Kinesio Tape, the granddaddy of this class of tape, was invented in the 1970s by Kenzo Kase, who is a Japanese-born, American-trained chiropractor who prides himself on practicing integrative medicine. Dr. Kase believes that all healing begins with human touch and developed Kinesio Tape as a way to send patients home with his hands.
Kinesio Tape markets its ability to enhance recovery and reduce pain, and its website also claims the tape may improve lymphatic drainage, promote post-surgical healing, optimize performance, improve circulation, prevent injury, and assist the body’s natural healing process.
Kinesio Tape is often used interchangeably with RockTape, KT Tape, Spider Tech, PerformTex and others, but in reality, these are just brand names. Just like Coke, Pepsi, and Dr. Pepper are different brands of soda, these are brands of tape.
The different brands of tape claim they can: cue form, reduce pain, provide neuromuscular re-education, optimize performance, improve circulation, and prevent injury for different body parts, like the shoulder, ankle, and wrists.
But the actual difference is mostly how stretchy the tapes are, which can affect how you use it. Other selling points include:
- Design (school or MLB logos, tiger stripes, etc)
- Level of adhesion
- Reflective elements for safety at night
- Pre-cut strips for easy to follow application
- Wear time
A quick Google search provides a ton of instructional YouTube videos for all the different techniques. Depending on the technique, the goal of the tape may be to enhance muscle function, improve joint stability, or decrease inflammation.
How do you apply Kinesio Tape to the knee?
There are several ways to apply Kinesio tape to the knee. If you don’t have an exact diagnosis, a basic “knee pain” technique can be used. It seems like a lot of steps but it’s really easy! You can even apply this tape job to yourself!
- Clean the skin surface of all lotions, oils, etc. They make it difficult for the tape to stick and can decrease wear-time.
- Position the knee in 90 degrees of flexion. Hanging the leg over the side of a table or chair is the easiest way to get this position.
- Cut the corners of a 4-5 inch strip of tape so that they are rounded. This decreases the amount of peeling-back of the corners over time.
- Pull the tape just enough to split the paper backing in the center of your tape strip. Be careful not to touch the adhesive, handle the strip from the intact paper ends.
- Pull the tape to 80% stretch and lay the center of the strip below the kneecap. Once the tape is placed on the skin, secure the middle portion and then finish affixing the ends of the strip by pulling the paper backing off and laying the tape down. The ends should always be laid down with 0% stretch so that the tape stays in place. This step can be repeated so that a second strip of tape overlays the first.
- Detach another strip of pre-cut tape or cut a 6-8 inch strip for the next step. This tape should be long enough to extend from just below the kneecap to about 2 inches above the knee.
- Tear the paper backing toward one of the ends (after rounding the corners) to create an anchor. Achor the strip about 2 inches above the top of the kneecap toward the outside of the thigh muscle.
- Pull the tape until there is 25% stretch and apply the strip in a path that traces the outer border of the kneecap until you get near the bottom of the knee. As you wrap around the bottom of the kneecap, increase the tension to 50% as you cross the first strip of tape and then reduce tension completely as you anchor the bottom of the strip.
- Repeat this process on the other side of the knee so that the bottom anchors create an “X” over the top of the first tape strip.
- Rub the length of the strips of tape to create some heat via friction so that the adhesive sticks better.
Does it matter how you apply Kinesio Tape to the knee?
According to the Kinesio tape manufacturers, the direction of pull and amount of tension are critical to taping the knee. The amount and direction of pull are hypothetically used to determine which muscles are being activated or inhibited.
Research disagrees. A study in the Journal of Science and Medicine in Sport examined the facilitatory and inhibitory effects of Kinesio tape during grip exercises. Participants were blindfolded while taped to either facilitate (increase) or inhibit (decrease) wrist extensor muscle activity. They had their grip strength tested in the three conditions (no tape, facilitatory, inhibitory). Researchers failed to identify differences in maximal strength, EMG activity, or perceived performance among the tape conditions.
Another study in 2016 published in Isokinetics and Exercise Science also looked at the effect of tape on muscle performance. The tape was applied to the quadriceps with 40% tension before participants performed isokinetic exercise. The results showed no enhancement of muscle performance with the application of kinesio tape at any of the muscle velocities tested.
Regarding improved circulation, the tape seems to work but not because of the way it’s applied. Craighead and colleagues found that blood flow under the skin increased “modestly” regardless of how much tension was applied. Tape was tested at 0%, 25%, 50%, and 100% tension with no difference in blood flow between the conditions. They also tested blood flow with and without convolutions of the tape and found no difference between conditions.
How do you remove Kinesio Tape?
Tape removal can be tricky. Oftentimes, if the tape has been worn for five to seven days, it should peel off easily. Thus, you should still protect your skin from being ripped by the tape by holding the skin down as the tape is removed.
This will require an extra person if the tape is applied to the upper body, but around the knee you can simply use one hand to hold the skin down and the other to gently peel or roll the tape in the direction of hair growth (usually away from the body).
