Kinesiology Taping-The Basics

Introduction

Kinesiology taping (KT) is a therapeutic tool and has become increasingly popular within the sporting arena. Taping has been used for a long time for the prevention and treatment of sporting injuries. KT is not only used for sporting injuries but for a variety of other conditions. It was developed by Japanaese Chiropractor Dr. Kenzo Kase in the 1970's with the intention to alleviate pain ^[1] and improve the healing in soft tissues^[2]. There are many proposed benefits to KT, including: proprioceptive facilitation; reduced muscle fatigue; muscle facilitation; reduced delayed-onset muscle soreness; pain inhibition; enhanced healing, such as reducing oedema, and improvement of lymphatic drainage and blood flow^[3].

Properties

KT is manufactured pre-stretched by 15-25% as it is applied to the backing paper. It is characterised by the ability to stretch to 120-140% of its original length and, following application, recoil back towards its unstretched length. KT purportedly mimics the physical qualities of the skin as it is believed to be the same weight and thickness of the epidermis along with its inherent elastic properties^[4]. It is comprised of polymer elastic wrapped in 100% cotton fibres, which allows for evaporation of moisture. The glue is heat-activated and is applied in a wave-like pattern to mimic the qualities of the fingerprint on the finger tip. KT is both waterproof and breathable and it can be worn during exercise, showering and even swimming. It dries quickly and seldom causes skin irritation, however; if skin irritation does occur, advise patient to remove tape immediately and wash the area with warm soapy water to remove any residual adhesive. When properly applied, it will last up to 3-5 days.

Theory

The type of application theoretically determines the physiological outcome: for example, KT is applied unstretched over manually stretched skin above the injured muscle. This type of application will cause the skin to form convolutions which lift the skin^[2]. Theories suggest that these convolutions encourage regeneration of injured tissue by increasing interstitial space and alleviating interstitial pressures which occur from swelling post injury^[5]. This decrease in pressure also decompresses subcutaneous nociceptors, leading to decreased pain^[2]. It is also theorised that lifting the skin detaches filaments which attach the skin to endothelial cells of the lymphatic and capillary beds. This is proposed to to create channels which allows for lymph to drain, thus reducing swelling and allowing increased blood flow to the area^[6]. The evidence for these theories is still in its infancy and requires extensive research.

Basics of Application

• Ensure to thoroughly assess the patient in order to identify the most appropriate application
• Do NOT apply tape to any area of skin that is damaged by: scrapes; cuts; burns; sunburn or any type of skin rash/irritation
• Skin should be free of oils and lotion prior to application
• If body hair is limiting adhesion you may need to trim or shave the area
• Do NOT apply with excess tension (as with zinc oxide application)
• If patient has been exercising, ensure perspiration has completely stopped before application 
• If you are using a roll of tape, measure and cut carefully
• Round all the edges of the tape to prevent premature peeling
• Avoid touching the adhesive side of the tape after removing the backing as this may decrease the adhesive strength on the skin
• Once the tape is applied, activate the heat sensitive glue by rubbing up and down the surface of the tape 
• Wait at least 1 hour after application before engaging in activity that causes sweating
• Do not swim or shower for at least 1 hour after application
• To dry the tape after exercising, swimming or a shower, pat gently with a towel

                                                   ^[7]

Contra-indications and Precautions

• Malignancy
• Infection, cellulitis
• Open wound
• DVT

Precautions:

• Diabetes
• Congestive heart failure
• Fracture

Different Types of Application

KT can be applied in the shape of a 'Y', 'I', 'X', 'Fan', 'Web' or 'Donut'. The shape selection depends on the the size of the affected muscle and the result you are trying to achieve. 

'Y' tape application is generally used to:

• Surround the target muscle
• Inhibit or facilitate muscle stimuli
• Should be 2 inches longer than the target muscle

'I' tape application is generally used for:

• Acute injuries in place of 'Y' tape
• Oedema and pain (primary purpose)
• Alignment correction

'X' tape application is generally used when:

• The origin and insertion of the target muscle change depending on movement e.g. the Rhomboids

'Fan/Web' tape application is used for:

• Oedema (web is different because the ends remain intact)

'Donut' tape application is generally used for:

• Oedema (use overlapping strips and the center is cut out over the area of focus)

Insertion to Origin:  

• Used to inhibit overused or stretched muscles
• Light stretch used to achieve goal

Origin to Insertion:

• Used to facilitate weak or underperforming muscles
• Light to moderate stretch required

^[8]

Type of Application Stretch

The target muscle should be elongated prior to stretch. KT requires none to partial stretch to be applied on tape. 

