“Something better than any laser, wrap or electric massager. The tape seemed to have special powers. Every morning before the stage, they would tape us all up, different parts of our bodies. The next day the pain disappeared — it was gone. Sometimes we’d be so wrapped up in hot-pink tape that we’d look like dolls, a bunch of broken dolls but the tape worked, so we kept it, because it could fix things.” – Lance Armstrong
This was my introduction to kinesiology taping, the comments of Lance Armstrong in the early 2oo0’s before all the allegations of doping. Lance described the “healing powers” of the tape in his books,It’s Not About the Bike & Every Second Counts. These comments piqued my interest, setting up a quest to understand how and if a piece of tape could affect performance.
The key question: “Is kinesiology taping science fiction or science?” I’ll pose both arguments and let you decide.
Before you read ahead, let me state that this blog is intended both for medical professionals and the average reader interested in knowing more about kinesiology taping. If you are the “average reader” of this blog, you may just want to read the next several paragraphs and STOP at the Kinesiology Taping As Science Fiction section of this blog.
General Overview of Kinesiology Taping for the Average Person
Kinesiology taping has been around for years . The tape evolved from a quest to provide therapeutic benefits to patients such as decreased pain and improved tolerance to activities without restricting normal motion of joints. The tape is not the traditional white athletic tape that adheres and restricts movements. The tape meshes with the skin and expands allowing the tissues to slide and glide underneath. Throughout its history, kinesiology taping has been very visible and very commercial. There are many theories as to why kinesiology tape works, but nothing has been proven beyond doubt. We do know from patients, case reports and limited studies that something is going on. We can’t fully quantify nor qualify what that affect is, but should it really matter? Isn’t the most important thing that somehow, someway patients are getting better as a result of the taping? Isn’t it equally as important that there is minimal to no complications from the tape or taping? The tape is NO substitute for a comprehensive evaluation and treatment by a trained health care practitioner(s) (ex: medical doctor, osteopath, chiropractor, physical therapist, occupational therapist, athletic trainer, etc.); however, the tape when used properly is a nice adjunct to established methods helping the patient and clinician accomplish mutual goals in a time efficient manner.
Kinesiology Taping As Science Fiction
The amount and quality of research on kinesiology taping itself is underwhelming (1, 9, 19, 20, 22). Relatively speaking, kinesiology taping is a new phenomenon. The concept itself originated from Kenzo Kase, a Japanese chiropractor who developed the tape and the original theories behind the tape. These theories were incorporated into a formal training program advocated by the Kinesio Taping Association. Theories included:
1). Pulling the tape muscle origin to muscle insertion (where the muscle starts to where it end) as well as pulling the tape from insertion to origin (muscle end to muscle start point) to facilitate (enhance) or inhibit (relax) a muscle.
When testing quad strength, the various applications of enhancing, inhibiting and a sham treatment did not impact measured quad strength. This theory may need to be rethought (10).
2). Channels for Lymphatic Flow: The tape will create channels (dimples or wrinkles) under the skin that allow for the passage of lymph (lymphatic drainage). This may be beneficial for removal of swelling from an area of trauma.
3). Enhancing Proprioception of the Skin & Underlying Soft Tissues (Muscles, Ligaments, Tendons & Fascia). Proprioception is the ability of the body and the brain to figure where it is in space. To make it more simple, this is a key reason why people can regain their balance on a slippery surface. This is a key reason why an Olympic gymnast can come out of a sommersault in mid-air and land on their feet. This theory seems to be the most plausible of the group. Research has not yet proven that this mechanism is at play, yet it leads us down the path that the tape is likely to affect the ability to sense where the body is at and what direction it is headed while making adjustments as necessary to keep us upright and on the correct path to accomplish our intended task (ex. running, jumping, landing, change of direction, etc.).
4). Color of the Tape: Initially the theories that tape color affect skin and internal body temperature with dark tape colors (red, black, etc.) increasing temperature of the skin beneath the tape and even into the subcutaneous structures. Conversely, light tape colors (sky blue, light green, etc.) would cool the skin and subcutaneous tissues or at the very least, wouldn’t heat them up to the same degree as light colors.
These theories have not been widely studied in the past 30 years despite increasing use of the tape in both the athletic and outpatient
rehab setting. The success of the tape in the commercial setting has spawned competitors. Additional brands have been created including: KT Tape (http://www.kttape.com/), Spider Tech Tape (http://www.spidertech.com/), Rock Tape (http://rocktape.com). Each major brand has its own marketing strategy, identity, and even has their own educational support system to train practitioners on how to apply the tape, where and when to use the tape. In a stroke of marketing genius, various different tape styles, tape colors, and tape patterns have been developed. The patterns and style play into our cultural identity of individualism and individual expression. The concept is similar to tattoos, which in many cases are a symbol if individualism. In some cases, individual expression has superseded medical necessity with patients and athletes wearing the tape for either no apparent reason or a placebo effect.
