Over the last four weeks in the Equine Members’ portal, we have had the privilege of learning from Dr Sybille Molle some of the intricacies of using kinesiology tape in the field of Equine Sports Medicine and Rehabilitation. She dove into four specific areas where kinesiology tape can be used to improve outcomes and shared some of her favourite applications.

We discussed using kinesiology tape to address postural changes, and to target the muscle and fascia. We then moved on to discussing the use of kinesiology tape in rehabilitating tendon and ligament injuries, before discussing its use in joint disease. Finally, we looked at the use of kinesiology tape in addressing the conditions that affect foals and young horses.

Join me as I share some of my favourite take-home points from each webinar.

 

Understanding kinesiology tape

Kinesiology tape is elastic along the longitudinal length and allows a full range of motion in whichever area is taped. It can be left in place for three to five days, is breathable and waterproof, and can be used to influence the muscles, joints, fascia, lymphatics, neurological system and posture.

It is essential to consider kinesiology tape as an extension of your hands and your manual therapy interventions, as this is how you will reach the maximum efficacy with taping. It is not a modality to be used in isolation, but as a part of a multimodal approach, enabling a far longer-lasting manual effect on the tissues you have treated.

How effective you are with this modality will be determined by your knowledge and understanding of application techniques, including different cuts and tensions, and the level of training that you have received in the use of this modality.

 

Influencing fascia, muscle and posture

Postural changes are usually the first indication that something is out of balance, or that there is a musculoskeletal condition developing in an equine. These conditions may remain latent until significant damage occurs as a result of continued stress or microtrauma, while other structures are negatively impacted as a result of the changed posture in the patient. Some of the earliest signs of postural changes include lateral stiffness, an altered head carriage, resistance, and a lack of propulsion from behind.

The fascia itself can also cause changes in posture, and can further pathological movement patterns once the original pathology is resolved. For this reason, rehabilitation of the fascia together with posture and movement patterns must form part of the treatment of a pathology occurring in horses. Fascia can be affected by pain, restriction, myofascial trigger points and pathological movement patterns. As a result of its rich innervation, it can also be a cause of pain.

 

What does the literature say?

  1. When treating myofascial trigger points (something that horses do suffer from), an approach that combines manual therapy with kinesiotape is more effective than manual therapy alone at reducing pain, improving muscle stiffness, and improving the contraction amplitude of the muscle (Chao et al., 2015).
  2. The direction of the tape application will affect the outcome achieved – to facilitate a muscle, we need to tape from origin to insertion, and to inhibit a muscle, we should tape from insertion to origin (Fukui et al., 2017).
  3. In stroke patients, kinesiology tape was shown to improve pelvic inclination, muscle strength and gait ability (In et al., 2021). If we extrapolate these results, there could be multiple beneficial applications in the equine population.

 

Our goals

When using this modality on equines to address muscular, postural or fascial imbalances, our primary goal is to restore optimal muscle function. To do so, we need to consider whether the specific muscle needs to be inhibited or facilitated, whether we need to address the agonist/antagonist in the application, and at which phase of healing the muscle may be.

We must retrain motor control to successfully rehabilitate these patients.

 

Tendon and ligament injury and rehabilitation

Tendon or ligament injuries can be considered as either acute or chronic, with the most commonly affected tendons being the SDFT, DDFT and biceps brachii tendon. The most commonly affected ligaments include the suspensory ligament (either the body, branch or insertion), the accessory ligament of the DDFT, sacroiliac ligaments, or stifle ligaments. Any collateral ligaments can also be injured, with those of the coffin joint or hock most commonly affected.

An acute injury occurs as a result of excessive loading, while a chronic injury is the result of chronic overload, or in the event of a failure of an acute injury to heal.

The major problem with the rehabilitation of tendon and ligament injuries is that the tissues involved are unable to heal without losing some of their characteristic elasticity and compliance. The key to successful rehabilitation has been shown to lie in a rehabilitation programme where proprioception, motor control, joint stability and mobility are addressed.

 

An effective protocol incorporating kinesiotape

In an acute injury, pain and oedema will be present. Kinesiology tape can facilitate fluid dynamics through space creation. Avoiding compression during the initial phase of healing is important, and all techniques used should aim to facilitate space creation, facilitate fluid dynamics, reduce pain and reduce heat.

