|
 
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| REVIEW ARTICLE |
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| Year : 2023 | Volume
: 23
| Issue : 1 | Page : 1-6 |
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Kinesio Taping for the management of athletic conditions
Dalal Najeeb Aldakhiel
Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| Date of Submission | 01-Jul-2023 |
| Date of Decision | 07-Jul-2023 |
| Date of Acceptance | 09-Jul-2023 |
| Date of Web Publication | 07-Aug-2023 |
Correspondence Address:
Dalal Najeeb Aldakhiel
Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam
Saudi Arabia
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/sjsm.sjsm_8_23
This article is meant to provide a full review of Kinesio Taping (KT), including its uses, benefits, characteristics, contraindications, and physiology. In addition, common sports-related musculoskeletal conditions are managed using KT, which targets athletes from different sports. These cases are shoulder impingement, tennis elbow, patellofemoral pain syndrome, shin splint, and ankle instability. In addition, this paper is covering the effect of applying KT with these conditions, the outcome of KT with or without another modality, providing recommendations, and detecting research gaps related to taping. Besides involving healthy athletes, this review highlights the sequel of using KT with various sports performances.
Keywords: Kinesio taping, sports injuries, sports performance
How to cite this article:
Aldakhiel DN. Kinesio Taping for the management of athletic conditions. Saudi J Sports Med 2023;23:1-6 |
| Introduction | |  |
Dealing with sportsmen, especially professional individuals, put the medical staff in a huge challenge regarding timing and the safety of the player. In addition, to improve their performance as soon as possible in a legal manner.[1] Therefore, it is necessary to choose modalities that enhance quick recovery, facilitate the treatment outcomes, or assist in the player's achievement. One of the tools that can be used as the modality of choice is Kinesio Taping (KT).
KT was developed by a Japanese chiropractor, Dr. Kenzo Kase in the mid-70 s.[22],[23],[24] He noted that the muscles are the main cause of the athletes' complaints due to the high demand for the musculoskeletal system in different sports. Thus, through different trials, the KT was invented, and it became one of the most frequent methods of treatment.[4] Its popularity started in 1988 when it was used on the players who participated in the Seoul Olympics.[5] Nowadays, it has become more famous as many therapists and other relevant individuals to the players (such as coaches) have a professional practice to apply it.[6] Moreover, due to high debate on its effect, it is a tool that commonly has researchers investigate its effect on different sports populations in different thoughts and manners.[1],[7]
Commercially, different companies have developed different brands of KT. However, they are similar in their effect, but some companies provide different colors and shapes to make them more fascinating to the stakeholders. Examples of these brands are CureTape, THERABAND Kinesiology Tape, Kinesio Tex Tape, KT Tape, and much more.[8],[9]
This article presents a discussion of KT uses, physiology, characteristics, and effects, including a review that supports or discourages the use of KT in different sports injuries commonly seen in athletes. The relationship between KT and athletic performance is also be mentioned.
To narrow the scope of the literature, the selected body areas covered included KT uses in the treatment method. These joints are the shoulder, elbow, knee, lower leg, and ankle.
| Kinesio Taping Uses | | |
The KT has several indications. It is mainly used for circulation enhancement, pain relief, joint and muscle function support and proprioception enhancement, and biomechanical correction.[22],[23],[24],[10] Furthermore, it can be used to decrease swelling, improve performance, and prevent reinjuries.[4],[5],[11]
Although it has a broad scope to be used, unfortunately, only some individuals can benefit from its effect, as it has particular contraindications. These contraindications are divided into absolute contraindications and relative contraindications. The conditions prohibited from using the tape are applied over an open wound or infected skin, having a deep vein thrombosis or active malignancy, or allergy to the tape. In addition, using other therapy modalities over the tape (such as hot packs or electrotherapy) must be discouraged. At the same time, the secondary contraindications are being pregnant, having heart disease (e.g., congestive heart failure and coronary heart disease), and having diabetes or kidney failure.[4],[5],[9]
| Theories of the Taping Physiology | | |
As mentioned, it is used to decrease pain. This results due to the theory that happens when the tape is applied over the skin. Thus, at the spinal level, the nocisensors (A-delta and C-fibers) will be blocked through the theory of Melzack and Wall of pain gate control.[4],[12] Moreover, at the level of supraspinal, the pain will be controlled by the impulses of the thick-fibered system, which reaches the reticular formation and causes inhibition of the efferent neuron.[4] However, the tape influence is seen more at the spinal level as it stimulates the thinner afferent nerve feedback, which is also in the skin.[2],[4] Therefore, the pain is reduced by decreasing the free nerve ends as soon as it is applied, as seen in specific muscles (e.g., upper trapezius).[5],[13]
Theoretically, joint position sense is improved when the tape is applied due to the stimulation of the mechanoreceptors, one of the cutaneous receptors, which aggravates the motor unit activation and the proprioceptors feedback.[14],[15] In addition, muscular facilitation is gained when the tape is applied because of the fascial pull from the proximal to the distal part. While on the contrary, muscular inhibition is observed when applied in the opposite movements.[9],[16]
Taping was also hypothesized to enhance circulation by lifting the skin, which causes decompression over the endothelial cells and capillaries, leading to microcurves in the area.[9],[14] This was proven to provide a significant impact as there was an increase in the blood flow by 20%–60% when measured through Doppler ultrasound.[9] Thus, taping can be used to control the swelling, too.