Another stroke of marketing genius saw the tape strategically placed on numerous Olympians in the 2008 Beijing Olympics and 2012 London Olympics. Kinesio tape donated thousands of feet of tape to be placed on America’s athletes. The strategic placements on recognized athletes such as Keri Walsh (3 Time Olympic Gold Medalist in beach volleyball) lead to the explosion of taping in the traditional clinic (physical therapy, chiropractic, and outpatient rehab) setting and in the athletic realm (http://www.abqjournal.com/main/2012/07/25/news/taping-americas-athletes.html).
1). We’ve got theories that have not been validated by good research (1)
2). We’ve got widespread use despite lack of evidence of effectiveness that may not be better than alternative taping methods (2, 12, 13, 16, 19, 22, 23, 24) or alternative strategies (5, 18)
3). We’ ve got media promotion
4). We’ve got the concept of individualism and individual identity
5). We’ve got the notion of a placebo effect
Kinda sounds like science fiction, doesn’t it?
Kinesiology Taping As Science
No overwhelming research to date has been published on kinesiology taping, yet several studies exist on its effectiveness in various conditions.
1. Pediatric Torticollis (aka “Wry Neck”): A 2012 study looked at 28 infants with torticollis. Torticollis is a condition where the child has an inability to rotate or bend their head from side to side. This is a painful condition for the child and scary for the mother. Kinesiology tape was used successfully in reducing muscular tension. Tension reduction was almost immediate. (3)
2. Rheumatoid Arthritis: 20 Rheumatoid Arthritis were included in a small study. All 20 patients received medication and physiotherapy. 10 of those patients additionally received kinesiology taping. Grip strength (dynamometer) and hand functional scale testing were used pre and post. The results showed that hand muscle strength had increased in the taped group vs the untaped group. (4)
3. Cerebral Palsy: Kinesiolgy tape was used to test sitting posture, gross motor function, and level of functional independence in children with cerebral palsy. 30 children were separated into 2 groups. 1 group had kinesiology taping and standard physiotherapy. The second group had physiotherapy without taping. The taping group showed changes in sitting posture only without changes in gross motor function and level of functional independence. The research concluded that the tape may be an adjunct to standard physiotherapy care. (5)
4. Trunk Range of Motion: This study found that trunk flexion (ROM) was increased in the study group that used kinesiology tape. (6)
5. Eccentric Quad Strength: This study looked at kinesiology taped, no tape and “placebo” taped (white athletic taped) individuals. The study measured concentric (shortening contraction) and eccentric (lengthening contraction) strength. The study found that eccentric quad strength could be impacted and improved in the subjects. (7)
6. Forearm Strength In Tennis Players: This study compared taped tennis players to non taped tennis players using the player as a control meaning that each player was tested against himself or herself. The players had wrist & forearm extensor strength measured before, during and after hitting tennis balls in the taped and untaped conditions. Research found that less strength was lost when hitting balls during the taped condition. (8)
7. Kinesio Taping On Muscular Activation: This study used kinesiology taped subjects, control subjects, and “placebo” subjects (white athletic tape) to determine if sequencing of the vastus medialis obliquus (VMO) and vastus lateralis could be altered in patients with patello-femoral syndrome (knee cap tracking issues & pain). The research found that the kinesiology taped group had earlier activation of the VMO than the other 2 groups. The research concluded that early activation of the VMO could allow for better positioning of the patella. (9)
8. Kinesio Taping’s Effect on Bioelectric Activity of the Vastus Medialis: This study used healthy volunteers to determine bioelectric activity (via transdermal EMG) and effects of kinesiolgy taping at 24 hours and 72 hours post taping. Their was also a subset that had tape removed at the 24 hour mark. The study found that peak torque and muscular recruitment improved at 24 hours and this effect was still present at the 72 hour mark despite tape removal at the 24 hour mark. The study also found a return to baseline values of peak torque and recruitment at the 4 day mark (1 day after the tape removal on the 3rd day). The study suggests that the immediate effects of kinesiology tape prior to sports, recreational or other physical activities may not have the desired or intended outcome. Tape application for improvement in muscular activation and recruitment for peak torque may require a period of 24+ hours. (11)
9. Athletic Taping vs. KT Taping vs. Placebo Taping vs. No Taping on Functional Performance Measures of Basketball Players with Chronic Inversion Ankle Sprains: The study looked at the effect of different taping conditions and a no tape condition in basketball players with chronic inversion ankle sprains. The taping conditions featured KT tape, standard white athletic tape, a “placebo” tape and a no tape condition. The study used a hopping test, single limb hurdle test, standing heel rise test, vertical jump test, star excursion test and a kinesthetic trainer to test balance, agility and coordination. The subjects were randomly assigned to a taping condition for 4 weeks and tested 1x weekly progressing through the taping conditions. Faster times were noted in the KT taped group and athletic taped group for the hurdle test when compared to the no tape and placebo tape group. Decreased performance was noted with the taped group on vertical jump and standing heel rise group. No differences were noted in the star excursion test for all groups. The findings suggest that KT tape did not impede overall performance and provided some assistance with the hurdle test. (14)
