Author(s): MUKHERJEE, S., TEO, J.F., Institution: NATIONAL INSTITUTE OF EDUCATION, NANYANG TECHNOLOGICAL UNIVERSITY, SINGAPORE, Country: SINGAPORE, Abstract-ID: 847

INTRODUCTION:
Tissue Flossing (TF) as a self-myofascial release technique has gained attention as a pre-activity intervention to improve range-of-motion (ROM) and athletic performance1. However, the exact physiological mechanisms are poorly understood and remain speculative2,3. The “Fascial Gliding” theory proposes that TF improves ROM by mechanically shearing fascial adhesions and restoring potential space between myofascial layers4. This study utilized diagnostic ultrasound to investigate whether a 4-week calf TF intervention would induce structural changes in musculotendinous junction (MTJ) displacement and deep fascia mobility, and if these changes correlate with improvements in ankle dorsiflexion ROM (DFROM).
METHODS:
Twenty-five high-intensity intermittent team sport athletes (age: 23±4years; height: 175.9 ± 6.7cm; weight: 72.0 ± 8.9kg) were randomized into Active TF (ATF; n =13) and Passive TF (PTF; n=12) groups. Both groups underwent a 4-week intervention (3 sessions/week) with a floss band applied to the calf (180mmHg). ATF performed active ankle mobilizations during the 2-minute occlusion, while PTF remained stationary. Ultrasound imaging (B-mode) was used to visualize the medial gastrocnemius MTJ and deep fascia during passive ankle dorsiflexion (0° to 15°). Image analysis (Tracker software) quantified the proximal displacement of the MTJ and deep fascia. DFROM was assessed via the weight-bearing lunge test. A two-way mixed ANOVA assessed Group x Time interactions.
RESULTS:
There was a significant main effect of Time for DFROM (p < 0.05), with both groups significantly increasing ankle mobility over 4 weeks. However, ultrasound analysis revealed no significant increases in MTJ displacement or deep fascia mobility (p > 0.05) in either group. Furthermore, there was no significant correlation between the magnitude of DFROM improvement and change in fascial displacement (r = 0.12, p > 0.05).
CONCLUSION:
While a 4-week TF intervention significantly improved ankle mobility in male HIITS athletes, this study did not find evidence to support “Fascial Gliding” as the primary mechanism of action. The lack of structural changes in fascial displacement suggests that the observed mobility gains are not driven by mechanical release of adhesions. Rather, it is likely neurophysiological, potentially involving increased stretch tolerance or alterations in sensory perception.

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3. Gao et al. The potential mechanisms of tissue flossing with Flossband application around the joints or soft tissues: A theoretical framework. Apunts Sports Medicine 2024; 59: 100453.
4. Stecco et al. Fascial components of the myofascial pain syndrome. Curr Pain Headache Rep 2013; 17: 1–10.