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What is kinesio taping?
Kinesio taping is a therapeutic, preventive and rehabilitative system that, while not "always" requiring an academic specialization, is based on the principles of Western medicine; it is mainly used in sports medicine, traumatology and orthopedics.
WARNING! Taping essentially means "bandaging" or "bandaging". Many believe that kinesio taping is limited to the fashionable application of the most recent colored bandages. In reality, the field of kinesio taping is really vast and includes rather complex treatments, of which we will mention below.
Generally adopted by graduates in physical education, especially kinesiologists, kinesio taping is based on the application of tape - particular bands or adhesive bandages. These, by exerting traction and transferring the force directly to the skin, alleviate the physiological load on the target body areas.
In summary, the strips of tape used are elastic but - at some lengthening - also inelastic, and on one side coated with adhesive; depending on the function, they are divided into several types. The bandages are not applied directly on the skin, but on an additional intermediate adhesive layer that acts as an anchor. The application of both requires great care; it is essential that no wrinkles and creases are formed, without applying excessive pressure on the affected area.
Did you know that ...
The use of the English word "tape" in this context dates back to the nineteenth century. As early as 1892, Paul Carl Beiersdorf had begun experimenting with stiffening adhesive plaster forms, which took the name of Leukoplast, which gradually led to the development of other similar solutions, up to the current kinesio taping.
The fundamental prerequisite for a correct application of kinesio taping is always an accurate and competent diagnosis, as well as a specialist knowledge of the operator. The most frequent complications and side effects of kinesio taping are:
- Skin irritation
- Compartmental syndrome
- Premature loss of the stabilizing effect.
The effectiveness of kinesio taping varies greatly depending on the indication and location of the discomfort. In this regard, several scientific studies have also been carried out; for example, it has proved useful in the external support and stabilization of the ankle associated with the treatment of a particular type of fracture on the fifth metacarpal bone. The evidence is however rather weak and difficult to consolidate.
Kinesio taping is therefore able to:
- Support the capsular ligament apparatus of a joint
- Download tendons and muscles
- Improve proprioception - perception of body movement
- Counteract the swelling of the tissue due to compression
- Stabilize fractures or wounds.
Kinesio taping is therefore very versatile and can be used in all joints of arms and legs. On the trunk and on the neck instead, it is mainly used to limit the movements that can disturb muscles damaged by: contracture, stretching or tearing.
It is important to emphasize that kinesio taping is based on the non-pharmacological resolution of pain and / or inflammation, but should exploit the natural physiological capacity for regeneration - which, of course, requires time and abstention (partial or total) from the activity. Ultimately, if used as a remedy, this system does not act directly on pain and / or inflammation but, by preventing or reducing unwanted or excessive movements, it takes on the role of functional bandage .
The doctor will therefore assess the relevance of an integrative pharmacological support. Furthermore, kinesio taping and drug therapy could be combined with other treatments, especially local ones, evaluated and managed by a physiotherapist - for example massages or other types of manipulation, tecar therapy, magnetotherapy, ultrasound, laser, shock waves, application of hot or cold packs - depending on the damaged fabric - etc.
Principles
Working principles of kinesio taping
Kinesio taping uses the action of bandages as functional supports. These bands do not completely immobilize the body segments, but allow a certain controlled dynamism. In contrast to the orthosis, the effect of kinesio taping is not based on the stability of the material used, but on the targeted and precise application of the strips. The operating principles have not yet been definitively clarified, but the components of compression, immobilization or functional limitation and tutoring / proprioceptive increase certainly exist.
Improvement of proprioception with kinesio taping
Unlike other medical solutions, kinesio taping can support the ligamentous capsular apparatus of a joint. The strips are applied to the skin based on the course and function of damaged or potentially at risk structures; in this way, the tensile forces that normally act on the ligaments are transferred to the skin. In addition to the purely mechanical effect, proprioception - significantly improved by kinesio taping - also plays an important role in stabilizing the capsule. Athletes perceive an improvement in unwanted movements and can therefore avoid them more easily. These two effects of kinesio taping have been known for decades and make it possible to prevent excessive strain or distraction that can compromise already injured ligaments - decreasing the risk of re-dislocation.
Unlike plaster dressing, kinesio taping does not lead to complete immobilization and is not associated with the onset of consequential damage. The adhesive bandage therefore allows the mobility of a joint within appropriate limits, but prevents harmful movements (functional association). The stability and the degree of limitation of the movements due to kinesio taping depend on the material used for the bandages and on the application procedure.
