Kinesiology Tape Application to the Upper Trapezius Reduces Pain, Trigger Point Irritability and Increases Muscle Strength

Research Review: Kinesiology Tape Application to the Upper Trapezius Reduces Pain, Trigger Point Irritability and Increases Muscle Strength

By Nicholas Rolnick SPT, MS, CSCS

Edited by Brent Brookbush DPT, PT, COMT, MS, PES, CES, CSCS, ACSM H/FS

Original Citation: Ozturk G, Kulcu DG, Mesci N, Silte A, et al. (2016). Efficacy of kinesio tape application on pain and muscle strength in patients with myofascial pain syndrome: a placebo-controlled trial. The Journal of Physical Therapy Science. 28: 1074-1078. - ARTICLE

Caption: The two conditions for kinesio taping used in the current study

The two conditions for kinesio taping used in the current study - Ozturk et al., 2016

Why is this relevant?: Myofascial pain syndrome (MPS) is characterized by the presence of multiple trigger points and taut bands in muscles, and is common complaint of clients/patients in rehab, fitness and performance settings. Kinesiogy Tape (KT) has been used as an adjunct intervention to reduce pain, alter dysfunctional movement patterns, and increase strength in individuals with MPS; however, there are few randomized controlled trials to investigate these applications. The current study investigated the effects of KT (inhibition-style application) on pain levels, trigger point irritability, and muscle strength in the upper trapezius muscle in those exhibiting MPS.

Study Summary

Caption: Dr. Brookbush applies Kinesiology Tape to the Lower Trapezius for reinforcement of activation exercises done during treatment.

Lower Trapezius Facilitation Taping

Review & Commentary:

The current study exhibited strengths in its methodology. First, the study was adequately powered to achieve statistical significance (high effect size of 0.92) in the variables investigated (pain, trigger point irritability (algometry), and muscle strength). The authors previously performed a pilot study to determine the degree of change needed and the number of participants required to achieve statistical significance. Second, the study investigated a common patient/client complaint, upper trapezius myofascial pain. As the application of KT is frequently used for the treatment of pain (1-2), investigating a commonly reported pain syndrome increases clinical relevancy.

The study also had weaknesses worth discussing before implementation into practice. First, the description of the experimental protocol lacked clarity regarding the time between intervention and T2 measurements. From the description it was not possible to determine whether T2 was measured after the first 3-day application of taping and re-measured after the second 3-day application, or measured after both rounds. Future studies, and or the researchers, should specify the timing of these measurements as it has an impact on determining best practices, and what results should be expected from the patient/client and the professional. Second, the protocol had both groups performing neck strengthening and neck stretching exercises. While this is clinically relevant, essential to the type of study performed (RCT), it adds a potential confounding variable. Last, both groups were different in their baseline upper trapezius strength. This could influence results of the degree of change in both conditions.

Why is this study important?

The mechanism by which KT reduces pain is currently unknown. It has been hypothesized that KT increases local circulation, increases or inhibits muscle activity (depending on the application), provides positional stimuli to the receptors of the skin, and/or increases afferent input to the central nervous system (1). More research is needed.

The current study suggests that inhibition-style KT application can reduce pain and increase strength in symptomatic individuals with myofascial pain syndrome of the upper trapezius , and may have long-term benefits (30days). This study also employed a placebo condition as a comparison group, which lends credence to the results of the study.

This study differs from other research studies that have suggested KT is ineffective, as it was used as an adjunct to treatment and not a treatment unto itself. Based on the findings of this study, the inhibition-style application of KT to the upper trapezius can be considered as an appropriate adjunct intervention to reduce myofascial pain along with an exercise program.

How does it affect practice?

Evidence regarding the efficacy of KT tape is mixed, but two previous studies comparing KT to a sham treatment have also shown a positive effect (one on acute neck pain and the other to subacromial impingement syndrome (1-2)). The use of KT as an adjunct therapy in the current study seemed to result in the largest effect size of the three studies, which may suggest that KT is best used as an adjunct therapy. It is interesting to note that in the study regarding KT tape and shoulder impingement the sham was ultrasound, another commonly used adjunct therapy, which may suggest KT tape is a better adjunct therapy than some other modalities (2).

How does it relate to Brookbush Institute Content?

From "The Effect of Kinsiology Tape On Subacromial Impingement Syndrome" :

• "Taping modalities such as Kinesiology Tape may be considered and applied relative to the inhibition and activation components of the integrated warm-up and rehabilitation templates of the Brookbush Institute. Generally, the Brookbush Institute uses taping at the end of a session, as a means of reinforcing release and activation interventions performed during a session. The intent and goal of these taping applications is to enhance carry over from sessions to session, and in some cases provide a competing stimulus that may help to reduce the perception of pain."

The current study focused on MPS in the upper trapezius muscle , a common pathology associated with Upper Body Dysfunction (UBD) . Taping of the upper trapezius produced an immediate increase in scapular elevation strength with a concomitant decrease in pain and trigger point irritability. In UBD , the upper trapezius has a tendency towards displaying both long/under-active and short/over-active activation patterns depending on the movement dysfunctions observed in the overhead squat and trapezius muscle strength assessments . In either case, the Brookbush Institute approaches postural dysfunction by releasing and stretching overactive synergists (supraspinatus , levator scapulae , and rhomboids ) and activating and integrating under-active musculature through corrective exercise. In the current study, upper trapezius scapular elevation strength increased after application of KT, which may suggest that application may have a positive impact on pain, quality of motion, and performance following activation and integration of the serratus anterior , lower trapezius , and infraspinatus/teres minor .

The following videos are commonly used taping techniques by the Brookbush Institute for those exhibiting Upper Body Dysfunction (UBD) :

Brookbush Institute Videos:

Lower Trapezius Activation Taping:

Shoulder External Rotator Activation Taping

Lower Cervical Extensor Activation Taping:

References:

1. Gonzalez-Iglesias J, Fernandez-de-Las-Penas, Cleland JA, et al. (2009). Short-term effects of cervical kinesio taping on pain and cervical range of motion in patients with acute whiplash injury: a randomized clinical trial. JOSPT. 39: 515-521.
2. Kaya, E., Zinnuroglu, M., Tugeu, I. (2010) Kinesio taping compared to physical therapy modalities for the treatment of shoulder impingement syndrome. Clinical Rheumatology. (30) 201-207.

© 2016 Brent Brookbush

Questions, comments, and criticisms are welcomed and encouraged -