Pain pressure threshold of a muscle tender spot increases following local and non-local rolling massage

Short-Term Effects of Rolling Massage on Energy Cost of Running and Power of the Lower Limbs

PURPOSE

Self-myofascial release (SMFR) is a type of self-massage that is becoming popular among athletes. However, SMFR's effects on running performance have not yet been investigated. The aim of this study was to evaluate the effects of SMFR on the cost of running (Cr). In addition, the authors evaluated the effects of SMFR on lower-limb muscle power.

METHODS

Cr and lower-limb muscle power during squat jump (SJ) and countermovement jump (CMJ) were measured before (PRE), immediately after (POST), and 3 h after (POST 3h) an SMFR protocol (experimental condition). In the control-condition testing session, the same measurements were performed without undergoing the SMFR protocol. Experimental and control conditions were tested in a randomized order.

RESULTS

Cr at POST trended to increase compared with PRE (+6.2% [8.3%], P = .052), whereas at POST 3h, Cr was restored to PRE values (+0.28% [9.5%], P = .950). In the experimental condition, no significant effect of time was observed for maximal power exerted during SJ. By contrast, maximal power exerted during CMJ at POST and at POST 3h was significantly higher than that observed at PRE (+7.9% [6.3%], P = .002 and +10.0% [8.7%], P = .004, respectively). The rate of force development measured during CMJ also increased after SMFR, reaching statistical significance at 200 ms from force onset at POST 3h (+38.9%, P = .024).

CONCLUSIONS

An acute use of foam rollers for SMFR performed immediately prior to running may negatively affect endurance running performance, but its use should be added before explosive motor performances that include stretch-shortening cycles.

Effects of Foam Rolling on Range of Motion, Peak Torque, Muscle Activation, and the Hamstrings-to-Quadriceps Strength Ratios

Madoni, SN, Costa, PB, Coburn, JW, and Galpin, AJ. Effects of foam rolling on range of motion, peak torque, muscle activation, and the hamstrings-to-quadriceps strength ratios. J Strength Cond Res 32(7): 1821-1830, 2018-To examine the effects of foam rolling (FR) on range of motion (ROM), peak torque (PT), hamstrings-to-quadriceps (H:Q) ratios, and muscle activation. Twenty-two recreationally active women (mean age ± SD = 21.55 ± 1.82 years, 161.91 ± 6.58 cm, 61.47 ± 10.54 kg) volunteered for this study. Participants performed pre- and posttests analyzing PT and surface electromyography (EMG) of their dominant limb, completing maximal knee extension and flexion at 3 different velocities. Participants foam rolled the hamstrings muscles or sat for the control condition between the pre- and posttests. Hamstrings ROM increased in the FR condition from (mean ± SE) 123.23 ± 3.49 to 126.41 ± 3.62° (p < 0.001) and decreased in the control condition from 118.82 ± 4.25 to 117.95 ± 4.29° (p = 0.013). Concentric hamstrings PT and conventional H:Q ratios decreased after both conditions, with smaller decreases after FR (p ≤ 0.05). No significant changes were found for eccentric hamstrings PT, eccentric hamstrings EMG, or functional H:Q ratios (p > 0.05). Foam rolling resulted in greater changes in hamstrings ROM without creating a deficit in PT or muscle activation when compared with the control group. When compared with other methods of stretching, FR may be beneficial in increasing ROM without decreasing functional H:Q ratios.

The Acute Effects of Foam Rolling on Fatigue-Related Impairments of Muscular Performance

The purpose of this study was to examine the effects of self-myofascial release (MFR) via foam rolling immediately following strenuous activity on acute fatigue-related impairments of muscular performance. Healthy male (n = 16) and female (n = 9) subjects visited the laboratory three separate times. During visit 1, subjects were familiarized with performance testing procedures and the foam rolling and fatigue protocols. For visits 2 and 3, subjects were (T1) assessed for vertical jump height, velocity, and power and dynamic reaction time (DRT). Subjects then performed the exercise fatigue protocol, followed by either a foam rolling treatment (MFR) or seated rest (CON). Immediately after, subjects repeated the performance tests (T2). CON resulted in a greater percent decline from T1–T2 for average power (p = 0.03), average velocity (p = 0.02), and peak power (p = 0.03) than the MFR treatment. No between-treatment differences were detected for %∆ vertical jump height (p = 0.14) or DRT (p = 0.20). According to magnitude-based inference analysis, MFR is likely beneficial in attenuating fatigue-induced kinematic decrements (i.e., power and velocity). Based on magnitude-based inference analysis, MFR is “possibly beneficial” with respect to mitigating acute fatigue-related impairment of jump height and dynamic reaction time. Results demonstrate the plausible short-term benefits of foam rolling on muscular performance decrements associated with acute muscular fatigue from exercise.

