The Effect of Stretching, Foam Rolling, and FIFA 11+ Warm-ups on Performance and Pain in Athletes with Knee Pain
,
Abstract
Background: Patellofemoral pain syndrome (PFPS) is the most prevalent disease of the knee. The purpose of this study was to compare the acute effects of various warm-up methods on several performance measures and pain intensity in athletes with and without PFPS. Methods: This clinical trial study included 18 to 24-year-old professional female athletes with or without PFPS. Both groups performed warm-up protocols, including general stretching, foam rolling, and Federation Internationale de Football Association (FIFA) 11+ warm-up exercises in three test sessions simultaneously. The data collection procedure was implemented on three separate days in one week. Pain intensity was measured using the Visual Analogue Scale (VAS). Countermovement jump (CMJ) and squat jump (SJ) to measure the stretch-shortening cycle (SSC) and Landing Error Scoring System (LESS) were examined before and after each session.
Results: No significant difference was observed between the effect of different warm-ups in groups with and without PFPS regarding the use of the SSC (P = 0.185), while there were significant differences in the effect of various warm-up protocols on LESS (P < 0.001) and pain scores (P < 0.001).
Conclusion: Using the foam roller as a warm-up method can decrease the pain intensity in athletes with PFPS but may increase their LESS score. In addition, there was no difference in the effect of various warm-up methods on the SSC between athletes with and without PFPS. Finally, it seems that foam rolling should be used with more caution as a part of warming up in athletes with PFPS.
1. Davis I, Power C. Patellofemoral pain syndrome: prox-distal and local factor. Journal Orthop physical therapy. 2010;40(3):40-1.
2. Boling M, Padua D, Marshall S, Guskiewicz K, Pyne S, Beutler A. Gender differences in the incidence and prevalence of patellofemoral pain syndrome. Scand J Med Sci Sports. 2010;20(5):725-30. doi: 10.1111/j.1600-0838.2009.00996.x. PubMed PMID: 19765240; PubMed Central PMCID: PMCPMC2895959.
3. Rothermich MA, Glaviano NR, Li J, Hart JM. Patellofemoral pain: epidemiology, pathophysiology, and treatment options. Clinics in sports medicine. 2015;34(2):313-27.
4. Meira EP, Brumitt J. Influence of the hip on patients with patellofemoral pain syndrome: a systematic review. Sports health. 2011;3(5):455-65.
5. Hudson Z, Darthuy E. Iliotibial band tightness and patellofemoral pain syndrome: a case-control study. Manual therapy. 2009;14(2):147-51.
6. Redd M. Mechanical and Physical Characteristics of Knee Flexors and Extensors Following Different Warm up Protocols in Collegiate Male Soccer Athletes. 2018.
7. Breda SJ, van der Vlist A, de Vos R-J, Krestin GP, Oei EH. The association between patellar tendon stiffness measured with shear-wave elastography and patellar tendinopathy—a case-control study. European Radiology. 2020;30:5942-51.
8. Zago J, Amatuzzi F, Rondinel T, Matheus JP. Osteopathic manipulative treatment versus exercise program in runners with patellofemoral pain syndrome: a randomized controlled trial. Journal of Sport Rehabilitation. 2020;30(4):609-18.
9. Fradkin AJ, Zazryn TR, Smoliga JM. Effects of warming-up on physical performance: a systematic review with meta-analysis. The Journal of Strength & Conditioning Research. 2010;24(1):140-8.
10. Haff GG, Triplett NT. Essentials of strength training and conditioning 4th edition: Human kinetics; 2015.
11. Morales‐Artacho A, Lacourpaille L, Guilhem G. Effects of warm‐up on hamstring muscles stiffness: Cycling vs foam rolling. Scandinavian journal of medicine & science in sports. 2017;27(12):1959-69.
12. Emery CA, Pasanen K. Current trends in sport injury prevention. Best Practice & Research Clinical Rheumatology. 2019;33(1):3-15.
13. Curran PF, Fiore RD, Crisco JJ. A comparison of the pressure exerted on soft tissue by 2 myofascial rollers. Journal of sport rehabilitation. 2008;17(4):432-42.
