Some Quick Thoughts on Taping for Patellofemoral Pain
As clinicians, we all want to help people. It feels good to help people. We do what we can to accomplish that goal.
Patellofemoral Pain Syndroms (PFPS) is known as “runner’s knee”. Knee pain is by far the most common location of pain for distance runners and PFPS is by far the most common type of knee pain in runners. In other words, we see it often.
There are many, well researched, effective ways to treat PFPS including quad, gluteal and core strengthening. There are many systematic reviews covering this (see here, here, here and here). Training errors also play a large role in developing this pain and shoe choice has a large role as well (see here).
However, I don’t want to explore all of that in this brief blog post. I only want to talk about taping for PFPS. If it is true that, as clinicians, we want to do what we can to help patients, why not do some taping as well? After all, taping helps reduce pain as well as alter the patellofemoral joint mechanics, so of course we should. Or…..does it?
McConnell taping is used ostensibly to change the patellar medial glide, medial tilt, anterior tilt or rotation. Most studies have been performed in non-weight bearing (here, here and here), which obviously is not practical. Even then, the results are mixed as to whether taping makes any difference as to the patellar positioning. More recently, a better study was published comparing the patellar positioning whilst in 0°, 20° and 40° of weight bearing knee flexion (patellar position was evaluated by MRI). Three different conditions were used – no taping, McConnell taping and Kinesiotaping. Patellar positioning was the same in all three condition, In other words – taping with Kinesiotape of rigid McConnell tape DOES NOT alter the position of the patella in any positional sense, or with contact area.
A 2015 recent systematic review concluded, “The findings of this review demonstrate that there is currently inadequate evidence for the effect of McConnell taping on biomechanics and muscle activation in individuals with anterior knee pain. This necessitates the questioning of the routine use of patellar taping in clinical practice.”
I often hear the argument – “OK, fine. It doesn’t change the biomechanics, but at least it helps reduce pain.” Well…does it? This 2012 Cochrane review would argue “No”. They concluded, “A meta-analysis of the visual analogue scale (VAS) pain data (scale 0 to 10: worst pain), measured in different ways, from four trials (data from 161 knees), found no statistically or clinically significant difference between taping and non taping in pain at the end of the treatment programmes”
However, let’s pretend that you don’t want to believe that meta analysis. In other words, let’s pretend for a minute that taping actually DID reduce pain; My question is, “Why would you take a runner with PFPS, and try to mask their pain when they run?” I suppose there is a situation where the runner/patient has really, really important race that they are adamant about running. However, for everyday training, I would argue that they are doing themselves a disservice by continuing to run without changing their listening to their body, even if you already have them changing training habits, changing footwear or performing rehab exercises.