How To Draw Movement,poster,joint,stability, And Heat Production

Int J Sports Phys Ther. 2022 November; 10(vi): 827–838.

THE EFFECTS OF Self‐MYOFASCIAL RELEASE USING A Foam Curl OR ROLLER MASSAGER ON Articulation RANGE OF MOTION, MUSCLE RECOVERY, AND Performance: A SYSTEMATIC REVIEW

Scott Due west. Cheatham, PT, DPT, OCS, ATC, CSCS, ¹ Morey J. Kolber, PT, PhD, OCS, CSCS*D,² Matt Cain, MS, CSCS,^ane and Matt Lee, PT, MPT, CSCSⁱⁱⁱ

Scott W. Cheatham

ⁱ California Country University Dominguez Hills, Carson, CA, USA

Morey J. Kolber

² Nova Southeastern University, Ft. Lauderdale, FL, Usa

Matt Cain

¹ California State Academy Dominguez Hills, Carson, CA, USA

Matt Lee

³ Ohlone College, Newark, CA, USA

Abstract

Groundwork

Self‐myofascial release (SMR) is a popular intervention used to heighten a client's myofascial mobility. Mutual tools include the foam whorl and roller massager. Frequently these tools are used as part of a comprehensive program and are often recommended to the client to purchase and employ at home. Currently, there are no systematic reviews that take appraised the furnishings of these tools on joint range of motion, muscle recovery, and performance.

Purpose

The purpose of this review was to critically appraise the current evidence and answer the following questions: (1) Does cocky‐myofascial release with a foam gyre or roller‐massager amend joint range of motion (ROM) without effecting muscle performance? (2) Later on an intense bout of exercise, does cocky‐myofascial release with a foam roller or roller‐massager raise mail service exercise muscle recovery and reduce delayed onset of muscle soreness (DOMS)? (3) Does self‐myofascial release with a foam gyre or roller‐massager prior to activeness bear upon muscle performance?

Methods

A search strategy was conducted, prior to April 2022, which included electronic databases and known journals. Included studies met the following criteria: 1) Peer reviewed, english language publications 2) Investigations that measured the furnishings of SMR using a foam coil or roller massager on joint ROM, astute musculus soreness, DOMS, and muscle performance three) Investigations that compared an intervention plan using a foam ringlet or roller massager to a control group iv) Investigations that compared 2 intervention programs using a foam scroll or roller massager. The quality of manuscripts was assessed using the PEDro scale.

Results

A total of 14 articles met the inclusion criteria. SMR with a foam curl or roller massager appears to accept curt‐term furnishings on increasing articulation ROM without negatively affecting muscle functioning and may assistance attenuate decrements in muscle functioning and DOMS after intense practise. Curt bouts of SMR prior to exercise practise not appear to result muscle performance.

Conclusion

The current literature measuring the effects of SMR is still emerging. The results of this assay suggests that cream rolling and roller massage may exist effective interventions for enhancing joint ROM and pre and mail exercise musculus performance. Nonetheless, due to the heterogeneity of methods amidst studies, at that place currently is no consensus on the optimal SMR program.

Keywords: Massage, musculus, treatment

Introduction

Self‐myofascial release (SMR) is a popular intervention used by both rehabilitation and fitness professionals to enhance myofascial mobility. Common SMR tools include the cream roll and various types of roller massagers. Prove exists that suggests these tools tin can enhance joint range of motility (ROM)¹ and the recovery process by decreasing the furnishings of acute musculus soreness,ⁱⁱ delayed onset muscle soreness (DOMS),³ and postal service exercise muscle functioning.⁴ Cream rollers and roller massage bars come in several sizes and foam densities (Figure 1). Commercial foam rolls are typically bachelor in two sizes: standard (6 inch × 36 inch)^2–8 and half size (half dozen inch × xviii inches).⁹ With foam rolling, the customer uses their bodyweight to apply force per unit area to the soft tissues during the rolling move. Roller massage bars also come up in many shapes, materials, and sizes. 1 of the most common is a roller massage bar constructed of a solid plastic cylinder with a dense cream outer covering.^1,x,eleven The bar is often practical with the upper extremities to the target muscle. Pressure during the rolling action is determined by the force induced past the upper extremities. The tennis ball has also been considered a form of roller massage and has been studied in prior inquiry.¹²

Examples of self‐myofascial release tools: Cream roller (left) and roller massager (correct).

For both athletes and agile individuals, SMR is ofttimes used to enhance recovery and performance. Despite the popularity of SMR, the physiological effects are still being studied and no consensus exists regarding the optimal program for range of motion, recovery, and performance.¹² Simply two prior reviews accept been published relating to myofascial therapies. Mauntel et al¹³ conducted a systematic review assessing the effectiveness of the diverse myofascial therapies such every bit trigger bespeak therapy, positional release therapy, active release technique, and self‐myofascial release on joint range of motion, musculus force, and muscle activation. The authors appraised 10 studies and institute that myofascial therapies, as a group, significantly improved ROM but produced no meaning changes in muscle function post-obit handling.¹³ Schroder et al^xiv conducted a literature review assessing the effectiveness self‐myofascial release using a cream roll and roller massager for pre‐exercise and recovery. Inclusion criteria was randomized controlled trials. Nine studies were included and the authors establish that SMR appears to have positive effects on ROM and soreness/fatigue following exercise.¹⁴ Despite these reported outcomes, it must be noted that the authors did not use an objective search strategy or grading of the quality of literature.

