SaveYourself.ca •Sensible advice for aches, pains & injuries
 

Kinesio Taping

Over-hyped, but harmless and at least a little bit promising

1,900 words, published Sep 13th, 2013, updated Nov 21st, 2013
by Paul Ingraham, Vancouver, Canada bio
I am a science writer, the Assistant Editor of ScienceBasedMedicine.org, and a former Registered Massage Therapist with a decade of experience treating tough pain cases. I’ve written hundreds of articles and several books, and I’m known for sassy, skeptical, referenced analysis and a huge bibliography. I am a runner and ultimate player, and live in beautiful downtown Vancouver, Canada. • full bioabout SaveYourself.ca

SHOW SUMMARY

Most therapeutic taping is either practical (stabilizing a sprained ankle), or aims to tinker with more subtle biomechanics. Taping has gotten a lot hotter in the last few years with prominent new products and branding, and lots of hype and claims about therapeutic effects, prevention, and performance enhancement. New materials that may achieve different and possibly superior benefits, but probably not much. It doesn’t work biomechanically, as many professionals assume. It’s more likely that the odd sensations change function and reduce pain, but that kind of effect tends to be minimal, and hard to predict and control.

For now this article is just a brief position statement on the value of taping (rather than the kind of deep topic-diving I specialize in). I have chapter specifically about taping for patellofemoral pain in my book on that topic.

Therapeutic taping of all kinds goes way back, and ranges from the utilitarian to barely more than a fashion statement. It’s enjoying a popularity explosion lately due to a couple of particularly well-marketed products/brands, the older but revitalized Kinesio Taping®,1 and competitors lik RockTape,2 or Spider-Tech™ Therapy Bandages, which was seen all over the athletes of the 2012 Summer Olympics.3 These companies and others are using some new materials that may achieve different results, and perhaps better. Right now it all seems fresh and new, but these are pretty obviously evolutionary and hype-powered products… not a therapeutic revolution.

And note that even Olympic athletes can be fad and fashion victims.4 The idea of making tape colourful was truly a stroke of marketing genius. I’m not sure who did that first, but it was probably a million-dollar idea, at least.

Kinesio Taping has its origins in old-fashioned taping for support — stabilizing a sprained ankle, providing some arch support. Its close cousin, compression bandaging, also has a clear, traditional place in medicine. Such straightforward uses are not on trial here. Over time taping slowly started to involve more and more fanciful biomechanical tinkering, trying to “correct” the position and movement of body parts — a classic example is trying to make kneecaps slide more evenly.5 This is more dubious stuff. It’s quite difficult to fix allegedly dysfunctional biomechanics with tape, primarily because most of these problems don’t really exist.6

Tape on an Olympic competitor. It’s extremely unlikely that taping achieves anything when applied to the trunk like this.

Tape on an Olympic competitor. It’s extremely unlikely that taping achieves anything when applied to the trunk like this.

Nevertheless, studies have often shown that all this taping seems to have some at least some benefits7… but generally minor, brief and inconsistent, probably somewhere in that murky gray zone between placebo and real cure. Its value is unclear, and many neutral experts — most of them, really — have dismissed it as placebo only.

Any benefits that do exist are almost certainly caused by novel sensory input, not by biomechanical tuning. Basically, when you tape people, they can feel it. A cat knows when it has tape stuck to its paw, and so does a human! Novel sensory input changes the “output” — motor control and pain. A cat knows when it has tape stuck to its paw, and so does a human!Stick some tape on a bad knee, and chances are good that, properly framed as “therapy,” the patient will feel a bit better, for a while. It’s even possible that the knee will actually in some sense work a bit better, for a while.

A lot of people have gone quite a bit further with claims about taping: they say it prevents injury or enhances performance. The tagline of the Spider Tech website: “Recovery, Performance, Prevention”! Or the Rocktape about page (all caps are all theirs):

I discovered that the tape can be used to ENHANCE PERFORMANCE. I found that taping in advance of exercise promotes increased blood flow to the muscles, thereby reducing fatigue.

That’s more far-fetched, and a statement like that just don’t stand up to close scrutiny.8 Or a little physiological perspective.910 Claims of performance enhancement could be true, but I strongly doubt it, and it’s obviously far from proven. I wouldn’t bet on taping being standard equipment for the pro sports teams and Olympians of the future — it’s just not good enough for that.