14. Huang SY, Di Santo M, Wadden KP, Cappa DF, Alkanani T, Behm DG. Short-duration massage at the hamstrings musculotendinous junction induces greater range of motion. The Journal of Strength & Conditioning Research. 2010;24(7):1917-24.
15. Hendricks S, den Hollander S, Lombard W, Parker R. Effects of foam rolling on performance and recovery: A systematic review of the literature to guide practitioners on the use of foam rolling. Journal of Bodywork and Movement Therapies. 2020;24(2):151-74.
16. Cheatham SW, Kolber MJ, Cain M, Lee M. The effects of self‐myofascial release using a foam roll or roller massager on joint range of motion, muscle recovery, and performance: a systematic review. International journal of sports physical therapy. 2015;10(6):827.
17. Peacock CA, Krein DD, Antonio J, Sanders GJ, Silver TA, Colas M. Comparing acute bouts of sagittal plane progression foam rolling vs. frontal plane progression foam rolling. The Journal of Strength & Conditioning Research. 2015;29(8):2310-5.
18. Behm DG, Alizadeh S, Anvar SH, Mahmoud MMI, Ramsay E, Hanlon C, et al. Foam rolling prescription: A clinical commentary. The Journal of Strength & Conditioning Research. 2020;34(11):3301-8.
19. Akbari H, Sahebozamani M, Daneshjoo A, Amiri-Khorasani M. Effect of the FIFA 11+ programme on vertical jump performance in elite male youth soccer players. Montenegrin Journal of Sports Science and Medicine. 2018;7(2):17.
20. Barengo NC, Meneses-Echávez JF, Ramírez-Vélez R, Cohen DD, Tovar G, Bautista JEC. The impact of the FIFA 11+ training program on injury prevention in football players: a systematic review. International journal of environmental research and public health. 2014;11(11):11986-2000.
21. Erkut O, Gelen E, Sunar C. Acute effects of different warm-up methods on dynamic balance. Int J Sports Sci. 2017;7(3):99-104.
22. Small K, Mc Naughton L, Matthews M. A systematic review into the efficacy of static stretching as part of a warm-up for the prevention of exercise-related injury. Research in sports medicine. 2008;16(3):213-31.
23. Alghadir AH, Anwer S, Iqbal A, Iqbal ZA. Test–retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. Journal of pain research. 2018;11:851.
24. Katz J, Melzack R. Pain control in the peroperative period, measurement of pain. Surg Clin North Am. 1999;79(2):231-52.
25. Padua DA, Marshall SW, Boling MC, Thigpen CA, Garrett Jr WE, Beutler AI. The Landing Error Scoring System (LESS) is a valid and reliable clinical assessment tool of jump-landing biomechanics: the JUMP-ACL study. The American journal of sports medicine. 2009;37(10):1996-2002.
26. Leif H. Evaluation of Biomechanical Risk Factors in Division II Collegiate Female Athletes Using the Landing Error Scoring System (LESS) After an 8-Week Neuromuscular Training Program. 2013.
27. Hanzlíková I, Hébert-Losier K. Is the Landing Error Scoring System Reliable and Valid? A Systematic Review. Sports Health. 2020;12(2):181-8. doi: 10.1177/1941738119886593.
28. Markovic G, Dizdar D, Jukic I, Cardinale M. Reliability and factorial validity of squat and countermovement jump tests. The Journal of Strength & Conditioning Research. 2004;18(3):551-5.
29. Bushong JR. Foam rolling as a warm-up: The effect on lower extremity flexibility compared to aerobic and stretching protocols: University of Arkansas; 2011.
30. Sadigursky D, Braid JA, De Lira DNL, Machado BAB, Carneiro RJF, Colavolpe PO. The FIFA 11+ injury prevention program for soccer players: a systematic review. BMC sports science, medicine and rehabilitation. 2017;9(1):1-8.
31. Bizzini M, Junge A, Dvorak J. Implementation of the FIFA 11+ football warm up program: how to approach and convince the Football associations to invest in prevention. British journal of sports medicine. 2013;47(12):803-6.
