4 weeks with 3 training sessions per week improved ROM in the stand-and-reach test, that is, hamstring flexibility” (p. 3483). Thus, the use of FR positively influences flexibility and the range of motions.
The majority of studies show that RM has a positive effect on the human body’s flexibility, some of them claim that the impact does not depend on the strength of the force applied while rolling. Grabow et al. (2018) conducted research and compared how different types of RM forces, including sham, moderate, and high ones, affected the participants’ pain perception, range of motion, and jump. Using a series of short RM interventions, the researchers found that there was an increase in active and passive range of motion, yet the varying forces did not have any effect (Grabow et al., 2018). They state that despite the fact that higher forces of RM exerted greater pain, the experiment subjects still managed to substantially increase their range of motion using the force that was comfortable for them. The difference in the force also did not influence the strength and power parameters tested during the research. Thus, it can be concluded that the intensity of the RM force cannot be linked to better performance, which means that this method can be employed without any potential risk of injuries and traumas.
FR was also compared with traditional methods of therapy, such as stretching or massage, to understand which one produces better results. For example, Su, Chang, Wu, Guo, and Chu (2017) discovered that FR was more effective in improving quadriceps and hamstrings’ flexibility than both dynamic and static stretching as a pre-exercise method. They attributed this effect to the warming of the muscle’s fascia caused by friction and pressure produced by the foam roller. MacDonald et al. (2013) conducted a similar experiment and achieved analogous results, they studied the impact of myofascial release using FR on knee extensor force and knee joint’ range of motion. Researchers registered a considerable increase in the ROM of the knee joint “at 2 minutes post foam rolling (12.7%) and 10 minutes post foam rolling (10.3%) of the quadriceps muscles” (p. 819). They linked this outcome to the FR’s ability to break down scar tissue on the fascia and bring it to its natural gel-like state (Stones cited in MacDonald et al., 2013). Static stretching negatively affects neuromuscular performance (MacDonald et al., 2013). Compared to it, FR has superior qualities as a form of a warm-up.
Nevertheless, there are studies suggesting that the method of foam rolling does not affect flexibility in a manner that would be of any practical value. Murray, Jones, Horobeanu, Turner, and Sproule (2016) tested the use of FR as a recovery technique on twelve adult squash players who were asked to use a foam roller for sixty seconds at different time points. The results of the study demonstrated that there was no significant statistical correlation between foam rolling and muscle contractility markers or muscles’ temperature. Despite the fact that the researchers discovered the positive effect of FR on the overall flexibility, it was not enough to be recognized as sufficient since it was within the test’s variation coefficient. The study employed objective measurements concerning the range of motion and the FR force applied, which might be the reason why the researchers could not register any change in ROM (Murray et al., 2016). The outcome of the study may also be linked to the short duration of the FR procedure because sixty seconds may not be enough to properly warm up the fascia and its muscles.
Agility
Foam rolling therapy is also often thought of as a means to improve athletes’ physical fitness before engaging in different types of exercise. Healey, Hatfield, Blanpied, Dorfman, and Riebe (2014) conducted a study where healthy college-aged volunteers were asked to use FR and planking exercise in order to determine whether it could enhance their performance. The research measured the subjects’ “vertical jump height and power, isometric force, and agility” (Healey et al., 2014, p. 61). The results showed that a thirty-second foam rolling procedure carried out on each of the lower limbs and spine and planking did not produce any effect on performance. Apart from men participants demonstrating better results on all tests than female participants, there was only one noteworthy outcome, FR caused less fatigue than planking.
There is also research on the FR’s effects on agility and the physical performance of athletes after training exercise. Rey, Padrón-Cabo, Costa, and Barcala-Furelos (2017) studied the benefit of FR as a recovery therapy tool for professional soccer players based on a twenty-minute foam rolling procedure, which affected quadriceps, adductors, and hamstrings. The researchers assessed the results produced by FR in terms of jump, agility, and sprint and compared them to passive recovery, involving twenty minutes of rest. The research found that FR positively affected the decrease of decrements in a so-called t-test, an agility performance test, yet it did not impact the sprint and jump test results. FR was a better solution than the passive recovery in the case with the perceived limb muscle soreness and the Total Quality Recovery, which indicates its effectiveness as a post-exercise measure.
