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I have a mild case of Posterior Tibial Tendonitis, the physio has applied some Kinesio tape for support whilst it heals up.

My understanding of tendons and muscles was that there wasn't much friction between them, if there were, moving would be a very painful experience. So, given that the tendons are lubricated via the inter-muscle membranes, how can applying tape to the skin provide any support at all to the tendons?

Thanks

Dave

NB: I'm not asking for medical advise, I trust my physio. I'm just curious.

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To clear up what I perceive as a misconception in your post - There is no friction between tendons and muscles. Tendons are what anchor muscle to bone, and they are encased in the same sheath. There may be friction/swelling between the tendon and the sheath or the muscle and the sheath, but tendon/muscle pretty much act as a single unit. – JohnP Mar 8 at 18:05
@JohnP That's right, or what I'd assumed, zero or negligible friction in a healthy person. So how can tape provide any support? – BanksySan Mar 9 at 14:16
They support the skin which supports the sheath. I am not a fan of kinesio tape, but there are others that really love it. Studies are mixed on results. One thing that I think they help with is the proprioceptive feedback (Awareness of where a limb is positioned in relation to the body without having to look at it). The tape will pull/stretch when you get towards the outer limits of where your motion should be, so it's an extra signal to the brain to not extend/flex/move as much in a certain direction. This is just my own theory, though. – JohnP Mar 9 at 14:25

3 Answers

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It's not so much support for the tendons. One of the theories behind it is that it helps lift the skin away from the structures underneath it (microscopically) which allows a little more room for swelling, which in turn helps minimize pain.

A second theory is that it acts much like rubbing an area does, which interrupts the pain signal to the brain. It is also theorized that it allows natural movement, while at the same time providing a proprioceptive feedback that helps limit the full range of motion.

Studies so far have shown no real benefit to kinesio tape, but there are people that swear by it.

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It's not lifting skin, as the skin obviously stays firmly attached to you, so it must be be contracting it. Contraction would cause 'buckling', thus any reduction in pressure in one point would be countered by an increase at another. I'm not sure the 'pulls skin away' theory holds water. – BanksySan Mar 8 at 15:15
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@BanksySan - Skin is held to the other structures by connective tissue which is loose. This connective tissue can be stretched before it starts pulling on the muscle/tendon sheath. This creates extra gaps. If skin were that firmly attached, it would be tearing constantly from various stresses. – JohnP Mar 8 at 17:29
Good answer. One day maybe they can figure out how/why it works. In the meantime, I'm one of those who swear by it :) – BackInShapeBuddy Mar 8 at 19:51
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It works for my shoulder (supraspinatus) tendinosis. It keep my shoulder in the right place and give me more strenght, also alivates pain, activate the muscule and give me more movility that improve my condition. The creator Dr. Kenso Kase assures that tape gently lift the skin and other tissue covering the muscules and that improves circulation.

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The simple answer is that it doesn't help with tendonitis. Randonmized controlled trial studies show that there are no benefits with kinesiotaping and tendonitis.

I know you do not ask for medical advice and you said that you trust your physiotherapist, but I want to ask you this question, "Why do you come up here and questioning your physiotherapist, and not asking your physiotherapist about this treatment plan right in front of him/her?"

The truth is that you need to know what causes the "mild posterior tib tendonitis - PTT in the first place?"

This can be from overtraining, bad shoe wear, poor foot alignment, tightness in the Achilles tendon and hamstrings, etc.

With this being said, the best treatment for any tendonitis is eccentric strengthening, proper training regimen to include rest and hydration, deep tissue massage, ice massage for pain management, and of course lots of flexibility.

Ask your physiotherapist again on how did you get this problem in the first place. Then go from there. Remember if the tire is low, and you keep filing it up with air, but never wonder why it was low in the beginning, then you only fixing the symptoms, not the problem. You might have to do this for a very long time if you keep thinking this way.

Hope this helps!

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I'm not avoiding questioning her, I came on here to understand the mechanics of taping. She says it was probably caused by exactly what you say, a sudden increase in training and some very old trainers. She also suggested there could be a micro-tear. – BanksySan Mar 9 at 14:20
Ahh... I can see, mechanically, how a micro-tear could benefit from tape... but not given the low friction between tendons and the surrounding tissue. – BanksySan Mar 9 at 14:23
I'm hoping that your physiotherapist will realize that kinesiotaping is another bandage when it comes to tendonitis. If not, you should realize that. However, micro-tearing applies to almost everything we do in life when it comes to sports and weight lifting: after a hard day of training (soreness), after increasing your stretching (soreness), after trying on new shoes and running new terrain (slight pain). – Trungmanator Mar 9 at 15:07
With this being said, I'm not saying that you should not try kinesiotaping. I'm just telling you that randomized controlled trials (high level research) showed no benefits regarding kinesiotaping and tendonitis. Matter of fact, you might have tendonopathy, which is 90% of the time people think that they have tendonitis. And unfortunately, you will need rest and lots of eccentric strengthening. Good luck! – Trungmanator Mar 9 at 15:09
Maybe, I was more interested in now any external taping\bandaging could provide support to the underlying tendons. – BanksySan Mar 9 at 23:14
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