32. Kallerud H, Gleeson N. Effects of stretching on performances involving stretch-shortening cycles. Sports medicine (Auckland, NZ). 2013;43(8):733-50. Epub 2013/05/18. doi: 10.1007/s40279-013-0053-x. PubMed PMID: 23681447.
33. Groeber M, Stafilidis S, Baca A. The effect of stretch-shortening magnitude and muscle-tendon unit length on performance enhancement in a stretch-shortening cycle. Scientific reports. 2021;11(1):14605. Epub 2021/07/18. doi: 10.1038/s41598-021-94046-2. PubMed PMID: 34272461; PubMed Central PMCID: PMCPmc8285374.
34. Pedley JS, Lloyd RS, Read PJ, Moore IS, Myer GD, Oliver JL. A Novel Method to Categorize Stretch-Shortening Cycle Performance Across Maturity in Youth Soccer Players. Journal of strength and conditioning research. 2020. Epub 2020/12/06. doi: 10.1519/jsc.0000000000003900. PubMed PMID: 33278273; PubMed Central PMCID: PMCPmc8172663.
35. Boguszewski D, Falkowska M, Adamczyk JG, Białoszewski D. Influence of foam rolling on the functional limitations of the musculoskeletal system in healthy women. Biomedical Human Kinetics. 2017;9(1):75-81. doi: doi:10.1515/bhk-2017-0012.
36. Aune AAG, Bishop C, Turner AN, Papadopoulos K, Budd S, Richardson M, et al. Acute and chronic effects of foam rolling vs eccentric exercise on ROM and force output of the plantar flexors. Journal of Sports Sciences. 2019;37(2):138-45. doi: 10.1080/02640414.2018.1486000.
37. Bushell JE, Dawson SM, Webster MM. Clinical Relevance of Foam Rolling on Hip Extension Angle in a Functional Lunge Position. The Journal of Strength & Conditioning Research. 2015;29(9):2397-403. doi: 10.1519/jsc.0000000000000888. PubMed PMID: 00124278-201509000-00003.
38. Everard E, Lyons M, Harrison AJ. Examining the association of injury with the Functional Movement Screen and Landing Error Scoring System in military recruits undergoing 16 weeks of introductory fitness training. Journal of Science and Medicine in Sport. 2018;21(6):569-73. doi: https://doi.org/10.1016/j.jsams.2017.05.013.
39. David E, Amasay T, Ludwig K, Shapiro S. The Effect of Foam Rolling of the Hamstrings on Proprioception at the Knee and Hip Joints. Int J Exerc Sci. 2019;12(1):343-54. PubMed PMID: 30899339.
40. Junker DH, Stöggl TL. The foam roll as a tool to improve hamstring flexibility. The Journal of Strength & Conditioning Research. 2015;29(12):3480-5.
41. Nakamura M, Onuma R, Kiyono R, Yasaka K, Sato S, Yahata K, et al. The Acute and Prolonged Effects of Different Durations of Foam Rolling on Range of Motion, Muscle Stiffness, and Muscle Strength. J Sports Sci Med. 2021;20(1):62-8. doi: 10.52082/jssm.2021.62. PubMed PMID: 33707988.
42. Li L, Huang F, Huang Q, Liu L, Opoku Antwi E, Nguyen T. Compression of Myofascial Trigger Points With a Foam Roller or Ball for Exercise-induced Anterior Knee Pain: A Randomized Controlled Trial. Alternative therapies in health and medicine. 2020;26(3):16-23. Epub 2020/05/24. PubMed PMID: 32445557.
43. Chen Z, Wu J, Wang X, Wu J, Ren Z. The effects of myofascial release technique for patients with low back pain: A systematic review and meta-analysis. Complementary therapies in medicine. 2021;59:102737. Epub 2021/05/14. doi: 10.1016/j.ctim.2021.102737. PubMed PMID: 33984499.
