Athlete recovery: can foam rolling match massage?

The research

The team of Spanish researchers recruited 47 subjects to perform in their study(1). These individuals were amateur athletes, so they had a lot of training experience compared to sedentary subjects. The subjects were split into three different groups – a manual therapy group, a foam rolling group and a control group (who did nothing).

All of the athletes performed an intense exercise bout consisting of 4 x 4-minute running intervals performed at 90-95% of maximal heart rate, with four minutes of rest between each interval. After the exercise bout, the subjects performed four separate tests:

• Firstly, they performed the ‘star excursion balance test’ (see the excellent video clip below) to assess dynamic balance. The test consists of standing on one leg and reaching as far as possible with the other leg in multiple directions.
• Next, the subjects performed a modified Schober test, which entails bending at the waist to assist lumbar flexibility.
• Thirdly, flexibility of the hip was assessed with the passive straight leg raise test. The subjects lay on their back and the tester raised their leg as high as possible without letting the knee bend.
•  Finally, the standing long jump was performed to measure dynamic leg force capabilities.

Star excursion balance test

After performing this testing battery, the athletes performed one of three different interventions:

• Manual therapy from a qualified practitioner focused on the lower back and lower body.
• A structured foam rolling routine focused specifically on the hamstrings and lower back.
• Nothing (the control group).

After the intervention, the subjects performed the same battery of tests to determine the impact of what they had (or hadn’t) done. Finally, the subjects performed the same testing battery one week later, without the previous running training session. The purpose of doing so was to see if any of the changes seen as a result of the intervention were maintained over the course of the next seven days.

The results

What effect did these interventions produce? In the foam rolling group, dynamic balance was improved immediately after the intervention, and this change was maintained one week later. This was also the case in the manual therapy group, although the improvements were not quite as large, and the changes were not statistically significant. Lumbar flexibility improved in both groups, but this result was only maintained one week later in the foam rolling group. There were no changes in hip flexibility or dynamic muscle force in any group. It seems therefore that both manual therapy and foam rolling can have a positive impact of different measures of lower body function following intense exercise.

Practical recommendations for athletes

After intense exercise, performing an intervention geared towards restoring lower body mobility appears to be effective at enhancing lower body function following intense exercise. For those who fear they may be missing out because they ‘only’ have access to foam rolling or the equivalent, that fear is largely unfounded. This data shows that foam rolling can have a positive impact on function, even if someone is not an ‘expert’ in performing foam rolling. If you have been on the fence as to whether foam rolling is worth the effort, this is solid evidence that it may be worth the effort!

Given these findings, should everyone foam roll? In other words, if you’re already receiving regular manual therapy, should you stop and start foam rolling? If you have access to therapy, don’t stop. Manual therapy has benefits as well and it’s entirely possible that interventions tailored specifically to your needs may be even more effective. In addition, a skilled practitioner who treats you regularly will be able to feel unusually stiff or tight muscles more effectively that you will be able to when using a roller. At the same time, if you’re unable to continue to access manual therapy for some reason, you have no need to worry - foam rolling can be very effective as well!

References
1. J Strength Cond Res. 2023 Jun 1;37(6):e361-e368. doi: 10.1519/JSC.0000000000004383.  Epub 2022 Dec 19