The effect of foam rolling on local and distant pain sensitivity assessed with pressure pain thresholds in healthy participants and musculoskeletal pain patients: A systematic review

Introduction: The self-treatment with a foam roller is a popular form of myofascial release, although the underlying mechanisms, particularly on pain sensitivity, remain unclear. It is hypothesized that the hypoalgesic local effects are probably due to changes in fascial and muscle tissue, whereas remote effects may be influenced by central endogenous pain modulation. This systematic review aimed to quantify the difference between local and remote hypoalgesic effects of the foam rolling intervention. Method: A systematic search was conducted in the databases Pubmed, Cochrane Library, Web of Science, and CINAHL. Published randomized controlled trials and non-randomized controlled trials investigating the effects of foam rolling on Pressure Pain Thresholds (PPTs) in healthy individuals and patients with musculoskeletal pain were included. Quality assessment and evidence synthesis were performed according to Cochrane Handbook recommendations. A meta-analysis was performed using standardized mean differences and 95% CIs. Results: Local PPTs changed after rolling in a pre-post comparison with a small effect size: SMD = −0.42 (95 % CI = −0.57 to −0.26); I2 = 1 %. Remote PPTs also changed after rolling in a pre-post comparison with a small effect size: SMD = −0.47 (95 % CI = −0.80 to −0.14); I2 = 0 %. Foam rolling showed no effect on local PPTs when compared with a control group: SMD = 0.10 (95 % CI = −0.19 to 0.39); I2 = 0 %. Conclusion: No consistent effects of foam rolling on PPTs were demonstrated in healthy individuals.