Why all the multicolored tape?

If you have watched any sport in the past few years either on TV or in person you will have seen athletes covered in bright colored tape all over their arms, and their legs. With so many athletes using it, surely it must be helpful, right? We will look at the history of this taping and then the evidence to see if you should be using it, or relying on it.

The first question you might ask is why did we not see this tape 15 or 20 years ago? Is it that the tape is made from a new material, or did some smart entrepreneur think up the up the idea and use awesome marketing?

Multicolored Tape!

Different material properties?

15-20 years ago there was certainly tape used in athletics and sports medicine; in fact, there has been tape for many more years than that. When I first started PT school 15 years ago, some of the taping I learned was from research papers on knee pain by an Australian PT called Jenny McConnell¹. She used the physical properties of a strong athletic tape to affect the body and make biomechanical changes on the patella and quad muscles. In the right cases it certainly appeared to be effective, and as a new PT, I enjoyed seeing the quick relief it could give. Over time, research has agreed that this gives an immediate pain relief and appears to be an effective companion to exercises over a 4-week period². Kinesiotape (KT), on the other hand, was introduced by Dr Kenzo Kase, a Japanese Chiropractor. He developed KT as he felt rigid athletic tape hindered movement and therefore athletic activity. This is interesting with the previously used rigid athletic tape giving good results in the presence of pain. So, this is a different product than the athletic tape I learned to use, but I do not think that KT tape could not have been developed 15-20 years ago, it is just nobody had thought of it or decided to do it.

Awesome marketing?

Why do we see these tapes used as much as we do? The biggest reason goes back 7 years to the 2008 Beijing Olympics; Kinesio USA donated 50,000 rolls of tape to 58 countries! You can see this in a New York Times article. That is pretty awesome piece of marketing!!! If you Google “2008 olympics beach volleyball tape” you will see players with more tape visible than skin across their shoulders. The bright colors only helped market the product more; if you look at lines of athletic clothing be-it shoes, shirts, shorts, you will notice that they are often in bright colors. So evidently they had a good marketing strategy in place! Like any product in the medical sphere, once it has gained some market people will start to undertake some research, and this was often positive. However, in the early stages of a treatment which is unlikely to have a negative/dangerous outcome, the studies are often lower in quality. They are more likely to be single case studies, or small case-series³, and are not applicable to the population at large. Compare this with a medication: because of the potential for bad side effects, a new medication is not available to the public until high-quality research, such as a randomized control trial, confirms its efficacy and determines the true contraindications.

So we can see that this initial product was the brainchild of a healthcare provider who was not happy with the tape that he was using for the athletic population he was treating. Early research was positive, so you can understand why people used it, loved it, and applied masses of it!

What do we know now?

The scientific community has now had more time to research, and during this period we have seen at least seven systematic reviews on KT over a three-year time period. This again highlights its popularity, and it should also show us if it is a good treatment. A systematic review is a paper that reviews all of the research that is out there on a particular question. It reviews the research for quality and the answers found. An example of a question from a systematic review on KT⁴:

“Is Kinesio Taping more effective than a sham taping/placebo, no treatment or other interventions in people with musculoskeletal conditions? Is the addition of Kinesio Taping to other interventions more effective than other interventions alone in people with musculoskeletal conditions? “

Let us look at the answers to the above question:

Is Kinesio Taping more effective than no treatment in people with musculoskeletal conditions?

They found ONE study looked at KT versus no treatment! This study was also of very low quality. They found that in 20 participants KT reduced pain on stairs but only by 0.5 on a 1-10 scale, which is an insignificant change on this type of scale.

Is Kinesio Taping more effective than sham/placebo in people with musculoskeletal conditions?

They found 4 trials considering this question, looking at outcomes and disability in people with low back pain, patellofemoral pain, whiplash and shoulder pain. The papers found KT no more effective than sham taping or no tape. All four papers were low quality.

Is Kinesio Taping more effective than other interventions in people with musculoskeletal conditions?

4 studies addressed this question, two of which were rated low quality and two very low quality. None of these papers found superiority of KT versus other treatments.

Is Kinesio Taping more effective when combined with other interventions in people with musculoskeletal conditions?

5 studies, again rated low quality did not find any superiority of adding KT to other treatments.

So what’s the answer?

There is currently no high-quality research showing superiority of KT for the treatment of musculoskeletal conditions. This contrasts with a systematic review showing good immediate pain relief with regular taping of the patella and it being good adjunct treatment for four weeks. All the KT research found in systematic reviews was of low to very low quality; therefore it is possible the findings of the review might be different with better quality evidence. But, on current evidence research cannot recommend the use of KT.

So what does Andrew think?

I’m not big for gimmicks and fads in Physical Therapy. Personally without the evidence being there, and with very effective marketing in place, I feel this is one of those fads. KT costs significantly more than regular athletic tape and I do not see a justification for this at this point in time. If something is well evidenced, +/- good marketing, I am more than willing to pay more money for that product in my clinic. However, I see no reason for using an expensive and unproven product. In your personal athletic life I would encourage you to consider the above arguments. But I would also ask you to consider a further question which we will address in our next post – should I still be competing if I need this tape to hold me together? Should I continue to train or compete when I have pain?

References:

1. Gilleard W, Mcconnell J, Parsons D. The effect of patellar taping on the onset of vastus medialis obliquus and vastus lateralis muscle activity in persons with patellofemoral pain. Phys Ther. 1998;78(1):25-32.
2. Barton C, Balachandar V, Lack S, Morrissey D. Patellar taping for patellofemoral pain: a systematic review and meta-analysis to evaluate clinical outcomes and biomechanical mechanisms. Br J Sports Med. 2014;48(6):417-24.
3. Słupik A, Dwornik M, Białoszewski D, Zych E. Effect of Kinesio Taping on bioelectrical activity of vastus medialis muscle. Preliminary report. Ortop Traumatol Rehabil. 2007;9(6):644-51.
4. Parreira Pdo C, Costa Lda C, Hespanhol LC, Lopes AD, Costa LO. Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. J Physiother. 2014;60(1):31-9.