Kinesio Tape Comes of Age-

Few who watched the 2008 Beijing Olympics will forget the Gold Medal beach volleyball performance of Kerri Walsh and Misty May-Treanor. The black Kinesio tape atop Walsh's 6-foot, 3-inch frame, in stark contrast to her white bathing suit, also sparked a good deal of speculation.

Internet message boards made wild guesses. Was it a political statement or a sponsor's logo? Perhaps a memorial to a deceased relative? Countless therapists knew the answer, but viewers were mystified. According to several reports, Walsh's therapists used the tape to stabilize the superstar's surgically repaired shoulder and boost blood circulation.

Steven Huber, PT, CKTI, estimates that about 200 athletes used Kinesio tape during the Olympics, and the kinesiotaping.com Web site reports that a donation of Kinesio® Tex Tape Gold™ for the 2008 games contributed to a "groundswell of support by Olympians from around the world" and a lot of free publicity. "In many sports, Kinesio tape is actually covered by the athlete's clothes," says Huber, also an orthotist and owner of Huber Associates, a private physical therapy practice in Auburn, Me. "At one point with the beach volleyball, Misty had tape on her leg, and Kerri had it on her shoulder. Their opponents also had the tape on, so there were four different players with four different colors of the same product on."

Rob Brandon, MPT, ATC, CKTI, works with Kinesio tape on both upper and lower extremities.

With that kind of worldwide exposure, it is no surprise that patients began to inquire about the baffling tape patterns. Will therapists be at a disadvantage if they don't learn the techniques, and will the therapy continue to gain in stature? "I think that kinesio taping is already hugely accepted," says Huber, one of just two certified Kinesio tape instructors (CKTI) in the entire Northeast region encompassing six states. "I really believe that people who do not know how to do the technique in the next 5 years will be well behind the eight ball."

With just 50 CKTIs in the United States, getting that training may take some patience. However, Huber and his colleagues believe that seeking out instruction from properly trained individuals is crucial if you want the best results. The highest-profile credentialing organization is the Albuquerque, NM-based Kinesio Taping Association (KTA), which receives the full blessing of the technique's founder, Kenzo Kase, DC, a Japan-based chiropractor who invented Kinesio Tex Tape tape in the early 1970s.

Huber teaches a KTA-endorsed standardized method, which is broken down into three sections. KT1 is an introductory class to learn the basics of how to tape muscles, while KT2 focuses on corrective techniques that involve stretching the tape to varying amounts and applying it in different directions. Finally, KT3 is the advanced application. All courses must be a minimum of 8 full hours each, and some KT3 courses can be as much as 12 hours.

All courses feature hands-on applications so practitioners learn how to cut, stretch, and place the tape. Huber starts with the basic principle of positioning the tape from the origin of the muscle to the insertion point (proximal to distal). Students learn that the tape can be used to inhibit pain, facilitate or inhibit a muscle, and re-educate muscles in lower and upper extremities. "You can use it for circulatory or lymphatic flow to change swelling and alter tissue turgor," Huber explains. "You can use it for scar management, to change fascia, and to redirect fascial curves. It is a mechanical application that has a physiological response. When you put this 2-inch-wide strip of cotton material that has an acrylic backing in the shape of a fingerprint, you are causing microconvolutions in the epidermis, and you are unloading the sensory receptors under the skin and changing the lymphatic flow."

EVIDENCE AND ANECDOTES

Ultimately, results are what continue to fuel the relatively young phenomenon of Kinesio taping. In one of many examples, a young lady recently came to Huber's practice suffering from shin splints, a condition she had been experiencing for the past 3 years. "I had her run, and she had the pain as usual," Huber says. "I taped her, had her run again, and the pain was gone. I taught her the home program because she was headed off to college. She has a chronic problem, and I don't profess that the tape got rid of it with one application. But now she can learn the program, how to use the tape over a certain period of time, and she can call me and follow up that way."

Another 19-year sciatica sufferer received tape once per week in Huber's office for about 6 weeks, and he has essentially been pain-free for the last year and a half. Nerve pain, rib fractures, and even chest tube drain holes can be treated with Kinesio tape.

Rob Brandon, MPT, ATC, CKTI, a therapist at Napa Valley Physical Therapy Center, Napa, Calif, completed a formal study with three different patellofemoral patients of all different ages (91, 56, and 12), with positive results. "We decreased pain and increased their ability to perform different functional tasks," says Brandon, one of seven CKTIs in five western states. "It really shows how the Kinesio taping method can be used across all ages and throughout the rehabilitation process."

Prior to earning his instructor credentials, Brandon had success treating patients in the clinic, with pain reduction literally happening in just minutes in some cases. As owner of Rob Brandon Seminars (www.robbrandonseminars.com), he has now shared his knowledge using a KTA-approved curriculum. One question Brandon gets at his seminars: Does Kinesio tape replace compression garments? The answer is that while Kinesio tape does help to control inflammation and pain, compression garments are different in their application and results.

Brandon believes Kinesio tape can be used in conjunction with many different modalities, including compression hosiery in some cases, and he views this as a strength of the tape and its applications. Harkening back to the founder's belief, Brandon sees Kinesio tape as a way to have his "hands go with the patient" as they leave the clinic, with the benefit of making real changes within a treatment session.

Having taught throughout the United States, Hong Kong, and Japan, Brandon says people are open to the method, but the biggest challenge is helping therapists relearn how to use tape. "Rigid athletic tapes are used to stabilize an area," Brandon says. "And you use quite a bit of tension as you wrap the tape on. The Kinesio tape takes more subtlety. It is an elastic tape, so it takes more skill to lay the tape on with the right amount of tension. That is the biggest challenge with teaching people, although within a weekend therapists definitely get the idea of how to put it on properly."

Brandon acknowledges that therapists rely on literature and research, and he says the KTA is slowly but surely building its evidence. Next year's international symposium in Rome is expected to reveal the latest research and bolster anecdotal claims. Huber agrees that the literature is "pretty basic" right now, but he too believes the annual conferences, and next year's international symposium, will go a long way toward helping therapists understand the physiology. "We can see that Kinesio taping works, but you have to understand the rationale and the physiology of it," Huber says. "If the patients understand, they are also more compliant."

Huber and Brandon view Kinesio tape as yet another excellent device in the therapist's tool kit, and one that can easily be used in harmony with more familiar modalities that heal upper and lower extremities. "One of the most important things for any physical therapist or occupational therapist to know is that Kinesio taping is an adjunct to existing techniques," Huber assures. "It enhances what we do and reinforces what we do clinically, and helps us to get results better and faster."

One misconception is that Kinesio tape works only while it is on, and "that is absolutely false," Huber stresses. Instead, he says the purpose of having the tape on is to change what is beneath the tape and what is in the surrounding area. "You are changing fluids and changing input to the sensory receivers," Huber says. "So the tape is working while it is on, but the goal should always be to use the tape to do a procedure, accomplish something, and then not use it."

Beyond the highly visible realms of Olympic competition, Huber believes Kinesio tape can ultimately gain a foothold beyond the athletic arena and even treat headaches. In fact, his conversations with therapists at the Midwest Headache Center already reveal that clinicians are using the tape to treat headaches in a way that is noninvasive and subtle. "My focus is neuro, so when I think about central nervous system learning, I think about consistency of input and repetition," Huber says. "What better way than to apply a product that is going to give us specific sensory input for 3 to 5 days. That consistent input is repetitive, and it helps the central nervous system."

Dr. Steven Shoshany is a Certified Kinesio Taping Practioner or CKTP visit www.drshoshany.com

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