In a chronic injury, the major concern is the formation of scar tissue and fibrosis. Kinesiology tape targeting the fascia and connective tissue can be used to unbind collagen cross-linking with a selective action on fibre alignment and orientation.

Facilitation of proprioception and healthy motor control is essential as the rehabilitation of the patient progresses, and kinesiology tape can aid us in optimising muscle function and providing appropriate proprioceptive feedback.

 

What does the literature say?

  1. Kinesiology tape can form a valuable part of the conservative management of patellar tendinopathies and patellofemoral pain in short- and long-term outcomes and can improve joint alignment and patellar stability (Sisk & Fredericson, 2020).
  2. Kinesiology tape is considered a part of the multimodal treatment approach for Achilles tendinopathies (Fares et al., 2021).
  3. In patients with elbow lateral epicondylitis, kinesiology tape proved to be an effective treatment choice over four weeks, with improvements in all parameters tested, and showing superiority over other treatment protocols over four weeks (Erpala et al., 2021).

 

Our goals

When we use taping as a part of a multimodal treatment approach, we will use applications in the acute phase of injury to reduce oedema, control pain and support the local area.

In a chronic injury, we are aiming to reduce fibrosis and stiffness, as well as to optimise muscular function and restore functional movement patterns. As we progress through rehabilitation, we want to primarily support the local area while retraining proprioceptive feedback. Optimising functional movement patterns and posture is essential throughout the rehabilitation of tendon injuries.

 

Equine joint dysfunction

Degenerative joint disease is a common pathology in the equine sports industry. It can occur as a result of abnormal loading of normal cartilage, or normal loading of abnormal cartilage. In order to choose the correct treatment option, it is essential that we understand which of the components of the joint are involved. Knowing and understanding the anatomy is therefore essential, starting with the differentiation between the intra and extracellular components of the joints affected. Any component of the joint may be affected alone or concurrently with other structures.

 

What does the literature say?

  1. A review of joint disease in sports horses highlights the importance of management protocols to slow the progression of the disease with a multimodal approach (Contino, 2018).
  2. In the treatment of pain and dysfunction in patients with knee OA, kinesiology tape is an effective treatment intervention for improving range of motion, muscle function, reducing pain, and improving psychological aspects of knee OA (Melese et al., 2020).
  3. In the treatment of temporomandibular joint disorders, kinesiology tape applications that facilitate the masticatory muscles and space correction of the joint, as well as enable stabilisation, were shown to be effective. There were changes in the neck, shoulders and spine associated with postural effects and improved alignment of the TMJ (Wieckiewicz et al., 2015).

 

Our goals

When intra-articular structures are involved, there will be an increase in the amount of synovial fluid, with resultant reductions in the range of motion, joint swelling and pain. We can use kinesiology tape to facilitate fluid dynamics, reduce swelling, provide analgesia and improve proprioception.

When there are extracapsular structures involved such as the capsule, ligaments, etc., we can use kinesiology tape to provide ligament support and proprioceptive feedback, reduce fibrosis, and encourage correct joint alignment.

 

Foals

When working with foals, some of the most common pathologies we see include polydactylism, anomalies of the head, spinal malformations, hoof wall defects and lameness, hyperextension, contractural deformities, angular limb deviations, and miscellaneous orthopaedic problems.

Hyperextension is usually related to prematurity or dysmaturity and can resolve in the first few days of life. Contractural deformities usually show improvements in four to five days, and kinesiology tape can form a useful part of the treatment approach, used in conjunction with or instead of casting. Angular limb deviations are axial deviations of the limb distal to one joint. Surgical correction is generally recommended in severe cases, although kinesiology tape has shown some promise as an effective treatment intervention to avoid more invasive correction. 

Safety and efficacy are important factors to consider in the treatment of foals, especially newborns. The neuromuscular and proprioceptive systems are largely undeveloped and require a few days of life to become fully functional. Ensure that any taping applications have the intended effect on foals, and avoid over stimulating their nervous systems. Additionally, always consider your safety with a young and unhandled foal. Foals are at high risk for ingesting applied kinesiology tape, so ensure that all strips used are big enough to avoid ingestion.

 

What does the literature say?

