Elastic Resistance Bands in Sports Medicine and Rehabilitation: A Narrative Review of Neuromuscular Mechanisms, Prescription, and Functional Applications

Background/Objectives: Elastic resistance bands are widely used in rehabilitation, injury prevention, and athletic conditioning because they are portable, inexpensive, and adaptable to multiple movement planes. However, their mechanical behavior and training dose are often insufficiently characterized. This structured narrative review aimed to synthesize current evidence on the neuromuscular mechanisms, prescription principles, and functional applications of elastic resistance bands in sports medicine and rehabilitation. Methods: PubMed, Scopus, Web of Science, and ScienceDirect were searched from inception to 31 May 2026. Peer-reviewed human studies and reviews were included when they addressed mechanical, neuromuscular, biomechanical, prescriptive, rehabilitative, injury-prevention, or performance-related aspects of elastic resistance exercise. Evidence was synthesized narratively to link mechanical configuration, neuromuscular responses, exercise prescription, and functional outcomes. Results: Elastic bands provide an ascending, position- and configuration-dependent resistance profile determined by band properties and exercise configuration. When effort and exercise configuration are controlled, elastic resistance can elicit muscle activation and strength adaptations comparable to conventional resistance, while supporting improvements in balance, functional capacity, power, sprint performance, change-of-direction ability, and selected sport-specific outcomes. Its directional versatility and capacity for gradual load adjustment support applications from early rehabilitation to return-to-sport and performance training. Nevertheless, prescription based on band color alone is inadequate, and inconsistent reporting limits reproducibility and study comparisons. Conclusions: Elastic resistance is a scalable and clinically relevant loading modality rather than an inherently low-load alternative. Evidence is more established for improvements in muscular strength and functional performance than for direct reductions in injury incidence or successful return-to-sport outcomes. Its effectiveness depends on explicit load quantification, individualized progression, appropriate exercise configuration, and transparent reporting of intervention parameters.