The NEW ROCKTAPE introduction and Research Review 2023
Introduction
The popularity of kinesiology tape surged after the 2008 Olympics and remains widely used by athletes in various sports like running, cycling, and functional fitness. It is now commonly employed by musculoskeletal, neurological, and equine therapists, and is a staple in household first-aid kits for pain relief and injury self-management.
Previously, there was skepticism about the tape’s effectiveness, but now a substantial volume of research exists. This review aims to summarize key themes and messages from the available research, providing a scientific foundation for our RockTape course.
While the literature on kinesiology tape’s efficacy remains divided, higher quality evidence is emerging, allowing for more robust conclusions. For instance, a recent systematic review by Tran et al (2023) found that Kinesio taping improved both pain and disability when applied to any body region, with both short term and longer term benefit.
A significant finding in the research is that while exercise is superior to taping in isolation, combining taping with exercise rehabilitation often yields superior results, enhancing the outcome of rehabilitation exercises.
Research also debunks the idea that application direction influences muscle response. Studies by Vercelli et al (2012), Fratocchi et al (2013), and Lumbruso et al (2014). Rather logically, elastic tape recoils towards its middle, leading to varied effects on muscles. The specific excitatory or inhibitory outcome cannot be reliably predicted prior to application, making it essential to consider the individual case.
In randomized controlled trials (RCTs), it is essential to blind participants to the intervention to minimize the placebo effect. However, when one group receives taping while the other does not, there is a risk of study bias due to differences in experiences and outcome expectations. To address this issue, researchers utilize “fake tape,” a sham intervention created using non-elastic medical tape or applying tape without stretching it. Interestingly, favorable results can still be achieved even without stretching the tape. Nonetheless, some research indicates that stretched tape tends to produce better results compared to non-stretched tape (Shakeri et al., 2018). In practice though we approach any addition of tape stretch, or pre-load cautiously as it can increase the risk of skin irritation over mobile areas such as the knee and shoulder.
The Decompression Theory
Kinesiology Taping was developed in the 1970s by Kenzo Kase, a Japanese Chiropractor. The original theory suggested that tape elasticity interacting with the skin caused decompression under the skin due to soft tissue laxity and offloading. Some research, like Pamuk Yucasoy’s MRI analysis (2015) and our own team’s ultrasound tests, partially support this theory, showing a physical change in the subcutaneous space after taping. However, the MRI study revealed inconsistent skin tension and deformation responses, suggesting that the results of taping may not solely depend on physical application principles. This leads us to the next topic, the nervous system.
The Nervous System
Well-conducted neuro-taping research shows growing evidence of benefits for various nervous system disorders. Studies include cerebral palsy in children (BAŞ et al 2021; ŞŞimşşek et al 2011), multiple sclerosis (Constantino et al 2015), hemiplegic shoulder (Pillastrini et al 2015; Huang et al 2017), balance issues (Rojhani-Shirazi et al 2015), sensory ataxia (Macefield et al 2016), and Parkinson’s disease (Merino-Andrés et al 2021), among others. The insights gained from these studies support the neuro-sensory approach to taping, which considers how taping’s sensory input through the skin influences movement and pain modulation.
Influencing Movement
RockTape provides a novel sensory input to the skin, which captures the brain’s attention. This increased awareness of the taped area enhances proprioception, as shown in studies by Macefield et al (2016) and Song et al (2015) for knee proprioceptive accuracy and reduced patellofemoral pain, respectively.
Research suggests that taping compensates for reduced sensory input, aiding proprioception, balance, and delaying muscle fatigue (References: Zulfikri et al 2017, Choi and Lee 2020, Kim et al 2020).
The mechanisms behind taping’s muscle function improvement are diverse and individual-specific. The decompression theory remains relevant as it may initiate a positive cascade of influences on the movement systems of the body. Presently, research primarily focuses on taping’s interaction with the nervous system, with various plausible neuro-centric mechanisms. The evolving RockTape education also explores the influence of psychology and behavior change, recognizing that awareness, confidence, and positive movement experiences are essential in physical therapy.
Pain Reduction
Kinesiology tape is commonly used for pain reduction, backed by research supporting its efficacy for various pathologies, such as shoulder pain (Tudini et al 2023; Dzulfakar et al 2022; Deng et al 2021), knee pain (Donec & Kubilius 2019; Melese et al 2020) , back pain (Mohamed et al 2023; Abbasi et al 2020), cancer-related pain (Amarowicz & Warzecha 2020) menstrual pain (Kiseljak et al 2023), and oral pain (Firoozi et al 2022). This versatile treatment option is likely to provide pain relief, regardless of the underlying trigger.
RockTape may reduce pain by pain gating, which involves providing a non-threatening, consistent stimulus that overrides or inhibits other more threatening sensory inputs. Additionally, taping may address mismatches between sensory input and motor output, leading to improved coordination, muscle power, and ultimately pain reduction. Taping application may also offer positive movement experiences, breaking down barriers and reducing movement anxiety, leading to increased confidence and decreased pain experience.
In conclusion, RockTape’s pain reduction effects are likely influenced by various mechanisms, including pain gating, improving sensory-motor congruence, and facilitating positive movement experiences to build confidence and reduce movement-related anxiety.
Oedema Control
Research into the efficacy of kinesiology tape for oedema control continue to be published at pace. Reduction of post-surgical oedema and the management of lymphodema are the most common uses of kinesiology tape. Some of the more recent publications include an informative literature review of seven studies which reported on oedema control for musculoskeletal problems, five of which were for knee pathologies. Although the results were varied the review reported on the reduction of oedema following total knee replacement and anterior cruciate ligament repair and in children with phalangeal joint strain (Yong et al 2022).
The efficacy of Kinesiology tape in the treatment of lymphodema secondary to mastectomy for breast cancer was considered by Kasawara et al (2018). Of the seven studies included for review in their systematic review and meta-analysis all of them reported positive effects in reducing lymphedema. It should be noted that the results also showed that taping was not superior to other commonly used treatments.
Oedema related studies continue to emerge, such as the recent one by Labianca et al (2021) who reported on the positive effects of kinesiology tape for early rehabilitation after ACL reconstruction. With reduced pain and edema noted in their prospective randomized control study. While edema reduction was higher in the taping group, other outcomes did not show significant differences when compared to the control group, both groups completed a standard rehabilitation protocol.
The Evidence Map
In 2020, Cupler et al published a comprehensive systematic review in the Journal of Chiropractic and Manual Therapies, including 127 RCTs that covered various types of taping, not just kinesiology taping. The review presented a well-organized table, grading the evidence for specific musculoskeletal conditions. Kinesio taping’s evidence quality was frequently reported as moderate and equivocal. Kinesio taping was recommended for chronic low back pain with high-quality evidence and showed favorable results with moderate-quality evidence for knee osteoarthritis, acute and pregnancy-related low back pain, and diastasis recti abdominis. The review’s findings revealed gaps in research, emphasizing the need for further studies.
In the future, kinesiology tape research may focus on several key areas. Firstly, researchers will likely continue exploring the efficacy of kinesiology tape for various conditions and its underlying mechanisms. Understanding the specific physiological processes that contribute to its benefits could lead to more targeted applications.
Additionally, continuing to investigate taping combined with other therapies, such as physical therapy or exercise, could lead to more comprehensive patient management.
Perhaps advancements in wearable technology may facilitate the integration of sensors or smart materials into kinesiology tapes, enabling real-time monitoring and personalized feedback.
Investigating kinesiology tape for preventive purposes, especially in healthy individuals like athletes, could be an area of interest.
Furthermore, exploring the potential psychological benefits of kinesiology tape, such as its impact on pain perception and anxiety will hopefully be pursued.
For our conclusion we lean on the words of Hodges (2008) who wisely concludes that while it would be ideal to thoroughly test and understand ideas before implementing them, this approach is not practical in the real world. Here we add that waiting for complete evidence would hinder progress. Therefore, taping should both inform and be informed by research, as relying solely on evidence-based practices would restrict its potential.
References & Bibliography
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