  1. Children with proximal interphalangeal joint sprains of the fingers had better outcomes in terms of pain, oedema and joint range of motion when treated with kinesiology tape instead of splinting (Serbest et al., 2020).
  2. kinesiology tape is an effective adjunctive therapy to improve sitting ability in children with spastic bilateral cerebral palsy (Inamdar et al., 2020).
  3. The technique and mode of application will impact the efficacy of kinesiology tape applications (Hassan et al., 2020).

 

Important take-home points

  1. Less is more. In terms of the proprioceptive input and neurological feedback mechanisms, when we use less tension and thinner strips of tape, we have a greater effect on the neurological system.
  2. A deep understanding of the modality, its applications, and the pathology of the patient is essential to achieving effective and efficient outcomes.
  3. It’s not about looking pretty; it’s about being effective.
  4. If you want to be effective in your use of kinesiotape, get certified!

 

Resources

If you would like to learn more about being an Onlinepethealth member, get in touch via the chat function.

Onlinepethealth members can watch the following webinars to learn more about the use of kinesiotape:

  1. The use of kinesiology taping in equine sports medicine and rehabilitation, a four-part series with Dr Sybille Molle.
  2. A glimpse into the evolving world of equine rehabilitation: Kinesiotape and WBV, with Dr Sherry Johnson.
  3. The use of kinesiology taping in the treatment of equine back pain, with Dr Sybille Molle.
  4. Integrating kinesiology taping into equine rehabilitation: A sticky connection, with Dr Sybille Molle.

And much, much more!

If you would like to learn more about getting certified, you can learn more at the Animal Rehab Institute. 

If you would like to learn more about Hestaband, our sponsor for the series, you can find out more on their website. 

 

References

 

  1. Chao, Y.W.,  Lin, J.J., Yang, J.L. & Wang, W.T. 2016. Kinesiotape and manual pressure release: Short term effects in subjects with myofascial trigger points, J Hand Ther Sci,Jan-Mar 2016, 29(1):23-9.
  2. Contino, E.K. 2018. Management and rehabilitation of joint disease in sport horses, Vet Clin North Am Equine Pract. August edition.
  3. Fares, M.Y., Khachfe, H.H., Salhab, H.A., Zbib, J., Fares, Y. & Fares, J. 2021. Achilles tendinopathy: Exploring injury characteristics and current treatment modalities, The Foot.
  4. Fukui, T., Otake, Y., Kondo, T. The effects of new taping methods designed to increase muscle stre &th, J of Phy Ther Sci.
  5. Hassan, B.S., Abbass, M.E. &  Elshennawy, S. 2020. Systematic review of the effectiveness of kinesio taping for children with brachial plexus injury. Physiother Res Int.
  6. In, T., Jung., M., Jung, K., Cho, H. 2021. Effect of posterior pelvic tilt taping on pelvic inclination, muscle strength, and gait ability in stroke patients: A randomized controlled study, J of Clin Med.
  7. Inamdar, K., Molinini, R.M., Panibatla, S. & Dusing, S.C. 2020. Physical therapy interventions to improve sitting ability in children with or at-risk for cerebral palsy: A systematic review and meta-analysis, Developmental Medicine & Child Neurolog.
  8. Melese, H., Alamer, A., Temesgen, M.H. &  Nigussie, F. 2020. Effectiveness of kinesio taping on the management of knee osteoarthritis: A systematic review of randomized controlled trials. J Pain Res
  9. Serbest, S., Tiftikci, U., Durgut, E., Vergili, O. & Kilinc, C.Y. 2020. The effect of kinesio taping versus splint techniques on pain and functional scores in children with hand pip joint sprain, J Invest Surg. 33(4): 375-380
  10. Sisk, D., Fredericson, M. 2020. Taping, bracing, and injection treatment for patellofemoral pain and patellar tendinopathy, Musculoskeletal Med.
  11. Erpala, F.,Ozturk, T., Zengin, E., Bakir, U., 2021. Early Results of Kinesio Taping and Steroid Injections in Elbow Lateral Epicondylitis: A Randomized, Controlled Study, Medicinia
  12. Wieckiewicz, M., Boening, K., Wilnad, P., Shiau, Y., Paradowska-Stolarz, A., 2015. Reported concepts for the treatment modalities and pain management of temporomandibular disorders, The Journal of Headache and Pain

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