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Tuesday, June 6, 2023

Foam Rolling May Reduce Post Exercise Soreness

Brent Brookbush

Brent Brookbush

DPT, PT, MS, CPT, HMS, IMT

Research Review: Foam rolling may reduce post exercise soreness

By Stefanie DiCarrado DPT, PT, NASM CPT & CES

Edited by Brent Brookbush DPT, PT, COMT, MS, PES, CES, CSCS, ACSM H/FS

Original Citation: Macdonald, G.Z., Button, D.C., Drinkwater, E.J., Behm, D.G. (2014) Foam rolling as a recovery tool after an intense bout of physical activity. Medicine & Science in Sports & Exercise 46(1): 131-142 - ABSTRACT

Foam rolling the quadriceps muscles

Why is this relevant?: Research supports the use of foam rolling as a means of improving muscle ROM prior to exercise with out the loss of force production seen in some static stretching studies (2,3,4). However, the use of this modality as a tool for recovery from physical activity requires further examination -- currently limited evidence exists suggesting foam rolling can limit subjective feelings of muscle fatigue (1). This study provides evidence for the use of foam rolling as a means of reducing post exercise muscle soreness.

Study Summary

Study DesignRandomized Controlled Trial (RTC)
Level of EvidenceLevel II: Evidence from at least 1 RTC
Subject Demographics
  • Age:
    • Foam Roll Group (FRG): 25.1 + 3.6 years
    • Control Group (CON): 24.0 + 2.8 years

  • Gender: 20 males, no females
  • Characteristics: performed resistance training > 3x / week
    • 1 rep max (1RM) squat: 129.2 + 26.7 kg
    • 1RM as % body weight: 152.2% + 24.5%

  • Inclusion Criteria: None listed
  • Exclusion Criteria: None listed
Outcome Measures

  • Measured prior to and immediately after intervention, then again after 24, 48, and 72 hours
    • Perceived Pain (Muscle soreness) - number scale    (0 = no soreness, 10 = worst soreness ever felt)
    • Max Voluntary Contraction (MVC) of quads
    • Vertical Jump Height
    • Muscle Twitch Force (TF) of quads
    • Muscle Electromechanical Delay (EMD) of quads
    • Rate of Force Development (RFD) of quads
    • Half Relaxation Time (1/2RT) of quads
    • Midthigh Circumference
    • Muscle Range of Motion (ROM)

Results
  • Perceived Pain (Muscle soreness)
    • FRG was significantly less sore at all time points with the greatest difference noted at 48 & 72 hours

  • Max Voluntary Contraction (MVC) of quads
    • No significant differences between groups

  • Vertical Jump Height
    • FRG was significantly better at 24 & 48 hours

  • Muscle Twitch Force (TF) of quads
    • FRG had significantly decreased TF at all time points

  • Muscle Electromechanical Delay (EMD) of quads
    • FRG had significantly decreased EMD duration at 24 & 48 hours

  • Rate of Force Development (RFD) of quads
    • FRG had significantly decreased RFD at 24 & 48 hours

  • Half Relaxation Time (1/2RT) of quads
    • No significant differences between groups

  • Midthigh Circumference
    • No significant differences between groups

  • Muscle Range of Motion (ROM)
    • Quadriceps (passive)
      • FRG had better ROM at 48 & 72 hours

    • Hamstrings (passive)
      • FRG had better ROM at 48 & 72 hours

    • Hamstrings (dynamic)
      • FRG with better ROM at 24 hours

ConclusionsFoam rolling may allow for faster recovery and decreased subjective discomfort after rigorous activity while improving joint range of motion with limited effect on muscle force output.
Conclusions of the ResearchersThrough its effect on connective tissue, foam rolling offers a means of reducing discomfort from delayed onset muscle soreness (DOMS) while maintaining muscle force production.

Foam rolling the Vastus Lateralis and IT-Band

Review & Commentary: This study is unique in its use of multiple outcome measures to compare foam rolling verses no intervention after a demanding exercise routine that aimed to damage muscle tissue and create delayed onset muscle soreness (DOMS).

