The Effects of Soft Tissue Flossing on Hamstring Range of Motion and Lower Extremity Power

# Background Flossing includes wrapping a specialized latex band around a muscle group providing compression, partially occluding blood flow, followed by performing exercises. This is hypothesized to improve flexibility by dissipating myofascial adhesions; however, research is lacking. # Objective To determine the effect of the application of a floss band to the thigh on hamstring flexibility and lower extremity power. # Design Crossover Study # Setting Exercise Physiology Laboratory. # Participants Twenty-one recreationally active individuals (8 male, 13 female; age = 22.62±2.99 years; height = 171.52±9.08 cm; mass = 73.57±11.37 kg). # Methods Three counterbalanced interventions were studied during body weight squats, lunges, and hamstring curls (without resistance): floss, sham, and control. The floss treatment included wrapping the Rogue Wide Voodoo Floss Band™ from the proximal knee to the gluteal fold at a pressure of 140 to 200 mmHg. The sham treatment included wrapping the same band in the same location with less pressure (10 to 40 mmHg) while the control treatment did not include floss band application. Hip flexion range of motion, via the straight leg raise, and power (single-leg vertical jump) were compared from pre-test to post-test using a 3x2 repeated measures ANOVA. # Results There was a significant interaction between time and session for hamstring flexibility (F~(2,40)~=17.54, *p*<0.001, η^2^=0.47). Post hoc tests showed significant differences between pre- (86.14±8.06 degrees) and post-test (90.81±7.69 degrees) for the floss session (*p*<0.001, Mean Difference=4.67, CI~95~=3.35-5.98) and between pre- (87.67±7.51 degrees) and post-test (89.86±7.88 degrees) for the sham session (*p*=0.001, Mean Difference=2.19, CI~95~=0.98-3.40). There were no significant interactions for jump power (F~(2,40)~=1.82, *P*=0.18, η^2^=0.08, 1-β=0.36). # Conclusions Flossing treatment increased hamstring flexibility more than the sham session without affecting lower body power. Flossing could be beneficial when treatment or performance preparation goals are increased flexibility without decreased power. Future studies should continue to examine the clinical effectiveness of flossing on an injured population

Trauma Induced Acute Compartment Syndrome of the Extremities: Predictors, Interventions, and Patient Outcomes A Critically Appraised Topic

Clinical Scenario: Acute compartment syndrome (ACS) is a sudden increase in osteofascial pressure as a result of a traumatic injury. An acute case is an emergency situation that requires surgical intervention. Trauma induced ACS of the extremities follow an injury to the musculoskeletal system and can vary from crushing injuries to avulsion fractures. However, not all ACS cases stem from fracture and the time frame from initial injury to diagnosis and treatment can vary from 4 hours to over 48 hours. Diagnosis and treatment time frames did not have a significant impact on patient outcomes. Clinical Question: What trauma induced injuries pose the most risk for acute compartment syndrome in the extremities? Summary of Key Findings: A thorough review yielded 4 studies that were relevant to the clinical question. Acute compartment syndrome (ACS) after trauma in the lower extremity is usually a result of crushing injuries and avulsion fractures especially at the tibial plateau. In the upper extremity they are a result of distal radius fractures, diaphyseal fractures of the radius and ulna, and perilunate dislocations. However, there have been outliers in either extremity that only involved soft tissue impact that did not present out of the ordinary when they occurred. Clinical Bottom Line: There is moderate evidence that trauma induced compartment syndrome has a higher incidence post fracture and crushing injuries. It is most common in the lower extremity with the highest incidence in the lower leg due to the size and number of muscles in the compartment. While trauma induced compartment syndrome in the forearm has occurred it is still considered rare. Soft tissue injuries and incidence of ACS in the thigh occur but with far less frequency. Predictors for such injuries also vary greatly. Strength of Recommendation: Moderate evidence exists to support that fractures and crushing injuries pose the highest risk for ACS in the extremities with the highest occurrences happening in the lower portion of the lower extremity

Comparison of Walking Mechanics Between Those With FCAI and Those Without FCAI Using RunScribe™ Technology While Walking 800m on a Standard 400m Synthetic Track

Context: Ankle sprains are among the most commonly injured joints to the physically active and have become increasingly troublesome to the general population. Recurrent ankle sprains are categorized as chronic ankle instability (CAI), leading to walking gait pattern discrepancies that can affect a person\u27s lifestyle and well-being. Objective: To compare walking mechanics between those with functional chronic ankle instability (FCAI) and those without FCAI using RunScribe technology while walking 800m on a standard 400m synthetic track. Design: Case-control Setting: Artificial synthetic track Participants: 26 individuals (CAI: n = 11; Healthy: n = 15) participated in this study. Main Outcome Measures: FAAM, IdFAI, Pronation excursion, pronation velocity, impact g, contact time, and stride length of every step of two 400 m walks were collected using RunScribe™ sensors. Results: A total of 26 participants (FCAI: n=11, healthy: n=15) completed this study. The FCAI group had higher weight, more ankle sprains, and self-reported significantly greater ankle impairments and activity limitations compared to the healthy in the IdFAI than the Healthy group. ANOVA analysis showed a significant main effect of pronation velocity on walking mechanics (p = .016). Participants in the healthy group ranked lower on pronation velocity than those with unilateral FCAI but not with bilateral. Conclusions: Our study aimed to compare the walking mechanics of individuals with functional chronic ankle instability (FCAI) to those without FCAI using RunScribe technology while walking 800m on a standard 400m synthetic track. Our findings suggest that individuals with FCAI exhibit some significant differences in walking mechanics compared to those without FCAI

