Kinesio taping in physiotherapy - does it matter? What do the studies say?

Author: Mgr. Lukaš Kasala

Kinesio taping is a frequently used therapeutic tool in our country. I have often had a "taped" patient in my practice, who was supposed to be helped by taping from pain. The "father" of the flexible taping method is considered to be the Japanese chiropractor

Dr.Kenzo Kase, who brought the idea of ​​flexible taping in 1979. When designing flexible taping, he based his idea on the idea of ​​decompression and "relief" of the tissue under the tape, which was supposed to affect fluid flows in the subcutaneous tissue and soft tissues in the subcutaneous tissue and muscles. Since the presentation of kinesio taping, the method has been gaining its supporters, especially among athletes and athletes' physiotherapists. The peak of the presentation of flexible taping can be considered the Olympic Games in Rio 2016, where an "untaped" athlete was almost a rarity and the consumption of "kinesio tapes was estimated at hundreds of kilograms.

But does it really have an effect on the musculoskeletal system, as his father imagined? Knowledge of anatomy and scientific studies will provide us with the answers. If we look at PubMed (MedLine), the initial studies were of very poor quality, brought irrelevant results and no specific conclusion can be drawn. We only see high-quality randomized controlled studies around 2014 and we can already draw some conclusions from their results. However, the results for elastic tape are not positive. No relevant study recommends the use of kinesio tape for musculoskeletal causes of pain and in clinical practice. When we study the anatomy of the individual layers from the skin to the muscle, we find that elastic (kinesio) taping has no mechanical effect on the muscle, because its pull is not transmitted to the muscle.

Based on the results of studies, the use of elastic tape has been limited worldwide. In our country, this method is still widely used and considered effective, taught at universities and courses, and its effectiveness is beyond doubt.

When we look at the anatomy and the way the tape is supposed to function and affect the musculoskeletal system, is it even realistic for it to fulfill its purpose? Is it even possible to influence muscle tone and activation with the tape as presented?

Let's take a closer look at this through the eyes of anatomy, which will give us a clear answer.

The tape sticks to the skin. Between the skin and the musculoskeletal system is a layer of subcutaneous fat, which is divided into 2 parts. Each of them has significantly different properties and arrangement. The superficial part (SAT-superficial adipose tissue) and the deep part (DAT-deep adipose tissue). SAT is firm, compact, architecturally organized, while DAT is looser, sparse and mobile up to several centimeters. Between SAT and DAT there is a thin fibroelastic layer called superficial fascia, which is connected to the skin and deep fascia by a system of so-called skin ligaments (retinacula cutis). This arrangement ensures, or rather thanks to this arrangement, that the muscle does not pull the superficial part of the subcutaneous fat and therefore the skin with it during movement, contraction and change in tension. This relationship also applies vice versa. If we pull the skin manually, we will not change the length of the muscle. The effect of the tape is completely lost in the loose and soft layer of DAT and the effect of the tape tension cannot be transferred to the muscle. Taping instructors also mention cases where it is necessary to stretch the tape by 50, 75%, etc. From the above, it is clear that this has no effect or significance. You also learn how to apply the tape, i.e. which side is fixed and which side is stretched depending on whether you want to facilitate or inhibit. By its mechanical nature, taping is a rubber band that is always pulled equally from both sides to the center. So it does not matter whether you stretch the tape from left to right or vice versa, the direction of the tension will always be the same from both sides.

from Atlas of human fascial system - Stecco

Another claim that teachers and advocates of elastic taping rely on is that it changes muscle tension and muscle activity, and ultimately muscle function. What does the real evidence say? In this 2014 double-blind, placebo-controlled, crossover study, the effects of elastic taping were evaluated using electromyography and isokinetic myography. The results show that the application of elastic taping has no effect on healthy muscle tone, EMG activity, flexibility, or muscle strength.

A strong 2018 study, Kinesio Taping effects with different directions and tensions on strength and range of movement of the knee: a randomized controlled trial, used dynamometry to examine the effect of flexible taping on rectus femoris strength and range of motion in the knee. The study also looked at the method of applying the tape - from where to where we stretch, and also at different taping tensions, namely 0%, 10% and 75%. The results of the study clearly state that "the application of flexible taping does not affect rectus femoris strength or range of motion in the knee. The directions of application, facilitative or inhibitory, and also the different amounts of tested tensions (tensions) did not produce any changes in this study."

The 2021 systematic review Effectiveness of kinesiotaping in patients with subacromial impingement syndrome: A systematic review with meta-analysis conducted on patients with impingement syndrome claims that the use of kinesio taping has no significance in patients with painful shoulder - KT does not support an effect in clinical outcomes in these patients.

The most cited study from 2014 (306 citations at the time of writing), which included 12 RCTs, 495 people and compared Kinesio Taping with sham taping/placebo, no treatment, exercise, manual therapy and conventional physiotherapy. The authors wrote the result of this study in the title: Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review, i.e.: current evidence does not support the use of Kinesio Taping in clinical practice. This study was published in the Australian Journal of Physiotherapy with a current impact factor of 7.

From the studies mentioned, it is clear that using flexible taping to influence a muscle has no effect on the muscle. Both the anatomy and the studies mentioned convincingly speak of this. Whether you apply the taping "inhibitoryly or facilitatively", with half or 3/4 tension, it is essentially the same. In conclusion: kinesio taping has no effect on the musculoskeletal system, deep fascia, adhesions, proprioception or any painful condition from the musculoskeletal system.

Proponents of taping usually present studies that demonstrate a positive effect on the musculoskeletal system. Unfortunately, these studies have very low informative value, the methodology is often poor and the result is practically none. Not to mention that many studies with positive results were organized or sponsored by manufacturers of kinesio taping.

But does the use of kinesio taping have any significance at all? It does, but to a limited extent and only in some cases. For example, in the treatment of subcutaneous bruising or postoperative edema. Another systematic review from 2020 Kinesiotaping for postoperative oedema - what is the evidence? A systematic review states: There is some evidence of the effectiveness of kinesiotaping in the treatment of postoperative edema. However, this evidence is not yet convincing due to the limitations of the published studies. Taping can also be used to support wound healing, support drainage of superficial veins, support the function of mimic muscles in facial nerve paresis, and support intestinal peristalsis in children under 6 months.

Another reason for using flexible taping may be placebo. If a patient requires the use of taping because they feel that it will help them, why not, placebo is a powerful tool. However, I believe that we should not use taping as a method of choice, supportive therapy to another approach, or tell patients that taping is essential for them. There are many far more effective approaches.