Photos courtesy of the author

Youth and adults are participating in sports and recreational activities at an increasing rate. By far, the most common sports injuries are sprains and strains.1-4 Popular Internet search engines display results in the millions for “sport injury treatments.” To narrow the investigation, one can add “therapeutic (or elastic) tape.” To further the whittling process, one can seek specific body regions. Here, one will find information about plantar fasciitis, ankle sprain, knee pain, hamstring strain, low back pain, and shoulder impingement among just a few.

Pediatric, orthopedic, neurologic, and sports are just some of the groups in which this tape is used. Clinicians who specialize in the treatment of lymphedema have also recognized the benefits of this unique tape. Naturopathic doctors (NDs) and licensed acupuncturists (LAcs) are also among groups who have seen the value of including this tape in their treatment plans.

How can therapeutic tape have such a wide effect on so many different populations and conditions? In his book, Every Second Counts, professional cyclist Lance Armstrong writes, “It is a special hot-pink athletic tape that came from Japan and seemed to have special powers.” Recently, we are gaining a better understanding as to how therapeutic tape is having the effects of “special powers” on our bodies. Research is ongoing to provide more evidence as to the efficacy of therapeutic tape and the application method. Studies are demonstrating positive results in support of the benefits that have been observed since the mid 1970s. These studies have looked at the effect on decreasing pain; increasing muscular strength/endurance; improving range of motion, neuromuscular control, and circulation; and allowing for 24-hour treatment.5-8

Once the tape is applied to the skin, there is an effect on the superficial lymphatic system, vascular system, and neurologic mechanisms.9-10 The goal in treatment with this method is to assist the body in achieving homeostatic regulation. Although 90% of those who use therapeutic tape rely on it for nonsports uses, it is being widely accepted in the arena of rehabilitation and prevention of sports injuries. It is also gaining popularity with regard to sports performance.

REHABILITATION

Along the road of the healing process, acute, subacute, and chronic phases present with changing physiologic scenarios. Therapeutic taping, as Kenzo Kase, DC, intended, can be used in a variety of ways throughout the rehabilitation phases. Of course, to determine the stage of healing, and therefore which treatment plan is appropriate, a clinician must be able to properly assess an individual’s condition. Assessment of the condition as rehabilitation progresses is a vital part of optimal recovery and return of function.

To observe the effects of therapeutic tape throughout the rehabilitation process, let’s take a look at one specific case: A 49-year-old healthy male presented to a physical therapy clinic 4 days after a severe hamstring strain. The injury occurred at the beginning of track season during pole vaulting practice (Figures 1 and 2). During a thorough evaluation, the initial findings included: antalgic gait patterns, pain, swelling, ecchymosis, muscle spasm, hamstring weakness, and loss of range of motion at the knee and hip. Over the course of rehabilitation, treatments included: soft tissue mobilization, ultrasound, interferential muscle stimulation, ice, therapeutic exercise (in the clinic and via a home exercise program [HEP]), and therapeutic taping. He was seen for 10 visits. At 23 days post injury, he was able to run up and down a 40-yard hill, run 100 yards on a track, and perform a strength and conditioning program geared toward pole vaulting. Not only was he able to return to his recreational activity sooner than anticipated, but he continued to work in the construction field. He did not lose a day from work.

Figures 1 and 2. A hamstring injury (left) is regularly taped at onset of rehab (right) through discharge to affect lymphatic and vascular circulation, fascia, muscle, swelling, and pain.

What were the components to the speed of recovery and rapid return of function? Patient motivation played a strong role: he was very diligent about performing his HEP. Early intervention of skilled rehabilitation services was another important factor, as was thorough and consistent assessment in order to update the treatments in keeping pace with his physiology of healing. Therapeutic tape also played a crucial role. The tape helped to bridge the gap between treatments. As Kase intended, the therapeutic effects continued once the patient left the office. Due to the fact that this tape can be worn for multiple days, the physiologic effects continue even when the patient is between visits.

The therapeutic taping component of the rehabilitation program was included in order to affect lymphatic and vascular circulation, fascia, muscle, swelling, and pain. To have these effects, the tape was applied in a thoughtful and skilled manner, specifically tailored to this individual’s condition and clinical presentation. There was clear progress at each visit. Therefore, treatments were adapted and advanced consistently. Therapeutic taping applications also advanced in order to keep pace with the changing physiology of the healing process. The value of the therapeutic tape was the ability to use it from the onset of rehabilitation until discharge. Understanding the principles and application method enabled an appropriate taping technique to match what was assessed during each treatment session. He did not require taping after rehabilitation because his body recovered fully.

