C rossFit athletes arc different from average weekend warriors. They are of all sizes, ages, and athletic backgrounds. They like to train for fitness and make it a lifestyle. Unlike those who work out in a big box gym. these athletes surround themselves with like-minded individuals, which creates a cool community and "team." Unfortunately, injuries happen to all athletes who participate in physical activities. Recent literature has reported that CrossFittcrs have injury rates similar to other high-intensity activities, such as gymnastics. When CrossFitters are injured and seek care, they look for providers who help them continue CrossFitting during recovery. Many times these athletes come in to my office, and they first say. "If you tell me to stop Cross-Fitting. I will leave." To approach injuries with these athletes. I help them modify exercises so they can continue to maintain their fitness levels and continue to be a part of their "team." Modalities that help athletes continue participation but support injured structures are in high demand with this athletic population. Kincsiology tape is one of those modalities that can help athletes overcome injuries. Kincsiology tape can be used to decrease pain by stimulating the neurologic system, supporting muscle function, reducing muscle spasms, and removing congestion of lymphatic fluids1. Kinesiology tape is a commonly used intervention in the management of a number of clinical conditions, including knee pain and shoulder impingement syndrome. Taping may also aid in the facilitation and inhibition of muscle activity, repositioning of joints, injury prevention, and to improve proprioccption. After incurring an injury, the body releases chemicals that cause inflammation, such as serotonin, prostaglandin E2. his-tamine. bradykinin. and substance P. to stimulate nociceptors (nerves that earn pain sensation to the brain) to increase activity and. thus, pain perception. The presence of these chemical irritants lowers the nociceptive (pain) threshold, which causes previously innocuous mechanical stimulus to feel painful. This ocurrcncc is known as peripheral sensiti/ation. Those same chemicals cause neurogenic inflammation characterized by vasodilation of the local vessels, increased vascular permeability, pigmenting of leukocyte and vcnulcs. PMN mediated phagocytosis, and mast cell release of histaminc. serotonin, and leukotriencs. This process results in even more pain and swelling at the injury site. Additionally, a number of changes take place within the spinal cord consequent to the nociceptivc input. The result is hyperexcitability of the interncuron pool, which serves to magnify reflex ramifications, including muscle spasm via synaptic communication with the scgmcntal gamma motor neurons and sympathetic hypcractivity to the injured tissue. The sympathetic neurons in the antcromedial lateral cell column of lamina VII from Tl to L2 may result in sympathetic vasoconstriction and ischemia in varying degrees resulting in more pain. Central sensiti/ation refers to hypcrcxcitablc spinal cord reflexes developed as a consequence of continuous nociccptivc input. Nociccptivc cffcrcnts at the spinal scgmcntal level consist of type A delta and C fibers, which have conduction velocities that are considerably slower than those of mechanoreccptor effercnts and. therefore, arrive at the spinal cord later. How Kinesiology Tape Is Used Kincsiology tape can liavc an effect on the chemical and neurological effects of an injury. Kinesiology tape is cut from a roll (there are also prccut versions available) to fit the desired length. The skin is then prepped with alcohol to clean the area of any dirt or oils. The tape is applied to the skin while the desired tissue is in a stretched position. By applying the tape appropriately, convolutions are formed. These convolutions increase the space between the skin and the underlying fascia (a layer of connective tissue covering muscles), thus increasing the flow of lymphatic fluid and extracellular fluid. By allow ing more fluids to flow through the tissues, the chemicals in your body that cause inflammation do not have the chance to build up. thus reducing further chemical irritation. Not only does kincsiology tape help increase circulation and lymphatic flow to the inflamed tissue, but it also acts directly as a pain mediator. There are two proposed mechanisms for how kinesiology tape decreases pain: Pain Gate Theory: By applying kincsiology tape, it stimu lates mechanoreceptors that are located in the skin. Those mechanoreccptors synapse with interneurons located in lamina II of the posterior horn, which release endorphins and inhibit the activity of nociccptivc efferents. This inhibits further com munication with its second order neuron and inhibits central sensitization. The faster conduction velocity and endorphin release effectively close the pain gate. In essence, when the skin is stimulated with kincsiology tape, the mcchanorcccp- tor signals are traveling faster to the brain and inhibiting pain communication. Decompression: As explained above, kincsiology tape helps to slightly pull the skin and fascia away from the muscles. Not only docs this increase space for the blood and lymphatic fluids to flow, but it also helps to create more subcutaneous space to relieve pressure and irritation on the nerves. Figure 1 (below) shows how pressure on a nerve following an injury can lead to increased pain. It has been well documented that when the body is in pain, it moves unpredictably and less efficiently. Sometimes these altered movements put other uninjured tissues at risk of a compensation or overuse injury. By allowing your CrossFit athletes to get out of pain quickly and by modifying their workouts for a short period, they can continue training and maintain their fitness. In conjunction with a healthy diet and proper exercise, kincsiology tape is a great way to help your body heal quickly and properly. References: Kincsio Taping Method. Retrieved from http://\v\v\v.kinesiotaping.com/ about/kinesio-taping-method on 15 April 2014. Callaghan MJ. Selfe J. Bagley PJ. Oldham JA. The effects of taping on knee joint proprioception. Journal of Athletic Training 2002; 37: 19-24. Copping J. ODriscoll ML. Ap plication of tape on the shoulder joint: An effective therapeutic modality for the treatment of impingement syndrome? Physical Therapy Reviews 2005; 10: 231-236. Alexander CM. Stynes S. Thomas A. Lewis J. Harrison PJ. Does tape facilitate or inhibit the lower fibers of trapc/.ius? Journal of Manual Therapy Feb 2003; 8 (1): 37-41. Zanclla PW. Willcy SM. Scibel SS. Hughes CJ.The effect of scapular taping on shoulder joint repositioning. Journal of Sports Rehabilitation 2001; 10: 113-123. Kneeshaw D. Shoulder taping in the clinical setting. Journal of Bodywork and Movement Therapies 2002; 6: 2-8. Anandkumar S. Kincsio tape man agement for superficial radial nerve entrapment: A case report. Journal of Physiotherapy Theory & Practice 2013; 29(3): 232-241. Ed Le Cara, DC, PhD, ATC, CSCS is board certified in sports medicine and rehabilitation. He is a chi- ropractic clinician, educator ami on the medical advisory board for Rocklape. He provides live and online education for movement professionals at www. HealthandWellnessProviders.com. To contact him, email at drlecara@ SportsPlusBayArea.com or follow on Twitter: @drlecara. He hosts a monthly webinar demonstrating different taping applications and answers questions. Look on Google Hangouts under 'Basics ofKinesiology Taping'for his next event.
