Kinesio Tape – does it work?

In 2008 Kinesio Tape (KT) was donated to 58 countries for use during the Olympic games. Its brightly coloured strips could be seen on a host of high profile athletes and since then its use in sports has blossomed. More recently footballer Mario Balotelli wore it during the Euros, and Serbian tennis star Novak Djokovic strapped his elbow with it at Wimbledon. With countless athletes wearing kinesio tape during the 2012 Olympics and Paralympics the tape is becoming increasingly sought after but a growing number of people are asking does it really work?

In July the Advertising Standards Authority (ASA) upheld a complaint against a company's claims on the benefits of KT, concluding that there wasn't sufficient evidence to support these claims. Limbvolume had stated, via their website, that KT aided lymphatic and muscle systems, reduced recovery times and improved fitness. It suggested that the tape could be used to treat a huge number of conditions from shin splints to sciatica. Limbvolume provided 47 articles, case studies and clinical trials to support the use of KT but the ASA decided the site was misleading and concluded,

“The claims must not appear again in their current form. We told Limbvolume to ensure they hold adequate substantiation for the claims they make in future”

This would appear to be a fairly damning indication of the effectiveness of kinesio tape but really it just reflects on the nature of Limbvolume's claims. They suggested KT was effective in a huge variety of cases based on a very small amount of research.

So what does the research say?…

Williams et al (2011) performed a Meta-Analysis of the evidence of the effectiveness of kinesio tape in treatment and prevention of sports injuries. They found just 96 relevant articles on KT, which indicates how little research has been conducted, especially when you consider something like acupuncture is said to have had thousands of studies. Of the 96 articles only 10 passed the inclusion criteria and were included in the review. Just 4 of these studies were on the lower limbs, all of which were on healthy subjects and none of the 10 were performed on runners.

Examining research from Williams et al (2011) and others we hope to answer a number of questions surrounding the use of KT.

Does kinesio tape improve performance in runners?

Despite claims from a number of tape manufacturers there seems to be no high quality evidence to show that KT improves running performance. What I wanted to see here was studies comparing KT with a placebo and control group to see its affect on 5km running times, running economy or any number of performance variables. I was unable to find a single study that did this. RockTape present a study on their site showing improvement in cycling performance with KT. But this included just 5 cyclists, has clear issues with potential bias and was even described by the article itself as a “low” level of evidence! What is remarkable about this work is that despite the claims on the site on improvement in sports the performance the study actually confirms the total lack of research,

“…to our knowledge there are no published randomized clinical trials that evaluate the effects of Rocktape in a performance-enhancement application”

It is perhaps unfair to pick on RockTape as other companies have made the same claims and at least they do present some research evidence on their site, they deserve some credit for that. But it is incredible that their slogan is Go stronger, longer and their own research admits there's no evidence to support that!

Does kinesio tape improve strength or muscle activity?

Williams et al concluded that KT may have small benefits on muscle strength but there was no substantial evidence for improvements in muscle activity. Two studies did report significant effects of KT on muscle activity but Williams et al questioned their methodological quality. There is also a question as to what is clinically beneficial in terms of change in muscle activity. In some cases you may seek to increase activity (for example in the medial quadriceps to improve patellofemoral pain) in others a decrease might be the aim (such as in TFL for ITBS).

A recent randomised, controlled clinical trial compared KT on the quadriceps muscles, with nonelastic tape and a control group. The study, by Alano de Almeida Lins et al (2012) concluded,

“Application of KT to RF (Rectus Femoris) VL (Vastus Lateralis) and VM (Vastus Medialis) muscles did not significantly change lower limb function, postural balance, knee extensor peak torque or Electromyographic activity of VL muscle in healthy women”

Thanks to @setherapies for recommending the article.

Does kinesio tape reduce pain or improve proprioception?

Williams et al concluded there was no substantial evidence to support the use of KT in decreasing pain or improving proprioception. (Proprioception is the system by which we monitor joint position and control movements)

Does kinesio tape improve range of movement?

Williams et al found there was some evidence to suggest KT may be beneficial in increasing range of movement but further research was required.

Does kinesio tape help to prevent injury?

I have been unable to find any quality evidence to show that KT can be used to prevent injury. Briem et al (2011) found that KT compared poorly to non elastic tape when used to prevent ankle inversion and would therefore be unlikely to reduce occurrence of ankle sprains.

Is there evidence for the use of kinesio tape to treat specific conditions associated with running?