Currently, at that place are no systematic reviews that accept specifically appraised the literature and reported the effects of SMR using a foam curlicue or roller massager on these parameters. This creates a gap in the translation from enquiry to do for clinicians and fitness professionals who utilize these tool and recommend these products to their clients. The purpose of this systematic review was to critically appraisal the electric current evidence and reply the following questions: (i) Does self‐myofascial release with a cream whorl or roller‐massager better articulation range of motility without effecting musculus performance? (2) After an intense bout of exercise, does cocky‐myofascial release with a foam roller or roller‐massager enhance post exercise muscle recovery and reduce DOMS? (3) Does cocky‐myofascial release with a foam roll or roller‐massager prior to activity affect muscle functioning?

Methods

Search Strategy

A systematic search strategy was conducted according the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines for reporting systematic reviews (Effigy ii).^xv,xvi The following databases were searched prior to April 2022: PubMed, PEDro, Scientific discipline Direct, and EBSCOhost. A straight search of known journals was also conducted to identify potential publications. The search terms included individual or a combination of the following: cocky; myofascial; release; foam roll; massage; roller; athletic; performance; muscle; strength; forcefulness production; range of motion; fatigue; delayed onset of musculus soreness. Self‐myofascial release was operationally defined as a cocky‐massage technique using a device such every bit a foam roll or roller massager.

Study Selection

Two reviewers (MC and ML) independently searched the databases and selected studies. A third contained reviewer (SC) was bachelor to resolve whatever disagreements. Studies considered for inclusion met the following criteria:i) Peer reviewed, english language publications two) Investigations that measured the furnishings of SMR using a foam roll or roller massager on joint ROM, astute muscle soreness, DOMS, and muscle performance 3) Investigations that compared an intervention program using a foam whorl or roller massager to a control grouping 4) Investigations that compared two intervention programs using a foam roll or roller massager. Studies were excluded if they were non‐english language publications, clinical trials that included SMR as an intervention but did not directly measure out its efficacy in relation to the specific questions, example reports, clinical commentary, dissertations, and conference posters or abstracts.

Data Extraction and Synthesis

The following data were extracted from each article: subject demographics, intervention blazon, intervention parameters, and outcomes. The research design of each study was likewise identified by the reviewers. Qualifying manuscripts were assessed using the PEDro (Physiotherapy Bear witness Database) scale for appraising the quality of literature.^fifteen,16 Intra‐observer agreement was calculated using the Kappa statistic. For each qualifying studies, the levels of significance (p‐value) is provided in the results department for comparison and the effect size (r) is also provided or calculated from the mean, standard deviation, and sample sizes, when possible. Outcome size of > 0.seventy was considered strong, 0.41 to 0.seventy was moderate, and < 0.40 was weak.¹⁷

Results

A total of 133 articles were initially identified from the search and 121 articles were excluded due to non meeting the inclusion criteria. A total of 14 articles met the inclusion criteria. Reasons for exclusion of manuscripts are outlined in Effigy ii. The reviewers Kappa value for the xiv articles was ane.0 (perfect agreement). Tabular array ​ 1. Provides the PEDro score for each of the qualifying studies and Appendix 1 provide a more thorough description of each qualifying study.

Table i.

PEDro scores for qualified studies

	Item one	Item ii	Item iii	Item 4	Item 5	Item half-dozen	Detail 7	Item 8	Detail 9	Particular 10	Particular 11	Total Score
Helperin et al	Y	N	N	Y	Y	Due north	N	Y	Y	Y	Y	7
MacDonald et al (2013)	Y	N	N	Y	North	N	Due north	Y	Y	Y	Y	6
Mohr et al	Y	Y	Due north	Y	Y	N	North	Y	Y	Y	Y	eight
Sullivan et al	Y	Due north	Northward	Y	N	North	N	Y	Y	Y	Y	vi
Bradbury et al	Y	Due north	N	Y	N	N	N	Y	Y	Y	Y	half dozen
Grieve et al	Y	Y	Northward	Y	N	N	Y	Y	Y	Y	Y	eight
Peacock et al	Y	Northward	N	Y	N	N	N	Y	Y	Y	Y	6
Bushell et al	Y	N	N	Y	Y	North	N	Y	Y	Y	Y	7
Macdonald et al (2014)	Y	Y	North	Y	N	North	N	Y	Y	Y	Y	7
Jay et al	Y	Y	N	Y	N	N	Y	Y	Y	Y	Y	eight
Pearcey et al	Y	North	Y	Y	Northward	N	N	Y	Y	Y	Y	vii
Skarbot et al.	Y	Y	North	Y	Northward	Due north	Y	Y	Y	Y	Y	8
Healey et al	Y	N	N	Y	N	Northward	Due north	Y	Y	Y	Y	6
Mikesky et al	Y	Y	Y	Y	Y	Y	Y	Y	N	Y	Y	10

