A Survey Reveals SMR Use Is Driven by Preference, Not Proof—for Now

In the first study of its kind, researchers surveyed fit pros on their use of SMR. Here’s the first release of the survey’s findings—and the gaps in research that they have brought to the forefront.

by Scott W. Cheatham, PhD, DPT, PT, and Kyle Stull, DHSC, MS

As self-myofascial release continues to grow in popularity, so, too, must the research done on it.

This observational survey study was the first investigation to analyze and document trends in the use of self-myofascial release devices among fitness professionals. The popularity of SMR has increased over the last decade, prompting the creation of various devices and the widespread use by fitness professionals.

THE STUDY: “Trends in the Use of Self-Myofascial Release Devices Among Fitness Professionals: A Descriptive Survey,” by Scott W. Cheatham, Kyle R. Stull & Morey Kolber.

EDITORS’ NOTE: For the past 3 years, the use of self-myofascial release devices has been ranked among the top 20 fitness trends in an annual survey by the American College of Sports Medicine (Thompson 2016a; Thompson 2016b; 2017). The latest edition of NASM Essentials of Personal Fitness Training recommends using SMR before stretching and during the cooldown to “help correct existing muscle imbalances, reduce trigger points (knots within muscle) and inhibit overactive musculature” (NASM 2018).

Still, a quick web search reveals that there is no consensus on the optimal SMR program and parameters for different musculoskeletal conditions, including specifics such as cadence (timing), technique, amount of force and type of rolling device (Beardsley & Škarabot 2015; Cheatham et al. 2015). This lack of scientific guidelines has prompted fitness professionals to use their own preferred methods of SMR, as revealed in this study by Cheatham, Stull and Kolber.

To identify current trends, the study team surveyed fitness pros to learn how they are using SMR devices in their practices. One very important result: More than 86% of respondents reported that they believe there is a gap in current research on SMR. The findings suggest that this perceived gap has led to variations in practice among fitness professionals. Cheatham, Stull & Kolber hope that their findings will inspire more research into the effectiveness of various SMR techniques and devices, eventually resulting in scientific guidelines based upon evidence rather than preference and opinion.

We are honored that they have chosen this issue of American Fitness magazine to discuss their findings for the first time. Read on to learn what else the survey revealed—and whether your practices are in keeping with the most popular trends.

Study Participants and Methods

In our survey, we reached out to 1,211 fitness professionals from the National Academy of Sports Medicine and Equinox Fitness Clubs. Of the 202 people who responded (111 men, 91 women), more than 97% reported having a fitness certification, and most worked in a fitness or wellness center.

The online survey, which initially had 20 questions, went through two rounds of testing before being pared down to 12 questions in these subject areas:

  • what respondents believe about best practices and gaps in research
  • which SMR devices they recommend and where they suggest clients buy them
  • what practices fit pros suggest, including preferred cadence (number of seconds rolling up and down) and the frequency of SMR interventions (daily, weekly, etc.)
  • how they assess the success of SMR practices
  • how they educate clients on the use of SMR
  • (Note: For a copy of the survey, contact Cheatham at the email address provided at the end of this article.)

Study Results and Discussion

Most respondents were fitness professionals who work in fitness or wellness facilities and have less than 10 years of experience. Professionals with a longer work history (>10 years) or who work in different settings (e.g., small studio or home) may not have access to the same equipment or continuing education as those in larger organizations. This should be considered for future research, since this segment of the industry may be underrepresented in this study. The results of the survey suggest several SMR trends in the fitness industry:

Benefits of SMR. Most respondents believe that SMR helps increase mobility, increase joint range of motion and decrease pain. Medium- to higher-density rollers were thought to have the greatest effects. These results are consistent with current SMR research (Beardsley & Škarabot 2015; Cheatham et al. 2015; Schroeder & Best 2015).

Recommendation to clients. Most of the fit pros who took the survey reported that they prefer the full-size foam roller and often recommend both full- and half-size rollers to their clients, directing them to generic and manufacturer websites for purchase. These results suggest that foam rolling continues to be the most popular method of SMR, and clients may use multiple internet sources to purchase devices.

