Kinesiology Tape for Postural Control

INTRODUCTION

            As chiropractors, sometimes our efforts become frustrating if our careful attention to adjusting, stretching and strengthening, is undermined by patients resuming the same postural flaws that landed them in our offices in the first place. How exciting would it be to have a sticky, stretchy little assistant that reminded our patients for 2-5 days about positional awareness? Enter elastic therapeutic tape!

            By now, the vast majority of practitioners have had some exposure to elastic therapeutic tape or “kinesio-tape”, the commonly used brand name of developer Kenzo Kase. Tape companies claim it “reduces muscle soreness, improves function, decreases bruising, and decreases pain” and to some extent, these claims appear to be accurate.

            Anything that touches our body’s biggest organ, the skin, has a cutaneous mechanoreceptor effect that stimulates receptors to enhance body kinesthesia or movement awareness. By stimulating large skin mechanoreceptors, kinesiology tape can also downgrade painful stimuli from the nociceptors, which decreases pain perception.

            Early and persistent reasoning suggested that using the tape in an “origin to insertion”, or “muscle action” methodology, best serves to support/stimulate external body areas. While this approach probably makes the most intuitive sense to medical practitioners as it follows anatomical “rules of engagement”, emergent theories, which consider entire postural muscle groups, are making a strong case.

            Dr. Steven Capobianco, chiropractor and developer of the Fascial Movement Taping (FMT) method argues, kinesiology taping should be “based on the obvious yet largely overlooked concept of muscles acting as a chain… the body’s integration of movement via multi-muscle contractions as a means of connecting the brain to the body’s uninterrupted fascial web in order to enhance rehab and athletic performance via cutaneous (skin) stimulation. By taping movement rather than muscles, FMT has demonstrated greater improvement in both patient care and sport performance.

            Dr. Capobianco is not alone in this line of thinking. Leading fascia researcher, Robert Schleip PhD, underscores movement and its role in pain and dysfunction¹. Additional support for this model comes from Thomas Myers in his ground-breaking book, “Anatomy Trains”². He offers a template to assess, treat, and manage body-wide motor dysfunction based on myofascial meridians, and movement impairment.  

            Physical Therapy professor, Heather Murray, makes a strong case for the use of elastic therapeutic tape in those who maintain abnormal postures of the head and neck (i.e. in the work place). Her team conducted a pilot study³, which seemed to suggest that taping for scapular protraction could maintain better posture and decrease perception of pain.

            Recent research indicates that kinesiology tape has a greater stimulatory effect with compromised tissue (due to injury or fatigue due to poor posture). Thedon, et al⁴ conducted a study to evaluate body sway in individuals with and without tape. They found that the tape showed very little change in the uncompromised condition, but when the subjects were fatigued, the tape provided an added stimulatory effect to the skin helping to compensate for the loss of information fed to the brain from the muscles and joints. For the pain and performance community, this study provides insight into an “auxiliary” system, such as the skin, to augment treatment and training outcomes.

            A 2012 study⁵ of 32 surgeons, showed a statistically significant reduction in neck and low back pain (using Oswestry Low Back Disability Index and Neck Disability Index) and functional performance (using neck and low back range of motion scores) with the use of kinesiology tape during surgery. This may have far-reaching implications for other jobs/activities where sustained positions result in musculoskeletal pain.

            Let’s look at a common complaint where chiropractors can utilize elastic therapeutic tape to enhance postural control (awareness). Kinesiology tape is commonly used in chiropractic offices to enhance scapular retraction, alleviating upper extremity discomfort caused by internally rotating shoulders (especially when the scapula is in a protracted position). The tape, according to Dr. Capobianco’s model, is applied in a functional manner to augment its therapeutic effect. Begin by addressing the neuro-myo-skeletal dysfunction associated with the protracted shoulder girdle (manipulation, myofascial release, movement re-patterning, etc.). Once the patient is able to appreciate an appropriate retracted/depressed scapula, apply the kinesiology tape (see inset) in a manner to, appropriately, stimulate the local receptors once the intended position is lost.

• Step 1: Manually mobilize/manipulate the thoracic spine and shoulder girdle and associated myofascial chains
• Step 2: Place patient/athlete into appropriate postural position that centrates the scapula-thoracic segment.
• Step 3: Tape the local area (see X pattern and H pattern) with “NO” stretch to stimulate local receptors
• Step 4: Corrective exercises that will help with postural re-education.

 

SUMMARY  

            Clearly the use of kinesiology tape is popular (millions of users) and the applications are broad (from athletic injuries to edema). Specific evidence for efficacy is scant but growing, and plausible. There are currently no reported dangers associated with using this elastic cotton mesh bandage, and the only significant contraindication is on open wounds. Kinesiology tape breathes well and flexes like a second skin, unlike most braces that act more like abrasive exoskeletons. It withstands sweat and/or water and is by most comparisons a cost-effective treatment modality. While science is unlikely to discover that kinesiology tape is the panacea for all aches, injuries and postural distortions, medical practitioners should keep this tool in the chest due to its vast possibilities in treating patient complaints and as a tool for postural re-education.

