#048 – The Effect of Taping on Musculoskeletal Conditions

Introduction

If you are a physical therapist during a major sports event, you probably get this question a lot: what’s that tape the athletes use? can I use it? does it really work? I always answered it depends, but honestly, it has been a while since I looked at the evidence for taping, so I sat out to answer the question, not does it really work, but on which conditions is it effective? and here what I found.

Luckily it did not take long, because I found a map review published in 2019 that summarized the evidence from 41 systematic reviews and 127 RCTs. These studies were published between December 31, 2007, to October 31, 2019, however, I continued the search and found additional systematic reviews and/or meta-analyses which I mention after the results of the map review.

These are the results of the map review categorized by the quality of evidence and summary of evidence. Click here to see the evidence grading table.

High-Quality Recommendation for Taping By Condition

Chronic Low back Pain:

• Kinesiotaping is recommended by high-quality evidence for patients with chronic low back pain.
• Note: I found a meta-analysis published in November 2019 that found low-quality evidence for the short-term effect of kinesiotaping on pain reduction and disability improvement for chronic LBP patients. This meta-analysis included 11 RCTs and 785 participants.

Knee Osteoarthritis

• Rigid Taping is recommended by high-quality evidence for patients with knee OA.
• Note: I also found 5 reviews not included in the map review, 2 of which concluded that the evidence does not support the use of taping (elastic/kinesio) for knee OA, while the other 3 found a positive effect for taping on Knee OA pain and function.

High-Quality Evidence that Discourages the use of Taping

Non-Specific neck pain

• Kinesio taping is discouraged to treat non-specific neck pain.
• Note: I couldn’t find other reviews or clinical trials that were not included in the map review on NS-NP KT or other methods. so for now, maybe we shouldn’t use KT for non-specific neck pain!

Moderate Quality Evidence that taping is Favorable

• Rigid tapping is favorable for subacromial Impingement by moderate-quality evidence.
• KT is favorable for Acute low back pain by moderate-quality evidence.
• KT is favorable for Diastasis recti abdominins.
• KT and McConnell Taping is favorable for Knee Osteoarthritis.

Moderate Quality Evidence that taping unfavorable

• KT is unfavorable for Ankle Sprain by moderate-quality evidence.

Moderate Quality Evidence that taping is Equivocal

Kinesiotaping is Equivocal for the following conditions:

• Subacromial Impingement
• Lateral Epicondylalgia (Tennis Elbow)
• Osteoarthritis (OA) of the Proximal Interphalangeal Joint
• Lumbar Disc Herniation
• Pregnancy-related low Back pain
• Postmenopausal Thoracic Hyerkyphosis
• Myofascial Trigger Points of Cervical Region (Upper Trapeziuz)
• Whiplash associated neck pain
• Temporomandibular joint dysfunction
• Patellofemoral Pain Syndrome (Anterior Knee Pain)

McConnell is Equivocal for the following conditions:

• Patellofemoral Pain Syndrome (Anterior Knee Pain)

Rigid taping is Equivocal for the following conditions:

• Ankle Sprain
• Plantar Fasciitis or Plantar Heel Pain

Weak Evidence that taping is promising

Rigid taping is promising for

• Lateral Epicondylalgia (Tennis Elbow)
• Sacroiliac Joint Dysfunction
• Primary Lateral Patellar Dislocation

KT is promising for

• Carpal tunnel syndrome
• de Quervain’s syndrome
• Tibial Stress Syndrome
• Plantar Fasciitis or Plantar Heel Pain

Mulligan taping is promising for

• Subacromial Impingement
• Plantar Fasciitis or Plantar Heel Pain

Systematic Reviews and/or Meta-analyses on the effect of taping

The following research articles were published after the map review.

The Effect of Taping on Upper Limb Conditions

Shoulder Proprioception:

• Elastic kinesiology tape does not appear to affect the sense of shoulder proprioception as concluded by a systematic review on conservative management for shoulder proprioception. (Ref)

Shoulder Pain:

• Adding KT to interventions performed in clinical settings appears to demonstrate efficacy regarding disability and ROM when compared to conservative interventions alone. However, despite the reasonably good methodologic quality, fidelity was lacking in a majority of studies. Because of its impact on the implementation of evidence-based practice, lower fidelity should be considered when interpreting results. Included 10 studies. (Ref)
• Despite reported positive effects in some studies, there is no firm evidence of any benefit of kinesio taping on shoulder disorders as concluded by a systematic review and meta-analysis. (Ref)
• Another review stating that the evidence is insufficient to support the use of kinesio taping in clinical practice as a treatment for shoulder pain, however, there is limited evidence for it as a complementary treatment for shoulder pain. (Ref)

Lateral epicondylitis:

• KT is effective in relieving pain, restoring grip strength, and improving functionality in patients with LE undergoing rehabilitation as concluded by a meta-analysis. (Ref)

The Effect of Taping on Spine Conditions

Chronic Non-specific Low Back Pain:

• There is low-quality evidence that KT has a beneficial role in pain reduction and disability improvement for patients with CNLBP, a conclusion by a meta-analysis of RCTs. (Ref)

Pregnancy-Related Low Back Pain:

• For Pregnancy-Related Low Back Pain: Osteopathic manual treatment (OMT), Kinesio tape, and ear acupuncture affected the lumbar pain intensity but the difference compared to typical care or sham treatment was not statistically significant. (Ref)
• In another review, there is low-quality evidence that kinesio tape can reduce pregnancy-related low back pain. (Ref)