• Full - 100%
• Severe - 75%
• Moderate - 50%
• Light - 15-25%
• None - 0%

For percentage stretch refer to percentage of available stretch.

Line of pull of the tape is key 

• Facilitate: proximal to distal (15-50% tension)
• Inhibit: distal to proximal (15-25%) 

^[8]

Kinesio Tape Instruction Video's

http://www.kinesiotaping.hk/how-to-use-Kinesio-Tapes.html^[9]

Clinical Implications

• Level of evidence - weak
• What does the evidence support?

     -Increase ROM

     -Increase in function

     -Decrease oedema/swelling

Pros

• Some evidence proves theories
• Provides a treatment
• Applicable to multiple patient populations
• Feeling of treatment encourages movement
• Versatile

Cons

• Small body of evidence to prove theories
• Expensive
• Requires practice
• Skin irritation

Patient After-Care Advice

• If the tape makes symptoms worse then take it off
• If the tape starts to come off then rub it to re-activate the tape adhesive
• Do NOT dry it with a hairdryer

Recent Related Research

Recent Related Research (from Pubmed)

• Effect of ankle taping or bracing on creating an increased sense of confidence, stability, and reassurance when performing a dynamic-balance task.
• The influence of short-term Kinesiology Taping on force-velocity parameters of the rectus abdominis muscle.
• The effects of ankle Kinesio taping on ankle stiffness and dynamic balance.
• The effects of two therapeutic patellofemoral taping techniques on strength, endurance, and pain responses.
• Lower leg neuromuscular changes following fibular reposition taping in individuals with chronic ankle instability.
• Development of a fulcrum methodology to replicate the lateral ankle sprain mechanism and measure dynamic inversion speed.
• The immediate effect of kinesiology taping on muscular imbalance for infants with congenital muscular torticollis.
• Tactile stimulation with kinesiology tape alleviates muscle weakness attributable to attenuation of Ia afferents.
• Conservative care of De Quervain's tenosynovitis/ tendinopathy in a warehouse worker and recreational cyclist: a case report.
• Effects of previous lateral ankle sprain and taping on the latency of the peroneus longus.

Resources

• http://www.kinesiotaping.com/global/corporation/about.html
• http://www.athletictapeinfo.com/category/kinesiology-tape-information/kinesio-tape/
• http://www.kinesiotaping.hk/how-to-use-Kinesio-Tapes.html

References

1. ↑ Liu YH, Chen SM, Lin CH, Huang CI, Sun YN. Motion tracking on elbow tissue from ultrasonic image sequence for patients with alteral epicondylitis.Proceedings of the 29th Annual International Conference of the IEEE EMBS Cite Interbationale, Lyon, France, 2007.
2. ↑ ^{2.0 2.1 2.2} Kahanov L. Kinesio taping, Part 1: An overview of its use in athletes.Athletic Therapy Today 2007;12:17-18.
3. ↑ Basset KT, Lingman SA, Ellis RF. The use and treatment efficacy kinaesthetic taping for musculoskeletal conditions: a systematic review. New Zealand Journal of Physiotherapy 2010;38(2):56-62.
4. ↑ Kase K. Clinical therapeutic application of the kinesio taping method. Ken-i Kai Information 2003
5. ↑ Hammer WI. Functional soft tissue examination and treatment by manual methods. 3rd ed. Boston: Jones and Bartlett Publishers, 2006
6. ↑ Lipinska A, Sliwinski Z,Kiebzak W, Senderek T, Kirenko J. Influence of kinesiotaping application on lymphoedema of an upper limb in women after mastectomy. Polish Journal of Physiotherapy 2007:7;258-269.
7. ↑ United States Food and Drug Administration (FDA). http://www.theratape.com (accessed 13 June 2013).
8. ↑ ^8.0 8.1 Kaze K, Wallis J, Kaze T. Clinical therapeutic applications of the kinesio taping method. Tokyo: Japan, 2003.
9. ↑ Kinesio Taping Association International. Kinesio HK:The original from Dr. Kenzo Kaze since 1979.http://www.kinesiotaping.hk/how-to-use-Kinesio-Tapes.html (accessed 13 June 2013).