44. Cheatham SW, Baker R. Differences in pressure pain threshold among men and women after foam rolling. Journal of Bodywork and Movement Therapies. 2017;21(4):978-82. doi: https://doi.org/10.1016/j.jbmt.2017.06.006.
45. Nakamura M, Konrad A, Kiyono R, Sato S, Yahata K, Yoshida R, et al. Local and Non-local Effects of Foam Rolling on Passive Soft Tissue Properties and Spinal Excitability. Front Physiol. 2021;12:702042-. doi: 10.3389/fphys.2021.702042. PubMed PMID: 34248682.
2. Boling M, Padua D, Marshall S, Guskiewicz K, Pyne S, Beutler A. Gender differences in the incidence and prevalence of patellofemoral pain syndrome. Scand J Med Sci Sports. 2010;20(5):725-30. doi: 10.1111/j.1600-0838.2009.00996.x. PubMed PMID: 19765240; PubMed Central PMCID: PMCPMC2895959.
3. Rothermich MA, Glaviano NR, Li J, Hart JM. Patellofemoral pain: epidemiology, pathophysiology, and treatment options. Clinics in sports medicine. 2015;34(2):313-27.
4. Meira EP, Brumitt J. Influence of the hip on patients with patellofemoral pain syndrome: a systematic review. Sports health. 2011;3(5):455-65.
5. Hudson Z, Darthuy E. Iliotibial band tightness and patellofemoral pain syndrome: a case-control study. Manual therapy. 2009;14(2):147-51.
6. Redd M. Mechanical and Physical Characteristics of Knee Flexors and Extensors Following Different Warm up Protocols in Collegiate Male Soccer Athletes. 2018.
7. Breda SJ, van der Vlist A, de Vos R-J, Krestin GP, Oei EH. The association between patellar tendon stiffness measured with shear-wave elastography and patellar tendinopathy—a case-control study. European Radiology. 2020;30:5942-51.
8. Zago J, Amatuzzi F, Rondinel T, Matheus JP. Osteopathic manipulative treatment versus exercise program in runners with patellofemoral pain syndrome: a randomized controlled trial. Journal of Sport Rehabilitation. 2020;30(4):609-18.
9. Fradkin AJ, Zazryn TR, Smoliga JM. Effects of warming-up on physical performance: a systematic review with meta-analysis. The Journal of Strength & Conditioning Research. 2010;24(1):140-8.
10. Haff GG, Triplett NT. Essentials of strength training and conditioning 4th edition: Human kinetics; 2015.
11. Morales‐Artacho A, Lacourpaille L, Guilhem G. Effects of warm‐up on hamstring muscles stiffness: Cycling vs foam rolling. Scandinavian journal of medicine & science in sports. 2017;27(12):1959-69.
12. Emery CA, Pasanen K. Current trends in sport injury prevention. Best Practice & Research Clinical Rheumatology. 2019;33(1):3-15.
13. Curran PF, Fiore RD, Crisco JJ. A comparison of the pressure exerted on soft tissue by 2 myofascial rollers. Journal of sport rehabilitation. 2008;17(4):432-42.
14. Huang SY, Di Santo M, Wadden KP, Cappa DF, Alkanani T, Behm DG. Short-duration massage at the hamstrings musculotendinous junction induces greater range of motion. The Journal of Strength & Conditioning Research. 2010;24(7):1917-24.
15. Hendricks S, den Hollander S, Lombard W, Parker R. Effects of foam rolling on performance and recovery: A systematic review of the literature to guide practitioners on the use of foam rolling. Journal of Bodywork and Movement Therapies. 2020;24(2):151-74.
16. Cheatham SW, Kolber MJ, Cain M, Lee M. The effects of self‐myofascial release using a foam roll or roller massager on joint range of motion, muscle recovery, and performance: a systematic review. International journal of sports physical therapy. 2015;10(6):827.
17. Peacock CA, Krein DD, Antonio J, Sanders GJ, Silver TA, Colas M. Comparing acute bouts of sagittal plane progression foam rolling vs. frontal plane progression foam rolling. The Journal of Strength & Conditioning Research. 2015;29(8):2310-5.
