Kinesiotape

What is a kinesiotape ? 

Kinesiotapes (KT) are flexible elastic bands that allow movement (unlike other restraints such as straps or others…). These bands are applied by a physiotherapist, osteopath or doctor before a physical activity or a medical treatment. They are an additional part of prevention, rehabilitation, exercise therapy and performance optimisation (1). These popular colour bands are based on two different principles depending on the direction of application. Indeed, they can play a role on the perception of pain by using the concept of « gate control » by decreasing muscle tone and disrupting nerve pathways or, on the contrary, increase muscle tone and thus induce more consistent muscle recruitment. 

What physiological effects does it induce ? 

A recent study by Wong et al (2) revealed that the application of KT to the vastus medialis did not modify the generation of maximal torque, but shortened the time required to generate this maximal torque in healthy participants. KT would thus produce an earlier muscle contraction. In other studies, it was found that Kinesiotape increased the speed of the ball during hitting or throwing and that these effects can be explained by a greater activation of skin sensors and a consequent strengthening of peripheral afferents. These changes increased the recruitment of motor units which in turn increased muscle tone (1).

Callaghan et al (3) reported improved proprioception in the knee with kinesiotape application. To justify these effects, the manufacturers of the KT explain that the tape causes micro-circumvolutions, or folds, in the skin, which lift the skin away from the underlying tissue. This facilitates the release of pressure on the sensitive tissues underneath and provides space for the movement of blood and lymphatic fluids. It is claimed that this can help relieve pain by unloading irritable nerve tissue through this « gate control » theory, prevent over-contraction, facilitate lymphatic drainage and improve joint position and kinesthetic awareness. According to its inventor, muscular performance would also be optimised thanks to an improvement in the neuromuscular system and all these effects would thus contribute to a reduction in the risk of injury during training sessions or matches carried out with these bands (4). 

What are the main indications ?

• Muscular or aponeurotic pathology : to combat the increase in the inflammatory phenomenon, increase vascularisation and promote healing, activate or inhibit the muscular response.
  
• Joint pathology : for stability, comfort, proprioceptive sensations and to reduce painful sensations due to arthrosis or other conflicts.
  
• Lymphatic or circulatory problems : work on oedemas, haematomas, lymphoedemas thanks to the application of special fixtures.
  
• Reduction of the sensation of pain : in connection with one of the problems mentioned above.

How to apply it ? 

Before applying the KT, it is important that the skin is dry or even degreased with a special spray. It is also essential to know the anatomy, the path and the action of each muscle in order to optimise the application of the KT. Indeed, before applying the base of the elastic band, the muscle must be placed in a long and stretched position. The literature varies in its opinions regarding the tension applied to the skin when placing the band, but it is often recommended to apply 25% of the stretch in relation to its basic elasticity. 

Depending on the desired effect, the direction of application will be different and opposite. For an activation of muscle tone, the tension will be applied from the proximal origin of the muscle to its distal insertion, whereas for an inhibition, the tension will be applied from the distal insertion to the proximal origin. (5)

What are the scientific challenges ?

Despite all the effects mentioned above, there is no consensus among scientists regarding the actions at the moment, although some lines of thought are already well advanced. Many studies have been done on the effects of kinesiotaping but they are often contradictory and focus on a single aspect (i.e. strength, pain or stability). 

For example, Bagheri et al (6) studied the impact of kinesiotape on the calf muscles. The kinesiotape break followed either « activating » (to increase muscle performance) or « inhibiting » (to decrease muscle activity and pain) application modes. The results of their study highlighted an increase in EMG activity (electrical activity of the muscle) for the activating pose and a decrease in this activity on the inhibiting pose during isometric contraction. However, they found little or no effect on dynamic contractions, thus not being able to scientifically justify the effects of KT. Other authors such as Yoosefinejad et al (7) contradict the activating and inhibiting effects. 

The hypothesis that muscle activity is improved by better blood and lymphatic flow has not yet been demonstrated either. 

It should also be noted that the psychological and placebo aspect, which is an important tool in any treatment, could also come into play and disturb the physiological validity of the effects of kinesiotape. 

As for the studies on the effect of KT on pain, they show diverging opinions. The excitability of motor neurons is sometimes questioned, although a slight anaesthesia is in most cases highlighted. 

Thus, although there are many differing opinions on kinesiotapes, they represent an additional tool in the management of injuries and also in the prevention of recurrence by influencing muscle activation, regardless of the intensity. Even if these effects are minimal or psychological, we should not hesitate to continue to use them if sportsmen and women give positive feedback. Thus, although KT does not rely on infallible support from the literature regarding its effects, each person must construct his or her own opinion with hindsight and practical experience, which is always more important than theoretical studies. 

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