Ankle sprains are very common injuries and need to be taken seriously. If you have a sprained ankle, it is important to seek medical treatment. The management of these injuries varies according to their type and severity. It is often necessary to consult a physiotherapist or other healthcare professional. Treatment can range from a simple tubigrip and activity modification to an extensive rehabilitation program or even surgery. Kinesio Taping is a relatively new treatment method that is aimed at providing support and stability to the affected area while still allowing the athlete to move. In recent years, use of Kinesio Taping has become widespread, particularly among athletes. The tape is both lightweight and flexible, thus is the closest artificial representation of the actual skin. It is designed to mimic the thickness and weight of skin, so as not to apply pressure on the area but provide the above-mentioned benefits. Kinesio Taping has a specific method of application that is intended to produce a holistic effect. Though it was developed primarily for use in athletes, the recent resurgence in use of Kinesio Taping has seen it used to treat a wide range of injuries and symptoms. Given that sprained ankles are a common injury, particularly among basketball players, Kinesio Taping may provide an effective means of treatment for acute and chronic ankle injuries. With the growing world of evidence supporting it, Kinesio Taping is gaining a reputation as a viable treatment option for ankle sprains.
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Following ankle sprains, the incidence of chronic ankle disability is reported to be as high as 40%. The most frequently cited residual symptoms are pain and swelling, decreased range of motion, and functional instability. The sequelae of functional ankle instability include an increased risk of reinjury, development of degenerative joint disease, and loss of mobility. Although ankle sprains are common, often debilitating injuries, there is no consensus regarding the most effective method of treatment. Because of the high rate of recurrence and residual disability associated with ankle sprains, these injuries represent a major health problem. Substantial residual disability can result from severe ankle sprains, particularly those that are inadequately treated. An injury of this type can negatively affect an athlete’s performance and, if chronic, may affect the athlete’s long-term health and well-being. The hypothesis of the current study is that Kinesio Taping will reduce pain and disability and improve proprioception in subjects with chronic ankle instability.
Benefits of Kinesiology Taping for Foot and Ankle Pain
Clinical bottom line (Best available evidence): Some studies have been done on the effect of kinesiology taping on the gait patterns of healthy adults and those with chronic ankle instability. However, the data is still inconclusive. This technique appears to have the same results as it does on muscle injuries at other anatomical sites.
Kinesiology Taping for Foot and Ankle Pain: Techniques and Benefits provides a thorough explanation of how kinesiology taping is being used for chronic foot and ankle pain, with a clear understanding of the theory and practical application of the technique from a clinical perspective. The goal is to provide clinicians with the best available evidence for the therapeutic use of kinesiology taping for chronic problems that are often seen in clinical practice. This article would be more focused and very useful in making decisions regarding the application of the kinesiology taping technique for foot and ankle pain.
Techniques for Kinesiology Taping
For nearly all techniques, tear the tape backing 2-3 inches from the end and then anchor the tape with no stretch. The anchor is an essential aspect of all kinesiology taping techniques and is used to create an area of tape with no stretch which will allow decompression on the skin and the underlying tissues. This will create an effective environment for rehabilitation of the injured area. Rub the anchor vigorously to create friction and heat. This will also activate the adhesive and help the tape to conform to the skin. The anchor should be applied with the injured area placed in a position that will elongate the injured muscle or joint. This will often require the patient to act against the tape or assume an awkward position, so always inquire about the comfort of the patient to assure the most effective and comfortable application of the tape.
Once you have selected the appropriate kinesiology tape for your patient’s condition, specific taping techniques can be employed to treat a variety of foot and ankle ailments. Prior to applying any technique, use rubbing alcohol or an astringent to clean the skin and remove any oils or lotions that would impede the adhesive qualities of the tape. Pre-wrap is not necessary when using kinesiology tape, so it may be more convenient for some patients. Always round or bevel the edges of the tape that will be applied to the skin. This will help to prevent the tape from catching on clothing or bed sheets, and will therefore prevent premature fraying of the tape. The heat-activated adhesive of kinesiology tape is most effectively secured by rubbing the tape after application to create heat. This helps to activate the adhesive and conform the tape to the skin. Additionally, the friction created by rubbing the tape will create an analgesic effect on the underlying tissue, soothing pain and discomfort.
