Comparing the Effectiveness of Tissue Flossing Applied to Ankle Joint Versus Calf Muscle on Exercise Performance in Female Adults: an Observational, Randomized Crossover Trial

Background The prevalence of ankle sprains in females has higher than in males. A deficit in ankle dorsiflexion range of motion (DFROM) is a substantial contributor to ankle injuries, resulting in hampering exercise performance. Tissue flossing improves joint ROM and enhances performance. However, evidence of how floss band (FB) intervention influences the ankle joint and calf muscle is still lacking, particularly in women. We investigated comparing the effectiveness of FB applied to ankle joint versus calf muscle on exercise performance. Methods This study was a randomized, counterbalanced crossover trial. Eighteen recreationally women received functional movements without wrapping FB (WF), movements with wrapping the FB around the ankle joint (FAG), and movements with wrapping the FB around the calf muscle (FCM). Main outcome measures included ankle dorsiflexion range of motion (DFROM), pressure pain threshold (PPT), agility test before and 5 (POST5), 30 (POST30), and 60 (POST60) minutes after each of the three interventions in random order. Two-way repeated measures analysis of variance and effect size (Cohen's d) were statistically analyzed. Results FAG significantly increased ankle DFROM at POST5 (p = 0.01, d = 0.5), POST30 (p = 0.03, d = 0.48), and POST60 (p = 0.001, d = 0.75). FCM significantly increased at POST30 (p = 0.01, d = 0.35) and POST60 (p = 0.004, d = 0.37). Furthermore, FAG significantly improved agility at POST5 (p < 0.001, d = 0.39), POST30 (p = 0.004, d = 0.44), and POST60 (p = 0.007, d = 0.45); however, FCM only did at POST5 (p = 0.04, d = 0.29). The pressure pain threshold on the calf muscle did not significantly change. Conclusions FAG and WF enhance ankle ROM and agility immediately. Moreover, FAG demonstrates a prolonged effect of agility for 1 h. Practitioners may take this information into account for choosing efficient applications.