References:

1. Schleip R, Muller D. Training principles for fascial connective tissues: Scientific foundation and suggested practival applications. J Body Move Ther 2012;1-13.

2. Myers, T.W. 2009. Anatomy Trains: Myofascial Meridans for Manual and Movement Therapists. New York: Churchill-Livingston.

1. Effects of Kinesio Taping on Posture and Presence of Upper Extremity Pain

4. Thedon T, et al. Degraded postural performance after muscle fatigue compensated by skin stimulation. Gait Posture, 2011 Apr;33(4) 686–9.

 

Colorful Olympic Tape for our Patients – TAPING MOVEMENT, NOT MUSCLES

Steven Capobianco D.C, DACRB, CCSP

Medical Director, Rock Tape.

www.rocktape.com

INTRODUCTION

            “Kinesiology tape” was first used by acupuncturists and chiropractors in Japan over 20 years ago. Today it is used by practitioners throughout the world in the treatment of injuries and to improve sports performance.

It was apparent that world-class athletes were seeking an alternative to managing pain and maximizing recovery potential at the 2012 London Olympic Games. Practitioners and spectators alike witnessed athletes, from the diving platform to track and field, wearing colorful tape in intricate patterns and with questions of what it was, word began to spread.. While the use of kinesiology tape is often associated with athletes, the reality is that kinesiology tape is effective for a wide variety of problems, not just sports injuries.

The evidence supporting the role of kinesiology tape still lacks high-level clinical trials, but if you spend the time to research further you will start to see a trend. This trend was spearheaded by Thibaud (Feb 2011), and reported the effects of taping the skin in subjects that are compromised, either fatigued or injured. They found that the skin acted as an auxiliary kinesthetic system providing the brain with postural awareness when the compromised muscle/joint receptors were fatigued.  

Kinesiology tape, developed and refined for the past 35 years, attempts to mimic the qualities of the skin in its elasticity and thickness. With these qualities in mind, the tape is applied on the skin in certain patterns to enhance certain physiological processes.  Once applied to the skin the elastic capacity of the tape  provides a light shear augmenting the mechanoreception of the area addressed. This  same elastic recoil aids in pulling the epidermis and dermis layers of skin away from the underlying fascial compartments, thus improving fluid dynamics (acute/chronic edema) (Ya-Hui Chou). Both of the above processes have a substantial benefit in down-regulating nociception (pain), in return improving movement patterns in accordance to the area addressed with tape. Lastly the tape in its ability to enhance kinesthetic awareness through skin stimulation, can improve postural dysfunction. Careful application of tape along “fascial strain lines” has been shown to improve common postural dysfunctions such as upper and lower cross syndromes, hyper and hypolordosis, anterior/posterior tiling of the pelvis, and more (see figure 1).

SUMMARY

The refinement of kinesiology taping has extended from the traditional anatomical (muscle) applications to the more integrated fascial (movement based) applications. This innovative way of taping has revised some new and improved taping applications that have shown to improve movement dynamics, such as postural sway associated with compromised environment like pain and fatigue states, as discussed earlier in the science of taping. Athletes, such as those in the Olympic Games, are interested in the advancement of taping technology. With this added interest in “legal” performance enhancement which doesn’t involve drugs, athletes and coaches are looking for an edge in other alternatives including kinesiology tape. By enhancing our body awareness via movement taping, we can improve the length-tension relationships of the associated muscles, and, in turn, improve the neuromuscular efficiency of the intended activity.

Recently, the Garmin-Barracuda professional cycling team has implemented this model of taping to improve postural position on the bike to optimize power outputs during long cycling time trials. The team’s physicians believe that the tape, applied in specific patterns, improves form which translates to a faster time with less incidence of injury. This all translates into improved performance without the use of illegal enhancements. Future studies on the effects of stimulating the largest organ in our body (the skin) via kinesiology tape, is a new direction to investigate with regards to improving proprioception, posture and performance.

References

1. Fuller, R.B. 1975. Synergetics. New York: Macmillan
2. Ya-Hi Choi, et al. Manual Lymphatic Drainage and Kinesio Taping in the Secondary Malignant Breast Cancer-Related Lymphedema in an Arm With Arteriovenous Fistula for Hemodialysis. American J. of Hospice and Palliative Med. 00 (0) 1-4, (2012).
3. Fascia Congress. 2009. www.fasciacongress.org/2009
4. yers, T.W. 2009. Anatomy Trains: Myofascial Meridans for Manual and Movement Therapists.  New York: Churchill-Livingston.
5. Thibaud, et al.Degraded postural performance after muscle fatigue can be compensated by skin stimulation. Gait and Posture 33 (2011) 686-689.
6. Hyun Mo An, et al. The effects of kinesio tape on lower extremity functional movement screen scores. International J. of Exercise Science 5 (3): 196-204 (2012).