Compression of kinesio taping
Kinesio taping can exert compression in a similar way to the plaster cast and to the inelastic rigid bandage; in the latter, the resting pressure is minimal, but the operating pressure is significant instead. Kinesio taping and traditional compression bandaging can be complementary or interchangeable, depending on the degree of elasticity of the materials used.
The application of kinesio taping as a compression bandage is also indicated as an emergency measure immediately after injuries - PECH rule. In this case, the use of predominantly inelastic material prevents the occurrence of an excessive and unnecessarily severe swelling. However, this first aid intervention should not be left for more than an hour.
The application as a compression bandage is not specific to kinesio taping, because it does not provide for a significant transfer of force on the skin. Therefore, in these cases the kinesio taping can be performed without the application of the basal adhesive.
Immobilization of kinesio taping
By creating a suitable bandage with kinesio taping, some types of bone fractures and ligament injuries can also be treated. These cases include, for example, fractures of the metatarsal bones and toes. On the metatarsus, the bandage of the tape is applied so that the fractured bone is stabilized by the other four undamaged metatarsal bones. A broken terminal phalanx can be stabilized by fixing it to a toe near it with tape, which at the same time significantly reduces the mobility of the primary, intermediate and final joint; even simple fractures of other phalanges can be treated similarly. The term "buddy taping" is also used for this type of immobilization.
To avoid any movement, the immobilization kinesio taping must adhere very well. However, even in this case the transmission of traction forces on the skin plays a secondary role. The stability of the dressing is essential.
Did you know that ...
The most important example of this kind of kinesio taping was the "Ducky" trainer and physiotherapist Drake; at the 1960 Rome Olympics, he omitted the athlete CK Young, to whom he had been bandaging for several weeks, the presence of an injury in the metatarsophalangeal area. Young won the silver medal in the decathlon and only later became aware of his condition.
Kinesio taping protection
As a rule, dedicated adhesive patches or dedicated bandages are applied to the damaged skin. However, small wounds can also be covered by kinesio taping. To obtain a proper bonding of the material with the skin, it is necessary to first clean it of blood residues. Increasing the contact pressure does not improve adhesion to the skin, however it increases the static pressure of the dressing. The strips are not wrapped like a complete bandage but shaped to cover only the specific area.
Liquids such as sweat and skin fat, hair - possibly to shave first, also to avoid pain upon removal - but also dust and other soil impurities affect the adhesion of kinesio protection taping.
Kinesio taping follow-up
Kinesio taping also requires a follow-up examination. In addition to a review of short-term functionality, it is necessary to perform a patient examination and investigation of symptoms such as pain, sensitivity or excessive venous stagnation.
If kinesio taping is planned not only for a short time - for example an athletic competition - but for a longer period, the patient must also be informed about the possible complications that could occur in the short and long term.
Kinesio taping removal
The removal of a kinesio taping is usually performed starting from a neckline, up to the entire length - possibly in the direction of hair growth.
When removing the dressing it is essential to avoid the formation of skin lesions. In most cases bandage scissors or specific tools are used.
Removal of the dressing can be facilitated by applying a suitable solvent - for example alcohol. Sometimes residual glue may remain; furthermore, potential skin irritations caused by chemical ingredients are not excluded. However, pain in removal is dramatically reduced.
Application
Applications of kinesio taping
Kinesio taping is used not only for the treatment of injuries, but also for preventive purposes. In this case, not all the principles of action - which we recall: compression, immobilization, proprioceptive increase / improvement - play a fundamental role.
As functional bandages, they reduce the mobility of the treated joint, but without eliminating it completely; this seems to play a fundamental role in the prevention of injuries especially in sports.
The taped bandages of kinesio taping allow sports doctors to intervene promptly and effectively in the field; for example in sports facilities or in competition.
For long-term applications and dressing renewal, other aids, such as orthoses, may still be cheaper.
Prevention of kinesio taping
The application of kinesio taping is widely used to avoid sports injuries in different activities such as: handball, basketball, sport climbing, taekwondo and windsurfing. To avoid overdistension of the ligament apparatus, usually rather narrow bandages are applied to be removed immediately after the performance.
The tapes are then used to prevent injuries to healthy athletes, but they are also particularly useful for reducing the risk of relapses after recovery. This is demonstrated by various studies conducted on the articulation of the ankle performed over the last fifty years; however, a prospective, large-scale and randomized experimental research is still lacking. For this kind of application, alternatively you can use orthoses commonly available on the market - which can be created faster and without specialist knowledge, but at the same time have a preventive effect quite similar to taping. Only the tapes intended for prevention are not considered to be of a therapeutic type, in the true sense of the term, and can also be applied by a properly trained physiotherapist or kinesiologist, or by the athlete himself - if competent.