10. Short Term Effects of Kinesiology Taping on Pain and Range Of Motion in Acute Whiplash Patients: Subjects were assigned to a kinesiology taped group and a “sham” taped group. The subjects were measured pre-tape for pain and range of motion . The subjects were measured immediately after the taping and 24 hours after the taping for the same variables (pain and range of motion). The results showed a greater decrease in pain immediately following the tape application and at the 24 hour mark in the kinesiology taped patients versus the “sham” taped subjects. Greater range of motion was also noted in the kinesiology taped patients at the 24 hour mark versus the “sham” subjects. (15)
11. Kinesio Taping’s Effects on Pain, Wrist Flexor Strength and Force Sense in Baseball Pitchers with Medial Epicondylitis (AKA Golfer’s Elbow): The study looked at healthy pitchers and pitchers with medial epicondylitis during 3 conditions: kinesiology taped, placebo taped and no tape. The results showed that maximal strength in the wrist flexors was not affected in the healthy pitchers or the pitchers in pain by either kinesiology taped or placebo taped conditions. Taped conditions improved the force sense and pain levels in both the healthy pitchers and the injured pitchers. Kinesiology taping was not superior to placebo taping in performance measures in this study; however, taping itself showed improvement in the measured variables. (16)
12. Stroke Rehabilitation: This post asserts that kinesiology taping may have some implication in the functional reactivation of the nervous system, movement and muscles following stroke rehab. (17)
13. Isokinetic Knee Function: This study looked at isokinetic knee performance (peak torque, work done and time to peak torque) in 30 subjects with and without kinesiology taping of the vastus medialis. The study found no difference between taped and untaped conditions for peak torque and work done. The study did find a difference in the time to peak torque as it took less time to reach peak torque. According to the study, the researches theorized that this may have a injury prevention benefit. (21)
14. Kinesio Taping’s Effects on Elbow Peak Torque: This study looked at isokinetic forces in 20 subjects in placebo taped, kinesiology taped and no taped groups. The study found significant differences in taped conditions vs. non taped conditions. The study also found differences in concentric elbow peak torque in the kinesiology taped group when compared with the placebo (24).
15. Kinesio Taping in Chronic Non-Specific Low Back Pain: This study assigned 60 subjects into two groups that wore either kinesiology tape or sham tape for 1 week. Outcome measures were taken at baseline (before taping), at the 1 week mark and 4 weeks following tape application. Disability indexes, functional outcome measures, endurance tests, a visual analog scale and trunk flexion ROM were measured. The study found that greater short term (immediate and 1 week) and long term benefit (4 week) in pain measures and muscle endurance in the kinesiology taped group over the sham taped group. Greater short term improvement in disability was noted in the kinesiology taped group; however, there was no difference at the 4 week mark. The study concluded that there was reduced disability and pain, but the difference may be too small to be clinically relevant. (25)
There are other studies, but you get the point. CONFLICTING EVIDENCE ABOUNDS! As healthcare practitioners, we have all taken oaths to “First Do No Harm.” There appears to be minimal to no chance at harm from the tape with the chance for therapeutic benefits. So, is this science or science or science fiction? You decide.
We have tried several types of kinesiology tape over the years including the name brands Kinesio Tape, Spider Tech, Rock Tape and KT Tape. Anecdotally, we’ve found the one that works best for us has been Rock Tape (http://rocktape.com/). The quality of the tape and length of time it holds seems to be the best of the group. Second on this list are the precut strips from Spider Tech (http://www.spidertech.com/). The strips are easy to apply and don’t require formal training to assist with application. Please note that why you tape and how ( style) you tape are more important than where you tape or what tape you use. There should be a comprehensive evaluation and analysis of movement helps the clinician figure out if taping is the right choice and how (what style of application) to use the tape. These comments refer to the discussion of principles versus methods. To summarize a famous quote, of principles there are few, but of methods there are many. There are many types of tape and styles of taping. Some of the methods have poor support (insertion to origin, temperature, etc.). The direction the literature is heading is to look at movements, not muscles in isolation. Don’t get fixated on the condition or the site of pain, but address the reasons the problem is there. These are principles, not methods. Looking at local and global movements and taping accordingly fits the principles best. Several courses seem to integrate these concepts better than others (http://www.medicalmindsinmotion.com/Seminars.aspx & http://rocktape.com/training/fascial-movement-taping-fmt/).