Report Characteristics

All qualifying manuscripts yielded a total of 260 healthy subjects (Male person‐179, Female person‐81) (mean 19.6 years ± three.10, range xv‐34 years) with no major comorbidities that would have excluded them from testing. Eleven studies reported including recreationally active individuals (e.g. exercising at least 2‐3 days per week),^{1–four,vii–12,18} one study included a range of subjects from recreational to highly active,⁵ i study included collegiate athletes,¹⁹ and one report included physically untrained individuals.^xx Due to the methodological diverseness among qualifying studies, a more descriptive results section is provided so the reader can understand the diverse interventions and measures that were used for each written report. The qualifying studies will exist grouping and analyzed co-ordinate to the proposed questions.

Joint Range of Motion

Foam Roller

Five studies^{5,7–9,xviii} used a foam roller as the main tool and measured its effects on ROM. Of the aforementioned five studies, 3^5,8,18 reported using a vi inch × 36 inch polyethylene foam roller and two studies^7,9 reported using a 6 inch × 36 inch loftier density cream roll constructed out of a hollow PVC pipe and outer ethylene acetate foam. Two studies^7,8 used a standard cadence for the foam roll interventions and all studies^{5,vii–ix,xviii} used the subject's bodyweight. All studies^{five,7–9,18} measured the firsthand effects (inside 10 minutes after the intervention) and several other mail service‐test time points. The SMR intervention catamenia for all studies ranged from two to five sessions for 30 seconds to one infinitesimal.^5,7,8,18

Cream Rolling: Hip ROM

2 studies^5,eight measured hip ROM after a prescribed intervention of foam rolling. Bushell et al⁵ foam rolled the anterior thigh in the sagittal plane (length of the muscle) and measured hip extension ROM of subjects in the lunge position with video analysis and used the Global Perceived Issue Scale (GPES) as a secondary measure. 30 1 subjects were assigned to an experimental (N=16) or command (N=xv) grouping and participated in 3 testing sessions that were held one calendar week autonomously with pre‐test and firsthand post‐exam measures. The experimental grouping foam rolled for iii, one‐infinitesimal bouts, with xxx 2d rests in betwixt. In that location were no reported cadence guidelines for the intervention. The command grouping did not foam roll. The authors plant a significant (p≤0.05, r=‐0.eleven) increase in hip extension ROM during the second session in the experimental group. Nonetheless; hip extension measures returned to baseline values after one week. The authors as well institute higher GPE score in the intervention grouping.

Mohr et al⁸ measured the furnishings of cream rolling combined with static stretching on hip flexion ROM. The authors randomized subjects (N=forty) into three groups: (i) foam rolling and static stretching, (ii) cream rolling, (three) static stretching. The foam roll intervention consisted of rolling the hamstrings in the sagittal aeroplane using the subjects bodyweight (three session of 1 infinitesimal) with a cadency of one 2d superior (towards ischial tuberosity) and one second inferior (towards popliteal fossa) using the subjects bodyweight. Static stretching of the hamstrings consisted of 3 sessions, held for one minute. Hip flexion ROM was measured immediately after each intervention in supine with an inclinometer. Upon completion of the study, the authors found that cream rolling combined with static stretching produced statistically pregnant increases (p=0.001, r=7.06) in hip flexion ROM. Likewise greater change in ROM was demonstrated when compared to static stretching (p=0.04, r=2.63) and foam rolling (p=0.006, r=i.81) lonely.⁸

Foam Rolling: Sit down and Reach

Peacock et al¹⁸ examined the furnishings of foam rolling along two different axes of the body combined with a dynamic warm‐up in male subjects (N=sixteen). The authors examined two conditions: medio‐lateral cream rolling followed by a dynamic warm‐up and anteroposterior cream rolling followed past a dynamic warm‐upward. All subjects served as their own controls and underwent the two conditions within 7‐days of each other. The foam rolling intervention consisted of rolling the posterior lumbopelvis (erector spinae, multifidus), gluteal muscles, hamstrings, calf region, quadriceps, and pectoral region forth the two axes (one session for 30 seconds per region) using the subjects bodyweight. At that place was no reported cadence guidelines for the cream scroll intervention. The dynamic warm‐up consisted of a series of active torso‐weight movements that focused on the major joints of the body (twenty repetitions for each movement).¹⁸ Outcome measures included the sit down and attain examination and several other performance tests including the vertical bound, broad jump, shuttle run, and bench printing immediately later the intervention. Cream rolling in the mediolateral centrality had a significantly greater issue (p≤0.05, r=0.sixteen) on increasing sit and reach scores than rolling in the anteroposterior axis with no other differences among the other tests.¹⁸

