Origin to Insertion or Insertion to Origin: Does it Matter?

I recently had the opportunity to attend an equine medical kinesiotape certification course hosted by Gilvarry Equine Rehab and Spa and Vetkin Equine tape. It was amazing to spend four days with a group of individuals passionate about learning, and to extend my hands-on skills with the use of kinesiotape (one of my favorite tools in my toolbox.)

One of the questions that came up for me was whether the direction of application truly changes the efficacy of the kinesiotape, when we are specifically applying it to a muscle to facilitate it or to inhibit that muscles function. 

To get a better understanding of this subject, I decided to supplement my knowledge by diving into Google Scholar and having a look at the research published in this area.

Join me as I explore the research and answer this question for myself!

Note: We will be discussing human research publications as there is currently no research that addresses this question in the canine or equine industry. This review excludes all other kinesiotape applications, such as for fluid dynamics, fascial release, pain reduction or proprioceptive facilitation. It focuses only on muscle applications that aim to facilitate or inhibit the function of a muscle.

Directional applications

We start with the preconceived idea or guideline that in humans:

• distal to proximal (D-P) applications inhibit muscle function;
• proximal to distal (P-D) applications facilitate muscle function.

And when the same theory is adapted to dogs and horses:

• insertion to origin (I-O) applications inhibit muscle function;
• origin to insertion (O-I) applications facilitate muscle function.

An application that goes across the muscle in a different direction should not affect the muscle’s activation or tone.

Muscle strength

In our first study – a double-blind, placebo-controlled crossover trial, 19 healthy participants underwent a gastrocnemius application and a sham application. In this study, they found that with the experimental group, there was a slight increase in EMG activity, but no significant difference in muscle tone and extensibility, or muscle strength (Gómez-Soriano et al., 2014).

In a repeated measures study with 16 students, the peak force of the biceps muscle was measured after three different KT applications: P-D, D-P, two horizontal stripes, and a control. A 30% stretch was applied.

Interestingly, the peak force increased after the application of the horizontal stripes but was no different after the P-D or D-P applications when compared to the control (Vered et al., 2016).

In a crossover study including 18 people, P-D (O-I) and D-P (I-O) applications of the quadriceps muscle were applied with one week between applications. Peak torque of the quadriceps was measured before and after each application. A 20% to 25% stretch was applied.

In this study, the peak force increased from the control to the kinesiotape applications in both group, regardless of the direction of application (Choi et al., 2018).

In a randomised controlled trial with 32 participants, P-D (O-I) and D-P (I-O) kinesiotape application directions were tested at three different degrees of stretch at 24-hour intervals. They evaluated both muscle strength and range of motion with 0%, 10% and 75% stretch.

There was no statistical change in rectus femoris strength or knee range of motion either directly after application or 24 hours after application in this study in either of the directional applications or the different levels of stretch (Lemos et al., 2018).

In another study, 39 participants were divided into three groups – a control group, a facilitation application group (O-I), and an inhibition application group (I-O). In this study a device was used to measure muscle tone in a resting state, the elasticity of the muscle (represented by the muscle’s ability to recover its shape after a contraction), and stiffness (measured by the muscle’s resistance to contraction). Kinesiotape was applied to the flexor muscles of the wrist and fingers with 20% stretch.

They found that a facilitatory application resulted in a statistically significant increase in muscle tone, stiffness, and elasticity from the baseline measurements (Lopes et al., 2022).

While this sounds positive, here is the caveat: The researchers used a device called the MyotonPRO to measure muscle tone, stiffness, and elasticity. The MyotonPRO is a handheld device that applies a brief mechanical impulse to the skin overlying a muscle and records the muscle’s response, providing quantitative data on its mechanical properties. For that reason, the results of this study cannot be considered alone as evidence that functional muscle contraction will be facilitated as a result of an O-I kinesiotape application (Cai et al., 2016).

In a systematic review titled Facilitatory and inhibitory effects of Kinesio tape: Fact or fad? published in 2016, the authors conclude there is limited evidence to support the notion that kinesiotape applications either facilitate or inhibit muscle function.

In 2023, another group of researchers aimed to answer this question in a randomised controlled trial. 32 participants were divided into two groups: an O-I group and an I-O group. Both applications were applied with 0%, 10% and 75% tension at 24-hour intervals. EMG values were used to measure muscle activity of the rectus femoris. 

They found that both applications increased EMG values, with the O-I application being superior, especially at 24 hours after application with 10% stretch (Lemos et al., 2023).

In a repeated measures study where each participant acted as their own control, 21 healthy men underwent O-I and I-O applications at 0%, 10% and 40% stretches of the quadriceps muscles. They measured passive joint repositioning errors as well as maximum concentric and eccentric peak torque of the quadriceps muscles.

