Kinesiology tape on the back of US-volleyball player April Ross in the shape of a star as she holds a volleyball.
AP Photo/Marcio Jose Sanchez
Application is an artform.
UNDER WRAPS

A lot of people swear kinesiology tape works, but science can’t explain why

By Katherine Ellen Foley

If you’re a fan of the Olympics or professional sports, you’ve probably seen athletes wearing patterns of brightly colored tape over their skin. Skillfully plastered over muscles and joints, this “kinesiology” tape bends and puckers with movement, and gives athletes a “super elite” appearance: the crisscrosses and star patterns look like a high-tech performance enhancement too complicated for amateurs to understand.

It started in the sumo-wrestling ring. In the late 1970s, a Japanese chiropractor named Kenzo Kase, who treated the ailments of some of these giant men, invented a flexible, latex-free, water-resistant stretchy adhesive substance intended to mimic human skin. He claimed it could solve two crucial problems for his patients. First, it would act as a support system for muscles and joints without blocking any movement, allowing users to recover from injuries with their full range of motion. Second, it would alleviate pain without drugs or surgery. This was the first iteration of kinesiology tape.

It started in the sumo-wrestling ring.

Throughout the 1980s, Kase would tell his sumo-wrestling patients to tape themselves up with it between office visits. At some point, he exchanged neutral shades for neon colors at the request of one of his younger female (non-sumo) patients.

In 1984 Kase founded a company, Kinesio, to market his new tape; by 1988, the company was selling the tape commercially as Kinesio Tex tape (today, there are several other brands). But  no one really paid attention to the tape until the 2008 Olympics when Kinesio shipped over 50,000 free rolls of the stuff to 58 participating countries, according to Pacific Standard. Some of the tape wound up on the right shoulder of US volleyball player Kerri Walsh. Despite still recovering from rotator-cuff surgery, Walsh won the gold that year with her partner Misty May-Treanor, and her signature look inspired thousands of physical therapists and sports-medicine specialists to suggest the tape for their patients.

Now it’s big business: the kinesiology-tape market is expected to reach $270 million by 2021, up from $150 million in 2016. There are more than a dozen brands of tape, many claiming they have designs that work better for specific sports or activities like swimming or strength training. And while kinesiology tape used to be reserved for patients in some form of physical therapy, it’s now is available for anyone to purchase over the counter or online, usually for $10-$60 a roll.

Basketball player James Harden tapes himself up even when he’s not hurt.

It’s the kind of thing that some people swear by for muscle and joint pain, like they would their grandmother’s chicken soup for a cold. “It’s absolutely bloody brilliant,” Paul Hobrough, a physical therapist based in the UK, told the Guardian. Olympic track cyclist Dotsie Bausch says she wears kinesiology tape for days at a time instead of taking ibuprofen for her back pain. Basketball player James Harden of the Houston Rockets tapes himself up even when he’s not hurt. “Whenever I’m sore, whether it’s my knee or my shoulder, putting the KT tape on gets the blood flowing and circulating around my body,” Harden told NBC. “I’m able to go out there and play free, not really thinking about injuries.”

But even almost 40 years after kinesiology tape’s invention, no one really knows how it works.

Application is everything

Modern kinesiology tape is about as elastic as our skin—meaning it barely prohibits movement—and has tiny pores, which allow sweat and water to escape from the skin. Kinesiology tape can be worn for three to five days at a time, including in and out of showers. It’s also hypoallergenic, made with medical-grade adhesive glue. It’s more pliable than traditional athletic tape, which is made with latex and intended to be worn for short periods of time (like one practice or a single game) to try to keep a player from becoming more hurt.

The question, though, is what kinesiology tape can do that regular tape cannot. Christopher Harper, a Utah-based physical therapist based in Draper, Utah, who serves on the Medical Advisory Board of KT Tape (another brand of kinesiology tape), says that tape can be applied in different ways to reduce swelling, manage pain, and improve muscle function and proprioception, our brain’s ability to sense where our joints and limbs are are in space even when we aren’t looking at them.

All of these proposed mechanisms are logical—but put to the test in lab settings, they don’t always hold together.

The claim: kinesiology tape can reduce swelling

According to Harper, to reduce swelling from an injury or otherwise, you can apply kinesiology tape such that it pulls your skin, and the tissue under your skin, upwards. For example, you could tape your elbow while it is bent; then when you extend your arm, the skin at your elbow will wrinkle and form bunches that are gathered up by the tape. That causes protein filaments (which play a role in structuring our tissue) to become more active. They start to suck up extra fluid released by cells as a result of the injury.

This idea was tested in 2003 (paywall) on rabbits who were all given the same lab-induced injury (sorry, guys), then given rabbit-grade physical therapy along with tape. Scientists tracked their healing process and found that the more tape over the injured site the more fluid drained.

