Kinesio Tape. Quackery?

GCN have started a series on using Kinesio Tape to treat injuries. Being of a skeptical mindset, I was rather suspicious of this. How can a simple strip of tape prevent or treat injuries? I decided to check this out.

Now, I need to make it clear up front. I’m a Skeptic. That capital S is there for a reason. I’ve spoken at Skeptical conferences and gatherings, appeared on a number of skeptical and science-promotion podcasts and I organise an annual event in Sydney called Skepticamp, where science advocacy and quackbusting are the order of the day. I’ve been involved with Stop The AVN since Day One

In short, I like evidence.

And I don’t see much evidence for this product’s efficacy. In addition, I see several red flags that make me deeply suspicious, which I explore below the fold.

Let’s look at the warning signs first of all.

First up, GCN’s video is presented by a chiropractor. Chiropractic, at least in Australia, is a profession under siege. Members of the Chiropractic Association of Australia are under fire for promotion of implausible and disproven quackery, including claims that spinal manipulation can treat all manner of non-spinal ailments, including – but not limited to – viral infections, infant bedwetting and colic, earache and – of all things – autism. These chiroprators are being firmly taken to task over their promotion of anti-scientific and anti-vaccination messages, hammered for their promotion of implausible, debunked ‘therapies’ like homeopathy and reiki and are generally on the run from regulators and activist medicos. Having said that, there’s a wing of the profession which has embraced evidence-based practice and restricts its scope to physical therapy – for which there at least exists some evidence. And there exists a range of practitioners in the grey area in-between the two, from ‘competent and dilligent’ to the ‘insanely deranged’.

I have no way to know which way Garmin Sharp’s team chiropractor leans in this respect – I think chances are he’s closer to the ‘competent’ camp than the ‘deranged’ – but it’s a warning flag. Employ skepticism.

Also, as an aside, Kinesio tape was itself invented by a chiropractor and acupuncturist. Which says something.

Secondly, the mechanism of action is not particularly plausible. The tape is strong, certainly, but the way it’s applied means it relies solely on adhesion for any support it provides – and personal experience will tell you that tape on skin doesn’t take a lot of effort to remove. In fact it’ll often just part company with skin on its own. Or, to put it another way, if this tape had a strong enough grip to actually provide support in the way it’s applied, it would be removing chunks of skin when taken off. Claims that it increases circulation are mildly implausible but I’d be willing to be persuaded. Wilder vitalist claims you may hear about ‘energy’, ‘magnetism’ or ‘chi’ have their own, much deeper problems and can be discounted.

Third, the name.  Kinesiology – a strikingly similar word – is simply the study of human movement. But Applied Kinesiology crops up again and again in quackbusting circles, as a bogus diagnostic and therapeutic technique based on ‘muscle testing’. It’s often used by the quackier end of chiropractic, and was used heavily in promotion of the PowerBalance wristband, itself a sports fad which sold millions of dollars of product before being abandoned, bankrupt, as just another rip-off, leaving lots of people out of pocket. It works mainly on the ideomotor effect and any association with Applied Kinesiology should have you reaching for the pinch of salt.

None of these warnings flags are sufficient to condemn the tape in and of themselves, but their existence is a warning sign that all might not be what it seems with this tape, and that deeper investigation is warranted.

So I had a bit of a look at the evidence. A simple search on Google Scholar returns a large number of studies on the tape. However, a large proportion of the returned results seem to be coming from websites with URLs such as ‘tapingbase.info’ and ‘kinesiotaping.hk’, and yes, these studies appear to support the tape. No surprise there. Marketing 101: If you’re selling something, you don’t post evidence that disconfirms the effect you’re claiming. To trawl the rest would take a day or more of detailed reading and investigation. What I needed to find among this lot was someone who’s studied the studies – ideally a meta-analysis or systematic review.

Image: wikimedia commons

Well, I found there were several decent reviews. None appeared to be as positive as the studies they were reviewing.

The journal Sports Medicine, for example, reviewed ten research papers on the topic of this tape and concluded that no clinically important results were found to support pain relief claims, and that range of motion results were inconsistent (and therefore inconclusive). There were some positive but minor effects on strength tests and there were some inconclusive muscle activity results, but the authors concluded that the evidence was lacking overall. Later commentators on this review note that placebo effects are probably a primary driver of the positive effects noted. WebMD does a good job of explaining this in layman’s terms. As if that review wasn’t conclusive enough, there’s also this one, which concludes “There currently exists insufficient evidence to support the use of KTT over other modalities in clinical practice.”

Dr Steven Novella MD was slightly more scathing. He said  in a 2012 article for the James Randi Educational Foundation:

“Kinesio tape, in my opinion, is also an example of a common feature of pseudoscientific medical devices – they provide some small non-specific benefit that is irrelevant to the specific and elaborate application”

He also noted that the inventors of this tape have had more than thirty years to come up with good evidence – and that evidence is startlingly lacking. He underlined this when talking about Kinesio on the Skeptic’s Guide to The Universe, saying

 I don’t think athletes who are competing in the Olympics are going to have any—are going to be on that medal stand because they put this fake strips of tape down their back.

Fake strips of tape. Yup.

Incidentally, I also found a rather entertaining and detailed blog post taking apart some of the positive studies, which – surprise surprise – featured some comically bad methodology. The whole thing just smells of a classic sports scam.

So what we have, in conclusion, is a product with no good evidence at all to support therapeutic use, but with some very scant evidence to support a minor performance benefit – most likely a psychological or placebo effect. And that’s fine. We all have our little rituals that we have before racing and we know deep down that they do little other than calm our minds and ready us psychologically. If you want to stick some tape on your leg as part of your pre-race ritual, well, it’s no different from writing “Rule 5” on the back of your hand with a magic marker.

But GCN is promoting the tape as a therapeutic device, and that’s much more problematic.

Riders viewing GCN’s videos will go away with the impression that they can support and lessen actual injuries with this tape, when the studies do not support this conclusion at all.

The direct result is that riders with injuries are likely to use this tape with no actual effect, but may well believe that an effect is forthcoming. This means that at last some of these athletes will worsen their injuries, because the psychological boost they’re given will make them push harder then they would without the tape.

I therefore think it’s irresponsible of GCN to be promoting a product with no good therapeutic evidence as a therapeutic device. And I think you, the reader, should steer clear of it, unless you’re firmly embedded in the superstitious lucky-socks-and-race-number-upside-down brigade, in which case you might get some small benefit.

But don’t use it to treat injuries. Please.