BACKGROUND: Shoulder pain or range of motion (ROM) deficits are the third most frequent reason for physiotherapy treatment in Germany. For medical flossing, an intervention in which the area to be treated is tautly wrapped with an elastic band with high tension and subsequently moved, improvement in pain and ROM have been proposed. OBJECTIVE: The aim of this study was to assess the feasibility of an evaluation of medical flossing treatment in clinical practice, regarding patients' strain and safety as well as the standardized practicability. In addition, data to be used to calculate the required sample size in future studies were generated. Therefore, the effects and side effects of medical flossing in patients with pain and/or a restricted ROM in the shoulder were evaluated. METHODS: Participants received five physiotherapy sessions, with additional medical flossing or sham flossing. The primary outcome was upper extremity function tested by the Disabilities of the Arm, Shoulder and Hand (DASH). Secondary outcomes were, among others, pain level by numeric rating scale (NRS), ROM and the occurrence of side effects. Furthermore, reasons to reject the participation were noted. RESULTS: Twelve participants were included and completed the study on schedule, whereas other rejected the participation because of reservations regarding the treatment method and no time for data collection. Function and symptoms were positively affected by sham flossing and medical flossing (DASH, max NRS, ROM) in pre-post-comparison. However, there were no statistically significant differences between groups. All participants noted side effects, specifically pain and skin changes. Critical symptoms like dyspnea were only noted in individual participants in the experimental group (EG). CONCLUSION: Although function and symptoms were positively affected by the sham flossing and medical flossing, no statistical differences between groups exist. However, the sham flossing had a better clinical efficacy on the DASH score and maximal pain levels. Effects of medical flossing and the relationship between effects and side effects of flossing using varying tension remain unclear and need further research. To improve recruiting of patients in further studies, the number of assessments (functional arm movements, goniometer measurement) can be reduced.

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