Injuries, Podcast, Science

Foam rolling: benefits, protocol, and scientific evidence with David Behm | EP#141

 August 6, 2018

By  Mikael Eriksson

​​​Foam rolling: benefits, protocol, and scientific evidence with David Behm | EP#141

Professor David Behm has published multiple studies on the topic of foam rolling. In this interview he gives a complete overview of the scientific evidence in foam rolling and its practical implications in terms of protocols, use cases and what sorts of benefits triathletes can expect from foam rolling.

Discuss this episode!

  • Let's discuss this episode and the topic in general. Post any comments or questions in the comments at the bottom of the shownotes. Join the discussion here!

In this Episode you'll learn about:

  • The benefits of foam rolling for triathletes and athletes in general.
  • Foam rolling and its impact on range of motion and recovery.
  • Protocols for foam rolling: when should you roll and how much is needed?
  • Different rollers: do you really need a hard and painful roller?
  • A summary of the scientific evidence on static stretching

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About David Behm

3:19 -

  • David is a researcher at the Memorial University in Canada.
  • He comes from an American football background. 
  • David has published over 220 peer reviewed articles on topics relating to how muscles respond to acute and chronic activity. 
    • These include resistance training, stretching and foam rolling.

Overview of David's work on foam rolling

3:58 -

  • We've published about 14 papers in the area of foam rolling, and we have 2 more upcoming. 
  • Throughout my career I've often seen new devices being used in training and often wondered if they worked or not. 
  • I've done research on instability resistance training, e.g. swiss balls, mobility balls etc. 
  • About 10 years ago I walked into a weights room and saw people using foam rollers. 
    • Once again I wondered 'do they actually work?'
  • We've done a few studies on the effectiveness of foam rolling now and we've found:
    • Almost every study shows an increase in range of motion. 
    • Even 5 seconds of rolling can increase range of motion, but typically 30-60 seconds would be better. 
    • There's not a great increase in performance but some studies show improvements in acute performance. 
      • This has not been found in chronic activity from our longitudinal study though.
    • We've seen decreases in pain with foam rolling.
    • We've also seen change in cortical spinal excitability and reflexes.
    • We've also done work on how intense the rolling should be. 
  • Overall, most of the studies show some form of positive results. 
    • There are a few studies that haven't shown an increase in range or motion, but this is probably 2-3 out of around 30. 
    • Only 5% are not showing an increase in range of motion, and that's with a number of different muscle groups.
  • We've shown increase in range of motion in the hamstrings, the quadriceps, the plantar flexors. 
  • We will soon be submitting an article which shows you can foam roll your quadriceps and hamstrings and then see a global response.
    • E.g. your shoulders will then have an increased range of motion. 

Foam rolling recommendations

8:07 -

  • Foam rolling is definitely recommended for triathletes and endurance athletes because you have an acute increase in range of motion
  • A lot of the research we've done has shown that prolonged static stretching can impair performance if you train after static stretching. 
    • We don't see this with foam rolling. 
  • Especially for triathletes who don't need an extravagant amount of range of motion, this technique is ideal.
  • In a study we hope to publish soon we found that in soccer, ​foam rolling in the half time period can be beneficial. 
    • Previous studies have shown that sitting around in this half time period can have a detrimental effect on performance in the second half. 
    • If you foam roll during this period, we found those detriments did not occur during the second half. 
  • In another study we looked at basketball players.
    • Second string players sit on the bench for 10-20 minutes before going into the game. 
    • They lose all the positive effects of the warm up. 
    • We had people do a warm up, and then roll for 30 seconds every ten minutes after that. 
    • The individuals who did this, maintained their increases in range of motion. 
  • We have also found some performance enhancements. 
    • We found improvement in the neuromuscular efficiency during the lunge action.
      • To do this we measured the electrical activity of the muscles when someone lunged, then rolled the muscles, and then we re-measured the activity. 
    • We found less electrical activity after they rolled, suggesting they don't need as much muscle activation to do the same activity and are thus more efficient. 

When to foam roll 

10:58 - 

  • We've investigated foam rolling as part of a warm up and found that to be effective.
  • We've also looked at foam rolling as a strategy to attenuate or decrease delayed onset muscle soreness (DOMS).
    • In studies we would induce DOMS, and then examine the subjects at 24, 48, 72 hours later. 
    • We looked at changes in muscle soreness, inflammation and performance. 
    • We found that when a person has a really hard workout and has induced damage from the exercise, there's performance decrements. 
    • But if you roll afterwards, there will be less pain, less inflammation, and the performance impairments are decreased. 
  • It's important to roll before and afterwards.
  • Regarding static stretching, we've recently published two studies in this area:
    • If you stretch for a prolonged period (i.e. more than 60 seconds) in isolation as a warm up then you're likely to have impairment. 
    • However, doing static stretching as part of a full warm up (e.g. 5 minutes of aerobic activity, then 60s stretching, then sport specific activity) doesn't impair performance.
      • The dynamic activities counter act possible decrements from static stretching.
  • You can static stretch after, but I would not recommend extensive or high intensity stretching after you workout. 
    • Your muscles are fatigued. 
    • If you have fatigued muscles, and you're putting them under high stress there's the possibility you can injure them. 
    • Low intensity stretching after a workout may be better to accelerate recovery and move the metabolites out of the muscles quicker.
  • If you really want a significant increase in range of motion, it should be a separate stretching session. 
    • You're fresh and you can focus on the stretching. 

