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Athlete sporting an injury in the knee

Foam rolling has become very popular over the last decade. It is believed to increase flexibility and range of motion, improve athletic performance and reduce pain and muscle soreness.  

Our laboratory within the School of Human Kinetics and Recreation at Memorial University of Newfoundland has been working to verify these claims and determine whether these assumptions about foam rolling are correct.  

This blog will summarize current research regarding the effectiveness of foam rolling on flexibility, performance, and soreness.

How rolling works 

Athlete rolling out their hamstringsIt is quite common to see foam rollers referred to as “self-myofascial release devices” in the scientific literature. It was believed that foam rollers release myofascial constrictions that occur due to inactivity, overload, injury, inflammation and disease. These constrictions can lead to pain and restrict motion.  

However, based on the evidence from research directly testing myofascial trigger points, the forces needed to break up or remove myofascial adhesions would exceed the strength of most people (Behm & Wilke, 2019). The foam roller’s broad surface would not be able to apply sufficient pressure to break up myofascial adhesions.  

There is, however, evidence showing reduction in muscle stiffness through foam rolling. Rolling the skin, muscles, and myofascia can increase blood flow and decrease the viscosity of the tissues. The muscle tone can be relaxed by stimulating proprioceptors, which may increase parasympathetic nervous system stimulation (Behm & Wilke, 2019) and there is also evidence for reduced reflex activity (Young, Spence, & Behm, 2018). Pain reduction with rolling allows a greater stretch tolerance and thus the person can achieve a greater range of motion by pushing themselves farther (Behm, 2018). 

Impact on flexibility 

In research, it is almost always impossible to reach unanimous agreement. A practice called meta-analysis is often used in this case to compare and summarize the findings.  

Two meta-analyses that we have been involved with have reported that foam rolling does acutely increase range of motion, with similar increases as stretching (Konrad et al., 2022; Wilke et al., 2020). These positive effects can last for at least 20 minutes after rolling.  

Similarly, when you train with foam rollers for 4 weeks or more, our meta-analyses demonstrated that you also see a moderate magnitude increase in range of motion (Konrad et al., 2022).  

However, we found that rolling was muscle specific and not all muscles experience the same flexibility gains. For example, rolling the calf muscles did not increase ankle joint range of motion.  

Woman stretching on a soccer fieldTo achieve the greatest range of motion, rolling prescriptions should involve 1–3 sets of 2–4-second repetition duration (time for a single roll in one direction over the length of a body part) with a total rolling duration of 30–120-second per set (Behm et al., 2020). Rolling does not need to be painful to be effective (Grabow et al., 2018). 

Impact on performance 

Most studies examining acute effects do not show improvements in athletic performance measures such as strength, jump height, or sprint speed. One of our reviews (Behm et al., 2020) and a recently submitted meta-analysis (Konrad, Nakamura, & Behm, 2022) showed no significant changes in performance when foam rolling training is applied either in a single session or for several weeks. Although at first glance, this may seem like a negative outcome, prolonged static stretching (>60 seconds per muscle group) tends to decrease performance (Behm, 2018; Behm, et al., 2016; Behm & Chaouachi, 2011; Behm et al., 2021). Thus, if foam rolling can increase range of motion without negatively affecting performance, then this is actually a positive outcome.  

Another benefit is that while working on your flexibility with foam rolling you also are activating and working your core (back and abdominals) muscles since the rolling position often closely resembles the action of planking (Zahiri et al., 2022). 

Impact on pain and muscle soreness 

Delayed onset muscle soreness (DOMS) from unaccustomed or excessive exercise can cause reduced strength and flexibility for days. Research shows that foam rolling after exercise can reduce DOMS and minimize performance deficits such as range of motion, maximum isometric strength, sprint speed, long jump distance, agility (Macdonald et al., 2014; Pearcey et al., 2015). 

Athlete foam rolling their calf muscleThe likely reason for these effects is that foam rolling can decrease pain and may also decrease DOMS-induced inflammation. In fact, rolling has global effects on the body. Rolling the calf muscles only on one side of the body (unilateral) has been shown to decrease the pain pressure threshold on the opposite calf (Aboodarda, Spence, & Button, 2015; Cavanaugh et al., 2017). Thus, rolling can reduce pain not only on the rolled muscle but other muscles that were not rolled. 

Conclusion

In summary, the research from our lab and collaborations shows that foam rolling can increase range of motion similarly to static stretching, as well as reduce pain and the effects of DOMS, while showing no significant adverse effects on performance. Foam rolling is advocated as another tool in the training kit to be used during warm-ups or to help recover from exercise. 


About the Author(s)

Dr. Behm has worked at Memorial University of Newfoundland since 1995 teaching more than 18 different courses. His research interests have been diverse with over 330 peer-reviewed articles, and over 26000 citations exploring neuromuscular responses to stretching, resistance training, balance, fatigue, foam rolling, and other topics. David has authored a number of chapters and a book entitled “The Science and Physiology of Flexibility and Stretching: Implications and Applications in Sport Performance and Health” (Routledge Publishers 2018). He has received a number of university, national and international awards such as the National Strength and Conditioning Association Outstanding Sport Scientist award (2014) and Canadian Society for Exercise Physiology Honour Award (2015). Dr. Behm attempts to bridge the gap between his athletic background (drafted into the Canadian Football League, junior ice hockey player, provincial champion in both tennis and squash) and his research pursuits. 

