Back in December 2013, I wrote a piece on the craze that is kinesiology tape (you can read it here). It examined the role of the elastic therapeutic tape (which goes by brand names like Kinesio Tape, KT Tape, RockTape, etc.) in sports injury management, the claims regarding its benefits, case studies highlighting its effectiveness and research questioning its use.

The overall picture at the time was that while kinesio tape had potential and obviously fans (both athletes and therapists) the world over, there was no real evidence at that time to support its use. More in depth, good quality studies were required. Two and a half years later, I've gone back to take a second look, peruse new research and see where the evidence lies now.

Recent research articles

In the two and a half years since my last article on kinesio taping, there have been several studies published looking into the various effects of kinesio tape on multiple conditions and injuries. A search on PubMed reveals approximately 10 of these articles that look into the efficacy of kinesio tape in several different musculoskeletal injuries, all of which may be presented to a physical therapist.

Here's a quick summary of some of the most prevalent:

Functional ankle instability

A paper by Simon, Garcia and Docherty published in the Clinical Journal of Sports Medicine in July 2014 looked at the effect kinesio tape has on ankle instability (FAI) in those with a history of ankle injuries. They used a small sample of 28 participants, split into a control group of 14 with no previous ankle injury and a test or FAI group of 14 who have a history of ankle injury with a recent episode of "giving way."

Those in the FAI group received taping to the lateral ankle where those in the control group were not taped. "Eversion force sense" was tested before tape application, immediately afterward and at 72 hours post application.

The results showed that at baseline and immediately after application, the FAI group demonstrated a much higher rate of force sense errors than those in the control group. This suggests the tape had no effect. However, at 72 hours post application, there was no significant difference between the groups — suggesting some improvement from the FAI participants.

This is a good start into our investigation, however it should be noted that this is a small study focusing on only one aspect of kinesio tape use. It may also be more useful to have the control group as individuals also with a history of ankle injury.

Knee osteoarthritis

Next up is an article from the March 2015 edition of the American Journal of Physical Medicine and Rehabilitation. This study observed the short-term effects of taping on the pain levels, range of motion and proprioception of 46 older adults with osteoarthritic knees.

The participants were randomly assigned to two groups, with one receiving kinesio tape to the quadricep muscles, and the other receiving "sham" tape — where no stretch was applied to the tape on application. The results showed the kinesio tape group to have improved range of pain-free motion, improved proprioceptive sense and reduced pain levels at rest and when walking.

Another piece of evidence to support the use of kinesio tape. A slightly larger sample size increases its validity, although further results would be nice to see the effects after several hours and days of tape application.

Shoulder joint position sense

The next article I came across from August 2015 looked at shoulder joint position sense (JPS). This is an important marker of shoulder control and stability. Faulty JPS could contribute toward injuries such as impingement syndromes.

The study examined 27 students with no history of shoulder injury and who did not participate in overhead sports. There was no control group. Instead all participants were tested prior to tape application and then again once the tape had been applied. The testing involved participants attempting to actively replicate three target positions in varying degrees of shoulder elevation.

The results actually showed a detrimental effect of the tape on JPS at 90 degrees of shoulder elevation. Again this is a small study, and it has its faults, including a lack of control group. It would have been interesting to see if there is any change in the effects after a longer period of tape application.

Round shoulder posture

Following on from the above study, I came across another one investigating shoulder position, this time round shoulder posture in desk based males. The researchers selected 14 men who met the criteria for having a round shoulder posture. All participants were tested at baseline for pec minor length, a supine measurement of rounded shoulder posture and total scapular distance.

After initial testing, an experimental round shoulder taping (with stretch) was applied to one shoulder and the same taping minus the stretch (placebo) applied to the other shoulder. Both shoulders were then reassessed. The authors found the taping with stretch increased pec minor length, and reduced both supine round posture and total scapular distance measurements. The placebo taping had no such effect.

Again this is a small study with no control group and no time-lapse measurements recorded. Most individuals have one shoulder more rounded than the other — often the dominant side. This needs to be taken into consideration as a more prominent round shoulder has more potential for improvement than one with a smaller imbalance.

Back muscle endurance in nonspecific lower back pain

The final article I came across looked into the effect of taping on lower back muscle endurance in those with nonspecific lower back pain. It included just 16 patients with lower back pain who performed the Biering-Sorensen test of lumbar paraspinal endurance.

All 16 performed the same test under three different conditions in a random order with between one and three days intermission. These were: with no tape, with kinesio (elastic) tape and with rigid sports tape. In both taping conditions, the tape was applied to the paraspinal muscles as per the Kinesio Tex guidelines.

Results showed no significant difference between kinesio and rigid sports tape. There was a difference between kinesio tape and no taping in favor of the taping, however it was small enough to be deemed within the threshold of measurement error.

This study suffers from many of the same flaws as those before it, although it is good to see a control condition as well as an alternative treatment condition.

Review articles

I also looked at three review articles that have examined and compared many of the papers published on the subject in recent years. The exact review articles I have consulted can be found here, here and here.

The general feeling among the researchers in all three reports was that kinesio taping demonstrates no beneficial effects in musculoskeletal injury treatment or in increasing muscular strength. In general, the research available that supports its use is of poor to average quality with small participant numbers. In some cases, the results have even been misinterpreted or misreported by the authors to conclude positive findings.

From my own research, I would agree with these findings. The instances where significant improvement has been seen following kinesio tape application are limited and tend to have small numbers and questionable methodology.

2013 vs. 2016

Unfortunately, research over the last (almost) three years has not got us any closer to establishing the real efficacy of kinesio taping. We are still lacking in large, well-thought-out studies investigating its use in those with musculoskeletal injury or pain, comparing its effects to placebo or alternative therapy groups. Those supporting its use tend to be small studies of poor quality.

From a personal point of view, I have used kinesio tape regularly over the last couple of years with mixed results. Some patients felt a definite improvement when tape was applied. Others could not say they noticed any change.

The one consistent finding is that in all cases the application of kinesio tape did no harm!