Navicular Drop in Collegiate Distance Runners

Context: Although previous research has shown that navicular drop increases with fatigue of the foot intrinsics, it is unclear whether or not this occurs in a functional setting. Objective: To evaluate navicular drop in collegiate distance runners before and after distance runs and track workouts. Design: Descriptive Laboratory Study Setting: University outdoor practice facilities Participants: Fifteen healthy collegiate cross country runners (10 males, 5 females) Intervention: None Main Outcome Measures: Navicular drop (cm) Results: There was a significant interaction between workout and time for WBAH (F1,14=9.333, p=.009, η2=.400). Main effect for time was significant (F1.14=6.512, p=.023, η2=.317). Post hoc tests showed post-workout WBAH (4.95±.62) was lower than pre-workout height (5.12±.56; p=.02). Post hoc results revealed post-workout WBAH (4.82±.16 cm) were significantly lower than pre-workout measurements (5.18±.55 cm, p Conclusions: We speculate that the greatest change in arch height was seen after an interval workout due to the differences in shoes between the two workout types (spikes during interval as opposed to normal running shoes for distance). Additionally, we believe the change in WBAH after both workout types are likely due to anatomical changes of the foot due to functional fatigue of the intrinsic foot muscles

Difference between Regular Season and Postseason Impacts of Women’s Soccer

Context: Subconcussive head impacts receive increased attention for brain health. It remains unknown if game type affects frequency or magnitude of head impacts. Objective: Examine relationship between magnitude and frequency of head impacts during regular and postseason soccer games. Setting: Collegiate soccer fields. Participants: 17 women’s soccer athletes (height=163.68±4.99 cm, age=19.88±1.05 years, mass=61.12±5.00 kg) participated in 19 regular and 9 postseason games during 2014 season. Main Outcome Measures: Game type. XPatch sensor (Seattle, WA) collected linear (g) and rotational (deg/sec2) accelerations, Incidence rates (IR) and incidence rate ratios (IRRs) with corresponding 95% confidence intervals (CIs) determining frequency differences. Mann-Whitney U tests determined magnitude differences because normality assumptions were violated. Results: Regular season participants received almost 1 head impact per exposure (IR=945.95, CI= 835.15-1056.75). Postseason participants received head impacts in approximately 1 out of every 5 exposures (IR=195.49, CI=120.35-270.63). Participants were almost 5 times more likely (IRR=4.83, CI=3.23-7.23) to be hit in regular season. Mann-Whitney U tests showed significant differences between regular and postseason rotational accelerations (U=2710.00, P=0.03), with higher accelerations during postseason (mean=422422.20, SD±252332.763) than regular season (mean=317905.57, SD±199716.408). Conclusions: Fewer impacts occurred in postseason likely due to higher skill level; however, rotational accelerations may be higher during postseason due to increased athlete speed and power as competition level increased. Keywords: magnitude, frequency, X2 xPatch, intercollegiate

Analyzing magnitude and frequency of head impacts in relation to impact location in collegiate soccer athletes

Analyzing magnitude and frequency of head impacts in relation to impact location in collegiate soccer athletes Context: Studying the location of head impacts may provide insight on potential preventative efforts. Objective:To explore the relationship between magnitude and frequency of head impact locations in soccer athletes. Design: Descriptive epidemiology study. Setting: Collegiate soccer fields. Patients or Other Participants: 9 men’s (age=18.67±1 yr, height=183.57±5.39 cm, mass=80.32±13.50 kg) and 19 women’s (age=19.42±1.43 yr, height=166.17±5.24 cm, mass=64.15±7.23 kg) soccer athletes. Interventions: Impact location (back, front, side, top) was used as the independent variable. Participants wore xPatch sensors for all games and practices. Each event was video recorded to verify impacts. Main Outcome Measure(s): Sensors collected linear (g) and rotational (deg/s2) acceleration. We calculated incidence rates (IRs) per 1000 exposures and incidence rate ratios (IRRs) with corresponding 95% confidence intervals (CIs). Results: Division III soccer athletes are likely to experience 2 head impacts every 10 exposures (IR=214.49, Cl=186.65-242.33). Participants were 2.33 times more likely to get hit on the side of the head (IR=113.83, Cl=93.55-134.11) than the front of the head (IR=48.92, Cl=35.62-62.21; IRR=2.33, CI=1.68-3.22). The effect of the location on linear (�23=34.23, P\u3c.001) and rotational (�23=47.31, P\u3c.001) acceleration were both significant. Further analysis showed that both linear (F3,227=12.52, P\u3c.001, n2=.14) and rotational (F3,227=17.2, P\u3c.001, n2=.19) acceleration were significantly altered by impact location. Conclusions: Our results may influence an increase in coaching emphasis, behavior modifications, and education in an effort to reduce head impacts, especially to the side of the head. Keywords: X2 Biosystems, sensors, sports, concussion. Word Count: 23