18. Behm DG, Alizadeh S, Anvar SH, Mahmoud MMI, Ramsay E, Hanlon C, et al. Foam rolling prescription: A clinical commentary. The Journal of Strength & Conditioning Research. 2020;34(11):3301-8.
19. Akbari H, Sahebozamani M, Daneshjoo A, Amiri-Khorasani M. Effect of the FIFA 11+ programme on vertical jump performance in elite male youth soccer players. Montenegrin Journal of Sports Science and Medicine. 2018;7(2):17.
20. Barengo NC, Meneses-Echávez JF, Ramírez-Vélez R, Cohen DD, Tovar G, Bautista JEC. The impact of the FIFA 11+ training program on injury prevention in football players: a systematic review. International journal of environmental research and public health. 2014;11(11):11986-2000.
21. Erkut O, Gelen E, Sunar C. Acute effects of different warm-up methods on dynamic balance. Int J Sports Sci. 2017;7(3):99-104.
22. Small K, Mc Naughton L, Matthews M. A systematic review into the efficacy of static stretching as part of a warm-up for the prevention of exercise-related injury. Research in sports medicine. 2008;16(3):213-31.
23. Alghadir AH, Anwer S, Iqbal A, Iqbal ZA. Test–retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. Journal of pain research. 2018;11:851.
24. Katz J, Melzack R. Pain control in the peroperative period, measurement of pain. Surg Clin North Am. 1999;79(2):231-52.
25. Padua DA, Marshall SW, Boling MC, Thigpen CA, Garrett Jr WE, Beutler AI. The Landing Error Scoring System (LESS) is a valid and reliable clinical assessment tool of jump-landing biomechanics: the JUMP-ACL study. The American journal of sports medicine. 2009;37(10):1996-2002.
26. Leif H. Evaluation of Biomechanical Risk Factors in Division II Collegiate Female Athletes Using the Landing Error Scoring System (LESS) After an 8-Week Neuromuscular Training Program. 2013.
27. Hanzlíková I, Hébert-Losier K. Is the Landing Error Scoring System Reliable and Valid? A Systematic Review. Sports Health. 2020;12(2):181-8. doi: 10.1177/1941738119886593.
28. Markovic G, Dizdar D, Jukic I, Cardinale M. Reliability and factorial validity of squat and countermovement jump tests. The Journal of Strength & Conditioning Research. 2004;18(3):551-5.
29. Bushong JR. Foam rolling as a warm-up: The effect on lower extremity flexibility compared to aerobic and stretching protocols: University of Arkansas; 2011.
30. Sadigursky D, Braid JA, De Lira DNL, Machado BAB, Carneiro RJF, Colavolpe PO. The FIFA 11+ injury prevention program for soccer players: a systematic review. BMC sports science, medicine and rehabilitation. 2017;9(1):1-8.
31. Bizzini M, Junge A, Dvorak J. Implementation of the FIFA 11+ football warm up program: how to approach and convince the Football associations to invest in prevention. British journal of sports medicine. 2013;47(12):803-6.
32. Kallerud H, Gleeson N. Effects of stretching on performances involving stretch-shortening cycles. Sports medicine (Auckland, NZ). 2013;43(8):733-50. Epub 2013/05/18. doi: 10.1007/s40279-013-0053-x. PubMed PMID: 23681447.
33. Groeber M, Stafilidis S, Baca A. The effect of stretch-shortening magnitude and muscle-tendon unit length on performance enhancement in a stretch-shortening cycle. Scientific reports. 2021;11(1):14605. Epub 2021/07/18. doi: 10.1038/s41598-021-94046-2. PubMed PMID: 34272461; PubMed Central PMCID: PMCPmc8285374.
34. Pedley JS, Lloyd RS, Read PJ, Moore IS, Myer GD, Oliver JL. A Novel Method to Categorize Stretch-Shortening Cycle Performance Across Maturity in Youth Soccer Players. Journal of strength and conditioning research. 2020. Epub 2020/12/06. doi: 10.1519/jsc.0000000000003900. PubMed PMID: 33278273; PubMed Central PMCID: PMCPmc8172663.