At best, taping is mostly just a legitimate but minor and imprecise method of pain control. The amount of tape being used by athletes lately is fun but silly. In particular, the idea that it can be expertly applied for a specific or impressive effect is just highly profitable voodoo.

So, does it work or what? Should you tape?

This almost certainly one of those “truth is in the middle.” Is there hype? Definitely!11 Is there something there? Yep, probably that too — just not much. The cost is not very high, the risk pretty much nonexistent, and some of the evidence and the mechanism a little bit promising.12 Although the evidence is limited, the effect on pain is what matters the most, and that evidence is the most discouraging so far.13

Creating fresh sensations and stimulating body awareness is just what we homo sapiens do. If we don’t do it with tape, we do it with something else, but especially our own paws. We are input-ouput machines, constantly and creatively tinkering with how we feel … touch-testing the world. Applying tape is only “wishful thinking” if you have unreasonable expectations, and it’s never unreasonable to tinker curiously with sensation. Applying tape in this spirit is only “wishful thinking” if you have unreasonable expectations of it, and it’s never unreasonable to tinker curiously with sensation. This is why I’m not hard-line skeptical about tape. But it’s also why my expectations for it are low — it’s just another way of feeling, one of many.

Functional challenges are pretty much always going to be far more important drivers of recovery and performance than any amount of sensory tinkering. If you made a list of everything that effects recovery and performance, tape and other sensation-tweakers are definitely going to be in the less important half of the list. I don’t think it has a hope in hell of generating consistent, clinically significant effects on function in rehab, let alone in healthy subjects. The bottom line is always going to be that we have to push ourselves a little to get better than we are — and being taped isn’t much of a challenge.

My final objection: I’m not really keen on putting my money into a hype machine. Especially for something that I am confident will not make any important difference to me.

But … for desperate patients or athletes keen on experimenting with any competitive edge, sure, why not? You could save yourself a few bucks and tie a bandana around your knee — it might do pretty much the same thing! But given the neurological mechanism, it’s certainly possible that different tapes and techniques could create a variety of sensations and, therefore, greater or lesser effects. So play with it. And look kinda awesome.

Another suped-up competitor. It does look good. Of course, these athletes look good no matter what.

Another suped-up competitor. It does look good. Of course, these athletes look good no matter what.

About Paul Ingraham

I am a science writer, former massage therapist, and assistant editor of Science-Based Medicine. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook and Google, but mostly Twitter.

Notes

  1. Kinesio Taping® (http://kinesiotaping.com) BACK TO TEXT
  2. Rocktape (http://rocktape.com) BACK TO TEXT
  3. Spider Tech™ Kinesiology Tape (http://spidertech.com) BACK TO TEXT
  4. On the one hand, elite athletes and their coaches and trainers are constantly driving innovation in exercise and sports health science, with obviously impressive results over time — a strongly positive long term trend. Today’s athletes are capable of feats that were once unthinkable. On the other hand, they are also wrong a lot, and countless approaches have been tried and abandoned over the decades. Often athletes have only made progress when they abandoned the pointless rituals and errors of the past! BACK TO TEXT
  5. I discuss this specific use in much greater detail in my patellofemoral pain syndrome book. Long story short, the evidence shows that taping has little or no effect on patellar position. For instance, as early as 1993, Bockrath et al found taping was “not associated with patella position changes,” and in 2002 Salsich et al showed that “vastus lateralis EMG activity level did not change with taping.” But wait, there’s more… BACK TO TEXT
  6. “Structuralism” is the excessive focus on causes of pain like crookedness and biomechanical problems. It’s an old and inadequate view of how pain works, but it persists because it offers comforting, marketable simplicity that is the mainstay of entire styles of therapy. For more information, see Your Back Is Not “Out” and Your Leg Length is Fine: Debunking the obsession with alignment, posture, and other biomechanical factors as a major cause of pain. BACK TO TEXT
  7. A couple footnotes back, I cited two papers (Bockrath, Salsich) that showed that taping didn’t have the biomechanical effect expected. Guess what? Both of those papers did show that patients felt better. No measurable biomechanical effect, but … less pain. Intriguing. BACK TO TEXT
  8. Vercelli et al. Immediate effects of kinesiotaping on quadriceps muscle strength: a single-blind, placebo-controlled crossover trial. Clinical Journal of Sports Medicine. 2012. PubMed #22450591.

