Voodoo Floss

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What is Voodoo Floss?

Commonly referred to as Compression Band Therapy (CBT), Voodoo Floss (VF) is the use of an elastic band to apply compression to improve range of motion and mobility, decrease pain, and improve performance. Personal trainers and Health Practitioners use VF as a rehabilitative tool to assist in one’s recovery.

How does Voodoo Floss work?

The honest answer is that we don’t really know. We know it works, but we’re not exactly sure how.
There are plenty of theories, but not much research focused on how VF works. One theory is that by applying compression, you would block blood flow to the affected area. However, research has found that VF has no significant effect on blood flow, debunking that hypothesis. The second theory is that VF can affect fascia, the connective tissue surrounding muscles. We now know that the only thing proven to affect facia is a scalpel, so VF is probably not making much change to the fascia. Another theory is that VF can improve proprioception, aka your awareness of your body’s position in space. For example, to treat your ankle we would tightly wrap it with an elastic band (VF) for several minutes. Naturally, you’re going to be more aware and have better control. The last theory is the placebo effect. The placebo effect is basically when you expect something to happen, it’s more likely to happen. This is also true in reverse. If you don’t expect anything to happen, it probably won't.

What does the current literature say about how VF works?

Several studies have looked at the benefits of using VF to improve power and range of motion in the upper extremity. Of the three studies, one concluded that it was too difficult to apply VF to the shoulder, do the complexity of the joint¹. One study found no significant improvement in elbow range of motion when compared to other modalities². The last study found no significant physical improvement in shoulder range of motion, but there was a perceived improvement in range³.

There are also several studies that looked at the use of VF for the lower extremity. One found that VF combined with lacrosse ball massage was an effective treatment for Achilles tendinopathy, whereby there was a significant improvement in pain and function4. Another study found that the use of VF significantly improved ankle range of motion and jumping performance5. The last study assessed the use of VF on improving ankle range of motion, and how long those effects last. They found an immediate increase in range of motion as well as an improvement in range seven hours post-treatment6.

With limited evidence available, it's difficult to conclude the effectiveness of VF on the upper extremity, or the shoulder and elbow. This is partly due to the difficulty of using VF on the shoulder. The study that used VF for the elbow found a significant improvement in range of motion, that was comparable to other modalities. The research focused on the use of VF for the lower extremity, more specifically the ankle, has found significant improvements in range of motion and performance.

How do you use Voodoo Floss?

There are several ways to use Voodoo Floss. If you’re looking to improve range of motion or mobility, increase performance or decrease pain, then VF may be useful to you. First off, you need to have the right supplies. You can purchase a Compression Band or Voodoo Floss, which is typically seven feet long and a bit thicker than your standard elastic bands, at several online retailers. Then you tightly wrap the Voodoo Floss around the joint in question and move it through the range of motion for several minutes before taking the VF off. Then re-test the range to see if you made any improvements.

We’ll use the elbow as a step-by-step example:

  1. Assess your current range of motion or pain levels in the elbow.
  2. Anchor one end of the band by wrapping it completely around the arm, about 10cm below the elbow joint.
  3. Begin wrapping the band around your arm overlapping by about half the band's width all the way up past the elbow.
  4. Apply approximately 50% pressure to the band. You want to know there’s pressure but you don't want to overly compress the nerves either. If after about 15-30 seconds you start to feel pins and needles in your hand, or your fingers turn white, the band pressure might be too tight.
  5. Continue wrapping the band around the arm working upwards until you are left with about 10-15cm.
  6. Tuck the remaining band underneath the last layer to act as an anchor.
  7. Now, you can: a) leave the band on and move your elbow through its range of motion or b) have someone move your elbow through its range of motion (passive range of motion). If you’re new to using VF then you might want to start with just getting a feel for the pressure and observing any of the signs that the band might be too tight.
  8. After about 3-4 minutes, detach the anchor at the end of the band and take it off. Move around a bit and, re-test your range of motion to note any improvement.

Although the research on VF seems to be inconclusive, plenty of evidence in the field suggests it may be a good modality for increasing range of motion at a joint, improve recovery of injuries, and improve performance. With this inexpensive, low-risk option that you can administer to yourself, it’s worth giving a try if you are experiencing range of motion deficiencies or rehabilitative issues.

Have you tried Voodoo Floss? Let us know what you think. Leave a comment below and tell us how it worked for you!

Dr. Cory Myers DPT, BKin, FMT
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References
1Plocker, D; Wahlquist, B; and Dittrich, B (2015) "EFFECTS OF TISSUE FLOSSING ON UPPER EXTREMITY RANGE OF MOTION AND POWER," International Journal of Exercise Science: Conference Proceedings: Vol. 12 : Iss. 1 , Article 37. Available at: https://digitalcommons.wku.edu/ijesab/vol12/iss1/37
2Hodeaux, Kenna, "The Effect of Floss Bands on Elbow Range of Motion in Tennis Players" (2017). Theses and Dissertations. 1948. https://scholarworks.uark.edu/etd/1948
3Keifer, B., Lemarr, K., Enriquez, C., Tivener, K., & Daniel, T. (20216). A pilot study: perceptual effects of voodoo floss band on glenohumeral flexibility. Athletic Therapy and Training: Vol 22; Iss https://journals.humankinetics.com/doi/pdf/10.1123/ijatt.2016-0093
4Borda, J. & Selhorst , M. (2017). 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: 25(1). https://www.ncbi.nlm.nih.gov/pubmed/28855793
5Driller, M. & Overmayer, R. (2017). The effects of tissue flossing on ankle range of motion and jump performance. Phys Ther Sport: 25(10). https://www.ncbi.nlm.nih.gov/pubmed/28254581
6Ross, Steven and Kandassamy, Gokulalakannan (2017) The Effects of ‘Tack and Floss’ Active Joint Mobilisation on Ankle Dorsiflexion Range of Motion using Voodoo Floss Bands. Journal of Physical Therapy.