Research Review: Foam rolling may aid in prevention of delayed onset muscle 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: Pearcey, G. E., Bradbury-Squires, D. J., Kawamoto, J. E., Drinkwater, E. J., Behm, D. G., & Button, D. C. (2015). Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures. Journal of athletic training, 50(1), 5-13. - ARTICLE
Why is this relevant?: Limited research exists on the efficacy of foam rolling as a means of muscle recovery (1). Previous research supports its use in reducing subjective feelings of fatigue and muscle soreness after physical activity, but further review and data collection is needed to understand the mechanism and proper application in a clinical setting (1,3).
Study Summary
| Study Design | Randomized Controlled Design |
| Level of Evidence | Level II: Evidence from at least 1 randomized controlled experiment |
| Subject Demographics |
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| Outcome Measures |
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| Results |
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| Conclusions | Foam rolling post exercise may offer a means of reducing subjective muscle soreness and may allow individuals to retain muscle performance or decrease recovery time following intense physical activity. |
| Conclusions of the Researchers | Foam rolling is an effective approach to reduce subjective feelings of muscle soreness and decreased objective muscle performance related to DOMS. |
Foam rolling the IT Band
Review & Commentary: The authors description of the issue addressed was thorough, including a review of prior studies. The author's describe Delayed Onset Muscle Soreness (DOMS) as a disruption of the muscle's intracellular matrix leading to pain and decreased muscle performance. This disruption was viewed as a type of muscle strain by the researchers, resulting in increased muscle soreness over 24 hours with a peak between 24 and 72 hours. The researchers continue to support their use of the outcome measures in this study, providing reference to studies showing this type of muscle damage can decrease joint proprioception, alter muscle recruitment strategies, impair an athlete's ability to train and may increase the risk of injury.
The authors implemented a highly standardized methodology and clearly described the parameters of each training and measurement session. The two training sessions consisted of the same cycling warm up, same squat warm up, the same orientation and instruction (minus foam rolling info in the control sessions), 1 rep max testing (1RM) and the same DOMS inducing protocol (10 sets of 10 squats at 60% 1RM). The researchers recorded 30 meter sprint time, t-test, and broad-jump distance immediately before the exercise protocol then again at 24, 48, and 72 hours after the DOMS inducing protocol, as was performed in a similar study by Macdonald et al (2014) . Subjects performed each test two times with 4 minutes rest between attempts, during each testing session. Subjects performed the dynamic strength endurance assessment last and only once due to the potential to create fatigue that may skew other outcome measures. During the foam rolling protocol (FR), subjects foam rolled the quadriceps (Rectus Femoris & Vastus Muscles ), adductors , hamstrings (Biceps Femoris , Semitendinosus and Semimembranosus) iliotibial band, and gluteal muscles (likely Piriformis & Gluteus Minimus ) immediately following all measurement sessions, except for the session 72 hours after the DOMS inducing protocol. The authors clearly described the tempo of the squat and foam rolling protocols, the duration of rest between sets, details on the type of foam roller used, and any specific instructions provided.
Authors ensured all subjects understood how to perform FR and how to perform each test to avoid a learning effect having an impact on outcome measures. Researchers provided guidelines to each subject regarding physical activity, caffeine and alcohol intake, and smoking prior to and during the study to limit the effects on performance. Subjects refrained from rigorous exercise 24 hours prior to, and throughout the study.
Subjects acted as their own controls; the authors designed the study so that subjects performed one of the conditions in a single session and then performed the other condition in a a separate condition 4 weeks later. The 4 week separation ensured no carry over or training effect from the exercise protocol that would reduce efficacy of the DOMS protocol. Subjects being their own controls eliminated the variation in interpretation of subjective scales, as well as allowed investigators to compare individuals using the two different protocols.
The subjects were not blinded, and although may not have understood the objective of the study enough to influence results, they may have performed differently knowing they received the experimental intervention. The researchers instructed subjects to use as much body weight as could be tolerated during FR which could have lead to variations in force applied (unlike Sullivan et al (2013) who used a custom machine), but this provided more clinically relevant evidence. Subjects used a custom foam roller instead of a more typical foam roller purchased from an equipment supplier. The researcher's reasoned that custom equipment allowed for better control over quality and stiffness.
Why is this study important?
This study is important because muscle recovery is an integral part of a training and rehabilitation program. By reducing the time to recover and a return to levels of performance noted prior to vigorous exercise, individuals may be able to complete higher training volumes. This may allow for greater strength and endurance gains over time, and potentially faster recovery in a rehabilitation setting. Further, this study (along with the study by Macdonald et al (2014) ) provides evidence of the efficacy of a commonly used practice in rehabilitation and training settings.
How does it affect practice?
Clinicians should consider implementing a foam rolling protocol to clients both immediately following and for several days after rigorous activity to reduce subjective soreness and objective decreases in performance.
How does it relate to Brookbush Institute Content?
The Brookbush Institute promotes foam rolling as part of a corrective exercise strategy to release overactive muscles determined by the overhead squat assessment (OHSA) and other objective measures . Although subjects were not evaluated for postural dysfunction/movement impairment , the muscles mentioned in this study are involved in both Lumbo-Pelvic Hip Complex Dysfunction (LPHCD) and Lower Leg Dysfunction (LLD) . Specifically, the rectus femoris , adductors , biceps femoris , iliotibial band (via the tensor fasciae latae ), piriformis and gluteus minimus have a propensity to become overactive in both LPHCD and LLD implying a need for release and potentially stretching techniques . The foam roller is one tool utilized by the Brookbush Institute for muscle release techniques.
An integral part of muscle control training is a focus on stabilization and eccentric muscle contractions. Eccentric muscle control should be included in any rehabilitation or exercise routine as the body must learn to not only produce motion but to control it. However, the authors present research showing eccentric exercises can increase the risk of DOMS. The Brookbush Institute does not specifically describe the use of foam rollers as a means of recovery but the evidence presented shows increased muscle recovery without detriments to muscle performance. Below are videos on how to refine your foam rolling technique of the quadriceps, as well as a video playlist of release techniques used for addressing Lumbo-Pelvic Hip Complex Dysfunction (LPHCD).
Refining Self Administered Release Technique Foam Roll Technique:
Lumbo Pelvic Hip Complex Self Administered Release Techniques Playlist:
Bibliography
1. Review: [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](http://Macdonald,%20G.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)
© 2015 Brent Brookbush
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