Kinesio taping therapy
Kinesio taping is used both to treat acute and post-treatment injuries. Case studies include:
- Damage to the capsular ligament apparatus of various joints - unless other methods such as plaster immobilization are absolutely necessary
- Chronic joint instability
- Some simple fractures
- Muscle injuries
- Damage due to functional overload.
The therapeutic efficacy of the medications with kinesio taping is unambiguously accepted, especially for the treatment of injuries to the outer ankle band. On the reduction of fractures, for example of the fifth metacarpal bone, the effectiveness of the tapes is equivalent to that of other equivalent methods. It also represents a therapeutic measure in the case of the heel spur, rotator cuff conflict syndrome and dislocated fingers. They can also improve chronic repetitive stress conditions such as, for example, the runner's knee - reducing femoral patellar movement (on the rear-patellar side) and carpal tunnel inflammation.
Increased performance of kinesio taping
Kinesio ankle taping can lead to significant increases in performance in the high jump discipline, through the so-called improvement of proprioception and the ability to exploit muscle strength - functioning in a similar way to a weightlifting restraint belt. Taping is also applied in certain joints of American football athletes and in the hands of boxers.
use
How is kinesio taping used?
Kinesio taping is usually applied to the arms and legs, but in principle it can also be used on the trunk of the body. This system is used not only for hands, feet, fingers, elbows, shoulders, knees, spine, chest, but also, for example, for the muscles of the lower part, such as the thighs. Their actual execution depends on the location and is based:
- on purpose - prevention or therapy
- on the expected duration for which the dressing should be left
- on the active ingredients intended for use - compression, immobilization, proprioceptive increase / improvement.
Below are the most indicative examples.
Bandaging of a finger of the hand
The medium joints of the long fingers are "hinged" joints with reduced mobility - in physiological conditions - on diffraction and extension. Active rotation or lateral movements are not possible.
If a lateral force acts on the finger joint, a tension occurs in the opposite side band. The lesion occurs when these forces exceed the stability of the ligaments. The possible extension of the ligament lesion may vary from a slight tension to a complete tear. In addition to swelling and bruising in the traumatized area, the consequences can be instability of the joint and pain when traction forces recur in the damaged lateral ligament. These injuries lead to more or less pronounced functional limitations of the hand, since traction forces normally occur even during normal gripping and holding movements - for example, holding a ball. Treatment recommendations for a partial or complete tear of the lateral ligament of a joint of a middle or long finger are based on immobilization and / or taping - with kinesio taping in fact; sometimes surgery is needed.
This type of kinesio taping essentially consists of two "reins" which connect the injured and the uninjured neighbor to the base and at medium height. The distances between the bandages and the central joint should be approximately the same, to avoid unnecessary skin irritations caused by traction forces. A padding between the fingers is also required. Usually, the injured side of the finger is placed centrally with respect to the dressing. This type of bandage limits the mobility of both fingers only partially. If applied to incomplete breaks, handball and basketball athletes can then quickly resume training. In these cases, the kinesio taping is left permanently for about three weeks and then applied for about six months only in sports.
For simple lateral ligament distortions, an adhesive reinforcement band on the affected finger is sufficient. It is very important to ensure sufficient adhesion of the strips on the skin. The band extends from the metacarpophalangeal joint up to the nail and its stabilizing effect is obtained from the longitudinal and semicircular "reins".
Bowler Wrist
The wrist of the pitcher is a consequence of the functional overload of the wrist linked to sport. Microtraumas, mechanical forcing, maximum dorsiflexion (hyperextension) are considered the main causes and should therefore be avoided throughout healing. The task of adequate kinesio taping is to prevent this wide range of incorrect movements.
Ligaments of the ankle
The kinesio taping in the upper portion of the ankle uses bandage bandages mainly to treat acute injuries and to compensate for the permanent weakness of the ligament.
The damage can be divided into three groups or degrees. These include:
- Simple distortions without any evidence of ligament weakness
- Partial lacerations of one or more parts of the external ligament
- Complete breaks.
The cause of these injuries is usually the so-called "supination trauma", that is the flexion of the ankle with the foot outwards. The most common reason for an unstable ligament apparatus is to be found in a badly healed ligament injury. Chronic instability leads to frequent failure of the foot towards the outside, especially in sports, and therefore to repeated micro-traumas of the articular cartilage. Kinesio taping can be used both for the treatment of acute injuries of all grades, and chronic instability of the ligaments. In this case, the bandages must be stretched and applied to the skin with good adhesion, above all because they tend to lose 40 to 50% of their stability during the exercise - even only after 10 minutes. The adhesive strips must be glued so as to support the function of the external wrapping system, especially preventing lateral movement.