Preparing the Foot and Ankle for Taping
After the skin is clean and dry, it is important to eliminate any hair that will be underneath the tape. This makes it easier to remove the tape, as taking tape off of hairy areas can be painful. The tape will stick better to hairless skin and will not roll up as easily. Use an electric razor to shave the area and then wipe the area with rubbing alcohol to remove any loose hairs and oils. This will ensure that the tape sticks better, be more comfortable for the patient, and will be less painful to remove.
When you are preparing to tape an area, it is important to ensure that it is clean and free of any lotions or oils. Most importantly, the skin must be dry, as kinesiology tape will not stick well to wet skin. Some areas of the body are particularly difficult to keep dry, such as the foot, due to socks and shoes, and with the ankle due to socks and pants. To ensure that the skin is dry, one may use a fan or hair dryer on a cool setting. This will ensure that the tape sticks better and is less likely to come off due to sweating or wetness underneath the tape.
Applying the Kinesiology Tape
Begin by cutting 2-3 strips of tape, depending on the size of the ankle and foot. The first strip will begin on the outside of the ankle and end 2-3 inches above the ankle bone on the inside of the ankle. The next strip will be a repeat of the first strip, just a little bit lower than the first strip. Both of these strips will be applied with no stretch, and be sure to smooth the tape into place to avoid friction with shoes and socks. The third strip will begin on the outside of the ankle, and will split into a Y to wrap around the heel. One side of the Y strip will wrap clockwise around the heel, and the other side will wrap counterclockwise, and both will end on the inside of the ankle. The fourth strip will be cut in half, and be applied above and below the site of pain but at a diagonal. This stretch on this strip will be 80% and should finish with a 1-inch unstretched portion. Lift the end of each strip after applying and rub the tape to activate the adhesive. This will generate heat and help the tape to conform to the skin. Remember to never stretch the last 1 inch of tape, whether it is at the end of a strip or anchor. This will allow easy facilitation or hold of the tape with no risk of the tape rolling off the skin.
Taping Techniques for Specific Foot and Ankle Conditions
Plantar Fasciitis Plantar Fasciitis is an acute or chronic inflammation of the plantar fascia. Begin by determining a precise location of pain within the heel or plantar aspect of the foot. For heel pain, for example, cut a single strip of kinesiology tape, tear one end with paper off 5cm in length creating an anchor, and apply the strip with 25% stretch from medial to lateral and finishing the tape on the anchor across the back of the heel. This will create a “U” shaped piece of tape with 25% stretch, have the patient stretch the fascia by moving from dorsiflexion to plantar flexion of the foot. This can be repeated 2-3 times with extra tape to reinforce the stretch if necessary. Another method involves fan cutting three strips with same sized anchors and applying the tape with 25% stretch from the medial side of the foot to the tissue of the fascia and around the heel. This technique should cover the width of the foot with the medial anchor preventing the tape from excessive peeling. This will help decrease inflammation and provide support of the fascia.
Lift in the Cavus Foot Lift simply describes the tape’s action and is a technique to reduce pain. Begin with the client prone with the foot hanging off the plinth. Properly measure and cut 1 strip of kinesiology tape. Using 25% stretch, anchor the tape proximally to the 1st metatarsal phalangeal joint. Keeping this anchor in place, remove the backing of the tape and apply the tape with no stretch over the dorsum of the foot and around the heel finishing the tape at the medial malleolus. For extra support on the lateral side of the foot, another strip of tape can be applied from the medial malleolus with 25% stretch, wrapping over the dorsum of the foot and finishing on the lateral malleolus.
Tips and Considerations
Practitioners are certainly capable of applying kinesiology tape to themselves, but having someone else apply the tape is always an easier process. During tape application, the average individual is unable to fully stretch the tape, keep the tape on tension, and/or follow a specific anchor without hands-on training. Kinesiology taping is also a very popular adjunct to various manual therapy methods such as the fascial and RockTape methods. This is logical when there is already a hands-on approach to treatment. For example, if a patient receives manual therapy to the lower back and is told to rest for a few days, a kinesiology tape application for posture support or pain alleviation is an excellent way to prolong the effects of manual therapy until the patient can receive care again.
