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Tale of the Tape

Reprinted from SNS July 2017

Athletic tape comes in many materials and colors and serves many purposes for professional and amateur athletes, but knowing how to use it is critical

Anyone who’s watched the last couple Olympic or Paralympic Games has probably seen some of the athletes using colorful tape stuck in different shapes all over their bodies. 

Taping is used frequently by athletic trainers, physical and occupational therapists and others in the medical field to help athletes with injuries. It’s only recently attracted the public’s attention, as more high-profile athletes have been spotted sporting the colorful strips on their bodies. But it isn’t just elite athletes who can reap the benefits of athletic tape.

There are many varieties of athletic tape and different taping techniques that all serve different functions, and some researchers debate the benefits of taping altogether. But taping can be a crucial piece of equipment for many athletes at all skill levels.

Ray Castle, PhD, LAT, ATC, is a professor of professional practice and the athletic training program director in the Louisiana State University School of Kinesiology, which is a member of the American Kinesiology Association. As a medical coordinator for the Cajun Classic Wheelchair Tennis Association Tournament in Baton Rouge, La., since 2013, and an athletic trainer for more than 25 years, Castle has seen athletic tape used in a variety of ways and says he couldn’t do his job without it. 

“It’s a difference in us being able to return an athlete [to activity], based on what the condition is. It’s an essential part,” Castle says. “As a health care provider, an athletic trainer uses athletic tape not just in athletics … but we’re using this to make sure the person stays in the activity, and it’s injury prevention. If they are injured, it helps us to facilitate them going back to activity sooner.”

Types Of Tape

Athletic tape brands are categorized by their material, tensile strength and elasticity. 

For example, non-elastic tape is a basic white tape typically made from non-stretchy cotton or polyester. It has a zinc oxide adhesive backing and is designed to be applied directly to the skin. Moleskin is a type of rigid, non-elastic tape, which has a felt backing, strong adhesive strapping and can be custom cut. Fiberglass cast tape is another type of semi-rigid tape used to immobilize an area.

Elastic tape has an adhesive backing or it’s cohesive, meaning it can adhere to itself. Elastic tape, also called stretch tape, refers to specific types that are used in protecting a body region from re-injury, providing support and reducing range of motion during the treatment or rehabilitation of a current injury, or securing protective padding or wound dressings to a body area.

Kinesiology tape, also known as K-tape, is an elastic cotton tape designed to mimic human skin. It’s heat activated and intended to stay in place through showers and sweat. It has a medical-grade acrylic backing and can stretch up to 140% of its original length, minimizing restriction to movement. Kinesiology tape is sold under different brand names, but the original elastic adhesive Kinesio tape, also called Kinesio Tex Tape, was developed by Kenzo Kase, a Japanese chiropractor and acupuncturist, in 1979. The strips can be applied in many different shapes, depending on the injury and body part, and they come in many colors, depending on the athlete’s preference.

Taping can be a cost-effective option when compared to braces, slings or splints, but only if the tape is needed for a short period of time.

“It can work more effectively because one, it is functional, number two it’s lightweight, number three you can get a true fit customized to the patient, versus a brace over the counter, there could be some form-fitting to it, but it doesn’t have the adhesiveness,” Castle says. “But there are some limitations to it [taping] as well. Braces are not going to fail. So the problem with taping is … with sweating, it stretches, it loses the supportive nature of it, so that’s why we use different types of taping to support the person.”

In addition, Castle says, medical professionals and athletes need to be aware there’s a small risk of contact dermatitis or allergic reaction, especially if materials have latex in them.

What’s It Do?

There are various uses for athletic tape, including:

1. Preventing an impact injury or overuse injury

2. Stabilizing a limb after an injury, in combination with rehabilitation therapy

3. Keeping someone from re-injuring an affected area

 

Especially for wheelchair athletes, Castle says athletic tape is frequently used as a buffer to prevent blisters or pressure sores on various body parts, including the anterior part of the knee where strapping goes across to secure athletes in their chairs. 


He’s also seen it used to secure protective padding or other sports equipment or as a supportive mechanism for wheelchair tennis players to secure their racket to their hand and wrist during match play.

In a rehabilitation setting, tape can be useful
for biofeedback.

“If someone has an injury and we’re trying to work on them working on posture, in the case of a para[plegic] or quadriplegic, we may be having to work on some muscle re-education work … and they’re getting some sensory feedback, that when that [tape] gets tight they can recognize there’s a tightness there,” Castle says.

