Duke Sports Medicine- Tracy Ray MD
CHALLENGES IN THE TRAINING
ROOM: TO TAPE OR NOT TO
TAPE?
Objectives
 Discuss Taping principles
 Explore the 3 primary types of tape used in
training room
 Establish theories and evidence for use of
taping techniques
 Provide examples and common uses of tape
in Division I athletic training room
Taping Principles
 Requires psychomotor skills and scientific
principles to guide use
 Taping and bracing are adjuncts to
performance and do not replace sound rehab
and training
 Main indications are prophylactic and
rehabilitative
 Must consider the anatomical structure,
mechanism of injury, and purpose for which
the tape is applied
Taping principles
 Suggested Purpose
 1. Immobilization
 2. Restriction or aid range of motion
 3. Support of ligament / capsule
 4. Support of muscle / tendon
 5. Proprioceptive feedback
 6. Sport specificity and function
 7. Decrease swelling/edema
Types of Tape
 Non-elastic rigid (athletic tape)
 Non-elastic semi rigid (McConnell tape)
 Proprioceptive elastic (kinesiotape)
Suggested Theories: Non
Elastic Rigid
Athletic Tape
 Immobilization
 Helpful to get athletes back on the field
during a game
 Similar to ankle brace
 Protection
 Prevention
Suggested Theories: Non
Elastic Semi Rigid
McConnell or Leukotape (also used with
Mulligan Mobilzation)
 Facilitation
 Inhibition
 Unloading
 Postural assist
 Joint approximation
Suggested Theories:
proprioceptive elastic
Kinesiotape (also known as spider tape)
 Facilitation
 Inhibition
 Lymphatic drainage
 Unloading
 Decrease pain
Jury is out…
Taping has NOT
 been standardized to determine one type over
another
 been proven to assist in any kind of joint
approximation via MRI studies
 Been shown to affect muscle activation via EMG
 Demonstrated ability to alter position
sense/proprioception
 been proven to prevent injuries in otherwise
healthy athletes
Benefits of Taping
Improvements in functional scale scores
 Someeh et al, 2014
 Whittingham et al, 2004
 Bicici et al, 2012
 Miller et al, 2013
Benefits of Taping
Decreased subjective reports of pain
 Shaheen et al, 2014
 Warden et al, 2008
 Kaya et al, 2011
 Nambi et al, 2012
Benefits of Taping
May decrease risk of further injury
 Kaminski et al, 2013
 Janssen et al, 2014
 Dizon et al, 2010
Benefits of Taping
Psychological benefits to athletes
 Hunt et al, 2006
 Gear et al, 2011
 Moiler, 2006
Benefits of Taping
Decreases swelling
 Ristow et al, 2014
 Donec, 2014
Taping Examples
Taping Example: McConnell
What We Know About McConnell
 Introduced in Aust J Physiotherapy, 1986 as
“long term solution for CMP”
 1996 prospective randomized trial found no
evidence to support it(Am J Sports Med
24(1):61-6)
 Again in 2005, no support was shown in a
systematic review(J Athl Train;40(4):341-51)
 Shown to shift patella inferiorly (Phys
Ther.2010;90(3):411-9)
Taping Example:Kinesiotape
What We Know About Kinesio
Csapo R, Alegre LM.Sci Med Sport. 2014 Jun 27. pii: S1440-2440(14)00125-X. Effects of
Kinesio® taping on skeletal muscle strength-A meta-analysis of current evidence.doi:
10.1016/j.jsams.2014.06.014. [Epub ahead of print)
While the application of Kinesio tapes may have some therapeutic benefits,
the usage of these tapes does not promote strength gains in healthy adults

Parreira Pdo C, Costa Lda C, Hespanhol Junior LC, Lopes AD, Costa LO.J Physiother. 2014
Mar;60(1):31-9. doi: 10.1016/j.jphys.2013.12.008. Epub 2014 Apr 24.Current evidence does
not support the use of Kinesio Taping in clinical practice: a systematic review.
Overall, Kinesio Taping was no better than sham taping/placebo and active
comparison groups. In all comparisons where Kinesio Taping was better
than an active or a sham control group, the effect sizes were small and
probably not clinically significant or the trials were of low quality.
Conclusion: This review provides the most updated evidence on the
effectiveness of the Kinesio Taping for musculoskeletal conditions. The
current evidence does not support the use of this intervention in these
clinical populations.
More info of Kinesio

