Short-Term Effects of Myofascial Release With or Without Active Mobility Exercises in Physically Active Men With Chronic Nonspecific Low Back Pain: A Randomized Crossover Trial

Myofascial release (MFR) is commonly used to reduce pain and facilitate movement in individuals with low back pain; however, whether adding active mobility exercises provides an incremental short-term benefit remains unclear. This randomized, controlled, three-condition crossover trial compared the acute and 48-h effects of MFR alone, MFR combined with active mobility exercises (MFR+MOB), and a Control condition in physically active men with chronic nonspecific low back pain. Thirty-two participants were enrolled, and 31 completed all experimental conditions and were included in the complete-case analysis. Pain intensity, trunk/posterior-chain flexibility, and bilateral active hip-flexion range of motion were assessed at baseline, immediately post-intervention, 10 min post-intervention, and 48 h. Nonparametric repeated-measures analyses preserved the within-participant structure of the crossover design. Pain reduction differed across conditions at all post-intervention time points (all p < 0.001), with both MFR and MFR+MOB showing greater reductions than Control, whereas MFR and MFR+MOB did not differ at Post-0 (adjusted p = 0.402), Post-10 (p = 0.683), or Post-48h (p = 0.672). Trunk/posterior-chain flexibility improved relative to Control after both active interventions, with no differences between MFR and MFR+MOB. Hip-flexion responses were more heterogeneous and were not consistently superior at 48 h. These findings indicate that a single session of MFR was associated with short-term reductions in pain and changes in mobility-related outcomes, while adding active mobility exercises did not provide a consistent incremental benefit over MFR alone within 48 h.