by Kathleen Choate, ATC, CSCS, CEAS, Athletic Trainer
I feel like every few years, a new treatment technique or tool comes out that catches a lot of people’s eyes and takes off like wildfire. Sometimes they aren’t even “new” products or techniques, but ancient and newly popular. Many years ago, I remember seeing massage sticks at a conference; now most of my athletes use it, and many own their own. Then I saw kinesiology tape on Misty May in the 2004 Olympics; now it’s widely used. A few years ago, I saw big red spots from cupping all over the swimmers in the 2016 Olympics; now it’s use is more commonplace, and we have methods of using it with suction cups instead of fire and glass. I was recently introduced to a new-to-me therapy technique that I haven’t seen widely used yet, but I wouldn’t be surprised if it gains traction.
Have you heard of flossing? I’m not talking about flossing your teeth or the floss dance move. I’m talking about tissue flossing. They are generally sold as rubber bands that are around 2 or 4 inches wide and 7 feet long. The band is typically wrapped around a muscle or joint. It can then be removed after a short period of time (30 seconds to 3 minutes), simple exercises can be performed, or a medical professional can apply additional therapy techniques to the area. The idea behind the floss is that it can be used to “increase joint range of motion (ROM), enhance prevention or rehabilitation from injury, and improve athletic performance.”1 One huge bonus for me when I’m learning about these new techniques is size. If it’s small and easily portable, it makes me more interested in the product.
Why does it work? There are a couple scientific theories. One theory is fascial shearing. The fascia is connective tissue under the skin that covers muscles and organs in the body. In an area of injury or reduced motion, it can become denser and the movement becomes limited. The application of tissue floss helps to return this tissue to a normal state. Another theory is blood flow occlusion. The wrapping technique temporarily restricts blood flow. When the band is removed, blood flows back into the area. This can increase hormones in the area that can cause, “enhanced muscle force and contractility and increased efficiency of excitation-contraction coupling.”2
As exciting as this is, there are downfalls. The biggest downfall is that very little research has been conducted so far. With so little research, it’s difficult to have a standard set of protocols, to know how safe the blood flow occlusion is, to know how long the effects of the treatment lasts, and how much of the benefits are a placebo effect. With that being said, there are areas where caution is warranted. Individuals with the following should not use tissue floss: bleeding disorders, varicose veins, severe health issues, systemic inflammatory conditions, areas with large blood vessels or veins, and over the head or neck. All tissue floss products on the market are made of latex, so those with a latex allergy will want to apply it over clothes or avoid using it altogether.
1. Driller, M. and Overmayer, R. (2017). The effects of tissue flossing on ankle range of motion and jump performance. Physical Therapy in Sport, 25, pp.20-24.
2. Driller, M., Mackay, K., Mills, B. and Tavares, F. (2017). Tissue flossing on ankle range of motion, jump and sprint performance: A follow-up study. Physical Therapy in Sport, 28, pp.29-33.