The typical length of time that kinesiology tape can be worn is usually 4-5 days. There are times, however, when retaining tape for the maximum duration is inappropriate and possibly harmful. If you catch athlete’s foot under the tape (creating an impromptu kinesiology tape wrap for athlete’s foot), skin irritations or itches develop, it is pertinent and highly recommended to remove the tape as soon as possible. Any type of skin infection under the tape is a clear sign for removing the tape. Also, be aware of the skin condition around the tape during long-term wear. If you notice any white, wrinkly “prune skin,” remove the tape immediately. This is a clear sign of skin maceration. Skin maceration occurs when the skin has been wet for prolonged periods. Although kinesiology tape is water-resistant, the ends can facilitate water under the tape and prevent water from drying after bathing or exercise. Skin maceration under the tape can lead to various infections and is a dangerous situation for pre-existing skin conditions.
The adhesive on kinesiology tape is designed to be non-irritating to the skin, but it rips out hairs like nobody’s business. Removing kinesiology tape is a delicate process. Often, taking off kinesiology tape can be just as painful as waxing your chest, but it doesn’t have to be. For individuals with little hair on the affected area, kinesiology tape can be taken off by simply peeling it off against the hair follicles in the direction that the skin moves. For individuals with a significant amount of hair on the affected area, the hair can be saved by wetting the tape and rubbing the area with an alcohol wipe. As the tape becomes wet, it will gradually start to peel off. If at any time during the removal of the tape you feel a sharp pain on the skin, stop immediately. You should never rip the tape off as it can cause skin irritation and damage the skin. Rather, peel the tape off more gently or wet it thoroughly.
Proper Removal and Care of the Tape
Data gathered from a survey of 34 certified Kinesio Tape Practitioners showed that a running shower can help the tape become “unglued” from the skin, making removal a more comfortable experience. If you experience any itching with the tape at any time during wear, use a hair dryer on a low cool setting and wave it over the tape to help promote adhesive removal.
Remember that despite proper removal techniques, kinesio tape should not be left on for an extended period of time. The adhesive on the tape is designed to stick for 3-5 days. After this time period, the tape can become difficult to remove and cause undue stress on the skin. Never stretch the tape when applying it and always break the last two inches off the tape and apply it with zero stretch. This will create an “anchor” and help avoid any skin irritation when the tape begins to peel.
After removing the tape, clean your skin with soap and water to remove any remaining adhesive. If you experience skin irritation or itching sensation after removing the tape, stop using it and consult a medical professional.
Proper removal of kinesiology tape is simple and, if done correctly, can help avoid potential skin irritation. Remember to use your fingers to carefully rub the tape and adhesive off of the skin. Slowly, but firmly, peel it back. Using the opposite hand to stabilize the skin as you peel the tape off can also ease any discomfort that some people may feel when removing the tape. Hair, moles, and other body hair should be avoided as the tape can cause damage to the skin when it is pulled off.
When to Seek Professional Help
When to seek professional help: If you are experiencing ongoing and severe pain, it is important to seek professional help. It is also important to seek professional help quickly if you experienced a traumatic injury or if you think you have a stress fracture. Signs of a stress fracture may include localized pain, possibly some swelling, and increased pain with weight bearing. In some cases, discoloration or bruising may be present. The process of healing a stress fracture is very delicate, and even if you are already seeing a health professional for the injury, kinesio taping may still be of benefit in stabilizing the area once it has moved on from the inflammatory phase. But, it is best to discuss it with the professional providing your care. If you have a pre-existing medical condition or experience profuse swelling, it is recommended that you speak to a doctor or physiotherapist before applying the tape to an affected area. Those with diabetes, poor circulation, or heart conditions may place themselves at risk of increased swelling or bruising from the application of kinesio tape. If the swelling is due to trauma and there is no pre-existing medical condition, it is probably okay to apply the tape immediately after an injury, but discontinue use if the swelling increases. Remember, if there is any increase in pain, swelling, numbness, or change in skin color around the taped area, remove the tape immediately and seek advice.