FOUR WEEKS OF ROLLER MASSAGE TRAINING DID NOT IMPACT RANGE OF MOTION, PAIN PRESSURE THRESHOLD, VOLUNTARY CONTRACTILE PROPERTIES OR JUMP PERFORMANCE

BACKGROUND

Roller massagers are popular devices that are used to improve range of motion (ROM), enhance recovery from muscle soreness, and reduce pain under acute conditions. However, the effects of roller massage training and training frequency are unknown.

PURPOSE

The objective was to compare two different roller massage training frequencies on muscle performance.

STUDY DESIGN

Randomized controlled intervention study.

METHODS

Twenty-three recreationally active university students were randomly allocated to three groups: control (n=8;), rolling three (3/W; n=8;) and six (6/W; n=7) times per week for four weeks. The roller massage training consisted of unilateral, dominant limb, quadriceps and hamstrings rolling (4 sets x 30 seconds). Both legs of participants were tested pre- and post-training for active and passive hamstrings and quadriceps range of motion (ROM), electromyography (EMG) activity during a lunge movement, unilateral countermovement jumps (CMJ), as well as quadriceps and hamstrings maximum voluntary isometric contraction (MVIC) forces and electromechanical delay. Finally, they were tested for pain pressure threshold at middle and distal segments of their quadriceps and hamstrings.

RESULTS

There were no significant training interactions for any measure with the exception that 3/W group exhibited 6.2% (p=0.03; Effect Size: 0.31) higher CMJ height from pre- (38.6 ± 7.1 cm) to post-testing (40.9 ± 8.1 cm) for the non-dominant limb.

CONCLUSIONS

Whereas the literature has demonstrated acute responses to roller massage, the results of the present study demonstrate no consistent significant training-induced changes. The absence of change may highlight a lack of muscle and myofascial morphological or semi-permanent neurophysiological changes with rolling.

LEVELS OF EVIDENCE

2c.

ROLLER MASSAGE: A COMMENTARY ON CLINICAL STANDARDS AND SURVEY OF PHYSICAL THERAPY PROFESSIONALS- PART 1

Roller massage (RM) has become a popular intervention used by rehabilitation professionals and active individuals. The emerging popularity has resulted in the production of various types of rollers and a growing body of research on the therapeutic effects and science behind RM. Despite the growing popularity and research, there is no consensus on clinical standards such as a describing the intervention, indications, precautions, contraindications, and assessment. There have been no specific peer reviewed publications that have discussed such standards. This leaves a gap in the knowledge regarding how clinicians are integrating the RM research into their clinical practice. The purpose of this clinical commentary is to discuss proposed clinical standards for RM. Part I will discuss the proposed clinical standards and Part II will report the results of a 20-question survey sent to physical therapy (PT) professional members of the Orthopedic and Sports Physical Therapy Sections of the American Physical Therapy Association.

LEVEL OF EVIDENCE

5.

THE EFFECTS OF AN ACUTE BOUT OF FOAM ROLLING ON HIP RANGE OF MOTION ON DIFFERENT TISSUES

BACKGROUND

Foam Rolling (FR) has steadily gained in popularity as an intervention to increase range of motion (ROM) and reduce pain. It is believed that FR can remove restrictions due to fascial adhesions, thus improving ROM. FR has been proposed as a means to increase ITB length as a means to achieve these outcomes. Previous research has focused on the effects of FR over both muscle and fascia tissue together. However, no studies have examined the effects of FR over fascial tissue not containing muscle.

PURPOSE

The purpose of this study was to compare the acute effect of a single bout of foam rolling (FR) over the Iliotibial Band (ITB) compared to FR over the gluteal muscle group on hip adduction passive range of motion (PROM).

METHODS

Twenty-seven participants were recruited for the study. Each participant performed three sessions: FR over tissue devoid of muscle, the ITB (PFR), FR over contractile tissue, the gluteal muscles (AFR), and a session without FR (control) in a randomized order. Hip adduction PROM was measured in a pre-post manner for each session.

RESULTS

Results of the repeated measures ANOVA showed a significant interaction across session and time (F_{(2, 25)} = 25.202, p < 0.001, ηp2 = 0.502, 1 - β = 1.000). Post-hoc analysis showed the AFR post-test measure was significantly different from both control (p < 0.001) and PFR counterparts (p < 0.001). FR over the gluteal muscle group lead to a 14.8% improvement in hip adduction ROM, with PFR only a 2% improvement.

CONCLUSION

A single bout of FR over a myofascial group appears to increase PROM in healthy young adults, whereas FR over the ITB itself (primarily fascial tissue) does not. This suggests the conventional theory behind FR may need to be reevaluated.

LEVEL OF EVIDENCE

Level 1B, laboratory study, repeated measures design.

ROLLER MASSAGE: SURVEY OF PHYSICAL THERAPY PROFESSIONALS AND A COMMENTARY ON CLINICAL STANDARDS- PART II

BACKGROUND

Roller massage (RM) has become a popular intervention prescribed by physical therapy (PT) professionals. While this popularity has stimulated an increase in research and product development, the trends in the use of RM among PT professionals remain undocumented. It is unknown how professionals are using RM and integrating the research into their clinical practice.

