What is kinesio tape

Kinesio taping was developed by a Japanese chiropractor, Dr Kenso Kase, in the 1970s; he described it as a natural way to relieve pain ¹. According to its inventor, kinesio taping offers several advantages over other conventional taping. Firstly, kinesio tape aims to give a free range of motion in order to allow the body’s muscular system to heal itself biomechanically. Secondly, the kinesio taping can be virtually applied to any joint or musculoskeletal region, it is easy to apply, non‐allergenic and with relatively low cost ¹. Dr. Kase describes kinesio tape as differing from traditional white athletic tape through its wave-like grain, elastic adhesive material, ability to stretch to 20–40% of its original length, and mimicking the thickness of human skin ¹. When applied to the skin, kinesio tape is said to lift the fascia and soft tissue to produce additional space below the area of application ¹. Using the methods outlined by Kase et al. ¹, the following advantageous effects are proposed to occur: (i) increasing proprioception by providing constant cutaneous afferent stimulation through the skin, (ii) realigning fascial tissue function by normalizing muscle tension, (iii) creating more space for improving circulation of blood and lymph flow by eliminating extra fluid, edema, or bleeding beneath the skin, (iv) correcting muscle function by strengthening muscle weakness, and (v) decreasing pain through neurological suppression. When applied as specified by its inventor, it has been claimed to have beneficial effects on the skin, fascia, circulation, lymphatic system, muscles, and skeletal system, and to provide pain relief, resolve edema, improve muscle performance, and increased joint stability ¹. It has also been stated that kinesio tape can be used in the treatment and rehabilitation of injuries or as a preventative measure; it is designed to assist the body’s natural healing process, provide support and stability to muscles and joints without limiting range of motion, and to extend the benefits of manual therapy by providing extended soft tissue manipulation ².

The research evaluating these claims has recently been summarized in several reviews addressing the effectiveness of the kinesio taping method on muscle strength ³, ⁴, the treatment and management of sports-related injuries ⁵, ⁶ and musculoskeletal pain and injury ⁷, ⁸, ⁹, ¹⁰. The authors of these reviews concluded that the information available was inadequate and stress the need for more rigorous investigation of the kinesio taping method before its effectiveness can be assessed ¹¹.

Kinesio tape has quickly garnered popularity in the athletic population as it has gained more mainstream use since the 2008 Beijing Olympic Games when athletes such as volleyball players wore the multi‐colored versions of kinesio tape. At present, kinesio tape is marketed by various companies under different brand names, often in a variety of colors. These qualities and aggressive marketing made kinesio taping an increasingly popular intervention amongst elite athletes who use it to try and prevent injuries ¹². Kinesio taping has also gained momentum as a potential rehabilitative intervention among the general public and health professionals in the last decade, even though sound scientific proof of its validity has been lacking.

Taping has been used for a long time to prevent and treat sports injuries as it provides protection and support to the joint or muscle or both during the movement ¹². The conventionally used tape is rigid while the recently introduced kinesio taping is an elastic, adhesive, latex‐free taping made from cotton, without active pharmacological agents and is water resistant ¹.

Kinesio taping was designed to simulate the qualities of human skin, and it has roughly the same thickness as the skin ¹. Manufacturers claim that kinesio taping provides benefits by facilitating the body’s natural physiologic and healing processes with sensory stimulation and mechanical support: aiding muscle and positional stimulus through the skin, aligning fascial (connective) tissues, creating more space by lifting the soft tissues above the area of pain or inflammation, assisting drainage of lymph, fluid exuding from a sore or inflamed tissue, by directing fluid toward the duct, and providing sensory stimulation and mechanical support without restricting the body’s range of motion, differently from a conventional rigid tape ¹.

These benefits are supposed to depend on the amount, as well as on the stretch direction, of the applied kinesio tape ¹. Kinesio taping can be applied producing different shapes (e.g. ‘Y’, ‘I’, ‘web’), according to the shape and size of the affected muscle. Application methods differ with the therapeutic aim. When the kinesio tape is used to inhibit or restore muscle function, it is applied from its insertion to the origin to limit the muscle performance ¹³ or from its origin to the insertion to enhance muscle activity (e.g., forearm grip strength) ¹⁴. Conversely, when the kinesio tape is used to promote lymphatic drainage, it is applied in the fan format directing lymph fluid towards less congested parts of the lymphatic system in order to try and reduce swelling. The arms of the fan direct lymphatic flow towards the anchor facilitating drainage (e.g. to help reduce swelling after a mastectomy) ¹⁵.

Theoretically, these mechanisms of these actions might reduce pain from rotator cuff disease. Authors claim that kinesio taping might: 1) improve shoulder strength, range of motion and proprioception (the sense of the relative position of body segments in relation to other body segments) ¹⁶; 2) improve proprioceptive feedback and correct alignment during movement, to help promoting the stability of the shoulder blade ¹⁷; 3) allow free movements of arms without pain ¹⁸; and 4) prevent acute injuries and the evolution to a chronic condition and impairments ¹⁹. There is little evidence to support these claims.

