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Small, flawed trial of foam rolling shows 8% ROM increase

PainSci » bibliography » Macdonald et al 2012
Tags: treatment, massage, knee, devices, structuralism, IT band pain, patellar pain, manual therapy, modalities, leg, limbs, pain problems, biomechanical vulnerability, overuse injury, injury, running, exercise, self-treatment, tendinitis, arthritis, aging, patellofemoral joint

Two pages on PainSci cite Macdonald 2012: 1. The Complete Guide to IT Band Syndrome2. The Complete Guide to Patellofemoral Pain Syndrome

PainSci notes on Macdonald 2012:

In this study, foam rolling was put the test … barely. Foam rolling is a popular form of self-massage using a firm foam tube. This relatively straightforward experiment is more a test of massage (“self-myofascial release”) than “foam rolling” per se. However, because foam rolling is often used in a sports massage context, the study focused on muscle function and joint range of motion.

A small group of healthy, active men used a foam roller application on their quadriceps to see of their knee range of motion would increase. It seemed to do so by as much as 8%, ten minutes after the activity. The researchers concluded that “an acute bout of SMR of the quadriceps was an effective treatment to acutely enhance knee joint range of motion” — but measuring only 10 minutes after the activity, these results seem less than exciting. And it was hardly a perfect study. Greg Lehman points out several key flaws: (1) the control group was not a true therapeutic control group, (2) the warm up was not consistent with standard practice, (3) the experimenters were not blind to the interventions, (4) the ROM testing was too subjective.

The significance of this paper was so well summarized by Jason Silvernail, PT, that it’s worth quoting him in full:

Here’s a small study about foam rolling in typical exercise science style: done on a very small number of healthy people. It’s an important first step, but the size of the study and it’s design limits what we conclusions we can draw. My prediction is that those who love foam rolling will talk about this like this is a big deal. It’s not.

Anyone who says “foam rolling works and this study supports it” is demonstrating their inability to appraise research well. Anyone who says “foam rolling doesn’t work and this study shows it’s useless” is also demonstrating that inability as well as their bias against this tool. The only rational response is a shrug and an acknowledgement that this is only a first step and that the core clinical claims for rolling remain unlikely from a mechanism standpoint and untested/unproven fom a clinical research standpoint.

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

Foam rolling is thought to improve muscular function, performance, overuse and joint range of motion (ROM), however, there is no empirical evidence demonstrating this. Thus, the objective of the study was to determine the effect of self-myofascial release (SMR) via foam roller application on knee extensor force and activation and knee joint range of motion. Eleven healthy male (height 178.9 ± 3.5 cm, mass 86.3 ± 7.4 kg, age 22.3 ± 3.8 years) subjects who were physically active participated. Subjects' quadriceps maximum voluntary contraction force, evoked force and activation, and knee joint ROM were measured prior to, two minutes, and 10 minutes following two conditions; 1) two, one minute trials of SMR of the quadriceps via a foam roller and 2) no SMR (Control). A two-way ANOVA (condition x time) with repeated measures was performed on all dependent variables recorded in the pre- and post-condition tests. There were no significant differences between conditions for any of the neuromuscular dependent variables. However, following foam rolling, subjects' ROM significantly (ρ < 0.001) increased by 10 and 8% at 2 and 10 minutes, respectively. There was a significant (ρ < 0.01) negative correlation between subjects' force and ROM prior to foam rolling, which no longer existed following foam rolling. In conclusion an acute bout of SMR of the quadriceps was an effective treatment to acutely enhance knee joint range of motion without a concomitant deficit in muscle performance.

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