Thoracic hyperkyphosis

• A systematic review and meta-analysis found that multimodal care, structured exercise programs over three months duration, and taping in older adults, and biofeedback and muscle stimulation in younger adults, are ineffective in reducing thoracic hyperkyphosis. (Ref)

The Effect of Taping on Lower Limb Conditions

Chronic Knee Pain (Knee OA or PFP):

• KT is essential to relieve chronic knee pain and prevent massive use injuries in patients with chronic knee pain but not in a long-term effect. Therefore, KT could be temporarily used in practice for exercise or rehabilitation training. Included 8 studies. (Ref)

Knee OA

• No strong evidence regarding the use of elastic taping alone when compared to sham taping for pain improvement in patients with primary knee osteoarthritis, a systematic review included 6 RCTs and 392 participants. (Ref)
• Another review found that the current evidence does not support the use of kinesiology taping in people with knee OA. (Ref)
• However, a systematic review and meta-analysis found that compared with PT alone, PT combined with KT provided better therapeutic effect regarding pain reduction and functional improvement in patients with knee osteoarthritis. The additional pain reduction and functional improvement could last at least six weeks after initial treatments. (Ref)
• The above conclusion was also found by another review that suggested KT be used for improving pain and functional disability for patients with Knee OA. (Ref)
• Meanwhile, this systematic review and meta-analysis found that elastic taping has significant effects on pain, physical function, range of motion, and quadriceps muscle strength in patients with knee osteoarthritis, but there was insufficient evidence when combined with other physiotherapy treatments! (Ref)

Patellofemoral pain or tendinopathy

• A Systematic Review of Clinical Practice Guidelines for Physical Therapist Management of Patellofemoral Pain: found that guideline-recommended interventions were consistent for exercise therapy, foot orthoses, patellar taping, patient education, and combined interventions and did not recommend the use of electrotherapeutic modalities. (Ref)
• Education combined with a physical treatment (exercise, orthoses or patellar taping/mobilization) is most likely to be effective at 3 months for patellofemoral pain as concluded by a living systematic review and network meta-analysis. (Ref)
• There is evidence for short-term use of taping and bracing for patellofemoral pain and tendinopathy. (Ref)
• Another review concluding that taping is effective for the short-term in patients with patellar tendinopathy. (Ref)

Patellofemoral joint osteoarthritis:

• Patellar tape can significantly reduce pain, immediately and after 4 days, from 2 studies with fair and good quality. (Ref)

Tibial Pain (tibial loading pain and shin splints)

• A systematic review on load modifying interventions found no evidence of beneficial effect from any of the load-modifying interventions on symptoms, physical performance or biomechanical measures, apart from a possible benefit of anti-pronation ‘kinesio’ taping. There was very low certainty evidence that kinesio taping improves pain and pain-free hopping distance after one week. Results from 6 studies. (Ref)
• A review revealed that the efficacy of KT on shin splints is not clear. Results from 4 studies including 141 participants. (Ref)

Plantar Heel Pain:

• Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values found that core treatment for people with PHP should include taping, stretching and individualized education. Patients who do not optimally improve may be offered shockwave therapy, followed by custom orthoses. (Ref)

Plantar Fasciitis:

• Taping is an effective short-term treatment for plantar fasciitis. (Ref)

Hallux valgus:

• Taping added to foot exercises showed significant pain reduction but not HV angle. (Ref)

Ankle Injuries:

• A systematic review and meta-analysis found on the effect of kiensio tape on ankle injuries or without concluded that current evidence does not support or encourage the use of Kinesio taping applied to the ankle for improvements in functional performance, regardless of the population. (Ref)
• Critically Appraised Topic on the effect of Kinesio Tape on factors for neuromuscular control of the Lower-Extremity recommended that there is grade B evidence that the use of KT on an athletic population does not improve biomechanical measures of ankle stability. There is inconclusive, grade B evidence that KT improves neuromuscular control at the knee in symptomatic populations. (Ref)

Chronic Ankle Instability:

• A network meta-analysis did not demonstrate the benefit of taping or bracing over no treatment for chronic ankle instability. (Ref)
• There is limited quality evidence (grade B) that taping and bracing can immediately alter gait biomechanics in patients with chronic ankle instability. (Ref)

Other Conditions

Delayed muscle Soreness:

• A systematic review and meta-analysis found that kinesio tape applied for more than 48 hours and not for 24 hours can alleviate pain. Results from 8 trials including 289 participants. (Ref)

Oedema:

• There is some evidence for the efficacy of Kinesio taping for the treatment of postoperative oedema. This evidence is, however, not yet convincing given the limitations of the published trials. (Ref)

Final Notes

• Taping is an adjacent treatment method.
• Many of the reviews suggested that even when taping was effective, its effect was more of a placebo than its proposed mechanisms
  • One of the articles stated that patients’ pain was alleviated immediately by simply applying the tape
  • Speaking of which, some reviews also suggested taping be used for decreasing pain while performing exercise.
• One of the articles said it best if you have it (afford it), use it, since there were no reported adverse events. (Ask the patient if they are allergic to adhesives)

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I hope this was helpful. Thank You for Reading.

Evidence Table for The Effect of Taping by Method and Condition