PURPOSE

To survey and document responses in the knowledge, clinical application methods, and use of RM devices among PT professionals in the United States.

DESIGN

Cross-sectional survey study.

METHODS

A 20-question online survey related to personal and professional demographics, beliefs about RM, preferred RM devices, RM exercise prescription, and client education was emailed to PT members of the Orthopedic and Sports Physical Therapy Sections.

RESULTS

A total of 685 sports and orthopedic PT professionals completed the survey. Most professionals surveyed believe that RM decreases pain (80%), increases mobility (68%), and increases range of motion (ROM) (40%). Fifty-one percent believed moderate density rollers have the greatest effect. Eighty percent of professionals use a foam roller in their practice and 51% recommend to clients. A high proportion of professionals prescribe RM for injury treatment (82%) and for pre and post-exercise interventions (55%). Most professionals recommend rolling daily for 30 seconds to two minutes (55%), per muscle group (64%), at a self-paced cadence (47%). A high proportion of professionals use patient reported outcomes (80%), followed by joint ROM (59%), and movement-based testing (42%) to measure effects of RM. Eighty-seven percent of professionals use live instruction to educate clients and 91% believe there is a gap in the research.

CONCLUSION

The results of this survey should be considered descriptive and a starting point for future research to establish a consensus on optimal RM programming, devices, and application parameters for different musculoskeletal conditions. The observed responses provide some insight into how PT professionals are using RM in their practice and highlight the existing gap between the research and professional practice. Further research is needed to explore the responses documented in this study.

LEVEL OF EVIDENCE

3.

COMPARISON OF THREE DIFFERENT DENSITY TYPE FOAM ROLLERS ON KNEE RANGE OF MOTION AND PRESSURE PAIN THRESHOLD: A RANDOMIZED CONTROLLED TRIAL

BACKGROUND

Foam rolling is a popular form of roller massage. To date, no studies have examined the therapeutic effects of different density type rollers. Understanding the different densities may provide clinicians with the knowledge to accurately prescribe a particular foam roller and safely progress the client.

PURPOSE

The purpose of this study was to compare the immediate effects of three different density type foam rollers on prone passive knee flexion range of motion (ROM) and pressure pain thresholds (PPT) of the quadriceps musculature.

STUDY DESIGN

Pretest, posttest randomized controlled trial.

METHODS

Thirty-six recreationally active adults were randomly allocated to one of three groups: soft density, medium density, and hard density foam roller. The intervention lasted a total of two minutes. Outcome measures included prone passive knee flexion ROM and PPT. Statistical analysis included parametric and non-parametric tests to measure changes among groups.

RESULTS

Between group comparisons revealed no statistically significant differences between all three rollers for knee ROM (p=.78) and PPT (p=.37). Within group comparison for ROM revealed an 88 (p < 0.001) post-intervention increase for the medium and hard density rollers and a 78 (p < 0.001) increase for the soft density roller. For PPT, there was a post-intervention increase of 180 kPa (p < 0.001) for the medium density roller, 175 kPa (p < 0.001) for the soft density roller, and 151 kPa (p < 0.001) for the hard density roller.

CONCLUSION

All three roller densities produced similar post-intervention effects on knee ROM and PPT. These observed changes may be due to a local mechanical and global neurophysiological response from the pressure applied by the roller. The client's pain perception may have an influence on treatment and preference for a specific foam roller. Clinicians may want to consider such factors when prescribing foam rolling as an intervention.

LEVEL OF EVIDENCE

2C.

Does manual therapy improve pain and function in patients with plantar fasciitis? A systematic review

OBJECTIVE

To assess if manual therapy (MT) in the treatment of plantar fasciitis (PF) patients improves pain and function more effectively than other interventions.

METHODS

A systematic review of all randomized control trials (RCTs) investigating the effects of MT in the treatment of human patients with PF, plantar fasciosis, and heel pain published in English on PubMed, CINAHL, Cochrane, and Web of Science databases was conducted. Research quality was appraised utilizing the PEDro scale. Cohen's d effect sizes (ES) and associated 95% confidence intervals (CI) were calculated between treatment groups.

RESULTS

Seven RCTs were selected that employed MT as a primary independent variable and pain and function as dependent variables. Inclusion of MT in treatment yielded greater improvement in function (6 of 7 studies, CI that did not cross zero in 14 of 25 variables, ES = 0.5-21.5) and algometry (3 of 3 studies, CI that did not cross zero in 9 of 10 variables, ES = 0.7-3.0) from 4 weeks to 6 months when compared to interventions such as stretching, strengthening, or modalities. Though pain improved with the inclusion of MT, ES calculations favored MT in only 2 of 6 studies (3 of 13 variables) and was otherwise equivalent in effectiveness to comparison interventions.

