Chapter 10 Epilogue

If you ask a patient what brings them to your clinic, or ask an athlete what stops them training or competing, they will not answer with: I think I have a problem with balance or I have too much inversion of my ankle or too much extension at my elbow. They will tell you that pain is the primary reason for their visit and, in the case of athletes, possibly a reduction in performance as well. Pain is quite possibly the most complex issue presented to any practitioner,¹ and among the most confounding presentations to treat.

The effects of tape and its ability to reduce pain are fairly well documented,^2–15 especially with regards to, but not limited to, the knee.^{2,3,7,8,10,11,13–15} Studies have been done on other areas of the body, such as the ankle, hip, shoulder, elbow, foot and even ribs.^4–6,9,12 Some researchers are looking at the effects of tape on pain in stroke sufferers.^5,16

In order for us to understand the reasons for pain reduction, we need to know the reasons for pain. This may at first sight seem simple, as in many cases the answer will be swelling of the tissues caused by trauma. During inflammation, pain is caused by chemical, mechanical and thermal irritants. Taping for this aspect of pain has already been adequately dealt with in the other sections of this book. However, this does not explain chronic pain or why many suffer discomfort long after the original injury has healed. For this we have to look to other areas for the answers. It would be a reasonable statement to say that other factors are multifactoral and therefore, by their very nature, complex. Two such theories have been hypothesized as possible reasons for maintenance of painful joints, represented by Panjabi and his hypothesis of a ‘neutral zone’^17,18 and Dye’s hypothesis on joint homeostasis.^19–21 Both are very feasible and have led to further research in these areas.

The need for pain reduction has prompted some tapers to look at other ways of obtaining maximal pain-alleviating effects by using tape. In some cases the more traditional tried and tested methods of taping may be inappropriate or contraindicated. In several cases, as the injury recovers less tape is needed to offer the same effect (limit joint range of motion and pain relief). McConnell describes a method of pain-relieving taping as ‘unloading’ and stated that: ‘tape may be used to unload painful structures to minimize the aggravation of the symptoms so treatment can be directed at improving the patient’s “envelope of function” ’.²

There are at present three primary taping techniques used: