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Asian J Kinesiol > Volume 27(2); 2025 > Article
Seo, Kim, Han, Lee, and Min: The Effects of Flossing Band and Kinesio Taping on Nondominant Knee Joint Muscle Strength, Power and Endurance in Young Adult Males

Abstract

OBJECTIVES

This study investigated the effects of flossing bands and kinesio taping on the muscle function of the non-dominant knee joint, focusing on changes in muscle strength, power, and endurance.

METHODS

Ten male university students were randomly assigned to three groups: no intervention, kinesio taping, and flossing band application. Participants performed knee flexion, knee extension, and squat exercises, while muscle function in the quadriceps and hamstrings was assessed using an isokinetic dynamometer at angular velocities of 60°/sec (strength), 180°/sec (power), and 240°/sec (endurance).

RESULTS

The results showed no significant differences in quadriceps strength among the groups(p > 0.05), but hamstring strength improved significantly in the flossing band group compared to the no intervention and kinesio taping groups(p < 0.05). Muscle power in both the quadriceps and hamstrings increased significantly with flossing band application(p < 0.001), while hamstring endurance was significantly enhanced in both the flossing band and kinesio taping groups compared to the no intervention group(p < 0.05).

CONCLUSIONS

The application of flossing bands significantly enhanced hamstring strength, power, and endurance compared to kinesio taping and no intervention. These findings suggest that flossing bands may be an effective intervention for improving knee joint muscle function, particularly in the non-dominant leg. Further research is needed to explore the long-term effects and practical applications of these interventions in rehabilitation and sports performance.

Introduction

In contemporary society, young adults spend prolonged periods in sedentary activities due to academic commitments, occupational obligations, and the extensive use of digital devices [1]. Prolonged sedentary behavior leads to a decline in physical activity levels, resulting in the weakening of lower limb musculature and potential joint health complications [2]. Among various joints, the knee is particularly susceptible to repetitive movements and mechanical loading, making young individuals prone to pain and functional impairments [3]. Improper posture, excessive usage, and insufficient muscular support exacerbate these issues, as evidenced by recent research conducted in South Korea, which indicates that 20-30% of young adults experience knee pain, leading to physical activity restrictions and disruptions in daily life [4]. These findings highlight that knee joint health is not exclusively a concern for the elderly but also significantly influences the quality of life and physical performance of younger generations [5].
The knee joint relies on the functional integrity of surrounding muscles, particularly the quadriceps and hamstrings, to maintain stability and facilitate dynamic movements. The quadriceps play a crucial role in knee extension, aiding in postural stability and locomotion, while the hamstrings contribute to knee flexion and hip extension, enhancing overall knee joint mobility [6, 7]. However, insufficient hamstring strength may lead to joint space narrowing and increased mechanical stress, potentially resulting in structural damage. Furthermore, an imbalance between quadriceps and hamstring strength can predispose individuals to musculoskeletal disorders such as patellar tendinitis, hamstring strain, and lower back pain [8, 9]. Additionally, strength asymmetry between the dominant and non-dominant legs negatively affects functional movement patterns and balance, increasing susceptibility to injuries [10, 11]. Research on ballet dancers has emphasized that disparities in strength between the dominant and non-dominant legs elevate knee joint loading during landing, thereby heightening the risk of injury [12]. Therefore, balanced lower limb strength is essential for ensuring functional stability, and identifying effective strategies to enhance knee joint strength and endurance is a critical concern for both athletes and non-athletes alike.
Flossing bands and kinesiology taping have garnered attention as potential methods for improving muscular function and joint stability. Flossing bands induce blood flow restriction, promoting metabolic stress and subsequently increasing lactate accumulation within muscles. This response stimulates growth hormone secretion, facilitating muscle recovery and enhancing strength development [13]. In contrast, kinesiology taping lifts the skin over targeted muscles, improving blood and lymphatic circulation while stimulating sensory receptors to modulate pain perception. Furthermore, it enhances neuromuscular activation, exerting positive effects on strength, power, and muscular endurance [14]. Despite their growing application, direct comparative studies on the effects of these methods on knee joint muscle function remain limited. Existing research on flossing bands has predominantly focused on enhancing ankle joint mobility and performance [15], whereas studies investigating their role in lower limb muscle strengthening are relatively scarce. Similarly although kinesiology taping has been extensively studied in musculoskeletal rehabilitation [16], comparative studies with flossing bands are still insufficient.
This study aims to bridge the existing gap in the literature by comparing the effects of flossing bands and kinesiology taping on strength, power, and endurance in the non-dominant knee joint of young adult males. While previous research has primarily concentrated on injury prevention and muscle recovery, this study seeks to empirically validate the efficacy of these two interventions in promoting lower limb strength development. Moreover, by elucidating the physiological mechanisms underlying each method, this study aspires to contribute to the optimization of training and rehabilitation protocols for young adults. The findings are expected to provide valuable insights into the practical application of flossing bands and kinesiology taping for individuals seeking to enhance knee joint muscle function.

