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A Meta-Analysis of the Effects of Foam Rolling on Performance and Recovery

PainSci » bibliography » Wiewelhove et al 2019
Tags: massage, self-treatment, manual therapy, treatment

One article on PainSci cites Wiewelhove 2019: Does Massage Therapy Work?

PainSci notes on Wiewelhove 2019:

This is a predictably inconclusive scientific review of foam rolling (self-massage with a hard foam tube). It’s a classic garbage in, garbage out meta-analysis. A couple dozen mostly poor quality little trials, all measuring different things in different ways, with no chance of adding up to a meaningful conclusion. To the extent that some studies showed some positive effects, they are small and unreliable, damned with faint praise. Science writer Alex Hutchinon (whose analysis I trust more than the authors):

My own conclusion after wading through the meta-analysis is basically a big shrug. If someone showed me this data and told me it was based on an exciting new pill, I’d tell them not to waste their money on the pill. It’s not convincing enough to win new believers. But neither is it damning enough to conclude that athletes definitely shouldn’t use foam rollers.

What about the single most promising data in the study, which showed a minor performance boost for rolling before sprinting? Alex again:

Of the four studies, two of them found essentially no effect, while one very small study found a positive effect that’s not significantly different from zero. So the conclusion that foam rolling boosts sprint performance is almost entirely based on a single study that disagrees with two others.

This is the exact opposite of “promising”: while technically just inconclusive, the absence of any robust benefit detected by any of these studies strongly suggests that better studies aren’t going to find much either.

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 performance and flexibility as well as to alleviate muscle fatigue and soreness. For this reason, foam rolling has become a popular intervention in all kinds of sport settings used to increase the efficiency of training or competition preparation as well as to speed post-exercise recovery. The objective of this meta-analysis was to compare the effects of foam rolling applied before (pre-rolling as a warm-up activity) and after (post-rolling as a recovery strategy) exercise on sprint, jump, and strength performance as well as on flexibility and muscle pain outcomes and to identify whether self-massage with a foam roller or a roller massager is more effective. A comprehensive and structured literature search was performed using the PubMed, Google Scholar, PEDro, and Cochrane Library search engines. Twenty-one studies were located that met the inclusion criteria. Fourteen studies used pre-rolling, while seven studies used post-rolling. Pre-rolling resulted in a small improvement in sprint performance (+0.7%, g = 0.28) and flexibility (+4.0%, g = 0.34), whereas the effect on jump (-1.9%, g = 0.09) and strength performance (+1.8%, g = 0.12) was negligible. Post-rolling slightly attenuated exercise-induced decreases in sprint (+3.1%, g = 0.34) and strength performance (+3.9 %, g = 0.21). It also reduced muscle pain perception (+6.0%, g = 0.47), whereas its effect on jump performance (-0.2%, g = 0.06) was trivial. Of the twenty-one studies, fourteen used foam rollers, while the other seven used roller massage bars/sticks. A tendency was found for foam rollers to offer larger effects on the recovery of strength performance (+5.6%, g = 0.27 vs. -0.1%, g = -0.01) than roller massagers. The differences in the effects between foam rolling devices in terms of pre-rolling did not seem to be of practical relevance (overall performance: +2.7 %, g = 0.11 vs. +0.4%, g = 0.21; flexibility: +5.0%, g = 0.32 vs. +1.6%, g = 0.39). Overall, it was determined that the effects of foam rolling on performance and recovery are rather minor and partly negligible, but can be relevant in some cases (e.g., to increase sprint performance and flexibility or to reduce muscle pain sensation). Evidence seems to justify the widespread use of foam rolling as a warm-up activity rather than a recovery tool.

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