Exercise programming. The majority of respondents instruct their clients in person (rather than by video) when introducing SMR, and they most often recommend the following program:

  • using SMR daily as a pre- and post-exercise intervention to be done for a total of 5–10 minutes
  • rolling each muscle group for between 30 seconds and 2 minutes at a cadence of 2–5 seconds or at a self-paced cadence
  • progressing clients through different roller densities
  • using movement-based assessments and client-reported outcomes to measure the effects of SMR

Making a Case for Future Studies

More than 86% of this survey’s respondents say further investigations into SMR are needed. This is in sync with the current consensus that the optimal SMR program and related parameters have not been confirmed by researchers and professionals (Beardsley & Škarabot 2015; Cheatham et al. 2015). Until now, the research has been repetitive and limited to small sample sizes and short-term assessments (Beardsley & Škarabot 2015; Cheatham et al. 2015; Schroeder & Best 2015). While our current findings on SMR trends are reflective of the beliefs and practices of the surveyed group, future studies could reveal more by obtaining a larger sample size and surveying fitness professionals who work in a variety of settings with different types of clients. We hope that our initial survey will inspire such research and encourage others to explore new constructs to bring the fitness industry closer to a consensus on the optimal program for SMR.

References Beardsley, C., & Škarabot, J. 2015. Effects of self-myofascial release: A systematic review. Journal of Bodywork and Movement Therapies, 19 (4), 747–58.
Cheatham, S.W., et al. 2015. 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, 10 (6), 827–38.
NASM (National Academy of Sports Medicine). 2018. NASM Essentials of Personal Fitness Training (6th ed., pp. 174–75). Burlington, MA: Jones & Bartlett Learning.
Schroeder, A.N., & Best, T.M. 2015. Is self myofascial release an effective preexercise and recovery strategy? A literature review. Current Sports Medicine Reports, 14 (3), 200–208.
Thompson, W.R. 2016a. Worldwide survey of fitness trends for 2016: 10th anniversary edition. ACSM’s Health & Fitness Journal, 19 (6), 9–18.
Thompson, W.R. 2016b. Worldwide survey of fitness trends for 2017. ACSM’s Health & Fitness Journal, 20 (6), 8–17.
Thompson, W.R. 2017. Worldwide survey of fitness trends for 2018. ACSM’s Health & Fitness Journal, 21 (6), 10–19.

Rolling Out the Survey Results
professionals expressed regarding which self-myofascial devices they believe to be best—and what benefits they’ve seen in clients using them. Take a look at the questions below (and the survey results in parentheses) to see if you’re of the same opinion.

Which self-myofascial release (SMR) devices do you use most often in your practice? Please rank them.
_____ foam roller (71.28%)
_____ roller massage stick (3.96%)
_____ massage ball (11.88%)
_____ other devices (12.87%)

What type of SMR devices do you recommend to your clients? Choose all that apply.
_____ foam roller (89.11%)
_____ roller massage stick (38.61%)
_____ massage ball (84.16%)
_____ other devices (32.17%)
_____ none (3.46%)

What length of foam roller do you most commonly use and recommend to your clients?
_____ half size, 13–15 inches (21.29%)
_____ full size, 26–36 inches (44.55%)
_____ both sizes (34.16%)

What type of roller density do you believe has the greatest effect on the myofascial system?
_____ high density (33.66%)
_____ medium density (43.07%)
_____ soft density (4.95%)
_____ other (18.32%)

What are the reasons you choose SMR for your clients? Please rank them.
_____ high density (33.66%)
_____ medium density (43.07%)
_____ soft density (4.95%)
_____ other (18.32%)

What are the reasons you choose SMR for your clients? Please rank them.
_____ performance enhancement (7.42%)
_____ injury prevention (24.75%)
_____ recovery from injury (10.89%)
_____ pre-exercise warmup and postexercise treatment (56.93%)

What type of immediate and lasting (>2 weeks) changes have you seen with SMR? Choose all that apply.
_____ increased mobility (90.10%)
_____ decreased pain (84.65%)
_____ increased joint range of motion (76.24%)
_____ no change (1.48%)
_____ other (3.96%)

What clinical measures do you use to assess the effects of SMR? Choose all that apply.
_____ joint range of motion (21.78%)
_____ joint range of motion (21.78%)
_____ client-reported outcomes (e.g., pain scale) (56.93%)
_____ movement-based testing (75.74%)
_____ I don’t measure (3.46%)
_____ other (6.93%)

"More than 86% of fitness pros surveyed say there is a gap in the current research on self-myofascial release. This perceived gap has led to variations in SMR practice among individuals."

"More than 70% of fitness professionals use foam rollers, but just under 4% use a massage stick themselves."

Most survey respondents recommend rolling each muscle group for between 30 seconds and 2 minutes at a cadence of 2–5 seconds or at the client’s own pace.

Meet our experts

AFM_Author_Cheatham Scott W. Cheatham, PhD, DPT, PT,, is a kinesiology professor at California State University, Dominguez Hills. He is a researcher and consultant for various health and fitness organizations, including NASM and TriggerPoint. Reach him at scheatham@csudh.edu.

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