Material and Methods

Participants

The sample size for this study was determined during the research design phase using the G-Power 3.1.3 software. A repeated measures design was employed, incorporating three conditions: no intervention, application of a flossing band, and application of kinesiology taping. The parameters set for sample size calculation were as follows: effect size (f) = 0.25, significance level (α) = 0.05, statistical power (1-β) = 0.80, and correlation among repeated measures (r) = 0.80. Based on the G-Power analysis, a minimum of 10 participants was required to ensure sufficient statistical power. However, considering potential attrition during the study, a total of 12 participants were recruited.
The participants were undergraduate students enrolled at G University, selected based on the following inclusion criteria: no history of orthopedic knee surgery within the past six months, no neurological disorders affecting the lumbar spine or lower extremities, and no allergic reactions to kinesiology tape. Prior to participation, all individuals received a comprehensive explanation of the study’s objectives and procedures and provided written informed consent voluntarily.
During the experimental phase, two participants withdrew due to personal reasons, resulting in a final sample of 10 participants included in the analysis. The physical characteristics of the participants are presented in <Table 1>.

Study design

This study aims to compare and evaluate the effects of no treatment, Kinesio taping, and flossing bands on muscular function when applied to the non-dominant leg during knee joint exercises. Prior to the intervention, pre-assessments were conducted to evaluate the bilateral muscle strength of 10 participants, and the leg with the lower strength values was designated as the non-dominant side. Based on these assessments, six participants were classified with a left-sided dominance, while four exhibited right-sided dominance. The difference in strength between the dominant and non-dominant sides ranged from 5% to 11% for the knee extensors and from 6% to 10% for the knee flexors. The flexor-to-extensor strength ratio was observed to be 35–45% on the left side and 38–48% on the right side <Table 2>. Participants were randomly assigned to different intervention conditions and exercise sequences using a lottery-based allocation method (drawing lots labeled A, B, C, D, E, and F). The knee joint exercise program was administered as a single-session intervention, incorporating modifications and refinements of previous studies that applied flossing bands. The exercises were performed at a low intensity utilizing body weight, with a perceived exertion level of 9–11 <17, 18> will be replaced with more recent studies. The program consisted of three exercises—Standing knee flexion & extension, and Squats—each performed for 15 repetitions across two sets, with a 2-minute rest interval between sets. The total exercise duration was 20 minutes <Table 3>. Following the completion of the exercise session, muscular function was assessed using isokinetic dynamometer. To account for neuromuscular recovery and to ensure accurate strength assessment under different intervention conditions, a 7-day washout period was implemented between each condition [19]. The experimental procedure is illustrated in <Figure 1>.