Foam Rolling: Knee ROM

MacDonald et al⁷ examined the furnishings of foam rolling on genu flexion ROM and neuromuscular activeness of the quadriceps in male subjects (N=xi). Subjects served as their own controls and were tested twice: once subsequently two sessions of one minute foam rolling in the sagittal plane on the quadriceps from the anterior hip to patella (cadence of 3 to 4 times per minute), and additionally afterward no cream rolling (control). The outcome measures included genu flexion ROM, maximal voluntary contraction (MVC) of the quadriceps, and neuromuscular action via electromyography (EMG). Subjects were measured for all the above parameters pre‐exam, 2 minutes after the two conditions, and x minutes afterwards. The authors found a significant increase (p<0.001, r=i.13) of 108 at ii minutes postal service‐exam and a significant increase (p<0.001, r=0.92) of 88 at ten minutes mail‐test of knee flexion ROM following foam rolling when compared to the control group. There were no significant differences in knee joint extensor force and neuromuscular action amidst all conditions.⁷

Foam Rolling: Ankle ROM

Skarabot et al⁹ measured the furnishings of cream rolling and static stretching on ankle ROM in adolescent athletes (N = 5 female, 6 male). The authors randomized subjects into 3 groups (conditions): (ane) foam rolling, (2) static stretching, and (3) foam curlicue and static stretching. The foam rolling intervention consisted of three sessions of xxx seconds rolling on the calf region while the static stretching intervention consisted of a unmarried plantarflexor static stretch performed for three sets of 30 seconds. There were no reported cadence guidelines for the foam rolling intervention. The outcome measure was dorsiflexion ROM measured in the lunge position pre‐test, immediately post‐test, 10, 15, and 20 minutes mail service‐exam. From pre‐examination to immediately post‐test, static stretching increased ROM by 6.two% (p < 0.05, r=‐0.thirteen) and foam rolling with static stretching increased ROM past 9.1% (p<0.05, r=‐0.27) but no increases were demonstrated for foam rolling lone. Post hoc testing revealed that foam rolling with static stretching was superior to foam rolling. All changes from the interventions lasted less than x minutes. ⁹

Roller Massage

Five studies^{1,ten–12,19} qualified for this analysis that used some type of a roller massager every bit the main tool. Ii studies^1,10 reported using a mechanical device connected to a roller bar that created a standard force and cadence. 2 studies^{eleven,nineteen} reported using a commercial roller bar that was self‐administered by the subjects using an established force per unit area but no standard cadence. One study¹² reported using a tennis ball every bit a cocky‐administered roller massager with no standard pressure or cadence. All studies measured the acute effects in which measurements were taken inside 10 minutes after the intervention period along with other post‐test time points. The intervention period for all studies ranged from two to five sessions for v seconds to two minutes.^{one,ten–12,19}

Roller Massage: Ankle ROM

Halperin et al¹¹ compared the effects of a roller massage bar versus static stretching on ankle dorsiflexion ROM and neuromuscular activity of the plantar flexors. The authors randomized subjects (N=14) into 3 groups: (i) cream rolling and static stretching, (2) foam rolling, (three) static stretching. The roller massage intervention consisted of the subjects using the roller bar to massage the plantar flexors for iii sets of 30 seconds at a cadency of one second per gyre (travel the length of the muscle in ane 2nd). The pressure applied was equivalent to 7/ten hurting on a numeric pain rating calibration. Subjects established this level prior to testing. The static stretching intervention consisted of a standing dogie stretch for iii sets of 30 seconds using the same discomfort level of 7/10 to gauge the stretch. The outcome measures included ankle dorsiflexion ROM, static single leg balance for 30 seconds, MVC of the plantar flexors, and neuromuscular activity via EMG. Measurements were taken pre‐test, immediate post‐test, and 10 minutes post‐test. Both the roller massage (p<0.05, r=0.26, four%) and static stretching (p<0.05, r=0.27, v.2%) increased ROM immediately and 10 minutes mail service‐test. The roller massage did show small improvements in muscle force relative to static stretching at 10 minutes post‐exam. Significant effects were not found for balance, MVC, or EMG.

Roller Massage: Knee ROM

Bradbury‐Squires et al^x measured the effects of a roller massager intervention on articulatio genus joint ROM and neuromuscular action of the quadriceps and hamstrings. Ten subjects experienced three randomized experimental conditions: (1) 5 repetitions of 20 seconds (2) five repetitions of sixty seconds, (3) no activity (control).¹⁰ The roller massage intervention was conducted by a constant pressure level apparatus that applied a standard pressure (25% of body weight) through the roller bar to the quadriceps. Subjects sabbatum upright in the apparatus and action moved their torso to allow the roller to travel up and down the quadriceps. The subjects rolled back and along at a cadence of xxx beats per minute (BPM) on a metronome, which allowed a full bike to be completed in four seconds (two seconds towards hip, ii seconds towards patella). The chief pre‐test, mail service‐test outcome measures included the visual analog scale (VAS) for pain, articulatio genus joint flexion ROM, MVC for articulatio genus extension, and EMG activeness of the quadriceps and hamstrings during a lunge. The authors found a 10% increment in mail service‐intervention knee ROM at xx seconds and a xvi% increment at 60 seconds mail service‐intervention when compared to the control (p<0.05). There was a significant increment in knee joint ROM and neuromuscular efficiency (e.g. reduced EMG activity in quadriceps) during the lunge. At that place was no difference in VAS scores betwixt the twenty and 60 2nd interventions.¹⁰

