Tale of the tape
Jean Wendland Century Oak Center
The Summer Olympics are upon us. We will be seeing swimmers, volleyball players and pole vaulters striped in colorful tape again. Four years ago at the 2012 Summer Games, host Bob Costas mentioned the tape, referring to it as “decorative tape worn by our athletes”. After the commercial break he corrected himself and said that the athletes wore the tape to decrease pain and increase function.
In truth, kinesiology tape (e.g. elastic therapeutic tape, RockTape©, Kinesiotape©), is used for dynamic facilitation of muscles, decreasing pain, diminishing swelling, and increasing circulation to injured muscles. It works great for young world-class sprinters and marathoners. But who else can benefit?
Our practice has begun using “Ktape” and related techniques on the geriatric population with incredible success. The 89-year-old who has foot drop? We tape his anterior tibialis muscle and he walks. The 76-year-old whose right knee buckles? We tape her quads and her walking becomes fluid, her pain resolves, and she goes home pain-free. Taping around a new total-knee incision decreases healing time and increases range of motion faster than expected.
Two years ago we had a hospice patient with bony arthritic changes to both knees with contractures. She couldn't sit without pain. She couldn't lie in bed without pain. She took narcotics that made her sleepy and lethargic and caused an incompetent swallow, and we still couldn't manage her pain. Hospice patients are not typically covered for therapy, but we wanted to try the tape because there were so few options left. Two strips of tape combined with ten minutes of unbilled treatment time plus thirty minutes equaled pain relief that she hadn't had in months. When the tape came off, we re-taped and because of the reduction in pain medication, she became more lucid and more engaged with her surroundings.
How can un-medicated tape that is applied to the surface of the epidermis possibly effect the changes we see? Is it a placebo or something more?
The International Journal of Bio-Science and Bio-Technology (Vol.6, No.3 (2014)) has a study called The “Effects of Kinesio-taping Applied to Delayed Onset Muscle Soreness on Changes in Pain.” It shows that application of tape stimulates the Golgi Tendon Organ and promotes healthy muscle contraction and diminishes pain. An accompanying study using paper tape as a control shows no impact on the muscles or on pain.
A therapist we know brought Ktape into the NICU to see if it would help the 4 pound, 29-week-gestation babies with hypertonia and spasticity. She applied the tape in nearly-microscopic strips to inhibit the abnormal positioning. Within a week the abnormal tone was gone and the positioning was normal.
Kenzo Kase, D.C., himself performed an experiment where he inserted a micro-fiber camera beneath the skin and applied Ktape. What he saw was increased lymph circulation, increased hydration of the fascia, and increased blood circulation. Use of the tape in a specific pattern and with a specific tension can also decrease localized swelling. A personal story - a “friend” got into a hornet's nest and got stung on “her” face. The tape was applied to the swelling, which was gone the next day.
So how can you apply the tape and improve your patient outcomes? My personal experience says it has to be a therapist who is trained in taping. One of our patients showed significant improvement in her neck pain and spasms after being taped twice, two weeks apart. Her pain returned about a month later, so she bought some tape and her husband (a scientist) applied it. She came back with blisters where the tape was in contact with her skin. Healing can be tricky!
But for skilled nursing facilities, if they want better results, quality measures and fewer narcotics, the answer is clear. Get your facility's therapists tape-trained, and invest in some tape. Watch your outcomes change.
Jean Wendland Porter, PT, CCI, is the Regional Director of Therapy Operations at Diversified Health Partners in Ohio.