NCT07519148

Brief Summary

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.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
30

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Sep 2025

Shorter than P25 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

September 18, 2025

Completed
4 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 30, 2026

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

January 30, 2026

Completed
2 months until next milestone

First Submitted

Initial submission to the registry

April 2, 2026

Completed
7 days until next milestone

First Posted

Study publicly available on registry

April 9, 2026

Completed
Last Updated

April 9, 2026

Status Verified

April 1, 2026

Enrollment Period

4 months

First QC Date

April 2, 2026

Last Update Submit

April 2, 2026

Conditions

Achilles Tendinopathy (AT)

Keywords

Achilles tendinopathyVoodoo flossingTissue flossing

Outcome Measures

Primary Outcomes (1)

  • Numeric Pain rating scale

    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 Outcomes (3)

  • Range of motion

    From enrollment to the end of treatment at 1 week

  • Counter-movement Jump Height

    From enrollment to the end of treatment at 1 week

  • Lower Extremity Functional Scale (LEFS)

    From enrollment to the end of treatment at 1 week

Study Arms (2)

Intervention group

EXPERIMENTAL

Group receiving tissue flossing and eccentric exercises

Device: Tissue flossing

Control group

ACTIVE COMPARATOR

Group receiving only eccentric exercises

Other: Eccentric exercises

Interventions

Tissue flossingDEVICE

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.

Also known as: Voodoo flossing
Intervention group
Eccentric exercisesOTHER

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.

Control group

Eligibility Criteria

Age20 Years - 45 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • · 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.

You may not qualify if:

  • · 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.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Fauji Foundation Hospital

Rawalpindi, Punjab Province, 46000, Pakistan

Location

Related Publications (4)

  • Chen J, Wang Q, Zhao Z, Song Q, Zhao P, Wang D. Acute effects of tissue flossing on boxers with chronic knee pain. Front Bioeng Biotechnol. 2025 Jan 14;12:1508054. doi: 10.3389/fbioe.2024.1508054. eCollection 2024.

    PMID: 39877264BACKGROUND

  • Cheatham SW, Baker R. Tissue Flossing: A Commentary on Clinical Practice Recommendations. Int J Sports Phys Ther. 2024 Apr 1;19(4):477-489. doi: 10.26603/001c.94598. eCollection 2024.

    PMID: 38576832BACKGROUND

  • 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 Mar 1;29(3):282-286. doi: 10.1123/jsr.2018-0302.

    PMID: 30676229BACKGROUND

  • Borda J, Selhorst M. The use of compression tack and flossing along with lacrosse ball massage to treat chronic Achilles tendinopathy in an adolescent athlete: a case report. J Man Manip Ther. 2017 Feb;25(1):57-61. doi: 10.1080/10669817.2016.1159403. Epub 2016 May 30.

    PMID: 28855793BACKGROUND

Study Officials

  • Muhammad Tayyab Iqbal, DPT

    Riphah International University

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

April 2, 2026

First Posted

April 9, 2026

Study Start

September 18, 2025

Primary Completion

January 30, 2026

Study Completion

January 30, 2026

Last Updated

April 9, 2026

Record last verified: 2026-04

Data Sharing

IPD Sharing
Will not share

Locations

PA(1)