DISCUSSION

MT is clearly associated with improved function and may be associated with pain reduction in PF patients. It is recommended that clinicians consider use of both joint and soft tissue mobilization techniques in conjunction with stretching and strengthening when treating patients with PF.

LEVEL OF EVIDENCE

Treatment, level 1a.

Roller massage decreases spinal excitability to the soleus

Roller massage (RM) interventions have shown acute increases in range of motion (ROM) and pain pressure threshold (PPT). It is unclear whether the RM-induced increases can be attributed to changes in neural or muscle responses. The purpose of this study was to evaluate the effect of altered afferent input via application of RM on spinal excitability, as measured with the Hoffmann (H-) reflex. A randomized within-subjects design was used. Three 30-s bouts of RM were implemented on a rested, nonexercised, injury-free muscle with 30 s of rest between bouts. The researcher applied RM to the plantar flexors at three intensities of pain: high, moderate, and sham. Measures included normalized M-wave and H-reflex peak-to-peak amplitudes before, during, and up to 3 min postintervention. M-wave and H-reflex measures were highly reliable. RM resulted in significant decreases in soleus H-reflex amplitudes. High-intensity, moderate-intensity, and sham conditions decreased soleus H-reflex amplitudes by 58%, 43%, and 19%, respectively. H-reflexes induced with high-intensity rolling discomfort or pain were significantly lower than moderate and sham conditions. The effects were transient in nature, with an immediate return to baseline following RM. This is the first evidence of RM-induced modulation of spinal excitability. The intensity-dependent response observed indicates that rolling pressure or pain perception may play a role in modulation of the inhibition. Roller massage-induced neural modulation of spinal excitability may explain previously reported increases in ROM and PPT.

NEW & NOTEWORTHY Recent evidence indicates that the benefits of foam rolling and roller massage are primarily accrued through neural mechanisms. The present study attempts to determine the neuromuscular response to roller massage interventions. We provide strong evidence of roller massage-induced neural modulation of spinal excitability to the soleus. It is plausible that reflex inhibition may explain subsequent increases in pain pressure threshold.

Does Roller Massage With a Foam Roll Change Pressure Pain Threshold of the Ipsilateral Lower Extremity Antagonist and Contralateral Muscle Groups? An Exploratory Study

CONTEXT

Foam rolling is a popular intervention used by allied health professionals and the general population. Current research suggests that foam rolling may have an effect on the ipsilateral antagonist muscle group and produce a cross-over effect in the muscles of the contralateral limb. The purpose of this study was to examine the acute effects of foam rolling to the left quadriceps on ipsilateral antagonist hamstrings and contralateral quadriceps muscle group pressure pain threshold (PPT). Through this research, we sought to gather data to further develop the methodology for future studies of this intervention.

DESIGN

A pretest-posttest exploratory study.

SETTING

University kinesiology laboratory.

PARTICIPANTS

21 healthy adults (age = 27.52 ± 8.9 y).

INTERVENTION

Video-guided foam roll intervention on the left quadriceps musculature.

MAIN OUTCOME MEASURES

Ipsilateral hamstring (antagonist) and contralateral quadriceps muscle PPT.

RESULTS

A significant difference was found between pretest to posttest measures for the ipsilateral hamstrings (t[20] = -6.2, P < 0.001) and contralateral quadriceps (t[20] = -9.1, P < 0.001) suggesting an increase in PPT.

CONCLUSIONS

These findings suggest that foam rolling of the quadriceps musculature may have an acute effect on the PPT of the ipsilateral hamstrings and contralateral quadriceps muscles. Clinicians should consider these results to be exploratory and future investigations examining this intervention on PPT is warranted.

Foam Rolling of Quadriceps Decreases Biceps Femoris Activation

Cavanaugh, MT, Aboodarda, SJ, Hodgson, DD, and Behm, DG. Foam rolling of quadriceps decreases biceps femoris activation. J Strength Cond Res 31(8): 2238-2245, 2017-Foam rolling has been shown to increase range of motion without subsequent performance impairments of the rolled muscle, however, there are no studies examining rolling effects on antagonist muscles. The objective of this study was to determine whether foam rolling the hamstrings and/or quadriceps would affect hamstrings and quadriceps activation in men and women. Recreationally, active men (n = 10, 25 ± 4.6 years, 180.1 ± 4.4 cm, 86.5 ± 15.7 kg) and women (n = 8, 21.75 ± 3.2 years, 166.4 ± 8.8 cm, 58.9 ± 7.9 kg) had surface electromyographic activity analyzed in the dominant vastus lateralis (VL), vastus medialis (VM), and biceps femoris (BF) muscles on a single leg landing from a hurdle jump under 4 conditions. Conditions included rolling of the hamstrings, quadriceps, both muscle groups, and a control session. Biceps femoris activation significantly decreased after quadriceps foam rolling (F(1,16) = 7.45, p = 0.015, -8.9%). There were no significant changes in quadriceps activation after hamstrings foam rolling. This might be attributed to the significantly greater levels of perceived pain with quadriceps rolling applications (F(1,18) = 39.067, p < 0.001, 98.2%). There were no sex-based changes in activation after foam rolling for VL (F(6,30) = 1.31, p = 0.283), VM (F(6,30) = 1.203, p = 0.332), or BF (F(6,36) = 1.703, p = 0.199). Antagonist muscle activation may be altered after agonist foam rolling, however, it can be suggested that any changes in activation are likely a result of reciprocal inhibition due to increased agonist pain perception.