I found a handful of case studies showing positive results, including 1 for Achilles tendon injury however single case studies are a low level of evidence. Patellofemoral Pain Syndrome (runner's knee) appeared to have been studied most extensively but even this yielded just a handful of articles. The results were mixed, with Akbas et al (2011) finding that adding kinesio tape to an exercise programme made no significant difference to outcome, while Chen et al (2008) found positive effects in reducing pain and altering muscle activity. Tsai and Lee (2010) studied 52 patients with plantar fasciitis and concluded that adding the use of kinesio tape (continuously for 1 week on calf and plantar fascia) might alleviate pain better than traditional physiotherapy alone. The sparsity of evidence and a number of methodological issues make it very difficult to make firm conclusions from this research into specific conditions.


So does kinesio tape work?

In my experience clinically I've found it very effective but there is minimal high quality evidence to support its use in runners.

There was some evidence to show that it doesn't decrease performance in a number of tasks and, in this regard, faired better than other types of taping. So, while we may not have evidence that kinesio tape helps there doesn't appear to be evidence to show it will harm. Clearly that's not a great reason to use the colourful tape but doing so shouldn't negatively affect performance.

Research is an important part of our decision making process with treatments. Lack of evidence isn't something we can ignore, but it also is very common among our treatments. This doesn't make it all ok but rather highlights the need for further work. You might be surprised that extremely common treatments like ice, massage and stretching have a relatively poor evidence base. We've discussed the role of research in sport before on RunningPhysio and opened a bit of a can of worms! My hope is that perhaps we have a similar situation to that faced by acupuncture when it was first used in the UK. At that time there was little high quality evidence to support its use but since then research has developed and acupuncture has become a common treatment for pain and has been included in a number of clinical guidelines.

Alongside research we also use our clinical experience in deciding treatments. I've used KT to treat runners and non-runners and seen some excellent results. I've had patients describe it as 'miracle tape' after a host of other treatments proved ineffective and the tape immediately reduced their pain. KT has proved popular with physios and patients alike. It appears to last longer than Zinc Oxide tape, stays on better during sport and is often more comfortable. The day before Brighton Marathon this year I stood at the expo and worried why my knee was aching so much. It had been all week, so I strapped it with KT and ran the race. I had no pain at all during or after it. The tape stayed on for all 26.2 miles and still looked good. I've run with Zinx Oxide in the past and it fell off after 6 miles!

I feel the tape has its main role as a strategy to offload tissues that are healing or have been overloaded. Considering how common overuse injuries are in running it should, in theory, have great potential in treating runners. In this regard I use the tape more as a traditional taping technique than as recommended by the KT companies or to directly improve performance. Other clinicians have questioned whether a flexible taping is capable of offloading structures involved in weight bearing. I share their concerns but the flexible nature of the tape allows it to be applied under some stretch in a position where the target tissue is under minimal load. For example, when using it to offload the Achilles you tape with the ankle slightly plantarflexed (moved down towards the ground), this means the tape resists dorsiflexion, the upward movement which places greater stress on the tendon. Injured tissues are unlikely to benefit from being completely offloaded as we know some stress on tissues stimulates the healing process. Our aim is optimal loading for the target tissue, perhaps by reducing load by even a small amount it helps to achieve this level of loading.

But sadly, my opinion, or anyone's for that matter, doesn't rank highly in terms of research evidence. You could even say my clear liking of the tape introduces an element of bias to the article! That said, I have done my best to present the research as I've found it.

 

My final thoughts are this; there is minimal high quality research to support the use of kinesio tape and no evidence that I'm aware of that it improves performance. In time this evidence base may develop and provide more guidance.

My recommendation is that kinesio tape can be used in the treatment of injury but should be used as part of a comprehensive treatment programme and not in isolation.

 

Oh and there is one other use for kinesio tape….

 

 

 

 

 

 

 

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24 Responses to Kinesio Tape – does it work?

  1. Sabreen Qureshi-Hitchens September 12, 2012 at 8:47 am #

    Nice article,thanks for your hard work!

  2. James September 12, 2012 at 5:15 pm #

    Really great coverage and presentation of the research Tom.

    I’ve had a hard time accepting kinesio tape mainly because the claims about how it works seem far fetched. I’ve used it before with some success (on myself even) so I’m not completely against it. I’d really like to see more investigation into the underlying mechanism in cases where it does seem to be effective.

    If I had to venture a guess I would say it works more along the lines of altering the perception of a painful injury and allowing someone to become more aware of how they are moving.

  3. Michelle Blore September 13, 2012 at 8:21 am #

    I’ve been trying out this tape myself with a generous helping of scepticism since it’s very apparent that there’s no empirical evidence to support the marketing claims (which I suspect is why they seem to be trying to turn it into a fashion item!). However, I must say I’ve found similar results to yourself – it seems effective at providing sufficient offloading of injured tissue to assist healing, without overly compromising normal movement, as one aspect of a treatment programme that includes massage and remedial exercises. I’ve found it particularly useful on foot injuries to just give a bit of protection and psychological as well as physical support.