PREVENTION

A 35-year-old female who was training for her first marathon presented with complaints of bilateral knee pain that occurred following her training runs. Upon assessing her condition, observation demonstrated pes planus bilaterally and internal tibial and femoral rotation bilaterally. During dynamic movement analysis, she performed bilateral and unilateral squats, which only magnified the static postural observations.

The therapeutic taping applications aimed to address these postural deficits. Muscle applications included rectus femoris and anterior tibialis facilitation. Corrective applications included mechanical correction of the medial longitudinal arch bilaterally.

Based on the general principles of therapeutic taping, the theory in these applications was to: 1. Improve lower kinetic chain alignment via proprioceptive input through the skin, and 2. Improve lymphatic and vascular circulation during running to reduce fatigue.

During subsequent runs, she had no pain complaints during or after the run. She went on to complete her first marathon without injury. Since that time, she has continued to train for and run long distance events.

Figure 3. Two-inch-width therapeutic tape is used on a cyclist to facilitate lumbar and thoracic extensors and the lower trapezius.

PERFORMANCE

Sherrington’s law of reciprocal inhibition states that a hypertonic antagonistic muscle may be reflexively inhibiting its agonist. Vladimir Janda’s Approach to Chronic Musculoskeletal Pain11 discusses the issue of reciprocal inhibition for helping to improve postural alignment. The PNF (proprioceptive neuromuscular facilitation) theory of proximal stability and distal mobility has been used since the early 1940s when the concepts of Herman Kabat, MD, began to have a role in rehabilitation. Bringing these concepts and theories together, therapeutic taping applications may be proven to demonstrate improvements in physical capacity and performance due to posture alignment.

There have been anecdotal reports relating the use of therapeutic tape for improving posture alignment to improvements in physical performance in cyclists, runners, and swimmers. Once again, the particular therapeutic taping application for postural misalignment is determined based on the particular assessment of an individual.

An example (Figure 3) is an application for a cyclist using one strip of 2-inch-width therapeutic tape to facilitate lumbar and thoracic extensors and the lower trapezius.

SUMMARY

The unique qualities of the therapeutic taping method have many uses in sports injury rehabilitation, injury prevention, and likely performance. Promising research is developing steadily in this arena. Skilled assessment and application of the taping method provide the clinician/practitioner with an added component in their approach to sports medicine and health care.

Rob Brandon, MPT, ATC, CKTI, is the owner of Rob Brandon Seminars (www.robbrandonseminars.com). He teaches the therapeutic taping method internationally. In addition, Brandon works as a physical therapist and athletic trainer at Napa Valley Physical Therapy Center Inc, Napa, Calif. He also volunteers as a certified athletic trainer at American Canyon High School. For more information, contact .

REFERENCES
  1. National Institutes of Health. Childhood sports injuries and their prevention: a guide for parents with ideas for kids. Available at: www.niams.nih.gov/Health_Info/Sports_Injuries/child_sports_injuries.asp. Accessed January 20, 2011.
  2. SAFE KIDS USA. Available at: www.safekids.org. Accessed January 20, 2011.
  3. www.runningusa.org
  4. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Handout on health: sports injuries. Available at: www.niams.nih.gov/Health_Info/Sports_Injuries/default.asp. Accessed January 20, 2011.
  5. Kim S-H. The effect of Kinesio taping on the change of muscle strength and endurance in trunk flexion and extension in chronic low back pain. Proceedings from the 20th Annual Kinesio Taping Association International Symposium; April 15-17, 2005; Tokyo.
  6. Mori A. Activation of cerebral cortex regions after using Kinesio tape. Proceedings from the 20th Annual Kinesio Taping Association International Symposium; April 15-17, 2005; Tokyo.
  7. Szczegielniak J, Krajczy M, Bogacz K, Luniewski J, Sliwinski Z. Kinesio taping in physiotherapy after abdominal surgery. Fizjoterapia Polska. 2007;3:299-307.
  8. González-Iglesias J, Fernández-de-Las-Peñas C, Cleland JA, Huijbregts P, Del Rosario Gutiérrez-Vega M. Short-term effects of cervical kinesio taping on pain and cervical range of motion in patients with acute whiplash injury: a randomized clinical trial. J Orthop Sports Phys Ther. 2009;39:515-521.
  9. Lipinska A, Sliwinski Z, Kiebzak W, Senderek T, Kirenko J. The influence of Kinesio tape application on lymphedema of an upper limb in women after mastectomy. Fizjoterapia Polska. 2007;3:258-269.
  10. Slupik A, Dwornik M, Bialoszewski D, Zych E. Effect of Kinesio Taping on bioelectrical activity of vastus medialis muscle. Preliminary report. Ortop Traumatol Rehabil. 2007;9:644-651
  11. Phil Page, MS, PT, ATC, CSCS; Clare Frank, PT, MS, OCS. The Janda Approach to Chronic Musculoskeletal Pain. Copyright 2007.