ACUTE EFFECTS OF DIFFERENT ANTERIOR THIGH SELF-MASSAGE ON HIP RANGE-OF-MOTION IN TRAINED MEN

BACKGROUND

Self-massage is a ubiquitous intervention similar to massage, but performed by the recipient him- or herself rather than by a therapist, most often using a tool (e.g., foam roller, roller massager). Self-massage has been found to have a wide range of effects. It is particularly known for increasing flexibility acutely, although not always. The variability of the results in previous studies may potentially be a function of the tool used. Recent findings also suggest that self-massage exerts global effects. Therefore, increased flexibility should be expected in the areas adjacent to the ones treated.

PURPOSE

To investigate the acute effects of foam rolling and rolling massage of anterior thigh on hip range-of-motion (ROM) - i.e., hip extension and hip flexion - in trained men.

METHODS

Eighteen recreationally active, resistance trained males visited the lab on two occasions over a 4-day period separated by at least a day. Each session included two baseline ROM measures of passive hip flexion and extension taken in a randomized fashion. Recording of baseline measures was followed by the intervention of the day, which was either foam rolling or rolling massage of the anterior thigh as per randomization. Immediately post intervention, passive hip flexion and hip extension ROM were reassessed. In order to assess the time course of improvements in ROM, hip flexion and hip extension ROM were reevaluated at 10, 20, and 30 minutes post-intervention.

RESULTS

Hip flexion and hip extension ROM increased immediately following both interventions (foam rolling or roller massager) and remained increased for 30 minutes post intervention. Foam rolling was statistically superior in improving hip flexion and hip extension ROM immediately post intervention. However, immediately post-intervention was the only time point that measurements exceeded the minimum detectable change for both interventions.

CONCLUSION

Both foam rolling and rolling massage appear to be effective interventions for improving hip flexion and extension ROM when applied to the anterior thigh, but the observed effects are transient in nature.

LEVEL OF EVIDENCE

2b.

Preventive and Regenerative Foam Rolling are Equally Effective in Reducing Fatigue-Related Impairments of Muscle Function following Exercise

Objectives of the study were to compare the effects of a single bout of preventive or regenerative foam rolling (FR) on exercise-induced neuromuscular exhaustion. Single-centre randomised-controlled study was designed. Forty-five healthy adults (22 female; 25±2 yrs) were allocated to three groups: 1) FR of the lower limb muscles prior to induction of fatigue, 2) FR after induction of fatigue, 3) no-treatment control. Neuromuscular exhaustion was provoked using a standardized and validated functional agility short-term fatigue protocol. Main outcome measure was the maximal isometric voluntary force of the knee extensors (MIVF). Secondary outcomes included pain and reactive strength (RSI). Preventive (-16%) and regenerative FR (-12%) resulted in a decreased loss in MIVF compared to control (-21%; p < 0.001) five minutes after exhaustion. Post-hoc tests indicated a large-magnitude, non-significant trend towards regenerative foam rolling to best restore strength (Cohen's d > 0.8, p < 0.1). Differences over time (p < 0.001) between groups regarding pain and RSI did not turn out to be clinically meaningful. A single bout of foam rolling reduces neuromuscular exhaustion with reference to maximal force production. Regenerative rather than preventive foam rolling seems sufficient to prevent further fatigue.

The effect of rolling massage on the excitability of the corticospinal pathway

The aim of the present study was to investigate the alterations of corticospinal excitability (motor evoked potential, MEP) and inhibition (silent period, SP) following rolling massage of the quadriceps muscles. Transcranial magnetic and femoral nerve electrical stimuli were used to elicit MEPs and compound muscle action potential (Mmax) in the vastus lateralis and vastus medialis muscles prior to and following either (i) 4 sets of 90-s rolling massage (ROLLING) or (ii) rest (CONTROL). One series of neuromuscular evaluations, performed after each set of ROLLING or CONTROL, included 3 MEPs and 1 Mmax elicited every 4 s during 15-s submaximal contractions at 10% (experiment 1, n = 16) and 50% (experiment 2, n = 10) of maximal voluntary knee extensions (MVC). The MEP/Mmax ratio and electromyographic activity recorded from vastus lateralis at 10% MVC demonstrated significantly lower values during ROLLING than CONTROL (P < 0.05). The ROLLING did not elicit any significant changes in muscle excitability (Mmax area) and duration of transcranial magnetic stimulation-induced SP recorded from any muscle or level of contraction (P > 0.05). The findings suggest that rolling massage can modulate the central excitability of the circuitries innervating the knee extensors; however, the observed effects are dependent on the background contraction intensity during which the neuromuscular measurements are recorded.

