Effects of Tissue Flossing on the Healthy and Impaired Musculoskeletal System: A Scoping Review.

Richard Močnik,Masatoshi Nakamura,Andreas Konrad

doi:10.3389/fphys.2021.666129

Richard Močnik, Masatoshi Nakamura + Show 1 more

Open Access

https://doi.org/10.3389/fphys.2021.666129

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Abstract

There is a belief that tissue flossing can improve the range of motion or performance, speed up recovery, and decrease the pain caused by various diseases or injuries. As a result, many therapists, patients, and athletes are now using this technique. Consequently, in the last 5 years, a number of studies have addressed these assumptions. The purpose of this scoping review is to introduce the application of a floss band and to summarize the existing evidence for the effect of floss band treatment on the range of motion, performance, recovery, and pain (due to disease or injuries). A further goal is to suggest what needs to be addressed in future studies. The online search was performed in PubMed, Scopus, and Web of Science databases. Any studies dealing with the effects of a floss band treatment on the range of motion, performance, recovery, or pain parameters in any population (e.g., patients, athletes) were included in this review. Twenty-four studies met the inclusion criteria, with a total of 513 participants. The included studies revealed that there is evidence that a single floss band treatment is able to increase the range of motion of the related joint and can positively affect jumping and strength performance. However, these findings show only small to moderate effect sizes. Although not yet clearly understood, a possible mechanism for such changes in the range of motion or performance is likely due to changed neuromuscular function, rather than changed mechanical properties, of the muscle (e.g., stiffness). All in all, there is a need to conduct long-term studies about the effects of flossing treatment on the range of motion and performance (e.g., strength or jumping parameters) and its related mechanism (e.g., pain tolerance). There is weak evidence that flossing can be of value for pain relief in the treatment of certain diseases and for speeding up recovery after exercise. Moreover, there is weak evidence that flossing might have a superior conditioning (warm-up) effect compared to stretching when the goal is to improve the range of motion or certain aspects of muscle strength, while no such superior effect has been reported when compared to foam rolling.

Highlights

Tissue flossing was first proposed by Starrett and Cordoza (2015), who suggested that flossing can increase the range of motion and/or performance, speed up recovery, and decrease pain caused by various disease or injuries
Other studies with control groups dealing with other joints than the ankle joint have reported a positive effect on the range of motion from a floss band application compared to the control group
According to the data that we extracted in this scoping review, it can be assumed that both joint flossing and soft tissue flossing have a positive impact on the range of motion, but with only a small to moderate magnitude of change

Summary

Introduction

Tissue flossing was first proposed by Starrett and Cordoza (2015), who suggested that flossing can increase the range of motion and/or performance (e.g., strength or jumping performance), speed up recovery, and decrease pain caused by various disease or injuries. One of the earliest peer-reviewed papers on the topic of floss band application (Driller and Overmayer, 2017) recommended wrapping the floss bland around a limb for 1 to 3 min and to overlap the floss band by 50% with regard to the previous wrap. Starrett and Cordoza (2015), e.g., suggested that possible mechanisms for increases in the range of motion could be related to fascial shearing or an increased reperfusion of blood following a vascular occlusion As of the time of writing, there was only some little scientific evidence on the responsible mechanisms behind the possible changes on the range of motion and performance parameters (e.g., strength or jump performance). Starrett and Cordoza (2015), e.g., suggested that possible mechanisms for increases in the range of motion could be related to fascial shearing or an increased reperfusion of blood following a vascular occlusion

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