# The long-term effects of tissue flossing on ankle range of motion, strength, balance, and jump performance in athletes with limited ankle dorsiflexion: a randomized controlled trial

## TL;DR

Tissue flossing improved ankle mobility and strength in athletes with limited ankle movement more effectively than static stretching, with some benefits lasting after stopping the treatment.

## Contribution

This study is the first to show that tissue flossing provides long-term improvements in ankle function compared to static stretching.

## Key findings

- Tissue flossing significantly increased ankle dorsiflexion and plantarflexion range of motion more than static stretching.
- Dynamic balance improved in specific directions with tissue flossing, but vertical jump performance was unaffected.
- Many benefits of tissue flossing were partially retained even after a six-week detraining period.

## Abstract

The long-term effects of tissue flossing (TF) on mobility, strength, balance, and muscle power remain unclear, particularly regarding its potential to produce performance enhancements. Here, we aimed to investigate the effects of TF on ankle range of motion (ROM), strength, balance, and jump performance in team- and racket-sport athletes with limited ankle dorsiflexion (DF).

Forty male athletes (DF-ROM < 10°) were randomized into a TF group (n = 20) or a control group performing static stretching (SS, n = 20). The TF intervention employed a standard figure-of-eight bandaging technique with 50–70% overlap, consisting of active movements with elastic band compression, three times a week for six weeks, followed by a six-week detraining period. The SS group performed 3 × 30 s stretches for the gastrocnemius and soleus muscles. Outcomes included DF and plantarflexion (PF) ROM, isokinetic strength at 30°/s and 120°/s, Y-balance test (YBT), and Sargent jump test (SJT), measured at baseline, post-intervention, and post-detraining.

TF produced larger gains than SS in DF-ROM (p < 0.001, d = 4.52) and PF-ROM (p < 0.001, d = 0.90), with partial retention after detraining (DF: p < 0.001, d = 1.26; PF: p = 0.004, d = 0.22). Strength improved mainly in DF (p < 0.001, d = 0.36–0.78) and in PF at slower speeds (p < 0.001, d = 017-0.29), with partial retention (DF at 30 and 120°/s: p = 0.004–0.04, d = 0.04–0.13; PF at 30°/s: p = 0.04, d = 0.06). YBT scores increased in the posteromedial (p < 0.001, d = 0.84) and posterolateral (p = 0.001, d = 0.84) directions, but not anteriorly (p > 0.05). No significant effects were observed for SJT (p > 0.05).

A six-week TF program effectively improved ankle ROM, strength, and dynamic balance in athletes with restricted DF, with many benefits persisting after detraining. Compared with static stretching, tissue flossing was more effective for long-term ankle function but did not enhance vertical jump performance. These results suggest that tissue flossing is a practical and efficient strategy for team- and racket-sport athletes seeking to restore and maintain ankle mobility and stability during training and rehabilitation.

This trial was registered at the Iranian Registry of Clinical Trials (Identifier: IRCT20230612058457N7) on June 14, 2025.

The online version contains supplementary material available at 10.1186/s13102-026-01609-9.