- Posted on: Oct 19 2017
One of the newer joint mobilization techniques that is commonly practiced in many physical therapy clinics, gyms, and athletic training facilities is Joint Flossing using a compressive wrap; one of the more popular brands called Voodoo-Floss. In practice a band is wrapped around a joint or muscle that is restricted creating a powerful compressive force, afterwards person performs movements into the direction of restriction to help improve their mobility. The great benefit of joint flossing techniques with compressive wraps is that a patient or athlete can be taught to use this on their own and use the technique as an adjunct to their current therapy program or training program; preventing any loss of movement between sessions.
The mechanism of action in compressive flossing includes a “global sheering” effect to restore a sliding and gliding mechanism between different layers of tissues in the body. When soft tissue is restricted, it is not only shortened at the muscle fibers themselves. Many joint range of motion restrictions are not only restricted by the muscle fibers but by fascia and scar tissue. Different layers of the human body must slide and glide along eacth other to create movement; muscle must often glide along a soft tissue sheath called fascia, which encapsulates many muscles in the body. When a person experiences restrictions in motion at a joint they often lose the gliding and sliding abilities of the muscle due to adherence of the fibers or fascia to bone, scar tissue, or themselves. Adding a compressive force to the restricted area and then performing movements is said to help restore the necessary gliding along all the different soft tissues in the body and ultimately restore movement.
Joint flossing can be done to any joint in the body, but is most commonly used with elbow, knee, and ankle joints. The reason for this compression creates a much needed gapping effect to these joints that is specific to their mechanics. Another great aspect of joint flossing is that it can be used to practice specific movements that are limited. An important factor in training or rehabilitation is specificity, the best way for a person to learn to walk again is to practice walking. The same concept goes for all movements, a person may perform a static runners stretch for their calves and decrease restriction at their ankle, but doing so may not improve ankle range of motion when performing a squat. The best way to improve this ankle motion while squatting is to perform a squatting movement and attempt to push the body into a full range of motion. Using a compressive flossing band around the ankle can help push out that extra range of motion needed to perform an efficient and pain free squat.
Flossing bands can also be beneficial with post-surgical patients because they can help clear swelling and push metabolites and toxins back into circulation. Swelling often restricts range of motion after surgery; with flossing techniques a patient can perform a movement with compression in order to pump all the excess fluid into their lymphatic system.
When applying a floss band, it is tightly wrapped from proximal to distal with an overlapping technique. A 75% stretch is applied when wrapping the band to ensure proper compression but avoid any anoxic effects or neural compression. The patient then performs the restricted motion and attempts to push themselves to end range. The compressive force will also help to reduce the pain that may be associated if a patient is pushing into their restriction. One should make sure to avoid any pallor, tingling, or numbness effects that can be created from excess compression, which is why it is important to have a skilled professional apply the technique on a patient.
While there is little evidence existing to support joint mobilization with compressive flossing due it being relatively new, it can still be an effective tool to supplement current rehabilitative treatments and training.