Medical Flossing at the Ankle Joint - Effects on Range of Motion, Balance and Subjective Effort Randomized Controlled Trial

Ankle sprain is one of the most frequent injuries of athletes. Consequently, adequate prevention is important. Known risk factors are limited mobility of the ankle and a lack of balancing ability. In these cases, medical flossing, a new form of therapy, could be put to good use, since it promises improved mobility and a reintegration of proprioception. The aim of this study was to test the impact of medical flossing on the dorsiflexion of the ankle joint and dynamic balance in healthy recreational athletes. In the randomized controlled trial, the intervention group performed an exercise with medical flossing at the ankle joint, the control group performed the same exercise without flossing. Primary outcomes were range of motion of the ankle joint in dorsiflexion, measured by the weight bearing lunge test, as well as dynamic balance, measured by the Y balance test. As a secondary outcome, subjective effort was assessed using a rating scale. The study employed a two-factor ANOVA with repeat measurements. Twenty athletes were included in the trial, 10 in each group. The results for dorsiflexion showed a statistical significant goup and time effect with a difference from pre measurement to all other time points. Compared to pre-measurements posterolateral reach in the Y balance test improved significantly in both groups, but no differences were observed between the groups. There was a time-effect in the postero-medial direction, but no differences could be demonstrated post hoc. There were no significant differences in the anterior direction. Subjective effort in the intervention group was found to be statistically significant lower. In this study, flossing in combination with active exercise could improve range of motion but not balancing ability in recreational athletes, compared to active exercise without flossing. However, exercises with flossing were found to require less subjective effort.