Kinesio taping can help treat a wide array of conditions, but choosing the right tape and applying it properly are essential to realizing successful outcomes.
Kinesiology tape was first conceptualized in the 1970s. Today, there are more than 60 different brands and varieties of tape available.1 Despite its longevity in the marketplace and growing popularity, some chiropractors and patients may still be unaware of its benefits, while others may not realize just how many conditions taping can aptly treat.
Potential benefits
Kinesiology tape is a specially designed elastic tape applied directly to the skin for a therapeutic effect. It works by being applied over and around muscles to provide support or prevent over-contraction of the muscles, while still allowing for a full range of motion. Many tapes on the market today claim to reduce pain, support muscles and joints, reduce muscle tension, increase strength, improve performance, enhance or correct movement, and reduce swelling.
The flexible tape mimics the performance and functionality of human skin. When placed on a body part, it helps to facilitate the body’s natural healing processes by lifting the skin away from the muscle fascia—creating space between the blood vessels, lymph, and nerves.2
There are many possible applications of kinesiology tape. The most common treatment areas in chiropractic are the low back, neck, shoulder, knee, and ankle. Practitioners applying kinesiology tape believe it improves blood and lymphatic circulation and reduces inflammation, excess chemical buildup, and pressure on sensory and neural receptors, resulting in reduced pain.
Pain reduction may also result from activating the endogenous analgesic system. “Endogenous” refers to something that is self-originating, and calling something “analgesic” means that it can relieve pain in a conscious person. When this process is set in motion, taping facilitates the body’s own healing mechanisms, which is a tenet of chiropractic.
Proper taping may improve a muscle’s ability to contract, even when weakened, in addition to reducing pain, fatigue, and the potential for cramps, overextension, and overcontraction.
Kinesiology tape may also increase range of motion and improve joint position by adjusting misalignments resulting from tightened muscles. In treatment you want to reinforce and train proper movement patterns; the right tape applications can help you achieve that.
Most kinesiology tapes are made from elastic, latex-free fibers so they’re safe to use with most chiropractic patients. It’s similar to the elasticity of skin and muscle, allowing both athletes and rehab patients to remain active even while injured.
The stretch component
Not all kinesiology tapes are created equal. A superior tape will have specific properties and maintain consistent quality over a period of several days and under stress. Proper tension is one of the most critical factors in application success.3 In a recent study of 616 clinicians, nearly 85 percent felt measuring the elongation or stretch applied to kinesiology tape is either “important” or “very important” (Performance Health data, 2014).
When applying tape, instructions should indicate how much stretch is appropriate for each application. Measuring stretch will help even the novice clinician or patient apply tape with ease. It will also reduce waste and hassle from re-taping (throwing away incorrectly applied tape and starting over or pulling up the tape and repositioning it, which weakens the adhesive). Some tapes provide visual cues that indicate when it reaches an ideal degree of stretch.
Specific applications are supported with recommended tensions. Taping for muscle support should range between 0 to 50 percent tension, structural and joint support should be applied at 50 percent or more tension, and neurological and circulatory with less than 25 percent tension. Note that tension above 50 percent may increase skin irritation.
Placing the tape on the body without stretch is called no-stretch or “paper-off” tension. Tension can also be achieved by stretching the body part, and then taping it in the stretched position.2
Application techniques
A good kinesiology tape should stick for three to five days without irritating the patient’s skin. Look for a tape that is water resistant and designed to wick away moisture and not peel off with sweat. A quality tape should allow the patient to bathe normally.
Prior to application, rid the skin of any oils, lotions, or perfumes with rubbing alcohol or an astringent and allow to dry. Anything that limits the acrylic adhesive’s ability to stick to the skin will limit both the therapeutic benefit and longevity of the application.3
Be wary of body hair. As tape recoils, it will pull and lift body hair, decreasing therapeutic effectiveness through the skin and limiting wear time.3 Trimming hair, such as that at the nape of the neck, may be necessary. After applying, rub the tape to activate heat sensitive adhesion.
Most tape jobs require one to three minutes to complete. Choose cuts based on the body part and injury. “I” cuts are the most common and are often used to stimulate a neurological grouping. Use a “Y” cut when bordering a larger muscle group. “X” cuts are mostly used with scapular stabilizers while fan cuts are used for edema and bruising.
Aftercare with kinesiology tape is critical. Always instruct patients to remove the tape if their symptoms worsen or if they experience skin irritation. Patients should always dry the tape with a towel after bathing, showering, or swimming. When they need to remove the tape, they should simply press down on the bare skin next to the tape and pull gently.
Coding and billing concerns
Most of your income generated from kinesiology tape will be in the form of cash payments from patients. Billing should be done per visit, per treatment plan, or over blocks of treatment. For example: You can establish a price range for monthly tapings or a per-visit taping charge. Retailing the product also generates cash.
Taping can be used in conjunction with a number of therapies such as neuromuscular re-education, therapeutic procedures, or gait training. When applying kinesiology tape to a patient in conjunction with another therapy, the taping should not be separately reported. The only appropriate code to report is a supply code for the tape itself, either A4450 for non-waterproof tape per 18-square inch or A4452 for waterproof tape.
In reporting kinesiology taping as a separate and distinct service not used in conjunction with a therapy, the appropriate code for the taping service is 97799 (unlisted therapy untimed). This will require proper documentation in your notes and may not guarantee payment.
If you have patients who are skeptical that kinesiology works, they will usually be amazed at the reduction of pain and improved function they experience immediately after application. Patients may find that meniscus tears stop hurting on stairs or when squatting, rotator cuff impingement fully abducts without pain, and sacroiliac joint injuries are no longer painful when the lumbar spine is in range of motion.
As you and your patients experience the benefits of kinesiology tape, you may want to learn more about the research behind taping, including evidence-based applications. Be knowledgeable about what’s available from kinesiology tape manufacturers and take advantage of their investments in kinesiology tape research and their free product sampling programs. And make sure you choose a tape that supports proper application and the ideal level of stretch.
Gregory H. Doerr, DC, CCSP, is a graduate of New York Chiropractic College. He is head physician at Bergen Chiropractic and Sports rehabilitation Center in Hackensack, New Jersey, and is certified in kinesiotaping, rockTape, SpiderTech, and SPrT. He has developed many of his own signature taping styles over 17 years of clinical taping experience. He serves as physician for a number of professional and semi-professional sports teams.
References
1 Kumbrink B. (2012). K-taping: An Illustrated Guide. Berlin Heidelberg New York: Springer-Verlag.
2 Haley RJ. “Stay in the game with kinesiology tape.” BodyBuilding.com. http://www.bodybuilding.com/fun/stay-in-the-game-with-kinesiology-tape.html. Updated Oct. 9, 2014. Accessed Nov. 25, 2014.
3 Kase K, Wallis J, Kase T. (2013). Clinical Therapeutic Applications of the Kinesio Taping Method, 3rd ed. Albuquerque, NM: Kinesio IP, LLC.
