TENS Versus Foam Rolling for Muscle Recovery After Eccentric Exercise in Elite Female Volleyball Players

NCT07438197 | Completed

• 1 other identifier: IR.USB.REC.1399.007
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

Purpose: This study compared two recovery methods-transcutaneous electrical nerve stimulation (TENS) and foam rolling (FR)-for muscle recovery after intense exercise in elite female volleyball players. Background: Delayed-onset muscle soreness (DOMS) is common after intense training and can reduce athletic performance. TENS uses mild electrical currents applied through the skin to reduce pain and improve blood flow. Foam rolling uses a cylindrical device to apply pressure to muscles. Both methods are widely used by athletes, but no previous study has directly compared them in elite female volleyball players. Participants: Thirty elite female volleyball players from Iran's Premier League, aged 18-28 years, with at least five years of competitive experience. Procedures: Participants completed a demanding lower-body exercise protocol designed to induce muscle soreness. They were then randomly assigned to one of three groups: TENS group: received electrical stimulation to thigh muscles for 20 minutes Foam rolling group: performed self-massage with a foam roller for 20 minutes Control group: rested quietly for 20 minutes Interventions were applied 30 minutes after exercise and repeated 24 hours later. Outcomes Measured: Blood marker of muscle damage (creatine kinase \[CK\]) Vertical jump height Anaerobic sprint power Muscle soreness Measurements were taken before exercise and at 1, 24, and 48 hours afterward. Hypothesis: Both active recovery methods would reduce muscle damage markers and preserve jumping ability better than passive rest, with TENS potentially providing faster benefits.

Conditions

Delayed-Onset Muscle Soreness (DOMS); Exercise-induced Muscle Damage; Muscle Recovery; Athletic Injuries

Keywords

Transcutaneous electrical nerve stimulation; Foam rolling; Creatine kinase; Delayed-onset muscle soreness; Eccentric exercise; Elite athletes; Muscle damage recovery; Neuromuscular performance; Self-myofascial release; Volleyball; Vertical jump; TENS; DOMS; Female athletes; Anaerobic power

Outcome Measures

Primary Outcomes (3)

• Change in Serum Creatine Kinase (CK) Concentration

  Serum creatine kinase (CK) activity was measured as a biomarker of exercise-induced muscle membrane disruption. Venous blood samples (5 milliliters \[mL\]) were collected from the antecubital vein into serum separation tubes. Samples were centrifuged at 1500 × g for 10 minutes, and serum was stored at -80 degrees Celsius (°C) until analysis. CK activity was measured using an enzymatic colorimetric assay (CK-NAC, International Federation of Clinical Chemistry \[IFCC\] kinetic method) on an automated analyzer. Results are expressed in units per liter (U/L).

  Baseline (pre-exercise), 1 hour, 24 hours, and 48 hours postexercise

• Change in Vertical Jump Height

  Explosive lower-extremity power was assessed using the Sargent jump test. Participants stood adjacent to a wall-mounted measuring board graduated in 0.5-centimeter (cm) increments and marked their standing reach height with the dominant hand. They then performed a countermovement jump with an arm swing and touched the board at peak height. The best of three trials, separated by 30 seconds of rest, was recorded. Jump height was calculated as the difference between standing reach and peak jump height, expressed in centimeters (cm).

  Baseline (pre-exercise), 1 hour, 24 hours, and 48 hours postexercise

• Change in Anaerobic Peak Power

  Anaerobic peak power was derived from the Running-based Anaerobic Sprint Test (RAST). Participants completed six maximal 35-meter (m) sprints with 10-second passive recovery intervals. Sprint times were recorded using dual-beam infrared timing gates (accuracy ±0.001 seconds). Power output was calculated using the formula: body mass × distance² ÷ time³. Results are expressed in watts per kilogram (W/kg).

  Baseline (pre-exercise), 1 hour, 24 hours, and 48 hours postexercise

Secondary Outcomes (1)

• Change in Muscle Soreness

  Baseline (pre-exercise), 1 hour, 24 hours, and 48 hours postexercise

Study Arms (3)

Transcutaneous Electrical Nerve Stimulation (TENS)

EXPERIMENTAL

Participants received transcutaneous electrical nerve stimulation (TENS) applied to the quadriceps and hamstrings of the dominant leg using a clinical-grade stimulator. Four self-adhesive electrodes (5 × 9 centimeters \[cm\]) were positioned over the rectus femoris and biceps femoris. Stimulation parameters: biphasic symmetric waveform; frequency 120-150 hertz (Hz); pulse width 100 microseconds (μs); intensity 10-30 milliamperes (mA) adjusted to produce strong, comfortable paresthesia without visible muscle contraction; duration 20 minutes per session. Interventions were applied 30 minutes after the eccentric exercise protocol and repeated 24 hours (h) later, resulting in two sessions.

Device: Transcutaneous Electrical Nerve Stimulation (TENS)

Foam Rolling (FR)

EXPERIMENTAL

Participants performed foam rolling (FR) using a medium-density, smooth-surface foam roller (15 centimeters \[cm\] diameter × 45 cm length). A standardized bilateral sequence targeted the quadriceps, hamstrings, iliotibial band, gastrocnemius-soleus complex, and gluteal muscles. Each muscle group was rolled for 45 seconds per side at a cadence of approximately 3 cm per second. Three complete cycles were performed, totaling approximately 20 minutes per session. Interventions were applied 30 minutes after the eccentric exercise protocol and repeated 24 hours (h) later, resulting in two sessions.