    Shocker: this experiment found that applying kinesio taping (KT) had no effect on muscle strength (as claimed by some KT propopents, probably too many of them). “These results do not support the use of KT applied in this way to change maximal muscle strength in healthy people.” It was a ridiculous idea to begin with — obviously. It is conceivable, but rather unlikely and wild speculation without the slightest confirmation (and now this evidence against it).

    Advocates of KT protest that a study of healthy subjects is irrelevant, but it’s clear that KT is routinely, fashionably used on/by many serious and elite athletes who are fighting fit and not “injured” enough for it to be likely to make a meaningful difference to this research. In other words, if KT can’t enhance the strength of an average healthy athlete, it probably can’t do it for a slightly injured elite one either.

    BACK TO TEXT
  9. Circulation is driven pretty much exclusively by metabolic demand — not by minor stimulation of the skin and superficial connective tissues. The idea that tape can increase circulation anywhere near enough to fight fatigue while exercising is extremely wishful thinking. Blood doping, cocaine, and better fitness can fight fatigue. Not tape. In someone with venous insufficiency — basically, blood pooling in the legs — you can bind up their calves with tape like compression socks, and that will be … about as helpful as compression socks (see Aguilar-Ferrándiz). There’s not really any reason to use tape for that. If tape (or compression socks) had a measurable circulatory effect on healthy people, now that would be mildly interesting. But it would be downright shocking if it was a robust enough effect to affect athletic performance, let alone elite performance. BACK TO TEXT
  10. “Performance enhancement” is usually a problematic claim, because it’s commonly based on sloppy extrapolation from recovery effects (which are themselves often a bit sketchy). What helps people who are sick or broke is definitely not necessarily effective for fit, healthy people. Rehabilitation and performance enhancement are different things. On the one hand, they are the same process with different starting points. On the other hand, how much value the body can extract from an input is generally proportionate to the need. A glass of water is more important to a man dying of thirst, and novel sensation is more neurologically useful to an injured person than a healthy Olympian. Many things that are legitimately useful in rehab are pretty much useless for performance enhancement. Here’s a simple, tangentially related example: compression bandaging for swelling. Unambiguously handy in recovery … but useless if you’re not swollen! BACK TO TEXT
  11. One taping enthusiast told to me, emphasis mine, “I know there’s too much hype, but taping has amazing results.” Really? “Amazing” isn’t just a wee bit of hyperboic? Antiobiotics are amazing. Heart transplants are amazing. The results of taping are not amazing. And calling them “amazing” is just more hype. BACK TO TEXT
  12. Williams et al. Kinesio taping in treatment and prevention of sports injuries: a meta-analysis of the evidence for its effectiveness. Sports Medicine. 2012. PubMed #22124445.

    This meta-analysis of kineso taping for sports injuries in New Zealand’s Sports Medicine journal doesn’t really have much good news to report, but it comes off as pro-taping and cautiously optimistic:

    In conclusion, there was little quality evidence to support the use of KT over other types of elastic taping in the management or prevention of sports injuries. KT may have a small beneficial role in improving strength, range of motion…. The amount of case study and anecdotal support for KT warrants well designed experimental research, particularly pertaining to sporting injuries, so that practitioners can be confident that KT is beneficial for their athletes.

    And yet even that tepid report may be over-enthusiastic. This formal response in the British Journal of Sports Medicine (Kamper) just seethes with irritation:

    Despite the title of the review, the authors do not report a meta-analysis of the included studies. … The review has several flaws, the most serious of which is selective reporting of outcomes. As only positive (significant) results are reported it is not possible to assess the entirety of the evidence for effectiveness of kinesio taping. In addition, while the authors report to have followed the methodological guidelines of the Cochrane Collaboration this does not appear to be the case. … Clinicians should look to other sources of information…

    BACK TO TEXT
  13. Kamper et al. Kinesio taping for sports injuries. British Journal of Sports Medicine. 2013. PubMed #24159095. From the conclusion:
    Kinesio taping does not appear to have a beneficial effect on pain when compared with sham treatment. Based mostly on studies of healthy populations, there are inconsistent results for other outcome measures such as ROM, strength, muscle activity and proprioception. … At present there appears to be little high quality evidence on which to assess the effectiveness of kinesio taping, it is hoped that future research will clarify the situation.
    BACK TO TEXT