Roller Massage: Hip ROM

Mikesky et al^xix measured the effects of a roller massager intervention on hip ROM and muscle functioning measures. The authors recruited 30 subjects and measured the furnishings of three randomized interventions: (1) control, (2) placebo (mock not‐perceivable electrical stimulation), (3) SMR with roller massager. Testing was performed over 3 days in which one of the randomized interventions were introduced and lasted for ii minutes. The roller massage intervention consisted of the subject rolling the hamstrings for two minutes with no fix pressure or cadence. The effect measures consisted of hip flexion AROM, vertical jump elevation, 20‐yard dash, and isokinetic knee joint extension strength.¹⁹ All outcomes were measured pre and immediately post the intervention. No astute improvements were seen in any of the outcome measures following the roller massager intervention.^nineteen

Roller Massage: Sit and Reach

Sullivan et al^ane measured the effects of a roller massager intervention on lower extremity ROM and neuromuscular activity. The authors used a pre‐examination, immediate post‐exam comparing of 17 subjects (8 experimental, 9 control) using the sit and reach test to measure flexibility, MVC, and neuromuscular activity via EMG measures of the hamstrings.^ane The roller massager intervention consisted of four trials (1 set of 5 seconds, i set of 10 seconds, two sets of five seconds, two sets of 10 seconds) to the hamstrings using a constant pressure level apparatus connected to the roller massage bar which is similar to the appliance and procedure described in Bradbury‐Squires et al^ten study. The apparatus was prepare at a constant pressure of (xiii kg) and cadence (120 BPM). Testing was conducted over 2 days with 2 intervention sessions per solar day on opposing legs separated by a 30 minute residuum period. The command group attended a third session that included the pre‐examination and post‐exam measures only no intervention. The use of a roller massager produced a four.iii% (p<0.0001) increase in sit and attain scores after the intervention periods of one and ii sets of v seconds. At that place was a trend (p=0.069, r=0.21) for 10 seconds of rolling to increase ROM more than than five seconds of rolling. At that place were no significant changes in MVC or EMG activity afterward the rolling intervention.¹

Grieve et al¹² conducted a study measuring the effects of roller massage to the plantar attribute of the foot using a tennis brawl. The authors randomized 24 subjects to an experimental or command group. The roller massage (lawn tennis brawl) intervention consisted of one session of SMR to each foot for two minutes.¹² There was no established pressure or cadence. The author measured pre‐test and immediate mail‐exam flexibility using the sit and reach exam every bit the main upshot measure. Upon completion of the study, the authors establish a significant increase (p=0.03, r=0.21) in post‐examination sit and accomplish scores when compared to the command scores.¹²

Post‐Exercise Musculus Recovery and Reduction of DOMS

Three studies^two,3,20 used an exercised induced muscle damage plan followed by an SMR intervention and measured the effects of SMR on DOMS and musculus performance. Two studies^2,3 used a custom foam roll made out of a polyvinyl chloride pipage (10.16 cm length, 0.5 cm width) surrounded by neoprene cream (1cm thick) and utilized the field of study'south own torso weight using a standard cadency. One study²⁰ used a commercial roller massage bar which was administered by the researchers using an established force per unit area and standard cadency. The intervention period for all studies ranged from 10 to twenty minutes.^ii,3,20

Foam Roller

Macdonald et al² measured the effects of foam rolling equally a recovery tool subsequently practise induced muscle impairment. The authors randomized 20 male subjects to an experimental (foam roll) or control group. All subjects went through the same protocol which included an exercise induced musculus damage programme consisting of 10 sets of 10 repetitions of the back squats (2 minutes of residual betwixt sets) at 60% of the subjects ane repetition maximum (RM) and four postal service‐test data collection periods (post 0, mail 24, mail 48, post 72 hours).² At each post‐test period, the experimental group used the foam roll for a xx infinitesimal session. The subject area's hurting level was measured every 30 seconds and the amount of force placed on the foam gyre was measured via a forcefulness plate under the foam roll. The foam roll intervention consisted of two 60 second bouts on the anterior, posterior, lateral, and medial thigh. The subjects used their own torso weight with no standard cadency. The main effect measures were thigh girth, muscle soreness using a numeric pain rating calibration, knee ROM, MVC for knee extension, and neuromuscular activeness measured via EMG.² Foam rolling reduced subjects pain levels at all mail service‐exam points while improving post‐exam vertical jump height, musculus activation, and joint ROM in comparison with the control grouping.ⁱⁱ