Other: Foam Rolling (FR)

Control (CON)

NO INTERVENTION

Participants in the control (CON) group rested quietly in a supine position for 20 minutes without receiving any therapeutic intervention. Rest periods were applied 30 minutes after the eccentric exercise protocol and repeated 24 hours (h) later, matching the timing of active intervention sessions.

Interventions

Transcutaneous Electrical Nerve Stimulation (TENS) DEVICE

Transcutaneous electrical nerve stimulation (TENS) was delivered using a clinical-grade stimulator (SL400; Berjis Medical Equipment Co., Tehran, Iran). Stimulation parameters: biphasic symmetric waveform; frequency 120-150 Hertz (Hz); pulse width 100 microseconds (μs); intensity 10-30 milliamperes (mA) individually adjusted to produce strong, comfortable paresthesia without visible muscle contraction. Each session lasted 20 minutes. Sessions were conducted 30 minutes postexercise and repeated at 24 hours.

Transcutaneous Electrical Nerve Stimulation (TENS)

Foam Rolling (FR) OTHER

Foam rolling (FR) was performed using a medium-density, smooth-surface cylindrical foam roller (15 centimeters \[cm\] diameter × 45 cm length; Denafoam, Tehran, Iran). Participants followed a standardized bilateral rolling protocol targeting five muscle groups: quadriceps, hamstrings, iliotibial band, gastrocnemius-soleus complex, and gluteal muscles. Each muscle group was rolled for 45 seconds per side at approximately 3 cm per second. Three complete cycles were performed per session, totaling approximately 20 minutes. Sessions were conducted 30 minutes postexercise and repeated at 24 hours.

Foam Rolling (FR)

Eligibility Criteria

• Age: 18 Years - 28 Years
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Age 18-28 years
• At least five years of competitive volleyball experience
• Current participation in Iran's national Premier League
• Training frequency of at least five sessions per week
• Absence of musculoskeletal injury during the preceding six months

You may not qualify if:

• Use of anti-inflammatory medications or supplements
• Contraindications to transcutaneous electrical nerve stimulation (TENS), including cardiac pacemaker, epilepsy, or pregnancy
• Exposure to the study interventions (TENS or foam rolling \[FR\]) within the preceding four weeks
• Lower-body strength training within 72 hours (h) prior to testing

Sponsors & Collaborators

• University of Sistan and Baluchestan: lead

Study Sites (1)

Zahedan Olympic Village

Zahedan, Sistan and Baluchestan, Iran

Location

Related Publications (3)

• Balasubramaniam U, Dissanayake R, Annabell L. Efficacy of platelet-rich plasma injections in pain associated with chronic tendinopathy: A systematic review. Phys Sportsmed. 2015 Jul;43(3):253-61. doi: 10.1080/00913847.2015.1005544. Epub 2015 Jan 20.

  PMID: 25599747 RESULT

• Dupuy O, Douzi W, Theurot D, Bosquet L, Dugue B. An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis. Front Physiol. 2018 Apr 26;9:403. doi: 10.3389/fphys.2018.00403. eCollection 2018.

  PMID: 29755363 RESULT

• Pinto Dos Santos D, Baessler B. Big data, artificial intelligence, and structured reporting. Eur Radiol Exp. 2018 Dec 5;2(1):42. doi: 10.1186/s41747-018-0071-4.

  PMID: 30515717 RESULT

MeSH Terms

Conditions

Athletic Injuries

Interventions

Transcutaneous Electric Nerve Stimulation

Condition Hierarchy (Ancestors)

Wounds and Injuries

Intervention Hierarchy (Ancestors)

Electric Stimulation Therapy; Therapeutics; Physical Therapy Modalities; Rehabilitation; Analgesia; Anesthesia and Analgesia

Study Officials

• Mohammadreza Rezaeipour, MD, PhD

  University of Sistan and Baluchestan

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: A single trained assessor, blinded to group allocation, conducted all functional performance measurements (vertical jump test and Running-based Anaerobic Sprint Test \[RAST\]) and processed blood samples for creatine kinase (CK) analysis. Participants could not be blinded due to the nature of the interventions.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assoc.Prof.Dr.

Model Details: Three-group parallel design with participants allocated to one of three groups: transcutaneous electrical nerve stimulation (TENS), foam rolling (FR), or passive control (CON). Each participant remained in their assigned group throughout the study period. Interventions were applied 30 minutes after the eccentric exercise protocol and repeated 24 hours later. All assessments were conducted at baseline and at 1, 24, and 48 hours postexercise.

Study Record Dates

• First Submitted: February 22, 2026
• First Posted: February 27, 2026
• Study Start: September 1, 2020
• Primary Completion: September 1, 2020
• Study Completion: December 30, 2020
• Last Updated: March 3, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL
• Time Frame: Data will be available beginning immediately after publication with no end date.
• Access Criteria: Researchers who provide a methodologically sound proposal may request access to de-identified data. Requests should be directed to the corresponding author (rezaeipour@ped.usb.ac.ir). Data requestors will need to sign a data access agreement.

Locations

IR (1)