| Kinesio Taping Characteristics | | |
It is an elastic tape which can be stretched 100% up to 140% in a longitudinal manner only to cope with the different application techniques.[3],[12]
It is mainly manufactured to be fully made of hypoallergic cotton material to avoid skin rashes.[1],[5],[6] Nonetheless, some special tapes by different brands have added a certain amount of viscose (rayon) to be used in sports that make the body too wet (e.g., swimming) to enhance the water resistance function.[17] Both tapes use the same adhesive material, which is latex-free, and its attachment will be more efficient when heating the area through manual rubbing after the application.[5],[16] Moreover, due to the unique adhesive material, it can only be used once but for several days as it lasts up to 5 days.[5],[14]
Although the different tape effects, it does not include any medical material while manufactured, it leads us to conclude its impact based on the accurate application technique only.[1] Furthermore, it is favorable to be used because its benefits are more than its side effects, and it is a painless and noninvasive modality.[2]
| Taping Effect in Different Common Sports-Related Injuries | | |
Shoulder impingement
Two systematic reviews investigated KT's effectiveness regarding pain in patients with shoulder impingement syndrome. They both included the same study, which resulted in significant pain relief for short-term effects in the numerical rating scale. At the same time, the other variables (range of motion [ROM] and shoulder pain and disability index) did not differ between the groups. However, the pain was controlled for 6 days trial in the intervention group.[9],[18]
Another randomized controlled study investigated the overhead athlete diagnosed with shoulder impingement syndrome to evaluate the immediate effects of the taping compared with the control sham taping group. Their hypothesis was partially accepted in their result as they found a significant difference in the enhancement of the scapular repositioning error in the posterior tilt with scapular scaption and scapular upward/downward rotation with an elevated arm.[19] However, a disagreement with these results occurred in another pretest/posttest study which had the same purpose when comparing the results of healthy, physically active candidates with those diagnosed with subacromial impingement syndrome. They concluded that taping did not affect shoulder strength, kinematics, or proprioception in their sample.[16]
On the other hand, when the taping is combined with exercises in a study applied to patients diagnosed with shoulder impingement syndrome, positive results were seen. The disabilities of the arm, shoulder, and hand questionnaire showed more remarkable improvement in the treatment group in the pain, function, and night pain at the end of the study. Moreover, the intervention group had pain-free shoulder abduction and greater external rotation strength in the shoulder compared with the sham group.[12]
The aforementioned studies had limited effect on the shoulder cases. However, it can have a greater effect when used with active treatment methods. Moreover, it can be used to facilitate the short-term effect of pain reduction. In spite of that, there is an urge for a study measuring the long-term effect of taping in shoulder pain cases.
Tennis elbow
The only elbow pain case highlighted in this essay is lateral epicondylitis/epicondylalgia. The most affected muscles are the extensor carpi radialis brevis, extensor digiti minimi, extensor digitorum, and extensor carpi ulnaris.[20] Two studies measured similar variables in chronic lateral epicondylalgia: pain and grip strength.[3],[14] When the aim was to investigate the placebo effect, it was reported that the KT did not have any legacy over the placebo taping.[3] While 2 weeks randomized controlled trial (RCT) compared the effectiveness of different modalities of treating tennis elbow and showed that three different modalities had a significant pain reduction in activities of daily living. However, the long-term effect of grip strength was noted in the KT group, compared with the ultrasound group and the extracorporeal shock wave therapy group. Although there was no significant difference between the groups at the end of the 8th week, which is referred to as the long-term effect.[14]
As a result, taping has no superior effect on lateral epicondylalgia. This could be due to its unique pathology, as it is a degenerative process in the common extensors' attachment in the forearm.[20],[21],[22] Hence, it is considered an overuse injury.[22],[23] Therefore, the optimal loading would improve the result of the rehabilitation of such an injury. As a recommendation, any pain modality can be used to control the pain while the tolerated loading is the golden target of the treatment.
Patellofemoral pain syndrome
Surprisingly, the effect of different taping techniques was a trend among scholars in this musculoskeletal condition. This might be due to patellofemoral pain syndrome is the leading cause of anterior knee pain that usually occurs in the physically active population during different functional activities, especially in young females.[7],[24]
A study examined the acute influence of applying KT, McConnell taping, or no taping group during the aggravating functional activities, which are squatting, ascending, and descending stairs in young candidates.[25] The pretest–posttest designed intervention allowed a rest between the first measurement and the second measurement for 15–30 min. The only significant change was between the nontaping and KT groups during the stairs tasks. Squat activity has not shown any obvious pain reduction in any group comparison moreover, no apparent difference between the KT and McConnell taping.[25]
An interpretation of the previous result might be due to the facilitation of the fascial concentric pull and the facilitation of the muscular activity, which in turn, increases the strength of the taped muscle.[15] This theory is also applicable in two different studies that found immediate eccentric strength enhancement in the quadriceps muscles. However, one of these articles included a placebo KT, which had a similar effect to the KT group.[15] Such results led the investigators to question the effect of KT on patellofemoral pain syndrome.
