I was skeptical…really, really skeptical.
When I was a chiropractic student, we had several nationally-recognized sports medicine physicians present on when and how they would use this flexible, colorful tape. My peers sat there in awe of the extensive list of famous athletes name dropped who recovered from their injuries with the help of this simple fabric. This was immediately after the 2008 summer Olympics when Kinesiotape stood out and became the most Googled term from the Games (Everyone wanted to know what was on Kerri Walsh’s shoulder). After dozens of hours of workshops explaining the science and protocols for proper tape usage I was still hesitant about implementing it.
Flash forward to one of my first patients out of school. He had a history of five shoulder dislocations in a span of four years. I had him begin several rehab exercises that I assumed were gentle enough but he noticed pain and clicking with instability when performing his routine. I thought about how there was no way we were going to make any progress if he could not follow the program I wrote out for him. Then, out of the corner of my eye was a roll of kinesiotape I had kept. It was still sealed in its plastic wrap, neglected for more than a year. Despite having no intention of ever using the product I still remembered the taping protocol for shoulder support. I thought I’d give it a try and after laying down the application I sent him home hoping that it would stick for more than a night. The next week he came back praising how it was the first time in years that he didn’t feel apprehensive about shoulder movements as he felt more stable (and the tape stuck for the entire week). It had served like a crutch to him and it allowed for his shoulder joint to sustain a greater load within its limits. At the end of his treatment program it got to the point where I forgot during one visit which side was his symptomatic one. His bad shoulder was as strong as, if not stronger, than his non-injured side.
Patient: “That tape really helped me with my shoulder exercises. Do you use that pretty often on others?”
Me: “Not quite, but I will…”
Kinesiotape was designed by a dual chiropractor-acupuncturist in Japan named Kenzo Kase in 1979. He has his own company that produces the tape but there are dozens of other brands that have sprung out there with their unique designs and approaches to using the product. One of the hallmarks of kinesiotape is the elastic property. The brand I use is built to withstand 180% stretch without falling off. The material is made of a mixture of cotton and polyester with acrylic used as the adhesive. Depending on how active you are and if you participate in a contact sport, it can last from 3-5 days. The only side effect is skin irritation with those with increased skin sensitivity.
In order to fully explain the effect of kinesiotape we have to go over some basic skin functions. Skin is a separate organ system in itself known as the “integumentary” system. That being said it is more complex than just a thin layer that protects your internal structures from the outside world. The surface is flush with sensory receptors that constantly communicate with your brain. For example, a house fly descends on your forearm and that sensation is sent to your brain which says, “This is a fly”, which then travels back down the arm where you respond by trying to shake the insect off. There are specific receptors (“mechanoreceptors” to be precise) for different types of input. The Pacinian corpuscle detects vibration and pressure, Meissner’s senses light touch, Merkel’s for pressure and texture, and finally Ruffini’s for sustained pressure. Kinesiotape uses this physiological process to its advantage by acting as a pain reducer. Depending on the type of injury, the tape is pre-stretched over the area of discomfort. This pre-tension, as opposed to simply laying the tape down flat, stimulates those mechanoreceptors to fire. With the way we are wired, there is only so much information that the brain can process instantaneously. Thus, the site of injury causing pain and the area of skin covered by tape are essentially competing for the brain’s attention. This is similar to a child clenching his teeth and tensing his facial muscles before getting a shot in the arm. He’s unconsciously trying to create a stimulus greater than the needle penetrating his skin. With the tape on, the brain is pre-occupied with the sensation of the mechanoreceptors and less the nociceptors that are sending pain signals to the brain (Specifically in the insula, the anterior cingulate cortex, and the prefrontal cortex).
The skin without and with tape applied. – Courtesy of RockTape
Delving more into the structural effect, there are several layers we have to keep in mind. Beginning from the exterior surface you have your skin (epidermis and dermis), fascia (which is a layer of fibrous, connective tissue), then a space containing nerves and your circulatory system followed by muscle below. Putting a stretch on the tape will lift the skin depending on how much tension is placed. In response, this lifts the fascia which decompresses the vessels underneath. This is beneficial in that it reduces swelling to a region. With the amount of fluid leakage to injured tissue, there is often a backup compounded by adhesions and scar tissue. Because of this, this is why people find it difficult to move an injured area because it is restricted from all this excess buildup of fluid and tissue (In addition to pain, etc…). Swelling has its own unique application in the kinesiotape world. You may have seen what appeared to be a spider web pattern on an athlete with an acute injury. The idea behind this is to create a vacuum effect by alternating areas of high and low pressure. This taping pattern combined with the amount the patient is able to contract the muscle underneath will aid in pumping fluid out of the region.
One of the main reasons I use kinesiotape is for support. Think along the lines of a brace only that it is more flexible and has very little restriction. More often than not an injury will involve a certain degree of tearing in the muscle, supporting ligaments, tendons or a combination of them all. With that comes a loss of function and coordination to the area. For example, lets say a sprinter strains his hamstring at the end of the race. The next day he has a slight limp and has restrictions with straightening his knee and flexing his hip due to pain. Applying kinesiotape to the affected hamstring and into those movement patterns will decrease the demand on the muscle since the tape is mimicking the motion through stretch and recoil. It serves a role similar to what a spotter is to a weightlifter. If you’ve ever worn a compression shirt, shorts or socks, you may have an idea of what this feels like. Of course there are factors that influence this effect such as location (upper vs lower extremity), injury severity, and so forth.
Even though kinesiotape has been in existence since the early 1980’s, it still lies in its infancy stage. There remains questions such as conditions it has a greater or lesser effect on, what application works best for a given condition and further explanation of the neurophysiological effect. Personally, it is an area that I have a research interest in and hope to have a study published in the near future.
– Dr. Jeffrey Chan, DC, CSCS, ART
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