Muscle Endurance and Performance
It is also interesting to determine whether foam rolling can have a positive impact on various muscle groups in the human body. Junker and Stöggl (2019) conducted an important study measuring the training effect of FR on core strength endurance and muscle performance. They invited forty adult men and women to participate in an experiment where they had to adhere to two programs, the foam roll, and the core stabilization, there was also a control group. The FR group had to perform five exercises targeting several muscles, including calf and gluteal muscles, quadriceps, and hamstrings, and the body sides. The participants had to use an FR device to apply pressure that would cause mild to moderate pain and not lead to cramping or spasms. The core group had to perform front and side plank, back bridge, quadruped exercise, and back extension. While the control group had to abstain from introducing any additional exercise to their normal training routine.
The study found that during the eight weeks of the experiment, the core group improved their performance according to the trunk muscle strength, while in the FR and control groups, no changes were registered. This finding indicates foam rolling exercise cannot improve the endurance of the trunk muscles, and the stabilization program must be used instead. The researchers did not find any evidence of the foam roller’s influence on “maximum voluntary contraction force and electromyography muscle activation of the hamstrings” (Junker & Stöggl, 2019, p. 235). Thus, there is no impact of FR on the core strength endurance and muscle performance.
Muscle performance was also studied by Macgregor, Fairweather, Bennett, and Hunter (2018), who assessed the effects of foam rolling on the mechanical properties of muscles. The research subjects were sixteen males who did not have any musculoskeletal and neuromuscular conditions and were not employing any kind of self-massage techniques. They were asked to avoid any strenuous physical activity twenty-four hours before partaking in the experiment testing sessions. Each time, the participants were asked to rest for thirty minutes in a supine position before the measurements of the mechanical and contractile properties of the vastus lateralis and rectus femoris were taken. After the initial testing, the subjects used foam rollers, positioned between the anterior inferior iliac spine and the upper border of the patella, to produce an undulating motion moving backward and forward.
This study demonstrated that the maximum voluntary contraction decreased during rest and stayed the same after applying FR, which demonstrates the fact that the foam rolling therapy suppressed the fatiguing effect. Muscle stiffness reduced, and contraction velocity increased after three consecutive days of using a foam roller (Macgregor et al., 2018). Peak torque was elevated thirty minutes following the FR procedure, which was higher compared to the same time period during the rest condition. The researchers assumed that a single bout of foam rolling could lead to neural drive alterations, which might improve the strength and performance of muscles and delay the fatigue process. Thus, despite the lack of effect of FR on trunk muscles’ endurance, it can be used as a means to enhance muscular performance and help avoid fatigue.
Muscle Pain Reliever
Many athletes have to tolerate pain in their bodies for long periods of time, which may hinder their ultimate performance. Foam rolling can alleviate soreness and help sportspeople achieve excellence in their field. A study conducted by Vaughan, McLaughlin, and Lepley (2014) focused on establishing the effects of using a foam roller on the pressure pain threshold by applying it to the right iliotibial band. Participants had to complete a questionnaire stating their age and the dominant leg, then they were measured to determine their height and mass. The subjects had to perform a three-minute procedure on a foam roller, moving from the greater trochanter to the lateral knee. Their pressure pain threshold was assessed with the help of a pressure algometer, the researchers took measurements before and after the FR intervention, including after five minutes following the rest period.
The study found that a short bout of FR produced a significant increase in the pressure pain threshold (PPT) in the lower thigh, yet after five minutes of rest, this change was no longer present. The researchers attributed this outcome to the possible ability of the foam roller to stimulate muscle and skin nociceptors, neurons that signal about potential damage and activate the antinociceptive systems, which causes an increase in the PPT. The scientists also noticed certain gender differences since the female participants demonstrated lower values of PPT compared to the male ones. Thus, foam rolling can be used as a means to increase the pain tolerance of athletes and successfully implemented in the warm-up training exercise.