Since then, there has been some evidence (a case study and a small trial involving women with extra swelling due to breast cancer-related lymph-node damage) to suggest kinesiology tape is better at reducing swelling than traditional (or no) bandages. But another slightly larger group study found that kinesiology taping was not as effective as compression-taping techniques at reducing swelling. And a study on patients with ankle injuries also found that kinesiology tape was not effective (paywall) at draining extra fluid.

The claim: kinesiology tape can reduce pain

Theoretically, kinesiology tape reduces pain by playing tricks on our nervous system. According to Harper, we sense touch before we sense any pain. That’s why we may instinctively rub the spot where we banged our shins on a corner after we hit it, but before we actually experience pain. The idea is that tape on an injured body part could distract our brains from feeling pain because the sense of the benign touch of the tape on our skin’s surface registers in our brain before the pain would.

In one lab study, patients who had whiplash felt slightly better and could move their necks a little more after the tight application of kinesiology tape compared to loose taping. In another, the tape seemed to help patients with shoulder injuries (paywall) recover some of their range of motion. However, both these studies were small and only lasted a short period of time, so we can’t draw strong conclusions from them.

That said, it seems like tape may be a useful addition to physical therapy because for many, it lessens movement-related pain, a key component of the healing process in some cases.

The claim: kinesiology tape increase muscle function and proprioception

Researchers have in the past hypothesized that the brain’s ability to locate internal joints, such as in the fingers or ankles, and then move them, depend partly on the tension it felt in the skin around the area. Proponents of kinesiology tape say that it may add an extra bit of sensory feedback while we move in space, improving muscle function and our general ability to control our bodies during movement.

This would be hugely beneficial to elite athletes, of course. Theoretically, it works by providing an extra bit of sensation over the skin, which activates the sensory receptors in muscles. These receptors trigger a slight reflexive reaction (paywall) that could help control movement a little more. At high levels of competition, that tiny extra reflex could be the difference between winning or losing.

Many of the studies conducted so far on muscle function have focused on patients with specific disorders, like stroke or cerebral palsy, and some have concluded that taping may help rebuild the muscles (paywalls) beneath the skin, particularly with regard to posture. A study on healthy adults, though, found that kinesiology tape had no effect (paywall) on performance during strength training exercises.

The notion that kinesiology tape improves the the body’s awareness of joints is dubious. There was 2016 study that found kinesiology tape could prevent re-spraining ankles—which is kind of a measure of proprioception because usually, rolled ankles result from the body failing to recognize where the foot is beneath the body. But most other investigations have turned up little to nothing. In one study from 2004, healthy participants were no better at moving their feet with or without kinesiology tape applied to their ankles. And two studies looking at kinesiology tape’s effect on proprioception related to the knee also came back negative.

Is it a limitation of the tape, or of the science?

Harper says some of the studies on the efficacy of kinesiology tape are flawed. “In a lot of the studies I’ve read that don’t have good results, the tape wasn’t applied properly,” he says.

When I pressed him to explain why there haven’t been more well-executed studies, he said the real issue is coming up with a good study design. Finding participants with exactly the same injury is always challenging, and pain is subjective. Seeing exact patterns of nerve activity in the body is impossible, and has to be done by proxy through movement. And it’s difficult to figure out exactly how much power muscles are generating because it’s hard to place electrodes to measure specific muscle output over areas that have been taped.

“There’s placebo in everything”

Which led me to my next question: How do we know that all of the benefits of kinesiology tape aren’t just placebo? What if people feel stronger because they know they have tape on them, and believe that their symptoms should improve? “There’s placebo in everything,” he says. “The placebo effect, that can be considered in any treatment.” But, he adds, he believes that the tape is more than placebo—that it is capable of actually helping his patients, in conjunction with physical therapy.

Even if it is just a placebo, though, that’s not necessarily a reason to stop using the tape if you think it helps you, or to try it if you think it might be beneficial. “Today the powerful performance-related outcomes associated with improved belief in a training program or novel intervention are seen as real effects that need to be harnessed,” a 2013 editorial in the International Journal of Sports Physiology and Performance states (pdf). And unlike drugs or surgery, there aren’t many risks associated with wearing kinesiology tape, unless it’s applied too tightly.

For the majority of recreational athletes, kinesiology tape is probably not necessary. For an injury, you should always go to a doctor or other professional first. Taping yourself is probably harmless, but it is possible to put the stuff on too tightly, which could strain an already injured area.

If you’re not hurt, and are just aiming for performance, you may benefit from the placebo effect. when athletes make a living from their winnings, any boost—even if it’s all in their heads—is worth it. “It just gives me that confidence. It gives me confidence to go out there and not worry about getting injured,” Harden told NBC. “If you’re playing free and you’re confident, great things are going to happen.”