An investigation to explore whether foam rolling the quadriceps influences range of motion at the knee joint
This investigation will be exploring how foam rolling the quadriceps impacts the range of motion at the knee joint. Range of motion (ROM) is the capability of a joint to go through its complete spectrum of movements. The ROM of a joint can be measured in two ways; passive ROM which is achieved by an outside force causing movement of the joint to the maximum range or active ROM which can be achieved when composing muscles contact and relax, which results in joint movement. Measuring ROM is highly important as it helps determine the cause and severity of limited joint movement, which is a reduction in the ability to move. ROM could be limited for a variety of reasons, including swelling of tissue, a problem within the joint, stiffness of the muscles or pain. Full ROM across all joints is imperative for individuals to move freely, with minimal effort, as well as joints being able to adapt easily to stress, which is imposed on the body, decreasing the chance of potential injury.
Foam rolling has been around for many years and quickly become widely popular among many sporting communities, athletes, and active individuals. Foam rolling is the use of a roll shaped tool, which is used as a self- myofascial release technique. This can help relieve muscle soreness, tightness, and inflammation, resulting in many benefits such as, improving balance, muscle strengthening and increasing ROM and therefore, can be an effective tool to use during the warmup or cool down, before and after exercise. The use of a foam roller can also assist in breaking up trigger points (muscle knots) in order to resume normal blood flow and function, reducing overall recovery time. Previous studies show evidence that self- myofascial release, using a foam roller has a positive effect on an individual’s ROM by decreasing muscle fatigue and soreness after exercise, without negatively impacting strength and improving overall performance (Scott W. Cheatham, 2015). Consequently, this shows the importance of investigation into the effects that foam rolling has on an individual’s ROM and therefore, the aim of this study is to explore whether foaming rolling has a positive impact on an individual’s knee range of motion. At the beginning of the investigation, it was hypothesised that foam rolling the quadriceps will improve an individual’s ROM at the knee joint for a set period of time.
Method
Participants –
For this investigation 29 undergrad sports students participated, 10 females and 19 males. From the data set which was calculated from these participants the average height (cm), weight (KG) and BMI was calculated. These are as followed; average height (cm): 174.39, average weight (KG): 75.58 and average BMI: 24.88.
Protocol –
Warm up – At the start of this investigation, participants began by increasing their heart rate by jogging at a steady pace for 5 minutes. All participants had a matched intensity and were instructed to work at a rate of perceived exertion (RPE) of between 4-6 on a 10 point scale. Participants then went on to complete a variety of dynamic stretches which were each performed for 30 seconds on both sides of the body in order to stretch the major lower limb muscle groups. This was then followed by specific warm up techniques, including incremental intensity sprinting and jumping exercises.
Range of motion – Each participant was also measured on their knee ROM. This was achieved by measuring the knee flexion of each individual before and after the implementation of foam rolling, which allowed for any differences in ROM to be seen. This was carried out in prone position and measured with the use of a clinical goniometer. Participants actively moved from anatomical zero into the maximum position of knee flexion that they could attain.
Foam rolling – Participants completed a period of foam rolling, between pre and post testing, which the foam rolling of each muscle group was completed for a time period of 90 seconds. Participants rolled their major lower limb muscles, including quadriceps, hamstrings, gastrocnemius, soleus and gluteal. Participants were instructed to actively roll across the entirety of the muscle and complete the foam rolling of both sides of the body. If the participant noticed a focal spot of tension, they were instructed to oscillate in that position until the symptoms decreased.
Data analysis –
All data of the participants including, sex, age, height, weight and BMI was calculated and recorded in an excel spread sheet, along with pre and post ROM scores. After these statistics were recorded, the average, standard deviation, minimum, maximum and count were able to be calculated and therefore, show the effect that foam rolling produced. The average (mean) was achieved by using the autosum function on excel and the minimum, maximum and count was achieved by clicking on the cell, entering the code, and putting the chosen data set into brackets.