Flossing band application and exercise method

In this study, a green (Level 1) flossing band manufactured by Sanctband was used for the application of the flossing intervention. The band measured 5 cm in width and 2 m in length and was composed of latex material. The application method was modified based on the study by Konrad et al. [15] and was implemented as follows. The flossing band was applied in a proximal direction, starting from the distal region of the thigh on the non-dominant leg (5 cm above the knee). The band was wrapped with a 50% overlap to ensure even compression and was stretched to 50% of its original length (Stretch Ratio 1.5) to maintain consistent pressure. Care was taken to ensure uniform tension throughout the wrapping process, and the band was secured after covering approximately half the length of the thigh <Figure 2>. Following the application of the flossing band, participants maintained proper body alignment while performing the exercises outlined in Table 3. If a participant reported pain exceeding 7 on the Visual Analog Scale (VAS) or exhibited adverse reactions such as numbness, cyanosis, or sensory abnormalities, the flossing band was immediately removed, and the experiment was discontinued [20]. Furthermore, the application duration of the flossing band was strictly limited to 5–7 minutes. After band removal, participants engaged in light movement for one minute to facilitate lower limb blood circulation recovery.

Kinesio tape Application method

In this study, the application of Kinesio taping was modified based on the methodology proposed by Kenzo et al. [21]. The tape used was 3NS tape (5 cm in width, 140% elasticity) manufactured by TS Corporation. Kinesio taping was applied to the quadriceps femoris and hamstring muscles, with the specific application methods detailed as follows. For the quadriceps femoris, taping was applied to the vastus medialis, vastus lateralis, and rectus femoris muscles. The application was performed while the participant was seated with the knee flexed at 90°. Using an I-shaped tape strip (25 cm in length), the tape was affixed starting from the superior region of the knee and extended proximally along the thigh. The tape was applied with an elongation of 25–30%. For the hamstrings, taping was applied to the biceps femoris and semitendinosus muscles. Participants were positioned in a prone position with the knee slightly flexed during the application. An I-shaped tape strip (30 cm in length) was used, starting from the distal region of the thigh (popliteal area) and extending proximally toward the gluteal region. The tape was applied with an elongation of 25–30%, and care was taken to prevent the formation of wrinkles during application <Figure 3>. Following the application of Kinesio taping, participants performed the same exercise program as in the flossing band condition. If participants exhibited symptoms such as pruritus, erythema, or inflammation during the exercise session, the tape was immediately removed [16].

Assessment of muscle function using an isokinetic dynamometer

Muscle function assessment was conducted using an isokinetic dynamometer, following methodologies described in previous studies [22]. The evaluation parameters included muscle strength (60°/sec), muscle power (180°/sec), and muscle endurance (240°/sec). For the isokinetic measurements, participants were positioned on the assessment chair with the hip joint flexed to 90°. The rotational axis of the knee joint was aligned with that of the dynamometer. To minimize compensatory movements, participants were secured using a lumbar belt, pelvic belt, and medial malleolus strap <Figure 4>. After completing the weekly knee joint exercise interventions, muscle function of the non-dominant leg was assessed. Measurements included three repetitions at an angular velocity of 60°/sec and 180°/sec, and 26 repetitions at 240°/sec, to evaluate the strength, power, and endurance of the quadriceps femoris and hamstring muscles. A 30-second rest period was provided between each test [23].

Statistical analysis

In this study, statistical analyses were conducted using IBM SPSS Statistics 26 for Windows. Descriptive statistics were calculated for all variables, including the mean and standard deviation. To analyze differences in muscular function following the application of flossing bands and Kinesio taping during knee joint exercise interventions, a one-way repeated measures analysis of variance (ANOVA) was performed. Additionally, to account for potential issues related to multiple comparisons due to repeated measures, a post hoc analysis was conducted using the Bonferroni correction to adjust for Type I error. The level of statistical significance for all analyses was set at α = .05.

Results

This study was conducted to compare and analyze the effects of three conditions—no intervention, kinesio taping, and flossing bands—on the muscle strength, power, and endurance of the quadriceps and hamstrings in ten male university students. The results are as follows.

Comparison of knee muscle strength by intervention method

As shown in <Table 4>, there were no statistically significant differences in quadriceps strength among the three conditions—no intervention, kinesio taping, and flossing bands (p = 0.05). However, a statistically significant difference was observed in hamstring strength (p < 0.05). Post hoc analysis revealed no significant difference between the no-intervention and kinesio taping conditions (p > 0.05).

Comparison of knee muscle power by intervention method

As shown in <Table 5>, significant differences in muscle power were observed among the three conditions—no intervention, kinesio taping, and flossing bands—for both the quadriceps and hamstrings (p < 0.001). Post hoc analysis indicated that there were no significant differences between the no-intervention and kinesio taping conditions (p > 0.05). However, the flossing band intervention resulted in significantly greater muscle power in both the quadriceps and hamstrings compared to the other two conditions (p < 0.05).

Comparison of Knee Muscle Endurance by Intervention Method

As shown in <Table 6>, significant differences in muscle endurance were observed among the three conditions—no intervention, kinesio taping, and flossing bands—for both the quadriceps (p < 0.05) and hamstrings (p < 0.005). Post hoc analysis revealed no significant differences in quadriceps endurance among the three conditions (p > 0.05). However, for hamstring endurance, no significant difference was found between the kinesio taping and flossing band conditions (p > 0.05). Nevertheless, both interventions resulted in significantly greater hamstring endurance compared to the no-intervention condition (p < 0.05).

Discussion

This study aimed to compare the effects of three different intervention methods—flossing bands, kinesio taping, and no intervention—on the muscle strength, power, and endurance of the quadriceps and hamstrings in adult males. Based on the results, the discussion for each measurement parameter is as follows.

Effects of flossing bands and kinesio taping on muscle strength

Flossing bands induce a hypoxic state by restricting blood flow and increasing metabolic stress, thereby promoting muscle growth and strengthening [24]. This mechanism effectively activates fast-twitch muscle fibers, contributing to rapid strength gains within a short period [25]. In contrast, Kinesio taping enhances muscle activation, provides consistent tension and support to prevent excessive fatigue, and stimulates proprioceptive feedback, which aids in strength development [26]. In this study, the application of flossing bands and Kinesio taping was found to have a significant effect on the strength improvement of the quadriceps and hamstring muscles. Notably, in the hamstring muscles, the flossing band intervention demonstrated greater strength gains compared to both the no-treatment and Kinesio taping conditions. This finding suggests that flossing bands may induce strength gains similar to those observed in high-intensity training, even when applied in low-intensity exercise settings [27]. The non-dominant muscles are more prone to weakening due to lower usage frequency and often exhibit muscle strength imbalances between agonist and antagonist muscle groups. Such imbalances can increase the risk of injury, particularly during landing and directional changes [28]. To address this issue, Karabulut et al. [24] conducted a study applying flossing bands to the non-dominant limb and reported significant improvements in muscle strength and stability, thereby reducing injury risk. Additionally, pre-assessment results in this study indicated a low Hamstring-to-Quadriceps (H/Q) ratio, suggesting that the hamstring (flexor) was relatively weaker than the quadriceps (extensor). Previous studies have reported that, in the presence of muscular imbalances, the relatively weaker muscles tend to exhibit greater adaptive responses to external interventions [29]. This trend was also observed in the present study, where interventions using flossing bands and Kinesio taping had a more pronounced positive effect on hamstring strength improvement.

