BACKGROUND: Postoperative shoulder stiffness after arthroscopic rotator cuff repair (ARCR) is a frequent complication limiting recovery. Flossing therapy, applying circumferential compression with an elastic band, has shown promise in sports medicine but has not been reported in postoperative shoulder rehabilitation. CASE PRESENTATION: Two patients in their 50s developed stiffness after ARCR despite standard rehabilitation. Flossing was applied by wrapping an elastic band from the upper arm to the shoulder, followed by passive and active movements under compression, and then active motion after decompression. Flossing therapy was performed as an adjunct to routine postoperative rehabilitation. OUTCOME AND FOLLOW-UP: Case 1 improved flexion from 160° to 180°, abduction from 150° to 180°, and internal rotation from T12 to T7. Case 2 improved flexion from 110° to 170°, abduction from 80° to 170°, and internal rotation from L2 to T10. Both patients experienced reductions in pain and improvements in strength and satisfaction. DISCUSSION: These cases suggest that flossing therapy may help improve shoulder mobility when progress plateaus with standard rehabilitation. Possible mechanisms include enhanced fascial gliding and proprioceptive modulation; however, no causal conclusions can be drawn from two cases. Further controlled studies are needed to evaluate safety, efficacy, and optimal treatment parameters.
Sasaki et al. (Thu,) studied this question.