  4. Catrin September 13, 2012 at 11:25 am #

    I agree with the comments above. I have also used it to some great effect an other times resorted to the “good old” Zink.
    I think research is a vital part of our profession but again it is through trial and anecdotal evidence that this can proceed. I remember the overuse of US for disc prolapse! Something that today would be questioned considerably if used as a reasoning for use. But by treating and trialling we can become more specific with techniques and guide research for better understandings. Thats my pennys worth anyway.
    Oh and it looks cool! ;)

  5. Chris Johnson October 25, 2012 at 1:22 pm #

    Nice objective article reviewing some of the key research. Kinesio tape is part of a DENIAL process when it comes to running injury management. I put it in the same category as NSAIDS, PRPS, etc. I always see runners and triathletes with Kinesio tape blowing in the wind and wonder what good it is doing at that point. Aside from being fashionable to some folks and giving the performer a psychology advantage and sense that they are prepping for battle, the manufacturers are making false claims and adding to the confusion that already exists pertaining to sound running management. FIgure out the problem and fix it. Unfortunately, medical and fitness professionals receive no training whatsoever on running injury management which is why we see runners plagued by injuries which are not properly addressed. I will say that I do think there is some promise with re: to Kinesiotape in the context of acute muscle strains to facilitate resolution of swelling and ecchymosis though these are anecdotal at this point. Thanks again for taking the time share this piece and hope your training is going well!!! Look forward to future blog posts on your site.

    Best
    Chris

  6. Peter A. Lorenzen January 23, 2013 at 12:22 pm #

    Great article about kinesio tape! I once had a serious knee injury, where kinesio tape helped me a lot by stabilizing and relieving. It definitely worked for me!

  7. Lee Firman January 24, 2013 at 10:25 pm #

    Very comprehensive, great work!
    There is definitely a fashion element as to why athletes are starting to wear KT. I’ve just received some samples, and am looking forward to trying it out. Having spoken to other amateur runners like myself, they swear by it. I’ll update my comment in 4-weeks after a good period of testing.

    Thanks, Lee from feetus.co.uk

  8. Rob Madden April 15, 2013 at 10:21 am #

    Hi Tom,
    Nice summary blog.
    I’m with you in that I have anecdotally used this hundreds of times with positive effect. However, we know it definitely does not always work. I was speaking with Jeremy Lewis last week and it is this unpredictability (for example using tape in tendinopathies) that does not really have a clear explanation at this stage.
    Why works for some but not all?
    Are we really changing the tissues/fascia?
    Probably not.
    Agree with James’ comment above – more likely we are influencing the sensory nervous system with an increase in afferent feedback. Theoretically leading to enhanced motor control thereby helping reduce pain where the dysfunction was part of the make up of pain mechanism driver.
    Of course, this is not an easy theory to prove as we go forward!

    I know Jeremy Lewis and Jill Cook are working/having worked on some good stuff as we work hard to try and get this technique better quality research with reduced bias.

    Really enjoy following your posts. You put a lot of effort in and it’s really good for the sports/running community and our profession! Well done.

    Best wishes
    Rob
    Physiotherapist – CHHP – 76 Harley Street
    Course Trainer – Sporttape & Sports-Taping.com (so I’m somewhat bias!)

  9. FIONA PRINGLE May 18, 2013 at 10:35 pm #

    Thank you, great work to improve clinical reasoning.

  10. Heidi Saarelma June 12, 2013 at 4:12 pm #

    Thank You! Great article about kinesio tape!

  11. Bruce Wilk August 5, 2013 at 4:46 pm #

    This is an important piece of work. I am going to share across the pond!

  12. Bea Schaeri October 26, 2013 at 11:25 pm #

    Thanks for your review, really interesting. Personally I have to say that I was very sceptical about its use when my physio started usin it as part of my treatment but I totally changed my mind. I can’t speak to any improvement in performance but it very much helps me to reduce or eliminatepain. Placebo or not, don’t care it’s better than swallowing painkillers

  13. Calvin November 13, 2013 at 5:53 pm #

    Great article. I’ve used it myself for running & while playing football and I’ve always felt it helped with offloading a little to reduce the symptoms of my PFPS…When I discovered taping I had previously had pain during running but since taping, both kinesiology and z/o, I have pain free matches and runs….If this is psychological and/or physical I don’t know as I’m not qualified to tell but either way, it works for me :)

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