Results
Figure 1:
Figure 2:
From the results collected during the investigation, the intervention of foam rolling increased the majority of participants knee joint ROM on a large scale. This is evident as in figure one, before the implementation of foam rolling (pre) the average was 125.54; STDEV(10.13) and after the implementation of foam rolling the average was 126.71; STDEV(8.52). This shows that after the implementation of foam rolling the average ROM of knee flexion increased by 1.17. Therefore, the measurement of the participants range of motion into knee flexion was less when compared to after the implementation of foam rolling. However, this was not the case for all participants, as 13 experienced a decrease in ROM.
Discussion
The most substantial finding from this investigation concluded that the majority of participants knee ROM increased by 1.17 on average with the use of foam rolling. In agreement with the hypothesis, which was made at the beginning of this investigation; based on the findings from figure one, this investigation demonstrates that the implementation of foam rolling on the quadriceps increases an individual’s ROM into knee flexion. The finding of increased ROM with the use of foam rolling in this investigation, is similar to the findings of other studies. In a previous study (David J. Bradbury, 2015) the use of a foam roller on the quadriceps increased knee joint ROM by 10% and a further 16% more with a 20 second and 60 second roller massager. Along with MacDonald GZ, who reported a similar finding, with an increase in knee joint ROM after the use of foam rolling the quadriceps when examining the acute effect of self- induced myofascial release of the quadriceps muscles (MacDonald GZ, 2013). This study tested 11 well trained men, who were each tested on a leg extension machine, then foam rolled for two minutes on the quadriceps, seeking to put the entire body weight on the foam roller, then retested. Researchers found that on average 7-10 degrees of improved knee flexion. However, referring to the two figures, 13 participants experienced a decrease in joint range of motion after the impletion of the foam roller. Therefore, this shows that the use of a foam roller may only have a positive effect if the participant is experiencing stiffness and tightness and will otherwise not have an effect on joint range of motion.
One potential factor which could indicate how the use of a foam roller increases ROM at the knee joint is the fact that a previous study (MacDonald 2013) demonstrates that foam rolling on the quadriceps can release tight fascia and lengthen or activate muscles therefore, increasing ROM at the knee joint. Fascia is a network of connective tissue that surrounds muscles and organs, holding them in place. If this fascia becomes damaged, a blockage is created, resulting in the dehydration of fascia and painful adhesions forming in the quadriceps, which can restrict movement and radiate pain to other areas of the body. With the mechanical pressure applied by the roller it encourages greater tissue mobility and helps reduce myofascial restrictions by rehydrating the fascia. (Behm and Wilke 2019). Stress on muscles, fascia and other tissues can result in additional fibers between mobile tissues, however the use of foam rolling can help reduce and eliminate these additional fibers, consequently increasing ROM. However, due to the fact that some participants presented a decrease in ROM it shows that foam rolling only increases ROM if adhesions are present and fascia is dehydrated.
Based on previous research involving the nervous system, evidence suggests that the use of a foam roller can increase parasympathetic control and decrease vagal tone. Behm and Wilke(2019) suggested that pressure from the roller causes activation of facial mechanoreceptors, therefore, during the mechanical manipulation of tissue, these receptors can be associated with rapid changes in the nervous system e.g. changes in heart rate and blood pressure. Due to this is it thought that slow sustained pressure through foam rolling can increase parasympathetic control and trigger a relaxation response, increasing joint ROM.
Due to the result of foam rolling on the quadriceps increasing the participants knee joint ROM, this is an important consideration for sports therapists when dealing with patients pre and post activity. This is due to the fact that introducing the implementation of foam rolling, pre and post activity may increase ROM and therefore, improve overall performance, with less risk to injury. However, sports therapists must consider that if the patient does not experience or show any signs of adhesions or dehydrated fascia foam rolling may decrease their ROM and therefore, should only be used in the presence of these restrictions.
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