In this study, an I-O at 0% tension application significantly decreased passive joint repositioning errors, but no application resulted in a change to the peak torque of the muscle, either eccentrically or concentrically (Mohammadi et al., 2024).

In a systematic review and meta-analysis performed in 2024, Stocco et al. concluded that kinesiotape was not able to improve lower limb muscle strength in athletes either with or without musculoskeletal injuries (Stocco et al., 2024).

Conclusion

Based on the above studies (which do not constitute a complete review of the literature but do include some systematic reviews), I maintain my biased opinion that the direction of application of kinesiotape from O-I or I-O of a specific muscle does not necessarily have an inhibitory or facilitatory effect. 

However, that does not mean that KT is not an effective tool – I just don’t think this ‘activation of the muscle’ is where we are getting the true effect.

To apply this information to our equine or canine patients: I do not believe there is strong enough evidence to support this specific application in humans, and therefore I do not believe that there is enough cause to use these specific applications in animals, either. Of course, to really know, we would need to conduct EMG-based studies on horses and dogs performing therapeutic exercises with the different kinesiotape applications.

A few of the studies above looked at outcome measures that showed an improvement. These were linked to the nervous system or proprioceptive system. This is certainly an area I would like to explore further in the available literature.

References

• Cai, C., Au, I. P. H., An, W. & Cheung, R. T. H. (2016). Facilitatory and inhibitory effects of Kinesio tape: Fact or fad? Journal of Science and Medicine in Sport, 19(2), 109-112. ISSN 1440-2440, https://doi.org/10.1016/j.jsams.2015.01.010.
• Choi, Im-Rak PT, Lee, Jung-Hoon. (2018). Effect of kinesiology tape application direction on quadriceps strength. Medicine 97(24): p e11038, June | DOI: 10.1097/MD.0000000000011038
• Gómez-Soriano, J., Abián-Vicén, J., Aparicio-García, C. Ruiz-Lázaro, P, Simón-Martínez, C., Bravo-Esteban, E. & Fernández-Rodríguez, J. M. (2014). The effects of kinesio taping on muscle tone in healthy subjects: A double-blind, placebo-controlled crossover trial. Manual Therapy, 19 (2), 131-136. ISSN 1356-689X, https://doi.org/10.1016/j.math.2013.09.002.
• Lemos, T.V., De Souza Junior, J.R., Dos Santos, M.G.R. et al.(2023). Kinesio Taping™ effects with different directions and tensions on the muscle activity of the rectus femoris of young adults with a muscle imbalance promoted by mechanical vibration: a randomized controlled trial. Bull Fac Phys Ther 28(33). https://doi.org/10.1186/s43161-023-00143-w
• Lopes, M., Torres, R. Romão, D., Dias, M, Valério, S., Espejo-Antúnez, L, Costa, R. & Ribeiro, F. (2022). Kinesiology tape increases muscle tone, stiffness, and elasticity: Effects of the direction of tape application. Journal of Bodywork and Movement Therapies, 30, 176-180. ISSN 1360-8592, https://doi.org/10.1016/j.jbmt.2022.01.003.
• Mohammadi, M. , Ghotbi, N., Ranjbar, P., Malmir, K., Rezaeian, T. & Bahadorifar, H. (2024). Immediate effects of kinesiology tape on quadriceps muscle peak torque and knee joint repositioning error in healthy males: Effects of different tensions and directions. Journal of Bodywork and Movement Therapies 39, 57-62. ISSN 1360-8592, https://doi.org/10.1016/j.jbmt.2024.02.048.
• Stocco, R. M., Ferreira Tsunoda Del Antônio, A. N., Gonçalves de Oliveira, R, Parreiras, S. O., Carvalho Andraus, R. A. (2024). Does kinesio tape alter muscle strength in athletes? Systematic review and meta-analysis. Journal of Bodywork and Movement Therapies, 38, 593-604. ISSN 1360-8592, https://doi.org/10.1016/j.jbmt.2023.11.023.
• Thiago V. L., De Souza Júnior, J. R., Dos Santos, M. G. R., Rosa, M. M. N., Cardoso da Silva, L. G., Matheus, J. P. C. (2018). Kinesio taping effects with different directions and tensions on strength and range of movement of the knee: A randomized controlled trial. Brazilian Journal of Physical Therapy, 22(4), 283-290. ISSN 1413-3555, https://doi.org/10.1016/j.bjpt.2018.04.001.
• Vered, E., Oved, L., Zilberg, D. & Kalichman, L. (2015). Influence of kinesio tape application direction on peak force of biceps brachii muscle: A repeated measurement study. Journal of Bodywork and Movement Therapies, 20(1) 2016.