Effectiveness of a Flossing Protocol and Manual Therapy in Improving the Clinical and Functional Status of Subjects with Recurrent Ankle Sprains; A Double-Blind Randomized Clinical Trial

• Published in: Medical sciences (Basel) Vol. 13; no. 3; p. 149
• Main Authors: Bermúdez-Egidos, Mario, Pérez-Llanes, Raúl, Cuesta-Barriuso, Rubén
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 20.08.2025; MDPI
• Subjects: Adult; Ankle; Ankle Injuries - physiopathology; Ankle Injuries - therapy; Basketball; Biomechanics; Clinical trials; Double-Blind Method; Exercise; Female; Humans; Joint and ligament injuries; Knee; Male; Manipulative therapy; Musculoskeletal Manipulations - methods; Pain; Range of motion; Range of Motion, Articular - physiology; Recurrence; Sprains and Strains - physiopathology; Sprains and Strains - therapy; Treatment Outcome; Warm up (exercise); Young Adult; manual therapy; flossing; pressure pain threshold; sprain; stability; range of motion
• ISSN: 2076-3271; 2076-3271
• DOI: 10.3390/medsci13030149

Introduction: Recurrent ankle sprains can lead to chronic ankle instability. The flossing technique aims to modify the function and characteristics of fascial tissue. The objective was to evaluate the effectiveness of flossing and sliding techniques in improving subjects with previous ankle sprains. Methods: Randomized, double-blind clinical study with a follow-up period. Twenty-six subjects were assigned to two study groups: experimental (flossing technique and passive manual therapy techniques) and placebo control group (flossing technique without compression and manual therapy techniques without sliding). The intervention lasted three weeks, with two sessions per week. The study variables were dorsiflexion under load (Leg Motion®), ankle mobility under unloaded conditions (goniometer), pressure pain threshold (algometer), and stability (Rs Scan® pressure platform). Three measurements were taken: pre-treatment (T0), post-treatment (T1), and after 3 weeks of follow-up (T2). Results: There were significant intergroup differences in dorsiflexion under load (F = 4.90; p = 0.02). Range of motion in plantar flexion without load (F = 3.78; p = 0.04), in the ellipse area (F = 4.72; p = 0.01), left stability (F = 3.74; p = 0.03), and right stability (F = 3.73; p = 0.03) without visual support. Conclusions: A physiotherapy protocol using flossing and manual sliding therapy can increase loaded dorsal flexion in young adults with previous ankle sprains. This intervention can also improve ankle plantar flexion under unloaded conditions. The area of the ellipse without visual support can improve in young adults with a history of ankle sprains following a program of flossing and manual therapy.