The Effects of Instrument-Assisted Soft Tissue Mobilization, Tissue Flossing, and Kinesiology Taping on Shoulder Functional Capacities in Amateur Athletes

in Journal of Sport Rehabilitation
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Context: Instrument-assisted soft tissue mobilization (IASTM), tissue flossing, and kinesiology taping are increasingly popular treatments among athletes for improving functional performance, despite limited evidence for their efficacy. Objective: Previous research regarding the efficacy of soft tissues and neuromuscular techniques on improving functional capacity of shoulder joints in athletes has yielded conflicting results. We examined the immediate and short-term effects of IASTM, flossing, and kinesiology taping on the functional capacities of amateur athletes’ shoulders. Design: Randomized controlled study. Setting: Clinical assessment laboratory. Participants: Eighty amateur overhead athletes (mean [SD]: age = 23.03 [1.89]; weight = 78.36 [5.32]; height = 1.77 [.11]). Interventions: We randomly assigned participants to 4 research sub-groups in which they received the following treatments on their dominant shoulders: IASTM (n = 20), flossing (n = 20), both IASTM and flossing (n = 20), and kinesiology tape (n = 20). Nondominant shoulders served as controls. Main Outcome Measure: We evaluated participants—before, immediately after, and 45 minutes after the therapeutic interventions—with the following tests: internal and external shoulder rotation range of motion, isokinetic strength and total work, the functional throwing performance index, and the one-arm seated shot put throw performance. Results: All therapeutic interventions significantly improved the strength and functional performance of the dominant shoulder in comparison with the control (P < .005) immediately after and 45 minutes after the treatment. The IASTM led to significantly greater improvement in shoulder internal rotation than kinesiology taping immediately after (P = .049) and 45 minutes after the treatment (P = .049). We observed no significant differences between the other treatment interventions (P > .05). Conclusion: Findings from the current study support the use of novel soft tissue and neuromuscular techniques for the immediate and short-term improvement of the shoulder functional capacities in amateur overhead athletes.

Angelopoulos, Mylonas, Tsepis, Billis, Vaitsis, and Fousekis are with the Department of Physical Therapy, University of Patras, Patras, Greece.

Fousekis (kfousekis@upatras.gr) is corresponding author.

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  • 1.

    Clarsen B, Bahr R, Heymans MW, et al. The prevalence and impact of overuse injuries in five Norwegian sports: application of a new surveillance method. Scand J Med Sci Sports. 2015;25(3):323330. PubMed ID: 24684525 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Asker M, Brooke HL, Waldén M, et al. Risk factors for, and prevention of, shoulder injuries in overhead sports: a systematic review with best-evidence synthesis. Br J Sports Med. 2018;52(20):13121319. PubMed ID: 29581141 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Ellenbecker TS, Roetert EP, Piorkowski PA, Schulz DA. Glenohumeral joint internal and external rotation range of motion in elite junior tennis players. J Orthop Sports Phys Ther. 1996;24(6):336341. PubMed ID: 8938599 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Torres RR, Gomes JLE. Measurement of glenohumeral internal rotation in asymptomatic tennis players and swimmers. Am J Sports Med. 2009;37(5):10171023. PubMed ID: 19261903 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Reinold MM, Wilk KE, Macrina LC, et al. Changes in shoulder and elbow passive range of motion after pitching in professional baseball players. Am J Sports Med. 2008;36(3):523527. PubMed ID: 17991783 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Hall K, Borstad JD. Posterior shoulder tightness: to treat or not to treat? J Orthop Sports Phys Ther. 2018;48(3):133136. PubMed ID: 29490601 doi:

  • 7.

    Driller M, Mackay K, Mills B, Tavares F. Tissue flossing on ankle range of motion, jump and sprint performance: a follow-up study. Phys Ther Sport. 2017;28:2933. PubMed ID: 28950149 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Saracoglu I, Emuk Y, Taspinar F. Does taping in addition to physiotherapy improve the outcomes in subacromial impingement syndrome? A systematic review. Physiother Theory Pract. 2018;34(4):251263. PubMed ID: 29111849 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Lambert M, Hitchcock R, Lavallee K, et al. The effects of instrument-assisted soft tissue mobilization compared to other interventions on pain and function: a systematic review. Phys Ther Rev. 2017;22(1–2):7685. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Plocker D, Wahlquist B, Dittrich B. Effects of tissue flossing on upper extremity range of motion and power. Int J Exerc Sci. 2015;12(1):37.

    • Search Google Scholar
    • Export Citation
  • 11.

    Nazari G, Bobos P, MacDermid JC, Birmingham T. The effectiveness of instrument-assisted soft tissue mobilization in athletes, participants without extremity or spinal conditions, and individuals with upper extremity, lower extremity, and spinal conditions: a systematic review. Arch Phys Med Rehabil. 2019;100(9):17261751. PubMed ID: 30797743 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Cai C, Au IP, An W, Cheung RT. Facilitatory and inhibitory effects of Kinesio tape: fact or fad? J Sci Med Sport. 2016;19(2):109112. PubMed ID: 25687484 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Dvir Z. Isokinetics: Muscle Testing, Interpretation, and Clinical Applications. London: Elsevier Health Sciences; 2004.

  • 14.

    Gursoy R. Effects of left-or right-hand preference on the success of boxers in Turkey. Br J Sports Med. 2009;43(2):142144. PubMed ID: 18203865 doi:

  • 15.