Pearcy et al³ measured the effects of cream rolling as a recovery tool afterwards an intense tour of exercise. The authors recruited eight male person subjects who served as their own control and were tested for two atmospheric condition: DOMS practise protocol followed by foam rolling or no cream rolling. A four calendar week period occurred between the two testing session. All subjects went through a similar DOMS protocol to that, utilized by Mac Donald et al,^two which included 10 sets of 10 repetitions of the back squats (two minutes of rest between sets) at 60% of the subject's one RM. For each post‐examination menstruation, subjects either foam rolled for a 20 minutes session (45 seconds, 15 2nd rest for each hip major musculus group) or did not cream scroll. For foam rolling, the subjects used their own body weight with a cadence of fifty BPM. Measurements were taken pre‐test and and so during four post‐test data collection periods (mail 0, post 24, mail 48, post 72).The chief outcome measures were pressure level hurting threshold of the quadriceps using an algometer, 30m sprint speed, standing broad jump, and the T‐test.³ Cream rolling reduced subjects pain levels at all mail treatment points (Cohen d range 0.59‐0.84) and improvements were noted in performance measures including sprint speed (Cohen d range 0.68‐0.77), broad bound (Cohen d range 0.48‐0.87), and T‐test scores (Cohen d range 0.54) in comparison with the control condition.³

Roller Massage

Jay et al^xx measure the effects of roller massage as a recovery tool after exercise induced muscle impairment to the hamstrings. The authors randomized 22 healthy untrained males into an experimental and control group. All subjects went through the aforementioned DOMS protocol, which included 10 sets or 10 repetitions of stiff‐legged deadlifts using a kettlebell, with a 30 second residuum between sets. The roller massage intervention included one session of 10 minutes of massage in the sagittal aeroplane to the hamstrings using "mild pressure" at a cadency of ane‐2 seconds per stroke past the examiner.^twenty The main outcome measures included the VAS for pain and pressure hurting threshold measured by algometry. The sit and reach test was used every bit a secondary outcome mensurate. The outcomes were measured immediately post‐test, and x, 30, and lx minutes thereafter. The roller massage group demonstrated significantly (p<0.0001) decreased hurting 10 minutes and increased (p=0.0007) pressure hurting thresholds upward to 30 minutes post intervention. Even so; in that location were no statistically significant differences when compared to the control group at threescore minutes post‐test. At that place was no significant difference (p=0.eighteen) in ROM between groups.²⁰

Muscle performance

Iii studies^{4,eighteen,19} qualified for this part of the assay that measured the effects of cocky‐myofascial release prior to muscular performance testing using a standard size high density commercial foam roll⁴ , standard commercial foam roll¹⁸, and a commercial roller massager.^xix The intervention for two studies^iv,18 began with a dynamic warm‐up consisting of a series of lower body movements prior to the foam rolling intervention that lasted for one session of 30 seconds on the each of the following regions: lumbopelvis and all hip regions (anterior, posterior, lateral, and medial). The subjects used their own body weight with no standard cadence.^4,18 One study¹⁹ used a combined five minute warm‐upwardly on a bike with the roller massager intervention which lasted for a period of i session for two minutes on the hamstrings.

Healey et al^four measured the effects of cream rolling on musculus performance when performed prior to activity. The authors randomized 26 subjects who underwent two test conditions. The first condition included a standard dynamic warm‐upward followed by one session of SMR with the foam curl for thirty seconds on the following muscles: quadriceps, hamstrings, calves, latissimus dorsi, and the rhomboids. Subjects used their own weight and no standard cadency was used. The second status included a dynamic warm‐upwardly followed by a forepart planking exercise for three minutes. Subjects were used as their own controls and the 2 examination sessions were completed on two days. The main outcome measures included pre‐test, post‐exam muscle soreness, fatigue, and perceived exertion (Soreness on Palpation Rating Scale, Overall Fatigue Scale, Overall Soreness Calibration, and Borg CR‐10) and performance of four athletic tests: isometric strength, vertical leap height, vertical jump for power, and the v‐10‐five shuttle run.^four No pregnant difference was seen between the foam rolling and planking conditions for all iv athletic tests. There was significantly less (p<0.05, r=0.32) mail handling fatigue reported afterwards foam rolling than the plank exercise.^iv

Peacock et al¹⁸ also examined the effects of foam rolling on muscle operation in addition to the sit and reach distance described in the prior section on joint ROM. The authors measured performance immediately afterward the intervention using several tests which included the vertical jump, broad leap, shuttle run, and demote press. At that place was no significant difference plant between the mediolateral and anteroposterior axis foam rolling for all operation tests.¹⁸

Mikesky et al¹⁹ also measured the furnishings of a roller massager on musculus functioning forth with hip joint ROM which was described in the prior section. The authors measured vertical bound peak, xx yard nuance, and isokinetic knee extension forcefulness pretest and immediately post‐test the intervention.^xix The use of the roller massager showed no acute improvements in all performance outcome measures.¹⁹

Discussion

The purpose of this systematic review was to appraise the current literature on the furnishings of SMR using a foam scroll or roller massager. The authors sought to answer the post-obit three questions regarding the effects of SMR on articulation ROM, post‐exercise muscle recovery and reduction of DOMS, and muscle functioning.