35. Boguszewski D, Falkowska M, Adamczyk JG, Białoszewski D. Influence of foam rolling on the functional limitations of the musculoskeletal system in healthy women. Biomedical Human Kinetics. 2017;9(1):75-81. doi: doi:10.1515/bhk-2017-0012.
36. Aune AAG, Bishop C, Turner AN, Papadopoulos K, Budd S, Richardson M, et al. Acute and chronic effects of foam rolling vs eccentric exercise on ROM and force output of the plantar flexors. Journal of Sports Sciences. 2019;37(2):138-45. doi: 10.1080/02640414.2018.1486000.
37. Bushell JE, Dawson SM, Webster MM. Clinical Relevance of Foam Rolling on Hip Extension Angle in a Functional Lunge Position. The Journal of Strength & Conditioning Research. 2015;29(9):2397-403. doi: 10.1519/jsc.0000000000000888. PubMed PMID: 00124278-201509000-00003.
38. Everard E, Lyons M, Harrison AJ. Examining the association of injury with the Functional Movement Screen and Landing Error Scoring System in military recruits undergoing 16 weeks of introductory fitness training. Journal of Science and Medicine in Sport. 2018;21(6):569-73. doi: https://doi.org/10.1016/j.jsams.2017.05.013.
39. David E, Amasay T, Ludwig K, Shapiro S. The Effect of Foam Rolling of the Hamstrings on Proprioception at the Knee and Hip Joints. Int J Exerc Sci. 2019;12(1):343-54. PubMed PMID: 30899339.
40. Junker DH, Stöggl TL. The foam roll as a tool to improve hamstring flexibility. The Journal of Strength & Conditioning Research. 2015;29(12):3480-5.
41. Nakamura M, Onuma R, Kiyono R, Yasaka K, Sato S, Yahata K, et al. The Acute and Prolonged Effects of Different Durations of Foam Rolling on Range of Motion, Muscle Stiffness, and Muscle Strength. J Sports Sci Med. 2021;20(1):62-8. doi: 10.52082/jssm.2021.62. PubMed PMID: 33707988.
42. Li L, Huang F, Huang Q, Liu L, Opoku Antwi E, Nguyen T. Compression of Myofascial Trigger Points With a Foam Roller or Ball for Exercise-induced Anterior Knee Pain: A Randomized Controlled Trial. Alternative therapies in health and medicine. 2020;26(3):16-23. Epub 2020/05/24. PubMed PMID: 32445557.
43. Chen Z, Wu J, Wang X, Wu J, Ren Z. The effects of myofascial release technique for patients with low back pain: A systematic review and meta-analysis. Complementary therapies in medicine. 2021;59:102737. Epub 2021/05/14. doi: 10.1016/j.ctim.2021.102737. PubMed PMID: 33984499.
44. Cheatham SW, Baker R. Differences in pressure pain threshold among men and women after foam rolling. Journal of Bodywork and Movement Therapies. 2017;21(4):978-82. doi: https://doi.org/10.1016/j.jbmt.2017.06.006.
45. Nakamura M, Konrad A, Kiyono R, Sato S, Yahata K, Yoshida R, et al. Local and Non-local Effects of Foam Rolling on Passive Soft Tissue Properties and Spinal Excitability. Front Physiol. 2021;12:702042-. doi: 10.3389/fphys.2021.702042. PubMed PMID: 34248682.
| Files | ||
| Issue | Vol 9, No 2 (2023) | |
| Section | Research Articles | |
| DOI | https://doi.org/10.18502/jost.v9i2.12625 | |
| Keywords | ||
| Patellofemoral Pain Syndrome Athletes Warm-Up Exercise Pain Athletic Performance | ||
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How to Cite
1.
Azizan S, Sheikhhoseini R, Piri H, Zamankhanpour M. The Effect of Stretching, Foam Rolling, and FIFA 11+ Warm-ups on Performance and Pain in Athletes with Knee Pain. J Orthop Spine Trauma. 2023;9(2):69-73.