    Cools AM, De Wilde L, Van Tongel A, Ceyssens C, Ryckewaert R, Cambier DC. Measuring shoulder external and internal rotation strength and range of motion: comprehensive intra-rater and inter-rater reliability study of several testing protocols. J Shoulder Elbow Surg. 2014;23(10):14541461. PubMed ID: 24726484 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Wassinger CA, Myers JB, Gatti JM, Conley KM, Lephart SM. Proprioception and throwing accuracy in the dominant shoulder after cryotherapy. J Athl Train. 2007;42(1):8489. PubMed ID: 17597948

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Negrete RJ, Hanney WJ, Kolber MJ, et al. Reliability, minimal detectable change, and normative values for tests of upper extremity function and power. J Strength Cond Res. 2010;24(12):33183325. PubMed ID: 21088548 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Edouard P, Samozino P, Julia M, et al. Reliability of isokinetic assessment of shoulder-rotator strength: a systematic review of the effect of position. J Sport Rehabil. 2011;20(3):367383. PubMed ID: 21828388 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Zanca GG, Oliveira AB, Saccol MF, Mattiello-Rosa SM. Isokinetic dynamometry applied to shoulder rotators–Velocity limitations in eccentric evaluations. J Sci Med Sport. 2011;14(6):541546. PubMed ID: 21640649 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Fousekis K, Eid K, Tafa E, et al. Can the application of the Ergon® IASTM treatment on remote parts of the superficial back myofascial line be equally effective with the local application for the improvement of the hamstrings’ flexibility? A randomized control study. J Phys Ther. 2019;31(7):508511. PubMed ID: 31417211

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Shih YF, Lee YF, Chen WY. Effects of kinesiology taping on scapular reposition accuracy, kinematics, and muscle activity in athletes with shoulder impingement syndrome: a randomized controlled study. J Sport Rehabil. 2018;27(6):560569. PubMed ID: 29364027 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Bakeman R. Recommended effect size statistics for repeated measures designs. Behav Res Methods. 2005;37(3):379384. PubMed ID: 16405133 doi:

  • 23.

    Muller KE, Barton CN. Approximate power for repeated-measures ANOVA lacking sphericity. J Am Stat Assoc. 1989;84(406):549555. doi:

  • 24.

    Gulpinar D, Tekeli Ozer S, Yesilyaprak SS. Effects of rigid and kinesio taping on shoulder rotation motions, posterior shoulder tightness, and posture in overhead athletes: a randomized controlled trial. J Sport Rehabil. 2019;28(3):256265. PubMed ID: 28714759 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Harput G, Guney H, Toprak U, Colakoglu F, Baltaci G. Acute effects of scapular Kinesio Taping® on shoulder rotator strength, ROM and acromiohumeral distance in asymptomatic overhead athletes. J Sport Med. 2017;57(11):14791485. PubMed ID: 27391411 doi:10.23736/s0022-4707.16.06583-x

    • Search Google Scholar
    • Export Citation
  • 26.

    Loghmani MT, Bane S. Instrument-assisted soft tissue manipulation: evidence for its emerging efficacy. J Nov Physiother. 2016;3:2.

  • 27.

    Trofa DP, Obana KK, Herndon CL, et al. The evidence for common nonsurgical modalities in sports medicine, part 1: kinesio tape, sports massage therapy, and acupuncture. J Am Acad Orthop Surg Glob Res Rev. 2020;4(1):e1900104. PubMed ID: 32672727 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Forthomme B, Croisier JL, Ciccarone G, Crielaard JM, Cloes M. Factors correlated with volleyball spike velocity. Am J Sports Med. 2005;33(10):15131519. PubMed ID: 16009986 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Mills B, Mayo B, Tavares F, Driller M. The effect of tissue flossing on ankle range of motion, jump, and sprint performance in elite rugby union athletes. J Sport Rehabil. 2020;29(3):282286. PubMed ID: 30676229 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Rhyu HS, Han HG, Rhi SY. The effects of instrument-assisted soft tissue mobilization on active range of motion, functional fitness, flexibility, and isokinetic strength in high school basketball players. Technol Health Care. 2018;26(5):833842. PubMed ID: 30103358 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Mostert-Wentzel K, Swart JJ, Masenyetse LJ, et al. Effect of kinesio taping on explosive muscle power of gluteus maximus of male athletes. S Afr J Sports Med. 2012;24(3):7580. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32.

    Tozzi P. Selected fascial aspects of osteopathic practice. J Bodyw Mov Ther. 2012;16(4):503519. PubMed ID: 23036882 doi:

  • 33.

    Sawicki GS, Lewis CL, Ferris DP. It pays to have a spring in your step. Exerc Sport Sci Rev. 2009;37(3):130138. PubMed ID: 19550204 doi:

  • 34.

    Schleip R, Müller DG. Training principles for fascial connective tissues: scientific foundation and suggested practical applications. J Bodyw Mov Ther. 2013;17(1):103115. PubMed ID: 23294691 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Kumka M, Bonar J. Fascia: a morphological description and classification system based on a literature review. J Can Chiropr Assoc. 2012;56(3):179191. PubMed ID: 22997468

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Coviello JP, Kakar RS, Reynolds TJ. Short-term effects of instrument-assisted soft tissue mobilization on pain free range of motion in a weightlifter with subacromial pain syndrome. Int J Sports Phys Ther. 2017;12(1):144154. PubMed ID: 28217425

    • Search Google Scholar
    • Export Citation
  • 37.

    Wang Y, Gu Y, Chen J, et al. Kinesio taping is superior to other taping methods in ankle functional performance improvement: a systematic review and meta-analysis. Clin Rehabil. 2018;32(11):14721481. PubMed ID: 30020820 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Ravichandran H, Janakiraman B, Sundaram S, Fisseha B, Gebreyesus T, Gelaw AY. Systematic review on effectiveness of shoulder taping in hemiplegia. J Stroke Cerebrovasc Dis. 2019;28(6):14631473. PubMed ID: 30956057 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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