There is scant evidence to support kinesio taping techniques as a successful means of affecting athletic-based performance outcomes such as improved strength, proprioception and range of motion, in healthy persons ²⁰.

Does kinesio tape work?

Despite kinesio tape recent gain in popularity and the proposed theories of effectiveness, there remains a lack of sufficient evidence supporting these claims and current literature is limited in its ability to draw discernible conclusions. At this time, there is no known systematic literature review commenting on the effects of kinesio tape on athletic performance outcomes in healthy individuals. Kinesio tape has the potential to be a valuable clinical intervention due to the fact that it is highly accessible, simple to apply, and not very restrictive.

The evidence is not adequately strong to determine the effectiveness of kinesio tape on improving athletic-based performance outcome measures in healthy individuals ²⁰. Merely six studies showed positive results of kinesio tape as an effective method for improving some measures of athletic-based performance ²¹. This review demonstrates that there is scant evidence that kinesio tape application immediately improves grip strength, vertical ground reaction force, gastrocnemius EMG activity, trunk flexion, single-leg hop test and peak torque within 0 to 45 minutes of application ²⁰. As well, it was shown that bio-electric activity and motor unit recruitment in the vastus medialis was increased after 24 and 72 hours of kinesio tape application and after 48 hours following removal of the kinesio tape only ²². There are numerous studies assessing the effectiveness of using kinesio tape as a treatment for a variety of injuries and disorders; however, only 10 studies evaluating its effect on performance in healthy individuals were identified. Evidence to suggest that kinesio tape should be used as a method for improving athletic-based performance is lacking. Consequently, chiropractors and other healthcare practitioners should proceed with caution when considering the use of kinesio tape as a method for improving athletic-based performance measures ²⁰.

This 2012 systematic review ²³ found insufficient evidence to support the use of kinesio tape following musculoskeletal injury, although a perceived benefit cannot be discounted. There are few high-quality studies examining the use of kinesio tape following musculoskeletal injury.

A 2013 systematic review ²⁴ of the effectiveness of kinesio taping on pain and disability in participants suffering from musculoskeletal, neurological and lymphatic pathologies. As to the effect on musculoskeletal disorders, moderate evidence was found supporting an immediate reduction in pain while wearing the kinesio tape. In 3 out of 6 studies, reduction of pain was superior to that of the comparison group. However, there is no support indicating any long-term effect. Additionally, no evidence was found connecting the kinesio tape application to elevated muscle strength or long-term improved range of movement. No evidence to support the effectiveness of kinesio tape for neurological conditions. As to lymphatic disorders, inconclusive evidence was reported. Although kinesio tape has been shown to be effective in aiding short-term pain, there is no firm evidence-based conclusion of the effectiveness of this application on the majority of movement disorders within a wide range of pathologic disabilities. More research is clearly needed ²⁴. In conclusion, the meta-analysis confirmed the inferences of systematic review and found that data on effectiveness of kinesio taping is still insufficient and further research is need-ed before definite conclusions ²⁵.

This 2014 meta-analysis ²⁶ examined and reviewed the existing literature to evaluate the effect of kinesiology tape application on pain in individuals with musculoskeletal injury. The combined results of this meta-analysis indicate that kinesiology tape may have limited potential to reduce pain in individuals with musculoskeletal injury; however, depending on the conditions, the reduction in pain may not be clinically meaningful ²⁶. Kinesiology tape application did not reduce specific pain measures related to musculoskeletal injury above and beyond other modalities compared in the context of included articles ²⁶. The review authors suggested that kinesiology tape may be used in conjunction with or in place of more traditional therapies, and further research that employs controlled measures compared with kinesiology tape is needed to evaluate efficacy ²⁶.

Kinesio tape for knee pain

Anterior knee pain is a clinical syndrome characterized by pain experienced perceived over the anterior aspect of the knee that can be aggravated by functional activities such as stair climbing and squatting. Two taping techniques commonly used for anterior knee pain in the clinic include the McConnell Taping Technique and the Kinesio Taping Method (kinesio tape). The results of this study found that both the kinesio tape and the McConnell Taping may be effective in reducing pain during stair climbing activities ²⁷. Further studies using a larger, more varied sample size and investigating pain responses during additional functional activities should be performed in order to support the current findings ²⁷.

