Does Foam Rolling Work?

Foam rolling is a commonly used technique in both the fitness and rehabilitation worlds. Some use it to reduce soreness, whereas others may use it to improve range of motion. As physical therapists and physical therapy students, foam rolling may be something you include in a home exercise program for your patients, and you may even foam roll yourself. On the other hand, maybe you don’t think it is an effective modality for producing any appreciable change.

Foam rolling is a relatively new modality, and evidence to support its use, regardless of the intended effect, is only recently increasing. There has been research to suggest that foam rolling can be effective in improving range of motion, decreasing soreness associated with delayed onset muscle soreness (DOMS), and even improving performance parameters in the presence of DOMS. On the other hand, there is research that has found no changes in ROM or in performance from the use of foam rolling.

If you do happen to believe in its efficacy, there is also the issue of how foam rolling works. It is often described as either self-myofascial release or self-massage. It may potentially work on the myofascia through the thixotropic effect, which would mean the mechanical pressure and friction from foam rolling causes the fascia surrounding the muscle to become less gelatinous. However, the idea that thixotropy can create noticeable and lasting changes is also commonly disputed.  It is also possible that the increased ROM observed as a result of foam rolling could be due to inhibition of the central nervous system through stimulation of sensory afferent nerves. If this were the sole cause for an increase in ROM, then it would seem unlikely that it could also increase performance as some studies have reported.

Foam rolling may or may not work for achieving certain effects, and the reason it may occur may be one of, or a combination of, many things. There is a decent amount of evidence to show that it can improve ROM under a variety of different conditions and decrease post-exercise muscle soreness. There is also research to show no significant effects due to foam rolling. Is foam rolling something you use on yourself or with your patients? If so, what are desired effects in using it and why do think it accomplishes that effect? What are your thoughts on the use of foam rolling, particularly with patients?

Summary of Research on Foam Rolling

Study Foam Rolling Protocol Findings Proposed Mechanism
Behara & Jacobson. The Acute Effects Of Deep Tissue Foam Rolling and Dynamic
Stretching on Muscular Strength, Power, and Flexibility in Division I Linemen.
“Deep tissue rolling” with “high profile bumps” to bilateral hamstrings, quadriceps, gluteus maximus, and gastrocnemius for one minute each. Rolling was performed prior to being tested for vertical jump, average isometric knee flexion torque and extension torque, and hip flexion ROM. Both foam rolling and dynamic stretching produced improvements in hip flexion ROM without negatively affecting any performance parameters. Authors concluded that foam rolling can be used interchangeably with stretching to produce the same
Self-myofascial release; reduction of "fibrous adhesions that occur between layers of the fascia/connective tissue"
Bushell et al. Clinical Relevance of Foam Rolling on Hip Extension
Angle in a Functional Lunge Position.
Rolling for one minute in plank position with foam roll from inferior to ASIS and to just superior to the knee. Following one minute, there was a 30 second rest interval and the rolling was repeated for a total of three times (3 minutes total). Participants were given the option to place the opposite leg on top of the leg being rolled to create more pressure or place the opposite leg on the ground to create less pressure. Foam rolling produced significant within-group increases in hip extension ROM in a lunge position (but no between-group difference compared to control group). Improvements returned to baseline after 1 week of not foam rolling. Foam rolling was also perceived as beneficial to participants as measured by the Global Perceived Effect Scale. Self-myofascial
release; “return the fascia into its original gel-like state” in order to
“improve restrictions and range of motion.”
Couture et al. The Effect of Foam Rolling Duration on
Hamstring Range of Motion.
Rolling of hamstrings from ischial tuberosity to knee at 40 BPM for four sets of 30 seconds or two sets of 10 seconds. Rolling was performed prior to measurement of hamstring ROM (knee extension). No significant difference in knee extension ROM from baseline to after foam rolling in either time condition. Self-induced
myofascial release; may see small improvements on muscle and surrounding fascia
or may achieve ROM improvements by sensory changes occurring from foam rolling.
Healey et al. The effects of myofascial
release with foam rolling on performance.
After dynamic warmup, foam rolling for 30 seconds to quadriceps, hamstrings, gastroc-soleus, latissimus dorsi, and rhomboids prior to performing 4 athletic tests. Compared to the control (planking for 30 seconds), foam rolling had no effect on the performance of athletic testing. The only significant between-group difference was found in perceived level of fatigue immediately following planking compared to immediately following foam rolling (greater fatigue after planking). Compared
to massage: stimulation of parasympathetic activity and positive change in perceived level of fatigue
et al. Foam rolling as a recovery tool after an
intense bout of physical activity.
Foam rolling with “high-density foam roller” (PVC pipe with neoprene foam) to anterior, lateral, posterior, and medial thigh and gluteal muscles for 60 seconds per location per side. In the presence of DOMS, foam rolling produced significantly better results compared to a control in dynamic movement, percent muscle activation, passive and dynamic ROM, and reduction of muscle soreness. Restoration
of “passive noncontractile strucutres (series of elastic components) in the
muscle in the presence of exercise-induced muscle damage, with little to no
effect on actual muscle tissue
et al. Effect of foam rolling and static stretching on passive
hip-flexion range of motion.
Foam rolling hamstrings from ischial tuberosity to popliteal fossa with pace of 1 second to move each direction for three sets of one minute with 30 seconds of rest. Significant increase in passive hip flexion ROM after six days of foam rolling, static stretching, and combined foam rolling and static stretching. The combination of foam rolling and static stretching produced significantly better results than either method alone. (*Note: a subsequent letter to the editor regarding this article challenged the conclusions made by this study and reported being unable to produce the same results with statistical analysis) Improved
viscoelasticity of muscle due to increased temperature and blood flow
et al. Roller-massager application to the
hamstrings increases sit-and-reach range of motion within five to ten seconds
without performance impairments
Rolling with a “roller massager” (not technically a foam roller) with standardized pressure and rate to the hamstrings for either one or two sets of either 5 or 10 seconds Significant increase in sit-and-reach distance with trend towards greater improvements with longer rolling duration without significant changes in maximal voluntary contraction force or EMG activity Stretching
of the fascia from the pressure and movement of the roller; decreased viscosity due to increased temperature from increased friction
et al. Acute effects of
anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length
in the modified Thomas test.
Foam rolling anterior thigh from just inferior to ASIS to superior to the knee at slow pace for two sets of 60 seconds with 30 second break Foam rolling resulted in a significant increase in hip extension ROM in the modified Thomas test, but the improvements were not clinically detectable amounts and may have been at the expense of knee flexion ROM and/or rectus femoris muscle
stretch tolerance of the muscle without any change in muscle length