Castle says K-tape works well for acute or sub-acute swelling, with different techniques of application to promote lymphatic return. In that case, the athlete would likely see less swelling, less pain and increased range of motion after several hours of use. 

K-tape can be used in combination with other kinds of tape to aid in rehabilitation as well, as in the case of a hyperextended elbow.

“So obviously, you want the elbow to flex and extend. However, based on what the activity is, we want to protect that full motion going out so hyperextension does not occur,” Castle says. “So we’re going to limit that going up to the point, so we would use a combination of the white tape. We want to secure it at both ends, on the distal forearm then up on the arm. We’re applying the white tape as a strapping that’ll actually be the buffer or tether, so to speak, then we’re putting elastic tape on top because the muscles contract, otherwise you’ll
restrict blood flow.”

Sometimes, K-tape may be supporting a muscle or muscle group to offset a condition, such as tendinitis. 

“They may apply it over the area, and they may have some reported effects of pain reduction, but really it’s helping to support the muscle in its function, what it normally does, whether it’s stretching or from a light contractile activity, which may be repetitive in nature, and it is very lightweight,” Castle says.

Elastic tape can be used for compression or to provide support while still allowing mobility. 

“With elastic tape, we can still provide a combination of white and elastic to secure it, to provide the compressive support, but also help the person from a functional standpoint as well, versus if we’re going to put [white] tape on somebody it’s going to limit motion, because it’s not going to stretch,” Castle says.

Christy Gardner, a U.S. women’s Para ice hockey team member and double amputee, frequently uses tape on her forearms for Para ice hockey and track and field. 

“A lot of para-athletes end up with overuse in their forearms because we use them for our sport and training and mobility,” Gardner says through Facebook. “I tend to have tendinitis in my wrists, inflammation and tightness in my forearms, and epicondylitis in my elbows most of the time.”

Gardner says her trainer or team medical staff typically will apply tape on her a few times a year, or whenever they judge that it would be beneficial after testing her range of motion. 

 “I think it helps because it provides some relief for my muscles when utilized in that manner and can also pull up the skin/fascia to allow more oxygenation and blood flow underneath to help heal,” Gardner says. “I just wish it stuck better. It’s annoying when the edges roll down after only a few hours or a day. It’s supposed to last for a few days.”

Technique Is Key

The methodology for applying the tape depends on the ultimate goal for the patient or athlete.

According to the Kinesio Tape website
(kinesiotaping.com), “the tape is applied over the affected area with the muscles in a stretched position. Then, the tape is applied from one end of the muscle to the other with very little to no stretch on the tape itself. The tape is applied from the origin to insertion of the muscle for support and from insertion to origin for rehabilitation.”

It’s important for athletes to be aware if they’ve developed any new pain or unusual soreness and to seek the medical advice of a trained professional who can determine whether tape is an appropriate treatment.

“Otherwise ignoring it enough, you have some minor soreness, now it becomes tendinitis and now they can’t do anything for two or three weeks, or it could be something even worse, like a rotator cuff tear or more significant injury, which may have seemed like minor pain,” Castle says.

It’s also a good idea for athletic trainers and medical professionals to exercise caution when applying tape to someone for the first time in case of an allergic reaction. For example, if someone is allergic to latex, there are alternatives, such as securing the tape around a piece of clothing so it doesn’t touch the skin.

“Make the athlete aware, if this their first time having tape applied, just some simple, ‘If you notice any blistering or swelling or if it’s uncomfortable, we need to come back and readjust it before it becomes a problem,” Castle says. “That’s one of the bigger things, especially if you’re taping someone for the first time. Don’t wait for it if it’s uncomfortable. You have to make sure they know to take it off. Don’t continue playing through it or the pain because you may have a blister, and now you have a whole other set of problems.”

Castle says elastic tape is sometimes easier to apply because it’s very adjustable to the body part, whereas with non-elastic tape you have to worry about wrinkles, which can lead to blisters. 

“Where you apply, the tension can cause a pressure point on the skin. The general person doesn’t see what tape does,” Castle says. “If I’m applying tape to the wrist, they think I’m just going as hard as I can around in a full circle. No, there are tension points, and there’s a time when you just lay it on, and you’re applying the tension just in that one area … It’s the nuances of it that make a difference in how effective that taping procedure is … the direction of the tape, where you start it, where you end it, and it goes in lines with the biomechanics of
that body part. 