Differences in pressure pain threshold among men and women after foam rolling

BACKGROUND

Rehabilitation professionals often prescribe foam rolling as an intervention to augment other manual therapies or as a warm-up or recovery after athletic activity. Currently, there is a gap in the literature regarding how foam rolling effects the pressure pain threshold (PPT) among men and women.

PURPOSE

The purpose of this study was to examine the immediate effects of a foam rolling intervention on the ipsilateral agonist, antagonist, and contralateral muscle group PPT among men and women.

SETTING

University kinesiology laboratory.

PARTICIPANTS

Twenty healthy adults (M = 10, F = 10; mean age = 27.4 ± 8.5 years).

RESEARCH DESIGN

Pre-test, post-test observational study.

INTERVENTION

Video-guided foam roll intervention on the left quadriceps group.

MAIN OUTCOME MEASURES

Ipsilateral quadriceps, ipsilateral hamstring, and contralateral quadriceps muscle PPT.

RESULTS

Within group comparison for men, revealed a statistically significant effect of time on PPT for the left quadriceps (p=<0.001), left hamstring (p = 0.001), and right quadriceps (p=<0.001). For women, there was a statistically significant effect of time on PPT for the left quadriceps (p = 0.001), left hamstring (p = 0.007), and right quadriceps (p=<0.001). No significant difference in PPT between men and women were found for the left quadriceps (p = 0.31), left hamstring (p = 0.13), and right quadriceps (p = 0.070) muscle groups.

CONCLUSIONS

These finding suggest that foam rolling can immediately reduce PPT in the ipsilateral agonist, antagonist, and contralateral muscle groups among men and women. Future investigations are needed to determine the long-term effects of foam rolling on PPT among sexes.

COMPARISON OF VIDEO-GUIDED, LIVE INSTRUCTED, AND SELF-GUIDED FOAM ROLL INTERVENTIONS ON KNEE JOINT RANGE OF MOTION AND PRESSURE PAIN THRESHOLD: A RANDOMIZED CONTROLLED TRIAL

BACKGROUND

The use of foam rollers to provide tissue massage is a commonly used intervention by rehabilitation professionals for their patients and clients. Currently, there is no consensus on the optimal foam rolling treatment approach. Of particular interest are the effects of different instructional methods of foam rolling, as individuals ultimately perform these interventions independently outside of formal care. Finding the optimal instructional method may help improve the individual's understanding of the technique, allowing for a safe and effective intervention.

PURPOSE

The purpose of this study was to compare the effects of video-guided, live instructed, and self-guided foam roll interventions on knee flexion Range of Motion (ROM) and pressure pain thresholds.

METHODS

Forty-five healthy adults were recruited and randomly allocated to one of three intervention groups: video-guided, live-instructed, and self-guided. Each foam roll intervention lasted a total of 2 minutes. Dependent variables included knee flexion ROM and pressure pain threshold of the left quadriceps. Statistical analysis included subject demographic calculations and appropriate parametric and non-parametric tests to measure changes within and between intervention groups.

RESULTS

Each intervention group showed significant gains in knee flexion ROM (p ≤ 0.003) and pressure pain thresholds (p < 0.001). An approximate 5 degree increase of knee flexion and a 150 kPa increase in pressure pain threshold was observed at the posttest measure for all groups. There was no significant difference (p=0.25) found between intervention groups.

CONCLUSION

All three foam roll interventions showed short-term increases in knee flexion ROM and pressure pain thresholds. The two instructional methods (video and live instruction) and the self-guided method produced similar outcomes and can be used interchangeably. Individuals can benefit from various types of instruction and in cases of limited resources video may offer an alternative or adjunct to live instruction or an existing self-guided program.

LEVEL OF EVIDENCE

2c.

ACUTE EFFECTS OF DIFFERENT SELF-MASSAGE VOLUMES ON THE FMS™ OVERHEAD DEEP SQUAT PERFORMANCE

BACKGROUND

The Functional Movement Screen (FMS™) is a battery of tests designed to assess movement competency; the overhead deep squat test, specifically, has been shown to be an accurate predictor of overall FMS™ scores. Self-massage (SM) is a ubiquitous warm-up utilized to increase joint range of motion and, therefore, may be effective for improving performance of the overhead deep squat test.

PURPOSE

To examine how different doses (30, 60, 90, and 120 seconds) of SM of different areas of the body (plantar fascia, latissimus dorsi, and lateral thigh) affects the score obtained on an overhead deep squat test.

