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The influence of kinesiology tape on a functionally demanding eversion sprint
in healthy male soccer players
Chris Brogden & Matt Greig
Summary.
Tape has often been used as a means of preventing and managing sports injuries, by
restricting range of motion at a joint. However, this restricted movement impair athletic
performance and increase the risk of injury at other sites. The development of kinesiology
tape offers a purported increase in mechanical support without the restriction in joint range.
Our results show that kinesiology tape applied to the ankle complex did not impair
performance on a functionally demanding eversion sprint in healthy male soccer players.
Landing kinetics were unchanged, but there was a beneficial effect in the rate of vertical force
development in the drive phase post-amortisation, initiating the 45° sprint. Kinesiology tape,
with no observed restriction on performance in a functionally challenging and high-risk task,
is therefore advocated as a means of injury prevention where subjects have no prior history of
ankle instability. Kinesiology tape might also offer some mechanical benefits to rate of force
development, though our findings are likely to be task-specific.
Author Information:
Chris Brogden, Matt Greig PhD,
Sports Injuries Research Group, Dept. of Sport & Physical Activity,
Edge Hill University, St Helens Road, Ormskirk, Lancs L39 4QP, United Kingdom
Corresponding Auhtor: Dr Matt Greig: Tel: (+44) 01695 584848
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Fax: (+44) 01695 584812
E-mail: [email protected]
The influence of kinesiology tape on a functionally demanding eversion sprint in healthy
male soccer players
Abstract
Background: Ankle injuries are prevalent in soccer, with implications for athletic
development, performance, and subsequent risk of re-injury. Injury prevention and
management strategies have included the use of tape, but inhibiting movement can impair
performance. The aim of the present study was to investigate the influence of kinesiology
tape at the ankle joint during a functionally demanding eversion sprint. Methods: The task
required a drop landing onto a force platform, immediately followed by a 45° reactive
(inversion or eversion) sprint. 11 male semi -professional soccer players (age = 25.5 ± 5.0
years, height 1.75 ± 0.12m, weight = 74 .50 ± 8.25 kg) performed 2 trials (separated by >48
hours) of the drop landing test, with counter-balanced assignment of the taped (KT) or no
taped (NT) condition. In addition to the task completion time for the sprint, gound reaction
force measures of drop landing impact forces, amortisation period, the rate of force
development in drive phase, and the angle of takeoff were quantified. Results: There was no
influence of tape condition on ground reaction forces at impact (Fz: P = 0.24; Fx: P = 0.51;
Fy: P = 0.96) or on the duration of the amortization period (P = 0.56). KT did produce a
significant improvement in the rate of vertical force development (P = 0.02) into the sprint,
but did not change the angle of takeoff (P = 0.93) or the time to complete the task (P = 0.99).
Conclusions: Application of KT using a functional correctional technique at the ankle did not
inhibit task performance. Improvements were observed in the rate of force development, but
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the mechanism of improvement is unclear. If injury prevention is enhanced, with no
detriment to performance, then KT could be advocated for athletic performance.
Key Words: soccer, ankle, injury, force, eversion, tape
INTRODUCTION
Taping is commonly used for the prevention and treatment of sports injuries, providing the
athlete with protection and support to the muscle or joint during movement (1,2). However,
whilst effective in injury prevention and management, the restriction on range of movement
(RoM) can affect athletic performance (3) and potentially increase injury risk at other sites
(4). The development of kinesiology tapes, which exert a pulling force to the skin (5), offer
greater mechanical support and proprioceptive ability without restricting RoM (6). Whilst
much of the previous literature into the purported benefits of kinesiology tape has considered
injury prevention, our aim was to quantify the impact of kinesiology tape on a functionally
demanding, sport-specific task, in subjects with no history of previous ankle injury or joint
instability.
Soccer is a huge participation sport with a relatively high injury rate (7-11). Ankle injuries
are prevalent in soccer (12,13), with ~13% resulting in an average rehabilitation period of 14
– 28 days (7, 11-14), and a reoccurrence rate between 10-28% (13, 15-18). Hop and drop
tests have been shown to be good predictors of ankle injury risk (19-20), with landing
replicating the concurrent (21) plantar flexion and inversion of the ankle observed in 85% of
injuries surrounding the lateral ligament complex. The activity profile of soccer is
intermittent, irregular and multi-directional, comprising a variety of high risk movements
such as sprinting, twisting, turning, cutting and landing (22). A widely accepted mechanism
of an ankle sprain is the aberrant nature of ankle joint positioning upon initial contact with the
surface during the transition period from an unloaded to loaded state. This is often seen in
sports such as soccer when jumping or running (23), and the reactive nature of soccer further
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increases the mechanical complexity of such movements. Our aim was to quantify the
influence of kinesiology tape on the performance and kinetic response to a soccer-specific
drop-and-drive task.
MATERIALS AND METHODS
Inclusion criteria required players to have no injury history in the lower limb for the previous
six months, neurologic or balance disorder or chronic ankle instability as determined by the
Cumberland Ankle Instability Tool. Eleven male sub-elite soccer players (age = 25.5 ±
5.0years, height 1.75 ± 0.12m, weight = 74 .50 ± 8.25 kg) with a minimum three training
sessions and one match per week completed the study. All players provided written informed
consent in accordance with the departmental ethical procedures and following the principles
outlined in the Declaration of Helsinki.