Does self‐myofascial release with a foam ringlet or roller‐massager improve joint range of motion without effecting muscle performance?

The research suggests that both foam rolling and the roller massage may offer short‐term benefits for increasing sit and attain scores and joint ROM at the hip, knee, and ankle without affecting muscle functioning.^5,7–9,18 These finding suggest that SMR using a foam roll for thirty seconds to 1 infinitesimal (ii to 5 sessions) or roller massager for five seconds to two minutes (2 to five sessions) may be beneficial for enhancing joint flexibility as a pre‐exercise warmup and cool down due to its brusque‐term benefits. Also, that SMR may have improve effects when combined with static stretching after exercise.^eight,9 It has been postulated that ROM changes may be due to the altered viscoelastic and thixotropic property (gel‐like) of the fascia, increases in intramuscular temperate and blood period due to friction of the cream roll, alterations in muscle‐spindle length or stretch perception, and the foam roller mechanically breaking down scar tissue and remobilizing fascia back to a gel‐like state.^seven,8,10

Later an intense tour of exercise, does self‐myofascial release with a foam roller or roller‐massager heighten postal service do muscle recovery and reduce DOMS?

The research suggests that foam rolling and roller massage after high intensity exercise does benumb decrements in lower extremity muscle performance and reduces perceived pain in subjects with a postal service exercise intervention catamenia ranging from 10 to 20 minutes.^2,3,twenty Continued foam rolling (twenty minutes per twenty-four hour period) over 3 days may further decrease a patient'south pain level and using a roller massager for 10 minutes may reduce pain up to 30 minutes. Clinicians may want to consider prescribing a mail‐exercise SMR plan for athletes who participate in high intensity exercise. It has been postulated that DOMS is primarily caused by changes in connective tissue backdrop and foam rolling or roller massage may have an influence on the damaged connective tissue rather than muscle tissue. This may explicate the reduction in perceived hurting with no credible loss of muscle operation.^vii Another postulated cause of enhanced recovery is that SMR increases blood period thus enhances blood lactate removal, edema reduction, and oxygen delivery to the muscle.ⁱⁱⁱ

Does self‐myofascial release with a foam roll or roller‐massager prior to action affect muscle functioning?

The research suggests that short bouts of foam rolling (1 session for 30 seconds) or roller massage (1 session for 2 minutes) to the lower extremity prior to activity does non enhance or negatively touch on musculus performance but may change the perception of fatigue.^4,18,19 Information technology'due south important to note that all SMR interventions were preceded with a dynamic‐warm‐upwards focusing on the lower body.^{iv,18,nineteen} Perhaps the foam roller or roller massagers' influence on connective tissue rather than muscle tissue may explain the altered perception of hurting without change in functioning.⁷ The effects of foam rolling or roller massage for longer time periods has non been studied which needs to be considered for clinical exercise.

Clinical Application

When considering the results of these studies for clinical practice four fundamental points must be noted. First, the enquiry measuring the effects of SMR on joint ROM, post‐exercise muscle recovery and reduction of DOMS, and musculus performance is still emerging. There is diversity among report protocols with unlike outcome measures and intervention parameters (eastward.chiliad. handling time, cadence, and pressure). Second, the types of foam and massage rollers used in the studies varied from commercial to custom made to mechanical devices attached to the rollers. It appears that higher density tools may have a stronger outcome than softer density. Curran et al⁶ found that the higher density foam rolls produced more pressure to the target tissues during rolling than the typical commercial cream ringlet suggesting a potential benefit. 3rd, all studies found just short‐term benefits with changes dissipating equally mail service‐exam time went on. The long‐term efficacy of these interventions is still unknown. Fourth, the physiological mechanisms responsible for the reported findings in these studies are still unknown.

Limitations

It should be acknowledged that SMR using a foam roll or roller massager is an area of emerging research that has non reached its tiptop and this analysis is limited past the chosen specific questions and search criteria. The main limitations among qualifying studies were the small sample sizes, varied methods, and issue measures which makes it difficult for a straight comparison and developing a consensus of the optimal program.

Conclusion

The results of this systematic review indicate that SMR using either foam rolling or roller massage may have short‐term furnishings of increasing joint ROM without decreasing muscle operation. Foam rolling and roller massage may likewise attenuate decrements in muscle performance and reduce perceived pain after an intense bout of exercise. Short bouts of foam rolling or roller massage prior to physical activeness have no negative affect on musculus functioning. However, due to the heterogeneity of methods among studies, in that location currently is no consensus on the optimal SMR intervention (treatment time, pressure, and cadency) using these tools. The current literature consists of randomized controlled trials (PEDRO score of 6 or greater), which provide expert testify, but in that location is currently not enough loftier quality show to draw whatever firm conclusions. Hereafter research should focus on replication of methods and the utilization of larger sample sizes. The existing literature does provide some show for utility of methods in clinical practice but the limitations should be considered prior to integrating such methods.