If the tape is being stubborn, use an oil-based product to loosen the adhesive. Taking a hot shower or trying to remove the tape when your body is warmed-up is unlikely to work because most of the adhesive is made to be non-water soluble. This means its stickiness is enhanced when it’s wet!
Does Kinesio Tape work for knee pain?
Kurt et al. looked at the short-term effects of kinesio tape on joint position sense, isokinetic measurements, kinesiophobia, pain, and functional limitations in participants with patellofemoral pain, or runner’s knee.
Ninety participants were randomly allocated to tape and placebo groups before performing isokinetic quadriceps strength testing and joint position sense measures.
They also completed scales to measure pain and kinesiophobia (fear of movement). All measurements were repeated two days after tape application.
Although no differences were found in isokinetic muscle testing after two days, significant improvements were noted in kinesiophobia, pain, and functional limitations after taping. This suggests that taping has no effect on strength but may be useful for improving joint position sense and decreasing kinesiophobia, pain and symptoms.
A recent study in the International Journal of Sports Physical Therapy compared the effect of different taping techniques on anterior knee pain during functional activities.
After being taped, the female participants who all had unilateral knee pain prior to the study were asked to squat and climb stairs.
Kinesio Tape was found to be an effective way to decrease knee pain in these patients while climbing stairs.
In the absence of any other observable findings, it is suggested that the effectiveness of the tape may lie in its ability to stimulate the receptors in the skin that sense touch which, in turn, may hinder the brain’s ability to sense pain. This taping technique is also used for bursitis with the same proposed mechanism of action.
A similar technique to that described above and used in this study has been suggested for patellar tendinopathy. Using only the strip of tape that lies horizontally over the patellar tendon, this technique calls for 25-50% tension and doward pressure over the inferior pole of the patella.
Once the tape is secured in the center, the tails pull up in the direction of the medial and lateral quadriceps muscles with minimal tension. When completed, it looks like a “U” under the knee. It is believed that this application reduces pain and improves circulation by lifting the skin and decreasing pressure on the pain receptors.
In older adults with knee osteoarthritis, the effect of kinesiotape on pain, swelling, and functional limitations was tested. The three groups of participants all performed exercise but two of the groups did so with tape applied.
The tape was either meant to stabilize the knee (as in the technique described earlier) or drain the knee and was applied twice a week for the duration of the 12-week study. Researchers found improvement in pain and functional as well as decreased use of anti-inflammatory medication with the advent of tape during exercise.
Legal issues with taping
Here’s the catch. The evidence suggests that the tape has some actual benefits, but there was also this pesky lawsuit against KT tape (not Kinesio tape but a similar product) where they settled without admitting wrongdoing.
KT tape claimed all the same effects as the rest of them, with particular attention paid to reducing pain and preventing injury from a legal standpoint. Evidence seems to support short-term effects of proposed mechanisms but also that may be heavily influenced by the placebo effect.
Knowing they are wearing tape that is supposed to do SOMETHING may produce enough psychological benefit to create physiological changes. An example of this would be a runner with knee pain who can not run without pain when not taped but with tape can finish a 5K.
Without any clear explanation for change in symptoms, we are left to wonder whether the improved performance is a result of stimulation of mechanoreceptors, placebo, or simply thinking the tape is helping because a trusted medical provider told them it was.
Should you use Kinesio Tape and other tapes?
I’ll admit, I use Kinesio Tape — albeit sparingly. There are typically three situations that call for Kinesio Tape in my practice.
- The patient has had previous success in the same or similar situation with tape. Who am I to mess with what works? If they come in and tell me that their shoulder pain was immediately improved by tape, I’m probably going to tape them. I’m also going to address their flexibility, mobility, and strength but there’s no reason not to do those things with the tape on if it’s been helpful in the past.
- I’m stuck. If I have tried every other evidence-based approach I can think of, I have been known to try tape. Admittedly, this is mostly in shoulders with persistent pain that may benefit from postural cueing. Most recently I used it to remind a patient with a tight pec minor, to keep his shoulder blades down and back. Spoiler alert: He felt immediately better but ultimately it didn’t work. In fairness, we were looking for a panacea in a tight post-operative shoulder and this wasn’t it.
- Persistent swelling. I don’t know why this works and I certainly don’t believe that tape that looks like a jellyfish is lifting the skin to improve circulation, but I have seen its success too many times not to keep it in my tool box.
I once drove 45 minutes to get it from the closest retailer (back when it wasn’t as readily available as it is today) to help my mom with swelling after a Jones Fracture. She went from unable to bear weight or wear shoes because of swelling in her ankle and along the top of her foot, to perfectly normal by the next morning. To be fair, I have taped a lot of people for swelling with very mixed results but when it works, it really works!
So if you are using it to enhance mechanoreception (decrease pain through the sensation of touch), for the placebo effect, or to see if you can get rid of persistent swelling, there’s probably no harm in trying.
But if you tell me the pink tape is used to “heat things up” and the blue tape is “to cool things down” as a certain athletic trainer once told me, I’m probably going to laugh out loud and move on.