Experimental Design
Players were tested in both a taped (KT) and no tape (NT) condition, performed in counter-
balanced order. Trials were separated by a minimum of 48 hours. All test sessions were
conducted at the same time of day to account for diurnal variation in postural stability (24).
Before tape application, the lower shank of the dominant leg was cleaned using alcohol gel,
before being thoroughly dried using a clean towel in order to allow the glue’s acrylic ability
to adhere to the skin (6). The tape was applied to the dominant limb using a corrective
application technique in accordance with the KT® application guidelines (6), shown in
Figure 1. The participant lay on a plinth in a supine position with the foot placed in relaxed
position. The first strip of tape was placed from the anterior mid foot, stretched
approximately to 115-120% of its maximal length and attached just below the anterior tibial
tuberosity over the tibialis anterior muscle. The second strip began just above the medial
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malleolus and wrapped around the heel like a stirrup, attaching just lateral to the first strip of
tape. The third strip stretched across the anterior ankle, covering both the medial and lateral
malleolus. Finally, the fourth strip originated at the arch and stretched slightly, measuring 4-6
inches above both the medial and lateral malleolus.
** Insert Figure 1 near here **
From the point of the tape application to the initiation of data collection, a period of 25
minutes was allowed in order for the tape to gain its full adhesive strength (6).
During performance of the drop landing test, participants were required to step off a 35cm
high platform (25), positioned to ensure landing was centred on the force platform (Bertec,
Columbus, USA). Upon landing players were required to react to a light stimulus and
accelerate through a set of timing gates (SmartSpeed, Fusion Sport, Australia) positioned at a
45° cutting angle from the mid-line of the force platform, at a distance of 4m. The stimulus
was triggered by the players stepping through a beam as they initiated the drop. Inversion
and eversion trials were counter-balanced, with 5 mins passive recovery between trials. Data
presented here were measured during the eversion trial, given the relevance to the mechanism
of ankle injury. The inversion trial was included to ensure a reactive task.
Performance was quantified as the time taken to complete the task. Kinetic measures at a
sampling frequency of 1000 Hz were obtained in the medio-lateral (Fx), anterio-posterior
(Fy) and vertical (Fz) movement planes. Ground reaction force data was calibrated to body
weight for each player. Analysis of the ground reaction force data enabled the measurement
of peak impact force in each direction, the duration between impact and initiation of the drive
phase, and the rate of force development during the drive phase toward the timing gate. The
resultant of the medio-lateral and anterio-posterior forces (Fxy) was used to calculate the rate
of force development along the angle of takeoff.
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Statistical Analysis
All results are reported as mean + SD, with significance set at P ≤ 0.05. Paired sample t-tests
were used to investigate the influence of taping condition for each variable. All statistical
analysis was completed using PASW Statistics Editor 18.0 for windows (SPSS Inc., Chicago,
USA).
RESULTS
The application of kinesiology tape (KT) did not inhibit task performance, with the time
taken to complete the sprint no different between trials (KT: 1.49 ± 0.11 sec; NT: 1.50 ± 0.13
sec; P = 0.99).
Figure 2 summarises the influence of kinesiology tape (KT) on the peak forces (Fx,y,z) at
impact from the drop landing. KT had no effect on peak force at impact in Fx (P = 0.51), Fy
(P = 0.96), or Fz (P = 0.24), suggesting a standardised drop landing task was completed.
** Insert Figure 2 near here **
Taping condition also had no influence on the duration of the amortisation phase (P = 0.56).
In both trials the duration from impact to initiation of the drive phase into the sprint was 0.46
± 0.22 sec.
Figure 3 summarises the kinetic measures derived from the drive phase into the eversion
sprint. The application of kinesiology tape significantly (P = 0.02) increased the rate of force
development (RFD) in the vertical plane. KT also resulted in a trend toward greater RFD in
the medio-lateral direction (P = 0.10), but less RFD in the anterio-posterior direction (P =
0.16), though these results failed to reach statistical significance at the accepted level. The
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RFD in the Fxy vector was not significantly different between trials (P = 0.56). The angle of
the Fxy vector toward the timing gates during the drive phase was also not influenced by the
tape condition (KT = 44.42 ± 8.87º; NT = 47.61 ± 15.98º; P = 0.93).
** Insert Figure 3 near here **
DISCUSSION
Kinesiology tape is a contemporary and increasingly popular method to enhance athletic
performance, prevent, manage and rehabilitate injuries. Our aim was to investigate the
effects of kinesiology tape on the performance of, and kinetic response to a novel,
functionally demanding drop-and-drive task. Specifically, we applied the tape at the ankle
joint given the prevalence of ankle sprain injuries, and used healthy participants performing a
task relevant to their sport. Tape has been used effectively to restrict range of movement
about a joint, helping to prevent or manage injury, but potentially impairing athletic
performance (3). The players were injury free, so that our aim was to investigate the
inhibitory effects of the tape on performance, given the potential benefits of tape to injury
prevention and management.