Williams S1, Whatman C, Hume PA, Sheerin K.Sports Med. 2012 Feb 1;42(2):15364. doi: 10.2165/11594960-000000000-00000.
Kinesio taping in treatment and prevention of sports injuries: a meta-analysis
of the evidence for its effectiveness.
In conclusion, there was little quality evidence to support the use of
KT over other types of elastic taping in the management or
prevention of sports injuries. KT may have a small beneficial role in
improving strength, range of motion in certain injured cohorts and
force sense error compared with other tapes, but further studies are
needed to confirm these findings. The amount of case study and
anecdotal support for KT warrants well designed experimental
research, particularly pertaining to sporting injuries, so that
practitioners can be confident that KT is beneficial for their athletes.
Summary
 Taping should be centered around anatomical
structure and function.
 3 primary types of type are used with varying
levels of flexibility
 There are many benefits to taping in the training
room including physical, psychological, and
preventative.
 Research is extensive, but overall mediocre
quality so interpret using best clinical judgment
 Benefit outweighs risk! There is no harm to
applying tape vs the many possible gains
References

Bicici, Seda. Karatas, Nihan. Baltaci, Gul. Effect of athletic taping and kinesiotaping on measurements in functional
performance in basketball players with chronic ankle sprains. Int J Sports Phys Ther. 2012 April; 7(2): 154–166.
PMCID: PMC3325641

Dizon, J. M. R., & Reyes, J. J. B. (2010). A systematic review on the effectiveness of external ankle supports in the
prevention of inversion ankle sprains among elite and recreational players. Journal of Science and Medicine in
Sport, 13(3), 309-317.

Donec, V., & Kriščiūnas, A. (2014). The effectiveness of Kinesio Taping® after total knee replacement in early
postoperative rehabilitation period. A randomized clinical trial. European journal of physical and rehabilitation
medicine.

Gear, William; Bookhout, Jessica; and Solyntjes, Amanda (2011) "Effect of Ankle Taping and Bracing on Dynamic
Balance and Perception of Stability," International Journal of Exercise Science: Conference Proceedings: Vol. 5: Iss. 2,
Article 6.

Hunt, E., & Short, S. (2006). Collegiate Athletes’ Perceptions of Adhesive Ankle Taping: A Qualitative Analysis. J
Sport Rehabil, 15, 280-298.

Janssen, Kasper. Mechelen, Williem. Verhagen, Evert. Bracing superior to neuromuscular training for the
prevention of self-reported recurrent ankle sprains: a three-arm randomised controlled trialBr. J. Sports.
Med. 2014;48:16 1235-1239

Kaminski TW, Hertel J, Amendola N, Docherty CL, Dolan MG, Hopkins JT, Nussbaum E, Poppy W, Richie D; National
Athletic Trainers' Association. National Athletic Trainers' Association position statement: conservative
management and prevention of ankle sprains in athletes.J Athl Train. 2013 Jul-Aug;48(4):528-45. doi: 10.4085/10626050-48.4.02.

Kaya, Erkan. Murat Zinnuroglu , )Ilknur Tugcu .( (2010) Kinesio taping compared to physical therapy modalities for
the treatment of shoulder impingement syndrome. Clinical Rheumatology
Volume 30, Issue 2 , pp 201-207
References

Miller, Joseph. Westrick, Richard. Diebal, Angela. Marks, Christopher. Gerber, J Parry. (2013). Sports Health: A Multidisciplinary Approach. May/June 2013 vol. 5no. 3 214-219

, Gopal. Shah, Bijal Tarun. (2012). Kinesio taping versus Mulligan’s mobilization with movement in sub-acute lateral
ankle sprain in secondary school Hockey players - Comparative study. International Journey of Pharmecuetical
Science and Helathcare. 2(2).

Ristow, O., Pautke, C., Kehl, V., Koerdt, S., Schwärzler, K., Hahnefeld, L., & Hohlweg-Majert, B. (2014). Influence of
kinesiologic tape on postoperative swelling, pain and trismus after zygomatico-orbital fractures. Journal of CranioMaxillofacial Surgery, 42(5), 469-476.

Someeh M, Norasteh AA, Daneshmandi H, Asadi A. Immediate effects of Mulligan's fibular repositioning taping on
postural control in athletes with and without chronic ankle instability. Phys Ther Sport. 2014 Aug 12.

Shaheen AF, Bull AM, Alexander CM3Rigid and Elastic taping changes scapular kinematics and pain in subjects with
shoulder impingement syndrome; an experimental study.J Electromyogr Kinesiol. 2014 Aug 4. pii: S10506411(14)00152-7.]

Warden, S. J., Hinman, R. S., Watson, M. A., Avin, K. G., Bialocerkowski, A. E. and Crossley, K. M. (2008), Patellar taping
and bracing for the treatment of chronic knee pain: A systematic review and meta-analysis. Arthritis & Rheumatism,
59: 73–83. doi: 10.1002/art.23242

Whittingham, Martin. Palmer, Shea. Macmillian, Fiona. 2004). Journal of Orthopaedic and Sports Physical Therapy. 34
(9). 504-510.