Effects of foam rolling and the knowledge-to-action gap: are practitioners’ beliefs supported by the evidence? An international survey study

Foam rolling (FR) is commonly used in health and sports settings, yet it remains unclear how well current practice aligns with scientific evidence. We synthesised the available research on FR and compared it with practitioners' knowledge across professions and language-based cultural spheres.The evidence consistently supports acute increases in range of motion (ROM), short-term pain reduction, and transient improvements in muscle stiffness and blood flow. However, evidence for performance enhancement, injury prevention, and "fascial adhesion release" is limited or inconclusive, and data on safety are scarce.A cross-sectional online survey (n = 452; conducted in German, Italian, Portuguese, Spanish, and English-speaking countries) showed that only 2 of 15 evidence-based items reached the 80% correct response threshold. A simple majority answered just 10 items in accordance with current evidence, indicating substantial knowledge gaps. Accuracy varied by profession and cultural sphere.Overall, while FR is effective for acute ROM gains and pain relief, current beliefs about performance and long-term effects are not supported by robust evidence. The mismatch between research and practice highlights the need for clearer communication of findings, accessible continuing education, and evidence-based guidelines.Identified research gaps do not allow an appropriate judgement of the responses. This research gap calls for future research, while substantial effort should be invested into science communication to reach a broader audience.