METHODS

Twenty recreationally active females were recruited to be tested on four occasions: sessions one and two consisted of baseline testing, session three consisted of SM applied to the lateral thigh, and session four consisted of SM applied to the lateral torso and plantar fascia.

RESULTS

In all SM conditions, at least 90 seconds was required for a change in deep squat score from baseline; therefore, it is concluded that SM the lateral torso, plantar fascia, and lateral thigh for 90 seconds or more are effective interventions for acutely improving overhead deep squat scores.

CONCLUSION

Self-massage appears to be an effective modality for inducing acute improvements in the performance of the FMS™ overhead deep squat in all conditions tested.

LEVEL OF EVIDENCE

2b.

MAXIMUM REPETITION PERFORMANCE AFTER DIFFERENT ANTAGONIST FOAM ROLLING VOLUMES IN THE INTER-SET REST PERIOD

BACKGROUND

Foam rollers, or other similar devices, are a method for acutely increasing range of motion, but in contrast to static stretching, do not appear to have detrimental effects on neuromuscular performance.

PURPOSE

The purpose of this study was to investigate the effects of different volumes (60 and 120 seconds) of foam rolling of the hamstrings during the inter-set rest period on repetition performance of the knee extension exercise.

METHODS

Twenty-five recreationally active females were recruited for the study (27.8 ± 3.6 years, 168.4 ± 7.2 cm, 69.1 ± 10.2 kg, 27.2 ± 2.1 m²/kg). Initially, subjects underwent a ten-repetition maximum testing and retesting, respectively. Thereafter, the experiment involved three sets of knee extensions with a pre-determined 10 RM load to concentric failure with the goal of completing the maximum number of repetitions. During the inter-set rest period, either passive rest or foam rolling of different durations (60 and 120 seconds) in a randomized order was employed.

RESULTS

Ninety-five percent confidence intervals revealed dose-dependent, detrimental effects, with more time spent foam rolling resulting in fewer repetitions (Cohen's d of 2.0 and 1.2 for 120 and 60 seconds, respectively, in comparison with passive rest).

CONCLUSION

The results of the present study suggest that more inter-set foam rolling applied to the antagonist muscle group is detrimental to the ability to continually produce force. The finding that inter-set foam rolling of the antagonist muscle group decreases maximum repetition performance has implications for foam rolling prescription and implementation, in both rehabilitation and athletic populations.

LEVEL OF EVIDENCE

2b.

Effects of roller massager on muscle recovery after exercise-induced muscle damage

Two experiments (n = 10) were conducted to determine the effects of roller massager (RM) on ankle plantar flexor muscle recovery after exercise-induced muscle damage (EIMD). Experiment 1 examined both functional [i.e., ankle plantar flexion maximal isometric contraction and submaximal (30%) sustained force; ankle dorsiflexion maximal range of motion and resistance to stretch; and medial gastrocnemius pain pressure threshold] and morphological [cross-sectional area, thickness, fascicle length, and fascicle angle] variables, before and immediately, 1, 24, 48, and 72 h after an EIMD stimulus. Experiment 2 examined medial gastrocnemius deoxyhaemoglobin concentration kinetics before and 48 h after EIMD. Participants performed both experiments twice: with (RM) and without (no-roller massager; NRM) the application of a RM (6 × 45 s; 20-s rest between sets). RM intervention did not alter the functional impairment after EIMD, as well as the medial gastrocnemius morphology and oxygenation kinetics (P > 0.05). Although, an acute increase of ipsilateral (RM = + 19%, NRM = -5%, P = 0.032) and a strong tendency for contralateral (P = 0.095) medial gastrocnemius pain pressure threshold were observed. The present results suggest that a RM has no effect on plantar flexors performance, morphology, and oxygenation recovery after EIMD, except for muscle pain pressure threshold (i.e., a soreness).

The Interaction of Fatigue and Potentiation Following an Acute Bout of Unilateral Squats

A prior conditioning resistance exercise can augment subsequent performance of the affected muscles due to the effects of post-activation potentiation (PAP). The non-local muscle fatigue literature has illustrated the global neural effects of unilateral fatigue. However, no studies have examined the possibility of acute non-local performance enhancements. The objective of the study was to provide a conditioning stimulus in an attempt to potentiate the subsequent jump performance of the affected limb and determine if there were performance changes in the contralateral limb. Using a randomized allocation, 14 subjects (6 females, 8 males) completed three conditions on separate days: 1) unilateral, dominant leg, Bulgarian split squat protocol with testing of the exercised leg, 2) unilateral, dominant leg, Bulgarian split squat protocol with testing of the contralateral, non-exercised leg and 3) control session with testing of the non-dominant leg. Pre- and post-testing consisted of countermovement (CMJ) and drop jumps (DJ). The exercised leg exhibited CMJ height increases of 3.5% (p = 0.008; d = 0.28), 4.0% (p = 0.011; d = 0.33) and 3.2% (p = 0.013; d = 0.26) at 1, 5, and 10 min post-intervention respectively. The contralateral CMJ height had 2.0% (p = 0.034; d = 0.18), 1.2% (p = 0.2; d = 0.12), and 2.1% (p = 0.05; d = 0.17) deficits at 1, 5, and 10 min post-intervention respectively. Similar relative results were found for CMJ power. There were no significant interactions for DJ measures or control CMJ measures. The findings suggest that PAP effects were likely predominant for the exercised leg whereas the conditioning exercise provided trivial magnitude although statistically significant neural impairments for the contralateral limb.