References

Aboodarda, S. J., Spence, A. J., & Button, D. C. (2015). Pain pressure threshold of a muscle tender spot increases following local and non-local rolling massage. BMC Musculoskelet Disord, 16, 265. doi:10.1186/s12891-015-0729-5 

Behm, D. G. (2018). The Science and Physiology of Flexibility and Stretching: Implications and Applications in Sport Performance and Health. London, UK.: Routledge Publishers. 

Behm, D. G., Alizadeh, S., Hadjizadeh Anvar, S., Mahmoud, M. M. I., Ramsay, E., Hanlon, C., & Cheatham, S. (2020). Foam Rolling Prescription: A Clinical Commentary. J Strength Cond Res, 34(11), 3301-3308. doi:10.1519/JSC.0000000000003765 

Behm, D. G., Blazevich, A. J., Kay, A. D., & McHugh, M. (2016). Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review. Appl Physiol Nutr Metab, 41(1), 1-11. doi:10.1139/apnm-2015-0235 

Behm, D. G., & Chaouachi, A. (2011). A review of the acute effects of static and dynamic stretching on performance. Eur J Appl Physiol, 111(11), 2633-2651. doi:10.1007/s00421-011-1879-2 

Behm, D. G., Kay, A. D., Trajano, G. S., & Blazevich, A. J. (2021). Mechanisms underlying performance impairments following prolonged static stretching without a comprehensive warm-up. Eur J Appl Physiol, 121(1), 67-94. doi:10.1007/s00421-020-04538-8 

Behm, D. G., & Wilke, J. (2019). Do Self-Myofascial Release Devices Release Myofascia? Rolling Mechanisms: A Narrative Review. Sports Med, 49(8), 1173-1181. doi:10.1007/s40279-019-01149-y 

Bradbury-Squires, D. J., Noftall, J. C., Sullivan, K. M., Behm, D. G., Power, K. E., & Button, D. C. (2015). Roller-massager application to the quadriceps and knee-joint range of motion and neuromuscular efficiency during a lunge. J Athl Train, 50(2), 133-140. doi:10.4085/1062-6050-49.5.03 

Cavanaugh, M. T., Doweling, A., Young, J. D., Quigley, P. J., Hodgson, D. D., Whitten, J. H., . . . Behm, D. G. (2017). An acute session of roller massage prolongs voluntary torque development and diminishes evoked pain. Eur J Appl Physiol, 117(1), 109-117. doi:10.1007/s00421-016-3503-y 

Grabow, L., Young, J. D., Alcock, L. R., Quigley, P. J., Byrne, J. M., Granacher, U., . . . Behm, D. G. (2018). Higher Quadriceps Roller Massage Forces Do Not Amplify Range-of-Motion Increases nor Impair Strength and Jump Performance. J Strength Cond Res, 32(11), 3059-3069. doi:10.1519/JSC.0000000000001906 

Konrad, A., Nakamura, M., Paternoster, F. K., Tilp, M., & Behm, D. G. (2022). A comparison of a single bout of stretching or foam rolling on range of motion in healthy adults. Eur J Appl Physiol, 122(7), 1545-1557. doi:10.1007/s00421-022-04927-1 

Konrad A., Nakamura M., Tilp M., Donti O., Behm D. G. (2022). Foam Rolling Training Effects on Range of Motion. A Systematic Review and Meta-Analysis. Sports Med, under review. 

Konrad A,. Nakamura M., & Behm D. G., (2022).Foam Rolling Training Effects on Performance Parameters. A Systematic Review and Meta-Analysis. Intern J Environ Res Public Health, under 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. Med Sci Sports Exerc, 46(1), 131-142. doi:10.1249/MSS.0b013e3182a123db 

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. J Athl Train, 50(1), 5-13. doi:10.4085/1062-6050-50.1.01 

Wilke, J., Muller, A. L., Giesche, F., Power, G., Ahmedi, H., & Behm, D. G. (2020). Acute Effects of Foam Rolling on Range of Motion in Healthy Adults: A Systematic Review with Multilevel Meta-analysis. Sports Med, 50(2), 387-402. doi:10.1007/s40279-019-01205-7 

Young, J. D., Spence, A. J., & Behm, D. G. (2018). Roller massage decreases spinal excitability to the soleus. J Appl Physiol (1985), 124(4), 950-959. doi:10.1152/japplphysiol.00732.2017 

Zahiri, A., Alizadeh, S., Daneshjoo, A., Pike, N., Konrad, A., & Behm, D. G. (2022). Core Muscle Activation With Foam Rolling and Static Planks. Front Physiol, 13, 852094. doi:10.3389/fphys.2022.852094 


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