Effects of flossing bands and kinesio taping on muscle power

Flossing bands restrict blood flow, inducing a hypoxic state and enhancing the activation of fast-twitch muscle fibers, thereby facilitating improvements in muscular power [30, 31]. Kinesio taping, on the other hand, has been suggested to shorten the time required for maximal force production, thereby improving muscle reaction time and contributing to enhanced muscle contraction efficiency [32]. The findings of this study confirm that both flossing bands and Kinesio taping are effective in improving muscular power, with the flossing band intervention yielding the greatest improvements. Plocker et al. [33] reported that flossing band training promotes the secretion of growth hormones, thereby enhancing the explosive capacity of muscle fibers. Additionally, Pisz et al. [34] suggested that flossing bands enhance muscular power and muscle fiber activation during training and are particularly effective in exercises requiring rapid contraction speeds. Meanwhile, Kinesio taping may serve as an intervention strategy that enhances joint stability and muscle activation, thereby contributing to improvements in muscular power [32, 35]. These findings suggest that the two intervention methods may be used complementarily and provide valuable foundational data for the development of training programs aimed at enhancing muscular power.

Effects of flossing bands and kinesio taping on muscle endurance

Flossing bands create a hypoxic environment by restricting blood flow, thereby increasing metabolic stress, which enhances capillary density and oxygen transport capacity [36]. In contrast, Kinesio taping facilitates the removal of metabolic byproducts by improving blood and lymphatic circulation, thereby reducing muscle fatigue and enhancing exercise endurance [32, 37]. The findings of this study demonstrate that both flossing band and Kinesio taping interventions significantly improved the muscular endurance of the quadriceps and hamstring muscles. Notably, in the hamstring muscles, the flossing band intervention resulted in greater improvements in muscular endurance compared to both the no-treatment and Kinesio taping conditions. This study confirmed that both flossing band and Kinesio taping interventions had a significant effect on improving the muscular endurance of the quadriceps and hamstring muscles. Notably, the flossing band intervention resulted in greater improvements in hamstring endurance compared to both the no-treatment and Kinesio taping conditions. Previous studies have reported that relatively weaker muscles exhibit greater adaptive responses to external interventions, which may explain the observed improvements in hamstring strength [38]. Furthermore, the findings suggest that flossing bands may enhance muscular endurance by increasing mitochondrial density within muscle fibers, thereby reducing oxygen consumption while improving endurance capacity [34, 39]. Meanwhile, Kinesio taping serves as an auxiliary tool that contributes to joint stability and muscle endurance enhancement, particularly by increasing resistance to muscle fatigue during prolonged physical activity [40]. This implies that it may play a role in both sustaining muscular endurance improvements and preventing injuries. Both intervention methods contribute to muscular endurance enhancement through distinct physiological mechanisms. Further in-depth studies across various populations and exercise intensities are warranted to determine the optimal conditions for maximizing the effectiveness of these interventions in improving muscular endurance.
This study has several limitations. First, the study population was limited to adult males, which may hinder the generalizability of the findings to other demographic groups, such as females and older adults. Second, the sample size was relatively small (n=10), and the experiment was conducted on a limited cohort, which may restrict the applicability of the results to a larger population. Future research should be conducted with a larger sample size to enhance the reliability of the findings. Third, this study only evaluated short-term effects and did not assess the long-term efficacy of the interventions. Fourth, variables related to the intensity and duration of flossing band application were not considered, indicating the need for a more precise and controlled analysis. Future studies should include participants of diverse age groups and genders, while also ensuring a larger sample size to improve the reproducibility and statistical power of the results. Additionally, further investigation into the combined effects of flossing bands and Kinesio taping is warranted. Long-term follow-up studies are necessary to verify sustained effects, and the development of individualized intervention strategies based on muscle fiber composition should be considered. These efforts will contribute to establishing more effective strength enhancement strategies in both athletic training and rehabilitation settings.

Conclusion

This study confirmed that both flossing bands and kinesio taping positively influence muscle strength, power, and endurance. Flossing bands, through blood flow restriction mechanisms, were particularly effective in enhancing short-term muscle strength and power. In contrast, kinesio taping improved joint stability and prolonged muscle activation, making it beneficial in rehabilitation settings. These findings suggest that both interventions can play significant roles in improving athletic performance, supporting rehabilitation, and preventing injuries, warranting further research on their combined effects.