An acute session of roller massage prolongs voluntary torque development and diminishes evoked pain

INTRODUCTION

Roller massage (RM) has been reported to reduce pain associated with exercise-induced muscle soreness and increase range of motion without force or activation impairments. The objective was to examine RM effects on evoked pain and contractile properties.

METHODS

Twelve men received three sets of 30-s RM at a perceived discomfort level of 7/10 on a visual analogue scale on the ipsilateral (IPSI-R) stimulated plantar flexors (PF), contralateral PF (CONTRA-R), Sham (light rolling on stimulated PF), or Control. At pre-test, post-test, and 5-min post-test, they received evoked maximal twitch, tetanus, and 70% maximal tetanic stimulation, and performed a maximal voluntary isometric contraction (MVIC). Data analysis included perceived pain and contractile properties.

RESULTS

The 70% tetanus illustrated significant 9-10% increases in pain perception with Sham and Control at post- and 5-min post-test, respectively (p < 0.01). There was no pain augmentation with IPSI-R and CONTRA-R. There were no main effects or interactions for most contractile properties. However, MVIC force developed in the first 200 ms showed 9.5% (p = 0.1) and 19.1% (p = 0.03) decreases with IPSI-R at post-test and 5-min post-test.

CONCLUSION

Data suggest that RM-induced neural inhibition decreased MVIC F200 and nullified the testing-induced increase in evoked pain associated with 70% tetanic stimulation.

Is self-massage an effective joint range-of-motion strategy? A pilot study

Increases in joint range of motion may be beneficial in both improving performance and reducing the risk of injury. The purpose of this study was to investigate short-term changes in passive hip flexion (HF) and extension (HE) after foam rolling (FR) and roller massage (RM) durations of 60 and 120s. Ten recreationally active men (27.6 ± 2.4 years old; 164.8 ± 6.6 cm; 62.2 ± 8.0 kg; 24.2 ± 2.1 m²/kg) were recruited for this study. Subjects performed foam rolling (FR) and roller massage (RM) on the hamstrings for 60 (FR60 and RM60) and 120 (FR120 and RM120) seconds. Significant differences between FR120 and RM60 were observed in both HF (p < 0.001) and HE (p < 0.001) suggesting an intervention (roller style) effect. Furthermore, significant differences (p < 0.001) between RM60 and RM120 suggest a dosage based response. Thus, the findings indicate that different roller type or rolling volume may affect range-of-motion.

The immediate effect of multiple mechanical impulses on electromyography and pressure pain threshold of lumbar latent trigger points: an experimental study

BACKGROUND

Myofascial pain is a common syndrome, which has not been studied extensively in the low back. Despite a variety of manual and instrument assisted interventions available, little work has targeted the possible effects of fast mechanical impulses on myofascial trigger points (MTrPs) on its sensitivity and electrical activity. The purpose of this experimental study was to quantify the immediate effect of one session of mechanical impulses to lumbar latent MTrPs and to normal muscle tissue with pressure pain threshold (PPT) and surface electromyography (sEMG) as outcome measures.

METHODS

During the autumn of 2009, in 41 asymptomatic subjects between 17-40 years of age the lumbar musculature was searched for a latent MTrP by a trained clinician. Using 3 disposable pre-gelled electrodes bilaterally, sEMG was recorded continuously from muscle containing either latent or no MTrP. Both the trigger point group and control group received the intervention and were blinded to group allocation. The immediate effects of mechanical impulses were assessed by sEMG and PPT before and after intervention using Wilcoxon matched-pairs signed-ranks test, Mann-Whitney U test and paired t-tests.

RESULTS

The PPT increased significantly across both groups (p < 0.01) after intervention. The proportionate increase (14.6 %) was comparable in both MTrP and control groups. The electrical activity on the MTrP side was not significantly higher in the MTrP group compared to the contralateral side. The decrease of resting electrical activity after intervention was significant in the MTrP group on the side of the latent MTrP (P = 0.001) as well as the contralateral side (p=0.022), and not significant in the control group on either side (p=0.33 and p=0.93).

CONCLUSION

In this study, the immediate effect of one session of mechanical impulses was associated with a significant increase in PPT for both groups and a significant decrease in the resting electrical activity of the lumbar muscles only in the MTrP group. It is unknown if these effects have clinical significance.