There are numerous suggestions for performing a correct procedure. Basically, after an appropriate examination of the joint, the optimal path is chosen to counteract the instability, favoring the external ligamentous apparatus. To achieve maximum stability, the bandage must be applied just below the knee joint and finish at the joints of the foot. Shorter dressings are less stable, but are used for example as a preventive measure in healthy athletes. The foot is placed in pronation and dorsiflexion; then, the main reins flow from the lower part of the leg slightly obliquely towards the foot, where they are subsequently fixed in a semicircular manner. This creates a space between the ankle region and the strip. Later the bandage is further fixed in a perpendicular direction and glued to the skin at the level of the lateral malleolus.
Internal ligaments of the knee joint
The knee joint is stabilized medially not only from the internal ligament, but also from other capsular structures. However, the contribution of individual structures to stabilization depends on the angular position of the joint. In an extended position, for example, the anterior cruciate ligament is much more involved than a 30 ° flexion. The latter also stabilizes the tibia on the femur, thus preventing the tibial head from sliding forward. If the anterior cruciate ligament is weak, the leg can be made to slide slightly forward. One speaks therefore also of antero-medial instability. The reason for this is usually to be found in a trauma in valgus, that is a force that acts on the knee joint laterally - from the outside. This may depend on the position and the rotation force on the axis. Treatment and post-treatment of the isolated lesions of the internal bands are based on orthosis and kinesio taping, regardless of whether it is I or III.
Kinesio taping on the knee joint is applied in a position of slight flexion. In doing so, the internal ligament is less stressed. Moreover, in this position an eventual front instability can be treated. The reins of the adhesive tape depart from the inner part of the thigh to the front of the leg, just below the knee, with a spiral pattern. However, for anatomical reasons it is difficult to add additional supplementary tapes. If the "front drawer" (slip) effect occurs instead, additional lateral reins can be applied.
Metatarsal bone fracture
Fractures of the five metatarsal bones can occur during exercise, both with and without trauma.
A very simple kinesio taping is applied, consisting solely of a circular band (360 °) applied to the forefoot. Consequently, since the circle is the shortest boundary of a surface - any other shape would require a wider circumference - the forefoot cannot deform further. This kinesio taping can also be used preventively in sports.
Deformations of the toes
Above all they involve the 2nd or 3rd phalanx, particularly in the central or distal interphalangeal joints. The reasons are not clear; some hypotheses consider the inadequate choice of footwear, or the incorrect way of walking. In the most serious cases, surgery may be necessary; in the milder ones, kinesio taping can be very helpful.
The function of the bandage is mainly to support the extension of the distal joints of the toes. After passive stretching of the joint, the joint position is fixed with adhesive bandages. The strips wrap around the tips of the fingers and slide, in the opposite direction to the deformation, up to the Achilles tendon.
Lower muscles of the legs
Kinesio taping is also used for the muscles of the lower leg, as in the case of contractures, stretching and tearing. For acute trauma, compression tape is recommended. For this purpose, the leg - sometimes even the foot - is wrapped in temporary taping, which is easy to remove in the short term. Above are then applied - without significant pressure - other inelastic bandages. Adhesion to the skin must be such that the dressing does not slip.
Complications and Side Effects
Complications and side effects of kinesio taping
The possible complications of kinesio taping are:
- itch
- Ache
- Swelling
- Numbness
- Discomfort and tingling
- Blood circulation disorders.
Skin irritation
Kinesio taping adhesives based on zinc oxide, rubber or resin often cause skin irritation. Those based on polyacrylate or fumaric ester are better tolerated; detergents or mechanical stress can also cause skin irritation.
When the tensile forces exerted by the bandage on the skin are greater than those that it can compensate, small cracks appear in the stratum corneum of the skin. As a further mechanical cause, frequent belt changes are also highlighted. With each removal of the adhesive on the skin, the superficial portions of the stratum corneum are also removed. This thins, loses mechanical strength and can therefore withstand less traction forces.
Loss of effectiveness
The main reason for the loss of effectiveness of kinesio taping is the reduction of adhesion to the skin. The reason is to be found in the normal turnover of the stratum corneum and in the secretion of sweat. When the sweat glands produce more liquid than can be absorbed by the tissue, stagnation occurs which tends to detach the bandages.
Compartmental syndrome
If a bandage causes significant obstruction of venous return for too long, stasis occurs which increases blood pressure in the veins, then in the tissue, giving rise to the compartment syndrome.