Appendix 1.

Clarification of qualified studies

Author	Type of Study	Subjects	Device	Target Region	Outcome Measures	SMR Intervention
Bushell et al	RCT	N=31 (12M,2F) Control (N=xv) Intervention (N = 16)	Foam roll	Anterior Thigh	Hip Extension ROM in Lunge Positon Global Perceived Upshot Scale	Type: Cream roll Duration: 1 minute Session:3 session (ane week autonomously) Cadence: None Force: Subject'south bodyweight
Mohr et al	RCT	N = 40 M Stretching (N=x) Foam Roll (N = 10) Stretch and FR (N = 10) Control (Northward=10)	Foam roll	Posterior Thigh	Hip Flexion ROM	Type: Foam roll Duration: 1 minute Session: three sessions Cadence: 1 2nd upwardly and down Force: Subject's bodyweight
Peacock et al	Inside subject design	Due north = 16 M	Foam roll	lumbopelvis gluteal muscles, hamstrings, dogie region, quadriceps, and pectoral	Sit‐and‐Reach (ROM) Vertical Jump Broad Leap Shuttle Run Bench Press	Type: Cream roll Duration: 30 seconds Session: 1 (per musculus grouping) Cadence: None Force: Subject'due south bodyweight
Macdonald et al (2014)	RCT	N = 11 K	Cream curlicue	Quadriceps	Knee flexion ROM MVC EMG	Blazon: Foam roll Duration: 1 infinitesimal Session: 2 sessions Cadence: 3 to 4 times per minute (up/downwards) Force: Subject's bodyweight
Skarbot et al	RCT	N = xi (6M, 5F)	Cream scroll	Ankle	Talocrural joint ROM	Type: Cream roll Elapsing: 30 seconds Session: iii session Cadence: None Force: Subject's bodyweight
Helperin et al	RCT	Northward=xiv (12M, 2F)	Roller massage	Talocrural joint	Dorsiflexion ROM MVC EMG Residue	Blazon: Roller massage Duration: xxx seconds Session: 3 sessions Cadency: 1 second per curlicue Force: pressure equal to 7/10
Bradbury et al	RCT	N = 10M	Roller massage machine	Genu	Knee joint flexion ROM VAS MVC EMG	Type: Roller massage Duration: 20 seconds, sixty seconds Session: v sets of each Cadency: 1 2d per gyre Force: Motorcar (25% of bodyweight)
Mikesky et al	RCT	North=thirty (7M, 23F)	Roller massage	Hamstrings	Hip flexion ROM Vertical jump height xx yard dash Isokinetic human knee extension strength	Type: Roller massage Duration: 2 minutes Session: 1 session Cadency: None Force: None
Sullivan et al	Within subject field design	N = 17 (7 M, ten F)	Roller massage machine	Hamstrings	Sit and reach EMG MVC (Isometric Force)	Type: Roller massage Duration: 5, 10 seconds Session: two (5 seconds), 2 (10 seconds) Cadence: 120 BPM Force: Machine (13 kg)
Grieve et al	RCT	N = 24 (eight M, 16 F)	Tennis Brawl	Plantar foot	Sit and reach	Type: Tennis ball Duration: 2 minutes Session: 1 Cadency: None Forcefulness: None
MacDonald et al (2013)	RCT	Due north = 20M (Control = 10 Experimental=10)	Foam roll	anterior, posterior, lateral, and medial thigh	Genu ROM NPRS MVC EMG	Type: Foam roll Duration: 20 minutes Session: i (post treatment) Cadence: None Force: Field of study'south bodyweight
Pearcey et al	Inside subject blueprint	North = 8 M	Cream coil	inductive, posterior, lateral, and medial thigh	Pressure level pain threshold 30‐m sprint Standing wide‐leap T‐test	Type: Foam ringlet Elapsing: xx minutes Session: 1 (postal service treatment) Cadence: 50 BPM Force: Subject'southward bodyweight
Jay et al	RCT	Northward = 22 One thousand	Roller massage	Hamstrings	VAS Pressure pain threshold Sit and reach	Blazon: Roller massage Duration: 10 minutes Session: 1 session Cadence: 1‐2 seconds per curl Force: "Mild pressure"
Healey et al	RCT	Northward = 26 (13 M, 13 F)	Foam curlicue	Quadriceps, hamstrings, calves, latissimus dorsi, rhomboids	Palpation Rating Calibration Overall Fatigue Calibration Overall Soreness Scale Borg CR‐x Isometric force Vertical jump height Vertical jump v‐ten‐5 shuttle run	Type: Cream curlicue Elapsing: 30 seconds Session: 1 session Cadence: None Forcefulness: Subjects bodyweight

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4637917/

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