Figure 1. Kinesio tape for knee pain

Figure 2. McConnell Taping Technique

Kinesio tape for knee pain due to osteoarthritis

Osteoarthritis or degenerative arthritis is a major factor that reduces an individual’s ability to perform acts of daily living, which causes secondary problems, including psychological and social problems ²⁸. Osteoarthritis is one of the joint diseases that leads to degeneration of joint cartilage and degenerative changes in the areas surrounding the joints and subchondral bones, resulting in pain and functional disorders ²⁹. Osteoarthritis appears when the joint cartilage is degenerated due to aging, excessive use, injury, etc., and this leads to joint deformation. Arthritis begins when cartilage is severely worn because the muscles and ligaments that move the joints have been weakened; pain appears thereafter ³⁰.

Cushnaghan et al. ³¹ reported that the results of application of kneecap medial taping to patients with degenerative knee arthritis indicated that it could be a simple and safe treatment method that could relieve pain in a short time. Lee et al. ³² reported that the results of application of kinesiology taping to the vastus medialis oblique and vastus lateralis of patients with patellofemoral pain indicated that pain was relieved, the maximum isometric contractile force of individual muscles was increased, and the activity of individual muscles was decreased during moving up and down stairs. In the present study, the results of analysis of pain using the visual analogue scale (VAS) revealed that pain was significantly relieved in the kinesiology taping group. Given this, it is assumed that application of kinesiology taping relieved the weakening of the quadriceps femoris muscle and the tonus and shortening of the gastrocnemius, improving the imbalance of muscle strength occurring in the knee joint, thereby relieving pain ³².

A study conducted by Park and Kim ³³ reported that application of taping therapy three times per week for four weeks to elderly persons complaining of knee pain, showed significant effects on knee joint range of motion. In the study by Lee et al. ³⁴ where general physical therapy modalities and kinesiology taping were applied and compared, and the kinesiology taping group showed significant effects in joint range of motion. This is considered attributable to the fact that in these elderly patients with degenerative knee arthritis, who were showing lower extremity muscle weakening and abnormal muscle tonus around the knee joint, the skin stimuli of the kinesiology taping acted on the muscle spindles or tendon organs to support the muscles around the joint. It also relieved the muscle tonus through the mutual suppression effects of the muscles, thereby further smoothing joint flexion and extension and increasing extensibility and flexibility, leading to increased joint range of motion ³⁵.

Kinesio tape for shoulder pain

The results of this study ³⁶ showed a significant improvement in pain intensity during movement, nocturnal pain, and pain‐free shoulder abduction, flexion and scaption range of motion immediately after kinesio taping as compared to the pre‐test values in patients with shoulder impingement syndrome. The results also revealed no significant difference in pain intensity during movement and shoulder flexion range of motion immediately, after three days, and at the one week after placebo taping assessment. However, a significant decrease in nocturnal pain measures was found immediately and one week after kinesio taping in control group. Although no significant differences were noted in shoulder abduction or scaption range of motion immediately after placebo taping, a significant increase in shoulder abduction or scaption range of motion was found one week after kinesio taping in control group ³⁶.

These data showed a significant difference in change of pain intensity during movement or nocturnal pain between the groups immediately after kinesio taping. The authors found a significantly greater decrease in pain intensity during movement or nocturnal pain immediately after kinesio taping application (experimental group) than placebo taping (control group) ³⁶. There was no significant difference in change of pain intensity (during movement or nocturnal) and change of pain‐free shoulder range of motion between two groups after one week.

The fact that the experimental group showed a significantly greater improvement in pain intensity immediately after kinesio taping, but did not maintain this pattern after one week, may suggest that the immediate effect of kinesio taping is the important part of the intervention in the experimental group ³⁶. Similar findings have been reported elsewhere. Kaya et al ³⁷ studied 55 patients with shoulder impingement syndrome treated by kinesio taping or local modalities and found that although immediate effect of kinesio taping is greater than the local modalities, kinesio taping was similarly effective at the second week of the treatment. They suggested kinesio taping as an alternative treatment option in the management of shoulder impingement syndrome especially when an immediate effect is desired ³⁷.The results of the study conducted by Miller and Osmotherly ³⁸ provided evidence for a short‐term role for taping as an adjunct to routine physiotherapy program in the treatment of shoulder impingement syndrome. They found that kinesio taping has main effect on the early stage of treatment and that there was not a significant kinesio taping effect after several weeks ³⁸. The immediate results and improvements following the kinesio taping are also reflected in the work of researchers who found significant improvements immediately following kinesio taping compared with placebo taping in patients with other musculoskeletal disorders such as patellofemoral pain syndrome ³⁹ or whiplash‐associated disorders ⁴⁰.

Kinesio tape for chronic low back pain

A systematic review ⁴¹ of kinesio taping for chronic low bakc pain found kinesio taping is not a substitute for traditional physical therapy or exercise. Rather, kinesio tape may be most effective when used as an add-on therapy, perhaps by improving range of motion, muscular endurance and motor control. More high quality studies that consider the multiple factors that mediate chronic low back pain, in the short, intermediate and long term, are needed to strengthen the evidence of the effectiveness of kinesio tape on chronic low back pain.

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