Protocols of foam rolling 

15:20 - 

  • We've found the minimum you can do to see increase in range of motion is 5-10 seconds.
    • 10 seconds is better than 5. 
  • It seems that between 30-60 seconds of rolling gives the best results. 
  • Typically we've used a 1 Hertz frequency, meaning we go down the muscle for 1 second then back up the muscle for 1 second. 
    • This has been found to be effective. 
  • We haven't looked at whether rolling the IT band is effective, but I would imagine it should have some effect. 
    • This is because of what's known as thixotropic effect. 
      • E.g. Imagine you have a bottle of ketchup, you open it and try and pour and nothing comes out. 
      • You shake the bottle and then try to pour again and it comes out. 
      • The reason it didn't come out the first time is because it was highly viscous - thick and dense. 
      • When you shook it up you added stress and strain to the liquid, which is the thixotropic effect. 
      • It decreases the viscosity of the liquid to make it more fluid like.
    • When you are rolling your muscles and connective tissue, you're adding stress and strain to those tissues.
      • They will experience this thixotropic effect, decrease the viscosity of the fluid in the tissues and allow you to have a greater range of motion. 
  • Which muscles groups you roll will depend on your sport. 
    • What you would typically do for stretching in order to increase range of motion, you would roll.

Different types of foam rollers 

18:25  - 

  • We haven't studied the density of different foam rollers. 
    • One of the first studies published in this area did look at the density and found something about a harder roller being more effective. 
    • However, I don't remember what they actually measured but it wasn't a performance measure or range of motion. 
  • We have looked at what intensity of rolling would be most effective. 
    • We identified the greatest pain threshold of the person, and then roll them at 50, 75 and 90% of that. 
    • We found that you don't need to kill yourself!
    • There was no different in the increase in range of motion across the three different intensities.
  • Vibrating foam rollers are also out there nowadays. 
    • I've had feedback from athletes that they like the feeling of a vibrating foam roller. 
    • So far, although there's not many studies, they are quite conflicting. 
      • In one case they found it provided a greater range of motion, but it most cases there haven't found increases in performance.
  • A roller massage is a long rod, and a foam roller is usually a cylinder. 
    • Due to these shapes, you might not be able to get at a particular point that's bothering you. 
    • Using something like a tennis ball allows you to pinpoint the area you're trying to attack.
    • It works in the same way with the thixotrophic effect. 
  • In the literature the foam roller is often called the 'self myofascial release technique'.
    • We found this isn't a proper name at all because it's not releasing any fascia. 
  • According to a research named Robert Schleip, you need supraphysiological forces in order to do anything to the fascia. 
    • You can't apply enough force to break up adhesions in your myofascia.
  • We did two interesting studies: in one we identified muscle tender points in the calf, in another we elicited pain in the calf using electrical stimulation. 
    • We would then either roll the calf, massage it, or roll the contralateral calf, and we had a control condition. 
    • We found that if you roll or massage the calf that hurts, the pain decreases. 
    • But you can also roll the contralateral calf and the pain decreases.
      • This shows you can't be releasing fascia. 
    • There must be some physiological inhibition going on - afferance from the opposite side is sending messages up the spinal cord to the central nervous system and causing global inhibition. 
      • This could be due to something called the gate control theory or the diffuse noxious inhibitory control theory. 
      • There is also a psychophysiological theory.
        • You can have an increase in pain tolerance. 
        • The diffuse noxious inhibitory control theory would argue if you hit your toe and it hurts, and you then start hitting your hand on the wall, your toe wouldn't hurt as bad.
        • It causes a global decrease in pain throughout the body by circulating some of those endorphins. 

Practical advice for triathletes 

24:34 - 

  • Foam rolling before workouts to increase range of motion.
    • 30-60 seconds per muscle group, maybe 2-3 repetitions. 
    • I don't see any reason why you can't do both legs at the same time rather than do one at a time.
  • Foam rolling after the workout to prevent DOMS is beneficial.
    • Use the same method as for the warmup - 30-60s, 2-3 repetitions. 
    • You should have decreased pain, decreased inflammation and less impairments for 72 hours. 
  • We have the only study so far on the long term effects of foam rolling and range of motion. This study was published in the International Journal of Sports Physical Therapy. 
    • We did 4 weeks of foam rolling 3-4 times a week. 
    • We didn't see any improvement in range of motion. 
    • Based on this study, it seems foam rolling is a more acute effect or DOMS effect.
    • Doing it daily on it's own probably doesn't do a lot.

Resources to learn more 

27:55 - 

  • Performance Health is a company in the US that sells foam rollers and other rehabilitation equipment. 
    • They have information on proper technique and studies you can read. 

Rapid fire questions

28:36 - 

  • What is your favourite book, blog or resource related to your field of expertise?
  • What's a personal habit that has helped you achieve success?
    • Organisation. I'm very organised and it allows me to get things done efficiently. 
  • What do you wish you had known or done differently at some point in your career?
    • I wish I had known the importance of power training. I was an American football player when I was young, I did a lot of strength training but nobody mentioned how important Olympic lifts and explosive plyometrics were. 
    • I was drafted into professional football but never made it because I wasn't fast enough, perhaps if I'd known this it would have been different. 
    • This can be relevant to triathletes too. 

Key takeaways

  • Foam roll before workouts to increase range of motion, which may lead to better performance in the workout. 
    • It's an acute increase in range of motion. 
  • You can also foam roll after workouts to reduce muscle soreness, particularly from hard workouts. 
  • You should foam roll for 30-60 seconds for each muscle group.
    • One second up the muscle, one second down. 
    • This would give you 15-30 passes up and down each muscle group. 
    • Calves, hamstrings and quads will be the main groups to focus on for running and cycling. 

Links, resources and contact

Links and resources mentioned

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