Conflicts of Interest

The authors declare no conflict of interest.

Figure 1.
Experimental procedure.
ajk-2025-27-2-19f1.jpg
Figure 2.
Flossing band application and exercise method.
ajk-2025-27-2-19f2.jpg
Figure 3.
Kinesio tape Application method.
ajk-2025-27-2-19f3.jpg
Figure 4.
Assessment method of muscle function using an isokinetic dynamometer.
ajk-2025-27-2-19f4.jpg
Table 1.
Physical characteristics of subjects
Number(n) Age(yr) Height(cm) Weight(kg)
n=10 23.4±3.13 174.3±3.80 71.5±6.28

Notes: Mean±standard deviation

Table 2.
Subject’s knee extension/flexion pre-test values (unit: N·m)
Lt Ext Rt Ext Lt Flex Rt Flex Strength symmetry (%)
H/Q ratio (%)
Ext Flex Lt Rt
1 260.6 243.6 115 103.8 7 10 44 43
2 330.1 297.9 142.1 130.8 10 8 43 44
3 301.4 322.1 127.7 135.2 7 6 42 42
4 310.2 295.1 121.5 112.7 5 7 39 38
5 276.4 262.2 113.7 103.4 5 9 41 39
6 277.6 264.8 116.7 109.8 5 6 42 41
7 294.9 262.2 104.3 98.5 11 6 35 38
8 256.3 280.5 107.9 118.4 9 10 42 42
9 235.2 250.5 102.1 111.8 7 10 43 45
10 269.4 287.2 125.3 137.5 7 10 47 48

Notes: Lt Ext, left leg extension: Rt Ext, right leg extension: Lt Flex, left leg flexion: Rt Flex, right leg flexion: H/Q, hamtrings/quadriceps

Table 3.
Exercise program
Phase Exercise Repetitions & Sets Intensity
Warm-up Light dynamic stretching (lower limbs) 3 min RPE 9
Main exercise Standing knee extension 15 repetition × 2 sets (rest interval between set : 2 min) RPE 9-11
Standing knee flexion
Squat
Cool-down Static stretching (quadriceps, hamstrings) 3 min RPE 9
Total exercise time 20 min
Table 4.
Comparison of knee muscle strength by intervention method (unit: N·m)
Intervention CON KKE FKE F P Post-hoc
KES 257.23±32.16 269.95±28.68 275.40±31.29 4.809 0.050 ①, ②, ③
KFS 104.67±20.65 112.99±11.08 122.12±10.36 11.745 0.006 ①, ② < ③

Notes: Mean±standard deviation, CON, control condition: KKE, kinesio taping knee joint exercise: FKE, flossing band, knee joint exercise: KES, knee extension muscle strength: KFS, knee flexion muscle strength

Table 5.
Comparison of knee muscle power by intervention method (unit: N·m)
Intervention CON KKE FKE F P Post-hoc
KEP 266.00±57.00 267.00±55.99 299.00±62.44 66.524 0.000 ①, ② < ③
KFP 184.00±42.48 193.00±42.44 218.00±40.22 32.351 0.000 ①, ② < ③

Notes: Mean±standard deviation, CON, control condition: KKE, kinesio taping knee joint exercise: FKE, flossing band, knee joint exercise: KEP, knee extension muscle power: KFP, knee flexion muscle power

Table 6.
Comparison of knee muscle endurance by intervention method (unit: N·m)
Intervention CON KKE FKE F P Post-hoc
KEE 1986.42±351.47 1991.24±381.49 2145.19±427.02 5.603 0.013 ①, ②, ③
KFE 944.63±296.39 1056.31±257.08 1081.10±260.33 16.461 0.003 ① < ②, ③

Notes: Mean±standard deviation, CON, control condition: KKE, kinesio taping knee joint exercise: FKE, flossing band, knee joint exercise: KEP, knee extension muscle endurance: KFP, knee flexion muscle endurance

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