The most common causes of knee pain are related to aging, injury, repeated stress, over-use, over-weight and under-use of the knee. Common knee problems include sprained or strained ligaments, cartilage tears, tendonitis and arthritis.
Knee pain affects approximately 25% of adults, and its prevalence has increased almost 65% over the past 20 years—accounting for nearly 4 million primary care visits annually, according to The American Academy of Family Physicians Foundation.
How to Tape a Knee: The Role of Tape
Taping to support the knee has been around since the early 1970s, and to date has a slew of research studies indicating it has benefits. In terms of understanding and documenting taping’s benefits, we want to use the best external evidence possible, while using our own individual clinical experience.
I recommend doing your own research by documenting each case, getting feedback from clients, measuring the area, and taking photos before and after.
Tape does not replace the need for manual therapy, strengthening, exercises or stretching, but it does assist in daily activities, sports and in the recovery process of healing from an injury. Taping is non-invasive, non-surgical and non-pharmaceutical, so for the most part you can do no harm.
Looking at the massage therapists’ scope of practice, there are a few considerations. Are you able to assess dysfunction? Are you able to provide the recommended exercises to strengthen or stretch? Proper evaluation of the underlying cause is critical to the success of the taping technique applied.
Strip Selection: Can be applied in the shape of a I, Y, X, Fan, Web and Donut. The most common are I, Y and Fan. (How to properly cut and apply tape is covered in CE classes.)
Y Technique is best used to facilitate or inhibit muscle stimuli and should be approximately 2 inches longer than the muscle origin to insertion and applied surrounding the muscle.
I Technique is used in place of Y strip for acute injured muscle to facilitate or inhibit muscle, limit edema and pain, and is applied directly over the injured or painful area.
Tape direction: the tape will recoil to where you anchored it first.
• Insertion to origin to inhibit the muscle or decrease spasm
• Origin to insertion to facilitate the muscle contraction and enhance circulation
Using this principle to tape for knee dysfunction:
• Inhibit overly tight quadriceps or hamstrings or facilitate a weak one.
• You could change excessive pronation of the feet that can cause the knees to rotate internally and causing the patella tendon to pull in the wrong direction.
• You could facilitate a weak gluteus medius muscle that allows your thigh to rotate and pull inwards abnormally, putting excessive stress and strain around your knee joint and patella.
Note: Most applications will have 25-35% tension. Once you go beyond 50% tension, the tape loses its ability to recoil effectively.
How to Tape a Knee for Patella Tracking Syndrome
We can use a Y technique so we can assist in the reduction of edema and pain by providing a proprioceptive stimulus through the skin, requiring the surrounding tissues to normalize skin tension. Patella tracking syndrome is a chronic, degenerative condition that gets worse with increased activity.
Improper patella tracking is one of the most common things to see and should have a proper evaluation of the underlying cause.
• Superior -tracks patella superior. Client position: Hip extension and knee flexion. Client position: hip and knee flexion. Anchor 2 inches above patella or higher on rectus femoris. Apply 15-25% tension to the tails around the medial and lateral borders of the patella. Lay down the ends with no tension on and overlapping the tibial tuberosity.
• Inferior Y-tracks patella inferior. Inhibits quads. Client position: hip flexion, knee extension. Anchor just below tibial tuberosity. Change client position: Hip and knee flexion. Apply 15-25% tension to medial and lateral border of patella. Lay ends with no tension and rub adhesive.
• Medial Y-Tracks the patella medially. Client knee extension. Anchor on medial side with no tension and rub adhesive, hold to maintain no tension. Client knee flexion. Apply tension at 25% tension over superior and inferior border of patella. Lay down ends with no tension and rub adhesive.
• Lateral Y-Tracks the patella laterally. Client knee extension. Anchor on lateral side with no tension and rub adhesive, hold to maintain no tension. Client knee flexion. Apply tension at 25% tension over superior and inferior border of patella. Lay down ends with no tension and rub adhesive.
How to Tape a Knee for Anchoring in the Middle
For Osgood-Schlatter disease and Sinding-Larsen-Johannson Syndrome (Stress injuries of patella tendon), or pain:
1. Client leg is extended. Anchor in center, on Tibial tuberosity and apply 50% tension. Lay down ends with no tension and rub adhesive. Taping: Horizontal I.
2. Client leg should be at 20- to 30-degree flexion. Anchor below tibial tuberosity and apply 25% tension superior. Lay down ends with no tension and rub adhesive. Taping: Vertical I.
How to Tape a Knee for Hyperextension Prevention
Hyperextension prevention-Client positioned prone with 30-degree knee flexion. Anchor in middle with 50% tension. Lay down ends with no tension and rub adhesive. Taping: Vertical I.
Combining Strip Techniques
Patellar tendonitis/general pain: pain in the knee at the attachment of the patellar tendon to the kneecap (patella). Taping: superior, or inferior, Y (depending on which way you want to track the patella combined with a Center I.
Applied Knowledge:
Patella Femoral Syndrome is prevalent among young female athletes.
Causes:
• Weak quads/adductors
• Prolonged Sitting
• Q-angle
• Flat foot medial rotation of tibia
• Tight hamstrings/IT band
• Dysfunction of hip external rotators
• Overload/overuse
Massage therapy and facilitated stretching of the hamstrings; cupping or IASTM on the area is also beneficial.
Client/PT: Strengthen the quadriceps (VMO) and the adductors and hips.
Taping: Combine Superior Y, Medial Y, and a Center I
How to Tape a Knee for Lymphatic Drainage
Lymphatic drainage uses a fan technique: The muscle is in a stretched position with anchors closest to lymph nodes with no stretch in the tape.
Taping: Shown here, fan technique for post-surgical total knee replacement. Concept of how it works: the lifting motion of the tape creates a space between the top layer of skin and the underlying tissues, movement that initiates the repair phase that is necessary, and cools to prevent damage the tissue.
Showing results two days after taping an injury.
How to Tape a Knee for Excessive Pronation
Taping may be used to correct excessive pronation. Taping:Anchor or tibialis anterior and apply 25% stretch under arch, so recoil supports supination.
After Care: Heat-activated adhesive in the tape takes approximately 20 minutes to gain full strength. Avoid vigorous activity during this time and remove if allergic reaction is starting or if pain increases or it is simply not helping them after this trial period. After that, they can leave tape on for three to five days, and it is OK to bathe and swim while wearing it.
Contraindications to Taping
• Severe allergic reactions to adhesive tape
• Open wounds
• Presence of deep vein thrombosis (DVT)
• Infection
• Altered sensation/uncontrolled diabetes
• Active cancer
About the Author
Tammy Roecker has been a licensed massage therapist for 30 years and is the president of the Arizona School of Medical Massage and Wellness, in Arizona. She is an Alliance for Massage Therapy Education (AFMTE)-certified Massage and Bodywork Educator, and was honored as the AFMTE 2019 Continuing Education Provider-Educator of the Year.