To provide a clinical recommendation for the case of interest, another systematic review was conducted to analyze five different RCTs, but only two focus on KT. One study revealed no meaningful difference when measuring the pain intensity on the same day for the KT and the placebo KT groups. Furthermore, a study over 6 weeks focused on strengthening exercises had significant pain reduction in both groups. However, no difference was noted between the no-taping and KT groups.[7]
To overcome a decision of taping in this sport-related condition usually seen in the athlete. It is recommended to plan an active treatment rehabilitation program focusing on strengthening exercises since the main pain source of anterior knee pain is muscular imbalance and biomechanical deficits.[25]
Shin splint
Although taping can be used in the whole body with different techniques and applications, a few pieces of evidence investigated its efficacy with the lower leg part were found. Particularly, studies targeted the medial tibial stress syndrome, commonly seen in runners. The shin splint occurs due to overload causing bone marrow edema. Therefore, the pain aggravates with higher-load activities such as running.[26] The dilemma of such an injury is that it increases the risk of stress fracture due to the higher load upon the navicular bone and foot pronation.[27]
KT was a method that showed an immediate effect on shin splint patients in decreasing the pressure over the medial compartment of the foot compared with the healthy participants of the study. However, the effect did not last for 24 h.[27] Thus, it can be a temporary pain relief modality used before a training session or a match for players.
A recent RCT compared KT and orthotic efficacy in addition to strengthening and stretching exercises on some functional outcomes. The athletes who participated in the study were included based on the pain aggravation caused by running. The trial was conducted over 1 week only. However, the results showed a significant difference in the KT group in the hop test and pain intensity, whereas no difference between both groups regarding the Navicular drop test.[10]
Again, the KT was proven to be a short-term pain relief modality. Nonetheless, the decision to use it is determined by the physiotherapist's plan of treatment as this overload injury is optimal to be handled by the controlled loading and decrease the risks of further damage to the tissues.
Ankle instability
Various studies were conducted on the ankle joint. However, there is an agreement that using the KT alone will not improve proprioception or postural stability in healthy candidates with no ankle injuries.[15],[28],[29] On the other hand, a significant improvement in dynamic balance was noted when the tape was accompanied by balance exercises in healthy young footballers.[29]
Adding KT application for balance exercises shows more benefits to injured athletes. For instance, a supporting document examined the effect of 6 weeks of balance exercise with and without KT on female athletes having functional ankle instability. The results disclosed that the addition of KT with the balance training showed a significant improvement in the postural stability and the instability severity when the outcome was taken by Cumberland Ankle Instability Tool.[30] On the other hand, using KT with sprained athletes diagnosed with chronic ankle instability showed a mild effect on muscular activation, balance, and ROM. There was a higher activation of the peroneus longus over other lower leg muscles, improving the mediolateral sway velocity. Furthermore, the ankle eversion/inversion ROM significantly improved compared with other knee and hip angle variables.[31]
Hence, repeatedly, the KT approves its effectiveness in the acute application with injured athletes. While it can have a positive effect on ankle instability when combined with balance exercises.
Performance
To check the performance with KT and other tape modalities or without tape at all in healthy competitive athletes, a systematic review was conducted. This evidence included 15 studies.[1] Surprisingly, the KT was not producing a significant improvement in squatting power, cycling endurance, agility, sprint speed, and distance running in all the data. In contrast, it was reported that the Mulligan tape effect was superior to KT in distance running in one study.[1]
Many researchers investigated jumping activities. Ten studies compared the KT versus no tape condition regarding jumping. No noticeable effect in this comparison.[1] Moreover, six studies compared the sham KT and the KT in different jumping activities. Similarly, they did not show a superior effect between the compared results.[1] A recent RCT investigated the effect of KT and sham taping upon weightlifters in horizontal and vertical countermovement jump. The results supported the systematic review with no significant difference in the comparison. However, the KT group significantly improved the horizontal jump distance.[11]
Despite the previous results, some evidence encourages using KT in performance enhancement as it may have a positive psychological effect, as seen in different placebo-taping methods.[32],[33] Yet, further research should be conducted to detect the psychological consequence of taping with the athletic population.
| Conclusion | | |
To summarize, KT is a modern modality that can be used by the staff around the athlete with different techniques and purposes. Although the convenient physiology of the KT effect, it should be applied professionally so the sportspeople can have the suspected advantages. All the overuse injuries represented in this essay showed mild-to-moderate effects of the immediate pain relief of KT. Nonetheless, KT can give promising results when combined with different types of exercises. Furthermore, KT had almost no effect on the other healthy athletes taped to enhance their performance. Finally, the positive psychological effect of using this modality must be addressed.
Acknowledgement
The author would like to thank all colleagues who shared their experiences, feedback, and knowledge in this article. Special thanks to Dr Moath Almusallam and Dr Shibili Nuhmani for their unconditional support.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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