Moreover, foam rolling can also be used as part of the recovery process in different settings, including sports. Pearcey et al. (2015) carried out an experiment on the benefits of FR as a recovery tool following an intense exercise routine and measured pressure pain threshold, power, and dynamic strength-endurance. Eight men who were professional resistance trainers, classified as moderately to very physically active, participated in the study as the subjects. They were asked to perform two experimental procedures, control, and FR. During the former condition, the session involved performing a squat protocol which induced delayed onset muscle soreness (DOMS). During the latter stage, subjects performed the same task but also used the foam-rolling technique. The testing sessions were carried out one, two, and three days after the exercise. During trials, each participant had a four-minute rest between the test procedures.
The most important finding of the study was that the squat protocol had a significant role in inducing the delayed onset of muscle soreness and negatively impacting performance. The use of the foam-rolling method was effective in improving the recovery process from DOMS, as well as in reducing the decrement of physical performance after the protocol (Pearcey et al., 2015). FR led to an increase in the pressure-pain threshold, power, and endurance in comparison to the results received during the control stage. The two aforementioned studies demonstrate that foam rolling can be beneficial both as a warm-up procedure and as a therapeutic recovery solution for athletes.
Prevention of Injuries
As it was stated earlier, FR can contribute to maintaining appropriate flexibility and range of motion, which is extremely important for athletes since it allows them to avoid any major trauma. Markovic (2015) conducted a study that measured passive knee flexion and straight leg raise tests before and after the intervention of FR and the Fascial Abrasion Technique (FAT). The author argued that the increased level of fatigue in muscles after training could lead to injuries. They compared FR with the Fascial Abrasion Technique and studied their effects on soccer players’ hip and knee range of motion. The twenty male participants with no prior experience of thigh muscle injuries were asked to maintain their standard diet and refrain from participating in strenuous activity two days before the study.
The study found that both FR and FAT had a positive impact on the subjects’ hip and knee ROM, with the latter being more effective and remaining present for a longer period of time. Similar results were found during the experiment carried out by MacDonald et al. (2013), previously mentioned in this research paper. The researchers used different knee joint tests concerning ROM and discovered that two minutes of foam rolling increased the subjects’, healthy males, results by ten percent. Based on these findings, it can be concluded that FR can produce acute knee and hip ROM gains that can be considered significant for improving athletes’ performance and contributing to injury prevention.
Another research that studied the effects of foam rolling on the range of motion, peak torque, and muscle activation was conducted by Madoni, Costa, Coburn, and Galpin (2018). Yet, one of its important features is that the researchers examined the hamstrings-to-quadriceps (H:Q) ratio, which plays a major role in assessing the risk of injury in athletes. The scientists provided data that showed that a greater H:Q ratio may lead to the activation of hamstrings and quadriceps actions, potentially resulting in the decrease of the injury risk. The study found that following an FR protocol, the range of motion of the subjects’ hamstrings increased, performance measures stayed at the level of the control condition, which was a three-minute rest (Madoni et al., 2018). The results demonstrate that FR can help athletes gain better flexibility while maintaining a normal level of the functional H:Q ratios. Thus, based on the fact that FR was a better solution than a simple rest, foam rolling can be employed as a useful method to improve ROM without any increase in injury risk.
Conclusion
The studies presented in the paper demonstrate that the use of foam rolling can be beneficial for flexibility, ROM and used to alleviate soreness, yet it is ineffective in improving agility, sprint, and muscle endurance. Experiments show that FR applied both as a long-term solution, used for several weeks, and a short-term one yields substantial results in increasing flexibility of muscles and joints in the human body. There is evidence that FR can also contribute to muscle performance and delay the fatiguing process, which decreases the chance of receiving an injury, yet it has no impact on the trunk muscles’ endurance. FR has been proved to be useful as a way to reduce delayed onset muscle soreness, which can negatively impact performance and enhance pain tolerance. According to research, FR does not affect sprint and jump performance, although it can moderately promote agility. Despite its ineffectiveness in some areas, FR still has a significant number of advantages and can be successfully utilized in various sports settings, both as part of warm-up and recovery routines.
References
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