Taping

Neil - Doctor of PhysiotherapyBlog, Health, Kinesiotape, Physiotherapy, Uncategorized0 Comments

I attended an Up The Buff trail race yesterday. I wasn’t running of course (that would be absurd) because I’m allergic to running.

I saw an 11yr old boy with some rigid tape poking out from the top of this socks. I asked him what it was for. He told me that he had sprained his ankle six months ago. The Physio he saw at the time told him that he had flat feet; I almost gave the kid a ‘high five’ and I proudly showed him my pair of pancakes. I told him that flat feet don’t really cause problems, to which he quickly responded with “mine do”. He then told me that he needs to wear orthotics as a result. We were standing on a bridge throwing sticks into the water with my 4yr old. I’m not sure who I most wanted to throw over the handrail; myself or the kid. It would have been the Physio had s/he been there.

I blame the Physio.

We were at the trail run because a close friend of my wife is one of Those Guys Events organisers and we wanted our 4yr old son Aston to run in the kids Dash for Duchenne. As kids do, Aston decided it wasn’t the right time and refused. We couldn’t even get the bib on him. Aston’s inherited my flat feet but runs really well, unlike some of his ‘arched’ companions who, to be polite, make it look a lot less ‘natural’. As a teenager, I was the second fastest kid in my High School over 100m, and the fastest over hurdles. Embrace flat feet and bask in their plumb-line quality I say! Nature’s spirit-level for when you don’t have one – what a wonderful gift to have!

No pre-teen should be catastrophising about their normal anatomy and believe they need to live the rest of their life with a walking aid! Why an 11yr old child was still wearing tape six months after a sprain is beyond me, and no, he wasn’t running.

A well-known Gold Coast Physio finished one of the two races as a top female finisher. She too had rigid tape on both ankles. It was a hot sweaty start to the day and after the race I noticed some of the tape was no longer stuck to her skin at all. I resisted the urge to ask why such a capable runner was wrapped up in tape.

Below are some highlights from a guest blog by Physiotherapist Paul Westwood @triathlonphysio on Tom Goom’s page here. This was written specifically about kinesiotape however, I believe the same sentiments apply to rigid tape. Paul’s opinion is based on being involved in endurance sport and triathlon for almost 20 years as a physiotherapist, coach and athlete. Paul works with athletes of all levels from novice runners to some of the best triathletes in the world, specifically in the JFT Racing Triathlon team, and his views apply to all athletes.

An athlete who has a positive attitude, is self-aware and has faith in their body and its ability, is rarely seen wearing tape.

I have heard many an athlete say, “The tape is all that’s holding me together” or “I’d never have completed the race without the tape”. This sounds like a good reason to use it at first. However, it isn’t true of course because tape can never physically make that much difference. However, it is an athlete’s lack of trust in their body which causes them to feel like they need something else to help them.

I have heard many an athlete say, “The tape is all that’s holding me together” or “I’d never have completed the race without the tape”. This sounds like a good reason to use it at first. However, it isn’t true of course because tape can never physically make that much difference. However, it is an athlete’s lack of trust in their body which causes them to feel like they need something else to help them.

Athletes need to trust their bodies if they are to have a long term career in sport and reach their full potential. Physiotherapists, doctors and any other professionals in sports medicine can have a considerable effect on an athlete’s trust or lack of trust in their physical ability. Almost every athlete I see has their own list of issues: “The physio says I have… tight hamstrings / a weak core / flat feet / no balance / poor biomechanics / an inability to squat / no glutes”… or that “my FMS is very poor and I’m going to get injured.”

Sometimes we get ‘injured’ but it’s totally normal. Our body for the most part will heal quickly, get stronger and adapt; this is a normal process and athletes need to know this. This positive input is vital. Telling athletes they are weak, have a rupture, have bio-mechanical issues or asymmetries etc. will only lead to negative and ultimately self-destructive beliefs – although their body has healed they will still have problems, pain and injury.

[Kinesio] tape can affect an athlete and the culture they inhabit in the following negative ways:

  • It promotes the belief that their body is not good enough and they need an extrinsic factor (tape) to allow it to function. The body heals itself, it doesn’t need help other than the basics of movement, nutrition and sleep.
  • The athlete becomes unable to function/perform fully without the use of the external factor/tape.
  • Any effect of the tape is likely to be placebic and as this effect wears off with repetitive use, you are eventually left with an athlete with chronic pain or injury who doesn’t trust their body.
  • It provides a constant reminder to the athlete that they have an issue/pain, turning up their pain amplifier with constant visual and sensory feedback.
  • It provides a visible sign to the athlete, other people and the ‘world’ that they have an issue and therefore don’t have to perform. Therefore, they have a ‘get out clause’ or excuse.
  • It provides attention and sympathy which can be rewarding. This can be dangerous as the brain learns that it can survive and gain attention from being injured and in pain just as much as it can from winning and performing, the latter being much harder to achieve. The primal brain always takes the path of least resistance… the easiest way to survive.
  • An athlete strapped with tape is showing a potential weakness. When I first encountered tape I couldn’t believe an athlete would use it because a high performing athlete would be very reluctant for fellow competitors to know they have an injury. The Maori lads I worked with at the NZ Rugby Academy wouldn’t wear tape as they thought it was showing weakness and they knew they would therefore get their injuries targeted and smashed even more by the opposition.
  • A physio, competitor and coach could make a note of those athletes wearing tape – as I have done. For example; calf taping for instance may mean the athlete is struggling with their running and this can be exploited. If you attack this athlete hard in the first section of the run it is likely that they won’t follow you.
  • Taping means the athlete is likely to have insecurities about their performance and their ability in the race. When the going gets tough other competitors could gain strength from being aware of this whereas the less confident athlete might fold. Successful athletes know how to use other’s insecurities to their advantage.

If you would like to hear Paul discussing the same topic with his colleague Joel Filliol in the JFT Racing Triathlon team, in session 32 of The Physio Matters Podcast Jack Chew asked Paul and Joel ‘Can the robust ‘anti-fragile’ movement win the battle of ideas in a world littered with nonsense? here.

I *don’t* believe tape it useless. It’s not possible to do something like this or this without altering kinematics. I have no idea what the kinetic changes may be; whether they do the job they’re intended for (I certainly haven’t seeing any reliable evidence to suggest that is the case), or whether it causes adverse changes in the system as a whole. If a sport requires fast running, not being able to swing an arm freely or having one ankle unable to bend normally must (I would suggest) have a negative effect on running mechanics. I believe taping is massively over-used. I’m not convinced by its’ clinical utility, and as a single-use intervention I will typically recommend some form of re-useable bracing option as an alternative.

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