Effects of Tissue Flossing on Pain and Functional Performance in Patients With Achilles Tendinopathy

April 2, 2026 updated by: Riphah International University
This study is a randomized controlled trial (RCT) investigating the effectiveness of tissue flossing as an adjunctive therapy for Achilles tendinopathy. Thirty participants, aged 20-45 years with a clinical diagnosis of Achilles tendinopathy (>6 weeks), will be randomly assigned to one of two groups. The intervention group will receive a single session of tissue flossing (involving an elastic band wrapped from mid-calf to heel under moderate tension, followed by active ankle exercises) combined with conventional eccentric loading exercises. The control group will receive conventional eccentric loading exercises only. The primary outcome measures will be pain intensity, assessed using the Numeric Pain Rating Scale (NPRS); ankle range of motion, measured via the Weight-Bearing Lunge Test (WBLT); functional limitation, evaluated with the Lower Extremity Functional Scale (LEFS); and jump performance, measured by countermovement jump height using the My Jump Lab app. Assessments will be conducted at baseline, after the intervention session, and at a one-week follow-up. The study aims to determine if tissue flossing provides significant immediate and short-term improvements in pain and function, potentially offering a novel, low-cost supportive technique for rehabilitation.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

30

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab Province
      • Rawalpindi, Punjab Province, Pakistan, 46000
        • Fauji Foundation Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • · Adults aged 20-45 years.

    • Clinically diagnosed with Achilles tendinopathy for more than 6 weeks.
    • Ability to walk independently.
    • Pain on palpation of the Achilles tendon.
    • A pain score greater than 3/10 on the Numeric Pain Rating Scale (NPRS).
    • Subjective reporting of pain located 2-6 cm above the tendon's insertion into the calcaneum (heel bone).
    • A positive Painful Arc sign (pain localized to the tendon that moves with ankle motion).
    • A Body Mass Index (BMI) between 18.5 and 29.9.

Exclusion Criteria:

  • · Systemic inflammatory diseases (e.g., rheumatoid arthritis).

    • A recent corticosteroid injection (e.g., within the last 3 months) or surgery related to the Achilles tendon.
    • Diagnosed neurological deficits.
    • Recent fractures in the lower limb.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention group
Group receiving tissue flossing and eccentric exercises
Device: Tissue flossing
The intervention group receives a single session of tissue flossing combined with conventional treatment. The flossing protocol involves applying an elastic band (50-70% tension) from the mid-calf to the heel. While wrapped, participants perform active ankle range of motion and bodyweight heel raises for 2-3 minutes. This is immediately followed by the conventional treatment: eccentric loading exercises for the gastrocnemius (knee straight) and soleus (knee flexed 45°) muscles, consisting of 2 sets of 20 repetitions with a 5-minute rest between sets.
Other Names:
  • Voodoo flossing
Active Comparator: Control group
Group receiving only eccentric exercises
Other: Eccentric exercises
The control group will receive conventional treatment only, which consists of a standardized eccentric exercise program for the Achilles tendon. This protocol involves performing eccentric loading exercises for both the gastrocnemius muscle with the knee held straight and the soleus muscle with the knee flexed to 45 degrees. The dosage is set at two sets of twenty repetitions for each exercise, with a five-minute rest period provided between sets. This conventional regimen will be administered in three sessions over the course of one week. Participants in this group will not receive any form of tissue flossing intervention. All outcome measures, including pain, range of motion, functional performance, and jump height, will be assessed at baseline, after each treatment session, and at the one-week follow-up to evaluate progress.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Numeric Pain rating scale
Time Frame: From enrollment to the end of treatment at 1 week
Level of pain measured by Numeric Pain rating scale (NPRS), 0 means no pain and 10 means severe pain
From enrollment to the end of treatment at 1 week

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Range of motion
Time Frame: From enrollment to the end of treatment at 1 week
Range of motion at ankle joint measured using weight bearing lunge test
From enrollment to the end of treatment at 1 week
Counter-movement Jump Height
Time Frame: From enrollment to the end of treatment at 1 week
Countermovement Jump (CMJ) is a widely used, rapid, and non-invasive athletic assessment that measures lower-body explosive power, neuromuscular function, and fatigue. It involves an athlete standing upright, performing a quick downward movement (countermovement) to a self-selected depth, followed immediately by a maximal vertical jump
From enrollment to the end of treatment at 1 week
Lower Extremity Functional Scale (LEFS)
Time Frame: From enrollment to the end of treatment at 1 week
A 20-item, self-report questionnaire assessing the patient-perceived functional ability of individuals with lower extremity musculoskeletal conditions
From enrollment to the end of treatment at 1 week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Muhammad Tayyab Iqbal, DPT, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 18, 2025

Primary Completion (Actual)

January 30, 2026

Study Completion (Actual)

January 30, 2026

Study Registration Dates

First Submitted

April 2, 2026

First Submitted That Met QC Criteria

April 2, 2026

First Posted (Actual)

April 9, 2026

Study Record Updates

Last Update Posted (Actual)

April 9, 2026

Last Update Submitted That Met QC Criteria

April 2, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • REC/02271 Tayyab

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Achilles Tendinopathy (AT)

Clinical Trials on Tissue flossing

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Uganda

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe