Hi, I'm Ali!
I’m one of the physios from treatmyachilles.com.
Treat my Achilles is an online virtual physiotherapy service, helping people with all kinds of
Achilles problems.
Today, we're focusing on Achilles tendonitis and tendinopathy when we're answering one
of the most common questions that we get asked, which is, ‘How can we tape our Achilles
to help with pain and function?’
So, I'm going to split the video into three sections.
The first section talking about why we tape, the second about what does the research say
about taping, and the third, well, what can we actually do to help improve that pain and
that function?
So, why do people tape?
We have some evidence base that shows us why clinicians think they're taping, and we also
have anecdotal and evidence base from patients about why they think we should be taping.
So, we're talking about the patient side to things at the moment.
So, patients tend to ask us to tape because they want to speed up their recovery and get
better quicker: Number 1.
Number 2, to keep running, to keep doing their sports and to make sure their symptoms – particularly
with the Achilles tendonitis and tendinopathy, we're talking about pain – and helping decrease
that pain and symptoms when they're running.
And third, to protect it or prevent that pain and symptoms coming back again.
So why do clinicians tape?
Well, clinicians seem to look for why kinesiology taping became quite popular in the first place
and the theories behind why kinesiology taping works.
Now, notice the word ‘theory’.
These are things that were set by the manufacturers and also historical as to why people might
tape.
When we're looking at this, we're … The theory is that when you put tape onto your
skin, it lifts that skin so there's more space between that skin and the muscles and the
other tissues.
So therefore, there's more space for circulation to go through.
So, this can help with in promoting circulation, so it helps with pain modulation.
By pain modulation, we're talking about controlling that pain symptoms.
And it's also been thought that taping or K taping – kinesiology taping – can help
with knowledge about where you are in time and space, giving you sensory feedback.
So, when we put our foot to the floor, it gives us information about what that surface
is like, what position of it is in, what position the rest of our leg is in.
There's also an important one: it's the placebo effect.
And the placebo effect is that it gives patients confidence in that area; it gives the patient
the thought process that they can use it and they may move more fluidly.
And also, the patient believes that this is helping and therefore there will be less pain.
So, what does the research say about all of those reasons why we might be taping?
Well, unfortunately, it's not great.
If we look at all of the different body parts that there are research papers out there for
– not just Achilles – and we look at K-taping, there are some evidence-based papers that
say, ‘Yeah, it does work!’
and there are lots of evidence-based papers that say, ‘No, it doesn't really work!’
So, we don't have a robust evidence base to say ‘Yes, let's tape!
Let's do this!
This is the best way of helping all of these symptoms!’
What we do know is that it can be like Marmite.
So, some people hate it, and some people love it.
So, you've either got those that find it absolutely useful, and it really helps their symptoms
or those that it's made no difference to at all.
We also know from the evidence that it doesn't do any harm.
It doesn't change what's going on physiologically or pathologically within that Achilles tendon,
so, it doesn't change the anatomy, it doesn't change what's happening that caused that Achilles
tendonitis in the first place.
So therefore, it's not harming anything.
So, you're not losing anything by giving it a try.
So, let's go back to thinking about those three most important things that patients
think that we're doing to help with taping.
So, first one, speeding up recovery, second one, keeping going with my activity or sports,
and my pain is well controlled, and thirdly, to protect it and to prevent re-injury.
So the first one, does it speed up recovery?
No.
It's not changing what's happening in that Achilles tendon.
And when we look at the evidence base and anecdotally about what patients are telling
us, the best way to get you back to doing the sports and activities that you want to
do is to rehabilitate that tendon, to make that tendon more robust, to withstand the
sports and activities, your day-to-day life, and also increasing those sports and activities
if you have a goal or a challenge.
The only way to do that is to make your Achilles more robust, and it could be stronger, it
could be better at hopping and jumping, but this rehabilitation program needs to be specially
made for you.
And that's where it's important you speak to a clinician to give that to you.
Secondly, does it keep you running, keep you doing your sport, and help with pain to do
that?
Again, this is the Marmite answer.
Some people, yes, yes, it really does.
Some people, no, it doesn't.
So yes, you could try it and you could give it a go and see if you like it or not.
But equally, if we look at how much time it takes you to tape, how much cost it is to
buy that tape compared to maybe just sticking a heel raise, a heel cup, which we do have
videos on as well on our YouTube channel, I'm sure the link will be below.
If we put that heel raise in, we're taking a little bit of stretch off that Achilles
tendon.
So, you've got a higher heel-to-toe, and if that's the case, that can help reduce your
pain symptoms.
Again, it's not changing anything that's going on about recovery and healing, it's just helping
with pain.
That heel cup is much quicker to put in your shoe and you can transfer it from one shoe
to the other.
Thirdly, does it protect your injury, and does it prevent it from coming back or prevent
your symptoms from coming back?
Again, absolutely no evidence to prove this at all.
So, at Treat my Achilles, do we advocate taping?
Not really.
We want to keep as evidence-based as we possibly can to give you as best information we possibly
can.
So it's all about rehab, rehab, and a bit more rehab.
Please see our videos in regards to what that means by, what's the most effective exercises,
how long it takes for an Achilles to get better, what types of exercises are out there?
But you could use taping alongside this rehabilitation program if you're aware of what the research
is saying and you're finding it useful, there is no harm in doing that.