During my time at school, I was taught that McConnell taping was used for patella femoral pain syndrome (PFPS). I was taught that it worked by changing the positioning of the patella during knee flexion and extension by drawing the patella more medially within the patella-femoral groove, making up for a weak VMO. However, after treating many patients without the aid of patellar taping, I began to become skeptical (in my opinion there were too many factors that played into the taping procedure which could make it “work” or “not work”). I recently came across this article which both confirmed my thoughts, but also confirmed that there may actually be benefits to patellar taping.
Click the following link to access the free article.
Christou, Evangelos A. Patellar taping increases vastus medialis oblique activity in the presence of patellafemoral pain. J of Electromyography and Kinesiology 14 (2004) 495-504.
Discussion – Obviously there are a few limitations to this study, just like most studies, the first of which being the subjects are only women; therefore if you adhere to the rules of research strictly, you cannot apply the outcomes of this study to men (due to different Q angles, quad to hamstring strength ratios, etc). There are also only 30 subjects. Finally, to assess EMG activity, a surface EMG unit was used instead of an intramuscular unit.
I am a fan of this study for the most part. I believe that the study draws some great conclusions. Mainly, that patellar taping (McConnell Taping) has more of a placebo effect than anything. Even when pulling the patella laterally, patients with PFPS have decreased pain and increased VMO activation within the study parameters. This completely contradicts the theory that patellar taping changes the position of the patella during flexion and extension of the knee. Like I said earlier, this study does support the use of taping, because subjects with PFPS who received medially oriented taping have the most significant pain decreases and EMG activity increases within the study. However, similar results in the placebo group and lateral glide group lead researchers (and myself) to believe that taping actually works because of neurological pain modulation (like Transcutaneus Electro Nerve Stimulation -TENS-)and/or that the tape provides medial support to structures like the retinaculum or medial patella femoral ligaments.
If you use patellar taping (McConnell Taping) I suggest you read this article, or at least read from the results section onward. Like I said, this article confirms my thoughts that taping may not work the way it should, BUT it does confirm that taping can be used to increase VMO activation AND decrease pain; therefore, I must see the use of taping as beneficial (even with such a small sample size).
Please leave your comments with personal experiences with taping, or even with the use of a tracking brace.
I am a trained Physio therapist (UK). I suffered a posterolateral corner injury 16 months ago, with avulsion fracture fibular head, extensive anterior medial compartment bone bruising and partial tear ACL. Rehabilitating this injury has been difficult, as I have been left with some hyperextension and varus laxity. I have been using an extension block knee brace and am trying to wean myself off it. I have had problems with anterior knee pain lateral to the patella tendon, with patellar tendonosis on MRI. This pain has limited my ability to walk for longer than 15 mins. My Physio suggested trying patellar taping. I have been taping my patella with a medial pull across. This has improved my function without the knee brace. It gives me an extra 10 minutes of walking time. It also makes it easier to do closed chain vmo strengthening exercises. I have been using the tape for 6 weeks and am now able to walk about 30mins with no knee brace.
http://www.ncbi.nlm.nih.gov/pubmed/18163413 has a review of a bunch of studies on the subject. Seems to indicate that there is a real effect.
I got a lot of relief from patellar taping back in 1992 or so after injuring myself doing a running slide on my knees repeatedly for a role in a play.
Many years later, I seem to have reinjured myself biking up steep hills too much. I kind of loathe the idea of taping again, it was such a production every time. Any opinion on FabriFoam’s KneeGard product ($30 at medco)? It lets you do something like patellar taping, but with reusable nylon/lycra/foam “tape” so you don’t have to use up a bunch of tape. I may try it out and report back.
Sorry for the delay in response here. I find it hard to argue with the results of the studies, although having not read them all I do not know the quality of the studies. I’m not really saying that patellar taping does ont work. I agreeing with the study I reviewed that taping works, but almost ALL taping works. So although this study says that medially directed tape jobs help more than sham jobs, and the study I reviewed also does (here’s the excerpt from my post);
“Like I said earlier, this study does support the use of taping, because subjects with PFPS who received medially oriented taping have the most significant pain decreases and EMG activity increases within the study. However, similar results in the placebo group and lateral glide group lead researchers (and myself) to believe that taping actually works because of neurological pain modulation (like Transcutaneus Electro Nerve Stimulation -TENS-)and/or that the tape provides medial support to structures like the retinaculum or medial patella femoral ligaments.”
this article states that almost all tape on the knee decreased pain in some form or another.
As far as the fabrifoam kneeguard goes, I have not tried it out, but have used similar braces like the Shields patellar stabilizing brace with minimal success. For me, tape has the best outcomes.
http://www.ncbi.nlm.nih.gov/pubmed/18163413 may be of interest; it reviewed a bunch of studies, and concluded that taping was somewhat effective.
I personally found it effective back in 1990 or so (injured myself doing running slides on my knees for a role in a play). I recovered after a year or so and was painfree, but shied away from heavy biking for a long time. Recently I reinjured myself by biking too hard up steep hills. I’m tempted to try fabrifoam’s kneegard instead of real tape this time, seems less messy. Have you tried it yet?