Wednesday, August 15, 2012

Kinesio Tape for Pain? The Science is Sticky.

Kinesio TapeAnyone who watched even snippets of the recent Olympic Games on TV probably noticed the intriguing, brightly-colored strips of tape adorning shoulders, arms, legs, abs, or other anatomy of many athletes. Apparently, the stretchy cotton bands called Kinesio® Tape are liberally applied when and wherever performance-robbing musculoskeletal pain strikes. But, is this product a clever marketing ploy, a sporty fashion statement, a colorful placebo, or the real deal? And, is this something that non-athletes with pain should look into?

According to news articles [here] and [here], and information at the Kinesio website [here], the tape was designed several decades ago by Kenzo Kase, a Japanese chiropractor and acupuncturist, to support injured muscles, increase range of motion, and decrease pain. Ostensibly, Kase considered rigid athletic tapes inadequate and believed his patients needed something with “a texture and elasticity very close to living human tissue.”

According to Michael Good, International Director of the Kinesio Holding Corporation, the tape has been used in Olympic competition since 1988, but according to news reports it got a huge boost when the company donated 50,000 rolls of the product to 58 countries for use on athletes at the 2008 Beijing Olympics. Sales of the product tripled soon afterward.

At the recent London Games, Kinesio Taping was even more conspicuous among athletes in almost every sport. It is apparently waterproof (many swimmers were wearing it) and sweat-resistant; one of the Chinese sand volleyball players was adorned in so much tape that she looked like a living billboard for the product. Having all of those Olympians wearing the tape will probably boost sales even further, Good observes.

According to the company website, Kinesio® Tape is used to re-educate the neuromuscular system, reduce pain, optimize performance, prevent injury, and promote improved circulation and healing. Another promotional website for the product [here] goes so far as to claim: “Kinesio Tape is used for anything from headaches to foot problems and everything in between. Examples include: muscular facilitation or inhibition in pediatric patients, carpal tunnel syndrome, lower back strain/pain (subluxations, herniated disc), knee conditions, shoulder conditions, hamstring, groin injury, rotator cuff injury, whiplash, tennis elbow, plantar fasciitis, patella tracking, pre- and post-surgical edema, ankle sprains, athletic preventative injury method, and as a support method.”

However, some clinicians are not impressed with such claims, or the tape. In one of the news articles, Amy Powell, MD — associate professor of sports medicine at the University of Utah School of Medicine and board member of the American Medical Society for Sports Medicine — observes that results in actual patients are inconsistent.

Powell states that there is a set of people, primarily with shoulder injuries, who respond well, “but it could also be the idea that any kind of tape would offer them structural support in the shoulder.” She believes the tape might be useful, especially in helping patients to do their physical therapy, but it probably is not the miracle product that Kinesio claims. “I think the company advertises it as more of a cure, but I see it as more of an aid,” she says.

However, some researchers think the company might be making lofty medical claims for what is, essentially, a piece of sticky, stretchy cloth. A team of investigators from New Zealand reported last February 2012 on a first-ever meta-analysis of evidence for the effectiveness of Kinesio Tape [Williams et al. 2012, see ref below].

Their search discovered 97 studies examining the product of which only 10 met inclusion criteria for analysis; ie, the articles reported data for effects of Kinesio Tape on a musculoskeletal outcome and had a control group. Two studies investigated sports-related injuries (shoulder impingement), and just one of these involved injured athletes. Trials involving musculoskeletal outcomes in healthy participants were included on the basis that these outcomes may have implications for the prevention of sports injuries.

The researchers’ analysis found that the efficacy of Kinesio Tape in pain relief “was trivial given there were no clinically important results.” Furthermore, there were inconsistent results for range-of-motion outcomes, with small beneficial effects seen in 2 studies, but insignificant results in 2 other studies. There were some likely beneficial effects relating to grip force, muscle strength, and muscle activity, but it was unclear whether the changes were beneficial or harmful.

The researchers conclude that “there was little quality evidence to support the use of [Kinesio Tape] over other types of elastic taping in the management or prevention of sports injuries.” Although, they concede that, based on all of the anecdotal support for the product, further well-designed experimental research might be warranted.

In one of the news articles, Kinesio’s Michael Good agrees that the science has not caught up with the anecdotal evidence of positive results that athletes have reported with the product. Meanwhile, Dr. Powell says that the lack of hard evidence may not matter in the athletic community, “Anything that [athletes] perceive as an edge, they'll try, whether it's scientific or not. And the athletes are convinced that [Kinesio tape] is really helpful,” she says. “It wouldn't be the worst placebo in the world; it's not doing any harm.”

So, perhaps Kinesio is just “placebo tape” after all. To some it may not matter, but for those who prefer evidence-based medicine the efficacy of this product seems undetermined, and this does not recommend clinical use of the product in patients with pain.

And, there is another sticky issue [excuse the pun]. As with other unproven complementary modalities, successful application of the therapy may depend highly on the individual skills of specially qualified practitioners.

Through a self-started international association, Kinesio promotes its proprietary Kinesio Taping Method and sponsors “Certified Kinesio Taping Practitioner” training programs. This is probably quite a profit center for the company, and might be a way of claiming that if the tape does not work as promised the person applying it is probably not adequately trained. However, the company further protects its product claims (and the need for continuing training) by stating at the website, “Even certification is only the beginning of a lifelong process of learning.”

REFERENCE: Williams S, Whatman C, Hume PA, Sheerin K. Kinesio Taping in Treatment and Prevention of Sports Injuries: A Meta-Analysis of the Evidence for its Effectiveness. Sports Med. 2012(Feb);42(2):153-164 [abstract here].

eNotifications Don’t Miss Out. Stay Up-to-Date on Pain-Topics UPDATES!
Register [here] to receive a once-weekly e-Notification of new postings.