Foam Rolling: What Therapists Believe, and What the Evidence Actually Shows

Foam rolling is now common in sport, rehabilitation, and fitness settings. Many therapists, trainers, and sports professionals use it to improve flexibility, reduce pain, speed recovery, and prepare people for exercise. But an important question remains: do these beliefs match the evidence?

A recent international survey study explored exactly that. The authors first reviewed the research on foam rolling, then surveyed 452 people from different professions and countries to see whether their beliefs were in line with current evidence. The overall message was clear: foam rolling does have some useful short-term effects, but many common claims are either overstated or not well supported by research.

What foam rolling seems to do well

The strongest evidence supports short-term increases in range of motion. Foam rolling appears to improve flexibility acutely, and repeated use over several weeks may also help improve range of motion over time. This is one of the most consistent findings in the literature.

There is also reasonable support for short-term pain relief, especially for post-exercise soreness and general musculoskeletal discomfort. In practice, this means foam rolling may help people feel better in the short term, even if it does not change the underlying condition in a major way.

Another likely short-term effect is improved blood flow. The review found that foam rolling can acutely increase local circulation. There is also evidence for temporary changes in muscle stiffness, although the wording in the paper is somewhat inconsistent in places. Overall, the broad practical message is that foam rolling may create short-lived mechanical and circulatory changes that can be useful before or after activity.

What foam rolling probably does not do

The evidence was much weaker for performance enhancement. Foam rolling does not appear to meaningfully improve strength, power, or sprint performance in either the short term or the long term. It may not harm performance, which is useful, but it should not be sold as a reliable performance booster.

There was also little support for long-term pain reduction. When foam rolling was added to standard treatment, it did not clearly produce lasting pain improvements over time. This suggests that foam rolling may be best seen as a short-term symptom management tool, not a stand-alone long-term pain solution.

Similarly, evidence for long-term changes in muscle stiffness was not convincing. And while many people speak about foam rolling as if it “breaks up adhesions” or “releases fascia,” the evidence here is limited and the underlying terms are poorly defined. Some studies suggest improved fascial gliding, but this is not the same as proving that foam rolling structurally removes adhesions.

The gap between belief and evidence

The most interesting part of the study was the survey of practitioners. The researchers tested 15 evidence-based questions. Only 2 of the 15 topics reached the target level of 80% correct responses. In other words, even among people working in movement, health, and sport, understanding of foam rolling was often incomplete.

A majority of respondents answered only 8 to 10 items correctly, depending on the threshold used. The best-known topics were the acute effects on blood flow and stiffness, where more than 80% answered correctly. Knowledge was also fairly good for short-term flexibility and pain effects.

However, confusion was common when questions involved long-term outcomes, performance, roller hardness, pressure intensity, and warm-up recommendations. Many respondents assumed positive effects even when the evidence was neutral or unclear. This shows a strong tendency to overestimate the benefits of foam rolling.

What this means for therapists

For therapists, the practical message is balanced rather than dismissive. Foam rolling is not useless, but it is also not a miracle technique.

It may be helpful when the goal is:

• improving short-term range of motion
• reducing soreness or discomfort temporarily
• adding a low-risk self-management option
• preparing tissue for movement without reducing performance

It is less convincing when the goal is:

• improving strength, speed, or power
• creating major long-term tissue change
• preventing injury on its own
• delivering lasting pain relief without broader treatment

So, foam rolling may have a place in treatment and exercise programs, but it should be used with realistic expectations.

Should foam rolling be part of a warm-up?

This is one area where practice and evidence seem to differ. Many people include foam rolling in warm-ups, but the study found that it is not clearly superior to other warm-up methods such as dynamic stretching or cycling. That does not mean it should never be used. It simply means it should not be promoted as the best option based on current evidence.

For therapists, this suggests a practical approach: foam rolling can be included if it helps the client feel ready or move more comfortably, but it does not need to replace other warm-up strategies.

Safety and contraindications

The study also noted that research on safety is surprisingly limited. No strong evidence of major adverse effects was reported, but experts still advise caution in cases such as:

• open wounds
• fractures
• severe medical conditions

This is a useful reminder that the absence of reported harm is not the same as strong safety evidence.

Why misconceptions persist

The authors argue that foam rolling has spread quickly through social media, fitness culture, and informal education. Because of this, many clinicians and trainers may use it regularly without having a clear picture of what the evidence actually supports.

There also appears to be a broader knowledge-to-action gap: research findings often take years to reach everyday practice. Foam rolling is a good example of this. It is widely used, but beliefs about it often go beyond the science.

Final take-home message

Foam rolling seems most useful for short-term flexibility gains, temporary pain relief, and possibly local blood flow and stiffness changes. It does not have strong evidence for improving performance, preventing injury, or producing major long-term tissue change. Many practitioners still believe in benefits that are not well supported by research.

For therapists, the best position is probably this: foam rolling can be a helpful adjunct, but it should be prescribed honestly, with clear limits, and not as a cure-all.