The authors implemented a strong and highly standardized methodology, and clearly described the protocol used for each session, along with the frequency of sessions, and rest times. Subjects participated in a total of 5 sessions, the first of which served as an orientation, recording of their squat 1 rep max (1RM), and randomization into either the foam rolling group (FRG) or the control group (CON). Subjects rested 96 hours after the 1st session, to ensure recovery from the 1RM determination and then 24 hours between all other sessions. The authors described, in great detail, the protocol for determining the 1RM and provided a visual chart listing the protocols for all sessions. The authors described their protocol to bring about exercise-induced muscle damage (EIMD) that results in DOMS as well as how they determined the subjects were experiencing EIMD (noted through muscle swelling, decreased muscle strength and ROM, and decreased neuromuscular performance). The authors provided several sources that found benefits of foam rolling (FR) on EIMD, as well as the benefits of massage on EIMD, as FR is often considered a self massage technique. The researchers recorded outcome measures pre- and post EIMD workouts with the FR intervention performed after the post-EIMD outcome measure recordings. Researchers randomized the order of testing for MVC and ROM with vertical jump always tested 1st. The authors marked the mid-thigh measurement area with permanent ink to avoid erroneous measurements. Subjects completed each session at the same time of day to minimize any cyclic energy or hormone influences. Individuals in the FRG group performed a specified FR protocol (2 x 60s bouts) on the anterior (Rectus Femoris & Vastus muscles ), lateral (Vastus Lateralis ), posterior (Semimembranosus, Semitendinosus , Biceps Femoris) , and medial (Adductor Longus, Adductor Brevis, Gracilis, Pectineus, Adductor Magnus ) aspects of the thigh as well as on the Gluteus Maximus and Piriformis . Subjects performed FR on a force plate to ensure standardized FR force. Authors clearly described all outcome measures, equipment placement and settings, as well as citations for studies validating their methodology.

An unavoidable weakness of the study is the inability to blind subjects. The subjects in the FRG were aware of the intervention, but hopefully were unaware of the purpose of the study and did not allow any knowledge of the intent of the study to influence their performance on any test. Interestingly, the authors did not list any inclusion or exclusion criteria, which may be a weakness in the selection process or simply an omission from the published article.

Why is this study important?

This study is important because it adds to our knowledge base on a commonly used modality in rehab, fitness and performance settings. Although foam rolling sore muscles is common practice, this study provides evidence that foam rolling post exercise, may reduce discomfort, muscle damage after rigorous exercise, and reduce recovery time. This may allow individuals to train more often (increase volume) and increase gains made over a training period.

How does it affect practice?

This article highlights foam rolling as a post exercise activity rather than its more typically studied use pre-exercise. Practitioners looking to limit DOMS, reduce the decrease in performance and mobility seen in the days immediately following rigorous exercise, and decrease recovery time should consider the use foam rolling at the end of their rehab, strength and performance routines. Note: The use of foam rolling post routine, may compliment the use of foam rolling before exercise as a means of increasing mobility (2,3,4); this study does not imply that one is better than the other or that benefits cannot be achieved from foam rolling both before and after exercise.

How does it relate to Brookbush Institute Content?

The Brookbush Institute promotes the use of self-myofasical release techniques within corrective exercise routine, rehabilitation intervention or as part of an integrated warm-up prior to a performance enhancement routine. Self-myofascial release techniques are generally followed by joint mobilizations and stretching as part of an integrated approach to addressing mobility restrictions. The "cool down" is just as important and should include self myofascial release, mobilization and stretching techniques for at least the most significant restrictions noted during a movement assessment , and as evidenced by this study it may be beneficial to include additional self-myofascial techniques for typically sore muscles post rigorous exercise. This study focused primarily on hip musculature. In both Lumbo Pelvic Hip Complex Dysfunction (LPHCD) and Lower Leg Dysfunction (LLD) , the rectus femoris , anterior adductors , biceps femoris and pirformis are often overactive and would benefit from pre-exercise release techniques - this study suggests additional benefit from foam rolling those same muscles again post rigorous exercise.The following videos demonstrate release techniques of these muscles.

Vastus Lateralis Active Release:

Rectus Femoris Active Release:

Adductor Self-administered Static Release

Piriformis SA Active Release:

Biceps Femoris SA Active Release:

Sources

1. Review: Healey, K.C., Hatfield, D.L., Blanpied, P., Dorfman, L.R., and Riebe, D. (2014). The effects of myofascial release with foam rolling on performance. Journal of Strength and Conditioning Research. 28(1). 61–68

2. Review: Halperin, I., Aboodarda, S.J., Button, D.C., Andersen, L.L., Behm, D.G. (2014). Roller massager improves range of motion of plantar flexor muscles without subsequent decreases in force parameters. The International Journal of Sports Physical Therapy. 9(1): 92 -102

3. Review: Mohr, A. R., Long, B. C., & Goad, C. L. (forthcoming 2014). Foam Rolling and Static Stretching on Passive Hip Flexion Range of Motion. Journal of sport rehabilitation. Currently in press.

4. Sullivan, K.M., Silvey, D.B.J., Button, D.C., Behm, D.G. (2013). Roller-massager application to the hamstrings increases sit-and-reach range of motion within five to ten seconds without performance impairments. International Journal of Sports Physical Therapy 8(3) 228-236

© 2015 Brent Brookbush

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