full article 2100 words
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 in my book about patellofemoral pain.
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 like 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
Nevertheless, studies have often shown that all this taping seems to have 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.8 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 probably won’t stand up to scrutiny.9 Or a little physiological perspective.1011 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.
This almost certainly one of those “truth is in the middle.” Is there hype? Definitely!12 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.13 Although the evidence is limited, the effect on pain is what matters the most, and that evidence is the most discouraging so far.14
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.
I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. 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 or Twitter.
Other related topics on PainScience.com:
After showing that patellar taping improved proprioception (see Callaghan 2002), this straightforward study of brain activity is small and un-powerful, but it also isn’t trying to prove much: just that “patellar taping modulates brain activity in several areas of the brain during a proprioception knee movement task.” This tends to support the notion that taping changes how the knee feels, at least temporarily, which may in turn have an effect on pain.BACK TO TEXT
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
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:
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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…
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