Taping for lower limb sports and musculoskeletal injuries can be an effective intervention to facilitate the rehabilitation process. Tape comes in many different forms and it is often difficult to separate convincing marketing claims from useful techniques in the management or prevention of injury. Below we will discuss some of the common questions around taping and explain how it may be used in the toolbox of our practitioners.
Tape can be broadly classified into two categories: typical rigid (zinc oxide) tape and the relative newcomer stretchy elastic tape (eg. kinesio tape, rock tape, dynamic tape).
Rigid taping has been around for over 100 years and has been used in the prevention and rehabilitation of many different sports injuries. Kinesio tape was the first form of elastic tape invented by Dr Kenzo Kase in the 1970s in Japan but surged back into popularity after the company reportedly donated the tape to 58 different countries before the 2008 Beijing Olympics.
These two categories of tape have the greatest body of evidence and consequently are the primary tapes we use at Pure Sports Medicine.
Figure 1. Elastic tape has been regularly seen on athletes competing at the Olympics, WTA Tour and many other competitions.
Image Source: Marianne Bevis / flickr.com
Rigid tape, as the name suggests, is a non-elastic tape that is designed to restrict range of motion (flexibility) at a joint. In contrast, elastic tape is stretchy and may be applied with a variety of different degrees of stretch to provide support and stability to muscles and joints without restricting range of motion. Individuals will have different preferences and it is important to find a taping modality that is both effective and comfortable.
Figure 2. Rigid tape.
Image Source: https://www.sportstapewholesalers.com.au/product/rigid-strapping-tape-38mm/
Figure 3. Elastic tape (rock tape).
Image Source: Pure Sports Medicine
Taping companies promote several different rationales for their products but in essence their utility for injury management can be summarised by taping for stability or pain reduction. Taping for stability will primarily involve rigid strapping and focuses on reducing load on injured structures (ligaments, tendons, joints) or preventing an episode of instability (rolled ankle, dislocated shoulder).
Taping for pain reduction has been studied in both rigid and elastic tape and aims to reduce the sensitivity of painful structures. It is important to note that the mechanisms behind taping for both stability and pain reduction are not well understood. Claims such as improved joint position awareness (proprioception) with rigid tape and that elastic tape lifts the skin to assist lymphatic flow, which reduces pain and swelling are either unsubstantiated or have been proven inaccurate.
Taping has been shown to be an effective, addition tool in the rehabilitation of knee, ankle and foot injuries. Below is a list of injuries and rationale for taping for some common presentations:
Taping for kneecap pain reduction has been studied extensively and is a common method used to help patients to progress through their rehabilitation. Both rigid (McConnell taping) and elastic tape have demonstrated reduction in knee pain (Logan, 2017) and tailoring the rigid tape to control movements of the kneecap is important to maximise effect (Barton, 2014) (see image below). For this reason it is important to consult your practitioner for the appropriate technique for your injury.
Figure 4. Image Source: McConnell tailored patella taping (Barton, 2014)
Taping (or bracing) for ankle stability following an ankle ligament injury is effective in reducing load (weight) on the injured ligaments to enable faster progression through rehabilitation. Re-injury is common and studies indicate that you have an elevated risk of ankle injury for up to a year.
Although rehabilitation is an important component of reducing your injury risk it has been suggested that taping when returning to sport significantly lowers your injury risk (Janssen, 2014). Below is an excellent infographic outlining the utility of taping in ankle injury rehabilitation (Janssen, 2019).
Figure 5. Image Source: Infographic on the timeline of taping + bracing following ankle sprain injury (Janssen, 2019)
Taping of the foot is most commonly performed for pain reduction by lowering the stress placed on sensitive or overloaded tissues. Foot injuries such as plantar heel pain (plantar fasciitis), 1st metatarso-phalagneal joint sprain (turf toe) and medial tibial stress syndrome (shin splints) are commonly managed with a variety of taping techniques to support the arch and reduce sensitivity of a painful area.
Taping, as with most interventions, does have a few relatively minor side effects. Skin irritations, in the form of a rash, itchiness or redness are the most common side effect and care should be taken in individuals that experience these symptoms.
Finally, taping must only be considered as an accompaniment to a comprehensive rehabilitation programme that is designed to improve capacity and return to your individualised goals and pre-injury level of function. The evidence is clear that taping does not work as a stand-alone treatment and thus you should only consider it as a short-term strategy to improve stability or reduce pain as part of your rehabilitation programme guided by your practitioner.