We found no change in performance of the drop-and-drive cutting sprint with kinesiology
tape applied to the ankle complex. Thus for healthy athletes the lack of any performance
impairment suggests that kinesiology tape can be advocated for injury prevention. Previous
research has shown a similar lack of inhibition, but in participants with chronic joint
instability (3). The healthy ankle used in our study presents a different context.
Our choice of task reflects the healthy status of our participants, with previous literature using
less demanding tasks given a focus on patients with chronic injuries. The drop-landing task
was incorporated into a 45° cutting sprint, functionally relevant to our chosen participants.
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Both the drop and subsequent drive elements of the task are functionally demanding, and
represent high risk. The kinesiology tape has no effect on the tri-axial impact forces,
suggesting a standardised landing technique was attained. The tape was administered in a
corrective application manner (6), in accordance with recommendations in an attempt to
enhance athletic performance. This method of taping does not aim to achieve a reduction in
ankle range of motion, but acts instead as a pre-cursor for increased mechanoreceptor stimuli
used to act as a pre-load during end of motion positions (6).
Similarly, the kinesiology tape had no performance inhibition on the time lapse between peak
impact during the landing phase, and the initiation of the drive phase. Again this suggests
equivalence in the functional performance of the task between the tape conditions. This
amortisation period between impact and drive is important for performance in the sporting
context, but also has implications for injury. It might be hypothesised that the amortization
period would be shorter with kinesiology tape, the tension from the tape creating a
stimulation of skin mechanoreceptors during active movement, and a decrease in reaction
time. The lack of performance benefit in our study might reflect the manner in which the tape
was applied, and a more mechanistic approach would be required to examine the reasons for
this. Electromyographical data might provide greater insight to the influence of kinesiology
tape on enhanced proprioceptive activity and the afferent activity to the surrounding
musculature.
Time to shift from landing to drive phase, and ultimately the time taken to complete the sprint
task were unaffected by the tape. This can be considered a positive result, indicative of no
evident performance inhibition, and thus facilitating the use of tape for injury prevention.
The kinetic response to the kinesiology tape did provide some interesting mechanistic
changes however. During the drive phase, the kinesiology tape had no effect on the angle of
takeoff, i.e. the angle of cut achieved during the drive phase immediately post-landing. The
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medio-lateral rate of force development was greater with KT applied, but the anterio-
posterior value was decreased. As such the vector in the angle of takeoff was unchanged, but
the observed benefit in the medio-lateral plane warrants consideration. The rate of force
development was statistically greater with KT in the vertical plane, this following a high
impact landing. Rate of force development has been shown to be a key predictor of athletic
ability and performance with many researchers, coaches and physicians suggesting that it
plays a key role (26). An emphasis on rate of force development is widely used across many
athletic disciplines, whether this be to improve strength and/or speed through a variety of
training mediums such as plyometric, speed, or agility training (27). Our findings suggest a
potential positive performance effect of kinesiology tape in enhancing rate of force
development. The ability to drive quickly away from a high impact landing and generate
higher medio-lateral force would benefit many athletic contexts.
Naturally our findings are specific to the nature of the task used, with a short 45° sprint
initiated from a drop-landing task. The reactive nature of the task also increases the
complexity and mechanical demand of the movement (28). Future research should consider
the nature of the tape, the manner of application, the functional task(s), and more mechanistic
measures of performance and mechanical response. Soccer players land in an uncontrolled
and unpredictable manner, from a variety of different heights and respond to stimuli in
multiple different directions. We conducted the study from one height with a pre-determined
angle of the speed timing gates at 45º. Injury incidence in soccer increases with match-time,
so that more ankle sprain injuries are observed in the last 15mins of each half (11). Several
studies have highlighted fatigue-induced changes in dynamic balance with soccer-specific
fatigue (29), and the efficacy of kinesiology tape as a means of mediating fatigue warrants
consideration. The effectiveness of tape in restricting joint movement has been shown to be
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time dependent (30), and thus the benefits of kinesiology tape might not extend to the
duration of the full match.
CONCLUSION
Application of Kinesiology Tape using a functional correctional technique at the ankle did
not inhibit performance on a functionally challenging reactive eversion sprint. No changes
were observed in the direction of cut, or the time taken to complete the sprint. Improvements
were observed in the rate of vertical force development in the takeoff phase of the sprint, but
the mechanism of improvement is unclear. If injury prevention is enhanced, with no
observed detriment to performance then KT can be advocated for athletic performance.
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LEGENDS TO FIGURES
Figure 1. Application of Kinesio Tape, numbered according to order of application.
Figure 2. The influence of kinesiology tape (KT) on the rate of force development (RFD)
during landing.
Figure 3. The influence of kinesiology tape (KT) on the rate of force development (RFD)
during the drive phase of the eversion sprint.
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z y x0
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NTKT
Planes of Movement
RFD
(BW
·s-1)
Figure 2. The influence of kinesiology tape (KT) on the rate of force development (RFD)
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z y x xy0
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NTKT
Planes of Movement
RFD
(BW
·s - 1
)
*
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