Rigid Strapping Tape and Elastic Kinesiology Tape
The effectiveness of traditional athletic tape tends to decrease during physical activity. Alternatives to traditional athletic tape are rigid strapping tape such as Leukotape and elastic kinesiology tape such as Kinesio Tape.
Rigid Strapping Tape
Underwrap tape (such as Cover-Roll) plus rigid strapping tape (such as Leukotape) (figure 1.6) adheres better than traditional athletic tape and allows athletes to withstand activity longer. Leukotape and other similar brands of rigid strapping tape have only a 30% stretch from the time of initial application and are therefore more useful for creating a bracing type of support to the area. This lack of stretch in the tape is especially important if the person is engaged in physical activity and is relying on stability gained from the tape. A tape underwrap is usually applied before the rigid tape is applied. The therapeutic effects of strapping tape include stabilizing joints, improving joint movement and tolerance to loading, changing and controlling posture or small deformities, aiding in assessment for use of orthotics, facilitating muscle activity and control, inhibiting muscle activity, reducing pain by unloading structures, increasing motor neuron excitability, increasing joint torque, and enhancing proprioception. (For more information on using rigid strapping tape, see Keil, 2012.)
Elastic Kinesiology Tape
The other form of therapeutic taping involves elastic kinesiology tape, such as Kinesio Tape (figure 1.7), which has elasticity up to 140% of the tape’s original length. This elastic tape allows full joint motion and aids lymphatic flow. Elastic kinesiology tape is latex free and water resistant. Despite its popularity, evidence for the effectiveness of kinesiology taping as the only treatment technique for an injury is limited, conflicting, and lacking in quality. Kinesiology taping is effective in reducing pain, increasing range of motion, and changing electromyographic (EMG) activity. However, these conditions are true only when used in conjunction with other physical therapy techniques such as manual therapy and exercise in people with neurological problems such as stroke or cerebral palsy or in people with orthopedic injuries. Benefits of kinesiology taping include joint support and unloading, stretching fascial tightness, decreasing lymphatic congestion (by stimulating lymph flow when the taping is directed toward the lymph collectors in the neck, axilla, medial elbow, dorsum of the wrist, spine, sacrum, groin, medial knee, and Achilles areas), normalizing muscle function by assisting muscle facilitation (decreasing fatigue) and inhibition (decreasing hypertonicity and cramping), increasing proprioceptive input, increasing joint range of motion, and decreasing pain.
Application Guidelines for Strap Taping and Kinesiology Taping
First, as with athletic taping, obtain an accurate assessment of the cause or contribution to the symptoms. This is especially important considering the activity that the patient wishes to perform. Taping is used as an adjunct to other treatment options, including exercising for muscle imbalances, stretching tight muscles, postural retraining, biomechanically evaluating form during the aggravating activity, and using manual therapy to address joint restrictions. A good knowledge of anatomy and biomechanics is imperative in choosing the most beneficial type of tape and the most appropriate technique, depending on the goal of the taping application.
Many athletic taping techniques can be modified (e.g., less tape involved) when applying strapping tape. Taping is a creative process as long as the precautions are kept in mind and the patient’s pain or symptoms have decreased once the tape is applied. Taping alone will not suffice in the assessment and treatment of injuries; a thorough evaluation by a qualified health professional is an essential first step in determining appropriate treatment options.
Precautions for Strap Taping and Kinesiology Taping
There are a few differences in precautions related to strapping tape and kinesiology tape compared to athletic tape. They are as follows.
1. Allergy to latex or adhesives. Cover-Roll (underwrap tape product) does not contain latex, whereas Leukotape and other brands of strapping tape do. Kinesiology tape is latex free and is applied directly to the skin. Strap taping techniques can be applied to people with allergies to latex, usually without problems, but the strapping tape should not come in direct contact with the skin. If there is a skin allergy or sensitivity to either latex or adhesives, a red raised rash will appear directly under the tape and may be very itchy. Allergy will occur usually within the first 24 hours but could appear up to 10 days after application. It is common for the skin to be red when the tape is removed, especially if it has been on the skin for a long time. This usually fades within a few minutes to a few hours. Cortisone or other topical anti-inflammatory cream can be used if skin is irritated. Calamine lotion or liquid antacid can also be helpful when spread over the affected skin areas; otherwise a skin protectant can be used before application.
2. Friction rub or blistering. This occurs in areas where a forceful pull or anchor is applied with strapping tape. Skin can break down and tear in certain areas of tension or excessive movement (most commonly seen around the anterior or medial knee). Skin in this area will toughen with time and not be as susceptible to breakdown.
3. Taping technique that limits joint range of motion. When using strapping tape, be aware of the range of motion that the patient requires for the activity he wants to perform so that when the area is taped, the joint mobility is not limited and performance is not inhibited, or the tape is not causing excessive pull, which can lead to a friction rub or blistering.
4. Impaired circulation distal to taping. When taping (using rigid tape especially) completely around a joint (elbow, knee, ankle, wrist), ensure that the tape isn’t so tight that it impairs circulation to the area distal to the tape. This can impede venous return and cause swelling in the area (e.g., hand or foot) as well as more serious complications.
5. Fragile skin. Use caution when taping persons with delicate skin (e.g., elderly, children, patients with connective tissue disorders, those with diabetes who are prone to skin breakdown), taping over open or scabbed wounds, or taping after recent surgery (i.e., on scars that have not fully closed). It is possible to tape over a plastic bandage covering an open wound or scab and have patients wear the tape for shorter periods so that the wound status can be checked. A patient who has problems with skin integrity can wear a small test strip of underwrap tape on the skin for a couple days to see how it is tolerated.