1. EFFICACY OF KINESIO TAPE IN THE REHABILIATION OF SHOULDER
IMPINGEMENT PATHOLOGIES: A CRITICALLY APPRAISED TOPIC
E. Chris Lynch
Clinical Scenario: Shoulder impingement syndrome is the leading cause of shoulder pain and
second only to the low back for causes of pain in the general population3. Shoulder impingement
syndrome is particularly prevalent among athletes engaged in overhead activities such as
swimming, tennis, volleyball, throwing, golf, etc. In recent years, kinesio tape has gained
popularity as a treatment method for a variety of musculoskeletal and lymphatic pathologies,
including shoulder impingement syndrome. Examining the effectiveness of kinesio tape may
allow clinicians to treat patients with shoulder impingement more effectively or efficiently. This
may allow athletes to return to play sooner and with greater functional ability than with just
conventional treatment.
Focused Clinical Question: Is kinesio tape an effective method of treatment for shoulder impingement
pathologies?
Keywords: shoulder impingement, kinesio tape, treatment
CLINICAL SCENARIO
Shoulder impingement syndrome is the leading
cause of shoulder pain and second only to the
low back for causes of pain in the general
population3
. Shoulder impingement syndrome is
particularly prevalent among athletes engaged
in overhead activities such as swimming, tennis,
volleyball, throwing, golf, etc. In recent years,
kinesio tape has gained popularity as a
treatment method for a variety of
musculoskeletal and lymphatic pathologies,
including shoulder impingement syndrome.
Examining the effectiveness of kinesio tape may
allow clinicians to treat patients with shoulder
impingement more effectively or efficiently.
This may allow athletes to return to play sooner
and with greater functional ability than with just
conventional treatment.
FOCUSED CLINICAL QUESTION
Is Kinesio Tape an effective method of treatment
for shoulder impingement pathologies?
SUMMARY OF SEARCH,
“BEST EVIDENCE” APPRAISED,
AND KEY FINDINGS
• The literature was searched for studies of
level 2 or higher evidence that investigated
the relationship between kinesio tape and
treatment outcome measures for shoulder
impingement.
• The literature search yielded 9 results
related to the clinical question; 3
randomized control trials met the inclusion
criteria and were included.
• Of the included published articles, 2 studies
found that kinesio tape in conjunction with
therapeutic exercise were more effective
and efficient than exercise alone.
• One article observed that kinesio tape
without the addition of other therapeutic
exercises or modalities had no significant
difference compared to sham taping.
2. CLINICAL BOTTOM LINE
There is moderate evidence to suggest that
kinesio tape used in conjunction with
therapeutic exercise may significantly decrease
pain, increase range of motion, and improve
DASH scores for the treatment of shoulder
impingement pathologies after two weeks of
therapy. Athletic trainers may consider the
addition of kinesio tape to their current
treatment modules for shoulder impingement in
order to improve results.
Strength of Recommendation: Grade B evidence
exists that KT used in conjunction with exercise
can affect pain, functionality, and range of
motion significantly more than exercise alone.
SEARCH STRATEGY
Terms Used to Guide Search Strategy
• Patient group: Patients with a primary
complaint of shoulder impingement
• Intervention: kinesio tape
• Comparison: control
• Outcome: functional outcome measures
and reported pain scales
Sources of Evidence Searched
• SCOPUS
• MEDLINE/PubMed
• UpToDate
INCLUSION AND EXCLUSION CRITERIA
Inclusion Criteria
• Studies that included baseline and post-
treatment outcomes for patients with a
primary complaint of shoulder
impingement
• Studies published in the last decade (2005-
2015)
• Level 2 or higher evidence
• Limited to English language
Exclusion Criteria
• Research studies that compared kinesio
tape to a different medical intervention
• Research that was not specific to shoulder
impingement
RESULTS OF SEARCH
Three relevant published studies were located
and categorized as show in Table 1 (based on
levels of evidence, Centre for Evidence Based
Medicine, 2009).
BEST EVIENCE
The included studies (Table 2) were identified as
the best evidence and selected for inclusion in
this critically appraised topic (CAT). These
studies were selected because they had a level
of evidence of 2 or higher, included patients
diagnosed with shoulder impingement, and
examined the relationship between treatment
and recovery effectiveness.
IMPLICATIONS FOR PRACTICE, EDUCATION,
AND FUTURE RESEARCH
The three studies1,2,4
included in this CAT
examined the relationship between the use of
kinesio tape and the quality of recovery with
regards to functionality and pain. Two of the
studies1,2
used kinesio tape in conjunction with
therapeutic exercise, broad age groups (age 18-
70) with large control and treatment groups and
a strong statistical power estimate, while the
third study4
used only kinesio tape without
exercise, college-age subjects (age 18-24) and a
weaker, although still significant, power
estimate. Kaya et al found and Simsek et al both
Table 1 Summary of Study Designs of Articles
Reviewed
Level of Evidence Study Design Reference
1b RCT Kaya et al1
1b RCT Simsek et al1
1b RCT Thelen et al1
5. found that post-treatment DASH scores were
lower in the KT group than the exercise-only
group. Simsek et al also found that mid-
treatment DASH scores were also significantly
lower than the control group. While all groups
saw a significant improvement in their DASH
scores, the results indicate that the use of KT
may not only improve the results of treatment
with exercise, but may show improvements
sooner. Both studies1,2
also resulted in
significantly lower VAS scores in the KT groups
compared to the control groups. This implies
that pain, in addition to functionality may benefit
from the use of KT in conjunction with exercise.
Simsek et al found that both groups saw a
significant improvement in painless range of
motion and that only shoulder abduction saw a
significant difference between the two groups,
once again favoring the KT group. Thelen et al
also found a significant improvement of shoulder
abduction ROM with the use of KT compared to
the control group after one day of treatment.
However, when tested at days three and six, it
was found that both groups improved
significantly with no statistically relevant
difference between them. This may be explained
by the shorter treatment period, the lack of
prescribed therapeutic exercise, or the weaker
power score. It was also found post-treatment
that some of subjects of Thelen et al suffered
from labral tears and other issues unrelated to
shoulder impingement syndrome. However, this
does indicate a lack of scientific consensus at the
moment and more research is needed to clarify
questions and concerns. None of the studies
indicated negative side effects from the KT.
Future research should investigate the impact of
KT and exercise versus sham tape and exercise to
help determine if the combination of the two is
what helps provide significant improvement.
References
1. Kaya E, Zinnuroglu M, Tugcu I. Kinesio taping
compared to physical therapy modalities for
the treatment of shoulder impingement
syndrome. Clin Rheumatol. 2011;30:201-207.
PubMed doi: 10.1007/s10067-010-1475.6.
2. Simsek HH, Balki S, Keklik SS, et al. Does
Kinesio taping in addition to exercise therapy
improve the outcomes in subacromial
impingement syndrome? A randomized,
double-blind, controlled clinical trial. Acta
Orthrop Traumatol Turc. 2013;47(2):104-110.
Doi:10.3944/AOTT.2013.2782.
3. Simons SM, Kruse D, Dixon JB. Shoulder
Impingement Syndrome. UpToDate. 2014.
http://www.uptodate.com.proxyiub.uits.iu.e
du/contents/shoulder-impingement-
syndrome. Accessed April 25, 2015.
4. Thelen MD, Dauber JA, Stoneman PD. The
Clinical Efficacy of Kinesio Tape for Shoulder
Pain: A Randomized, Double-Blinded, Clinical
Trial. J Orthop Sports Phys Ther.
2008;38(7):389-395. SCOPUS doi:
10.2519/jospt2008.2791.