“If you’re trying to support a muscle, which would be longitudinal, for example, the biceps. Biceps originate in the shoulder, one of two tendons, and it goes the mass of it, just below the elbow in the forearm it inserts. If you’re trying to support it from a muscular standpoint, you want to go from origin to insertion with a strap that goes from the shoulder to there to help with muscle contraction, versus if it’s a ligament, if you’re trying to prevent motion, or depending what you’re trying to do, versus going perpendicular to the line of stress. You can put as much compression as you want on it, it’s not going to support it the way it needs to.”

In the long term, Castle says taping should be considered just one modality to return someone to an activity, but it’s not going to be the only modality for every individual or every instance of an injury. Safety and protecting the injured body part, as well as whether the athlete has a trained professional to apply the tape correctly, should ultimately be the determining factors for using tape instead of a brace or splint.

“What are we doing from a function standpoint and what are doing to complement that; is there a brace, is there something else that’s going to help them be more effective?” Castle says. “We can tape any body part, but it may not be as effective as a brace. It goes back to injury mechanics and what the anatomy and the biomechanics of that particular body part are … But it’s not just putting the brace on or the tape on, you’ve got to know what’s causing this problem and how do we stop that problem from occurring more? It may be muscle re-education, it may be strengthening, it may be modifying the activity and doing other therapeutic interventions, that includes using anti-inflammatories, going for injury rehabilitation sessions with an athletic trainer or physical therapist or occupational therapist, trying to get them on a rehabilitation plan.”

Does It Really Work?

The science community is split on kinesiology tape’s effectiveness on pain, swelling and blood flow.  

Some clinical studies, such as a case report published in 2009 in the journal Manual Therapy, have shown kinesiology tape to be effective for some types of injuries or conditions. The study showed a patient with intense shoulder pain from swimming had improved function after being treated with Kinesio Tape. The study concluded, “Data on pain, joint motion and shoulder function obtained from this study may suggest that treatment with Kinesio Taping contributed to the resolution of the patient’s pathology, producing an immediate improvement and resolving the problem in the following days.”

In addition, a 2007 study presented at the annual international conference of the IEEE Engineering in Medicine and Biology Society indicated that Kinesio Tape applied to patients with lateral epicondylitis, or tennis elbow, caused the motions of muscle on ultrasonic images to be enhanced, which the authors believe indicated that the performance of muscle motion was improved.

On the other hand, some studies, including a 2015 meta-analysis published in the British Journal of Sports Medicine, have shown treatment with kinesiology tape is better than no treatment at all. However, it emphasized that taping an injured body part shouldn’t take the place of other traditional medical interventions. In the 2015 study, the participants who used kinesiology tape reported some pain reduction, but that didn’t necessarily equate to healing. It also wasn’t shown to be any better or worse than other modalities or traditional therapy. 

And in 2012, a double-blind study published in the Journal of Orthopedic & Sports Physical Therapy found that while kinesiology tape may provide clinicians assistance in improving pain-free range of motion in treating shoulder pain, it was not effective in treating young patients with suspected shoulder tendinitis/impingement syndrome.  

Some researchers suggest that the improvements the athletes experienced may have simply been a placebo effect, or that some athletes choose to wear athletic tape simply because they think it looks cool, rather than because they have or are trying to avoid an injury. 

Despite the controversy, there is no evidence that using kinesiology tape poses any additional health risk, and there are athletes who believe kinesiology tape helps them in some way.

Castle says the bottom line is any tape needs to be applied by someone with proper medical training and credentials for the tape to be effective.

“What a common misconception is is, ‘I’m just gonna apply tape to this.’ Like, no, you have to have a reason,” Castle says. “A lot goes into the anatomy, also what the function of that body part is or the biomechanics of it. Also, the pathomechanics, that if we’re taping to prevent something, we also don’t want to put them into a position or do something where applying a brace can potentially put them at increased risk for injury. You’re trying to gauge that. And also the timing; is it more protective or preventative in nature? Is it post-injury in nature where they’ve already had a previous injury? It’s truly individualized to what the needs are of the patient and going back to what their function is.”

In addition, Castle says taping is just one part of the whole assessment and rehabilitation process. 

“Athletes should also be doing strengthening exercises, proprioceptive [your body’s ability to know where it is in space] exercises to strengthen the area, because you want to be strong and not use the tape or at least be healthy without using the tape,” Castle says. “Some sports may use it prophylactically, risk taking, etcetera, but you still want the body part to be as normal and strong and fully functional as it should be.”

 

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