Journal of Bodywork & Movement Therapies 22 (2018) 700e706

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Journal of Bodywork & Movement Therapies

journal homepage: www.elsevier.com/jbmt

MYOFASCIAL PAIN AND TREATMENT: RANDOMIZED, SINGLE-BLINDED, CONTROLLED STUDY

Short-term effects of kinesio taping on trigger points in upper

trapezius and gastrocnemius muscles
Leonid Kalichman*, Inbar Levin, Itzhak Bachar, Elisha Vered
Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-
Sheva, Israel

a r t i c l e i n f o a b s t r a c t

Article history: Background: Kinesio taping is a possible therapeutic modality for myofascial pain, nevertheless, very
Received 3 June 2017 scarce research has been performed on this subject.
Received in revised form Objective: To evaluate the immediate and short-term effect of kinesio taping application on myofascial
6 November 2017
trigger points (MTrPs) and pressure pain thresholds (PPTs) in the upper trapezius and gastrocnemius
Accepted 12 November 2017
muscles.
Methods: Two randomized, single-blinded, controlled trials were simultaneously executed on the upper
Keywords:
trapezius and gastrocnemius muscles. Different participants in each study were randomly assigned to an
Kinesio tape
Physiotherapy techniques
active intervention (N ¼ 15) or control (N ¼ 15) group. Kinesio taping was applied on the gastrocnemius
Myofascial trigger points or upper trapezius muscles by positioning three “I” strips in a star shape (tension on base) directly above
Randomized controlled trial the MTrPs in the active intervention group and a few centimeters away from the MTrPs in the controls.
Results: The second evaluation on both sides showed lower PPT values than the first evaluation in the
control group, denoting that the spots were more sensitive. The third evaluation showed even lower
values. The active intervention group showed a contralateral side pattern similar to the controls. How-
ever, on the side of the kinesio taping application, the PPT values of the second evaluation were higher
(the spots were less sensitive) and after 24 h returned to the original values. The difference between the
PPT measurements on the MTrPs’ side of the active intervention group vs. the controls (time-group
interaction) was significant (F (2,56) ¼ 3.24, p ¼ 0.047).
Conclusions: We demonstrated that a kinesio taping application positioned directly above the MTrPs may
prevent an increase in sensitivity (decrease in PPT) immediately after application and prevent further
sensitization up to 24 h later. The fact that two different muscles were similarly affected by the kinesio
taping application, confirmed that the results were not in error. Further studies are needed to directly
test the effect of a kinesio taping application on post-treatment soreness.
© 2017 Elsevier Ltd. All rights reserved.

1. Introduction in the upper trapezius and gastrocnemius muscles (Grieve et al.,

Myofascial pain is a common form of pain arising from muscles
or related fascia, usually associated with myofascial trigger points
(MTrPs) (Halski et al., 2015). MTrPs are highly localized, hyperirri-
table spots found on a palpable, taut band of skeletal muscle fibers
(Fischer, 1987; Kalichman and Vulfsons, 2010), possibly causing
allodynia at the site. They may also be associated with peripheral
and central sensitization (Grieve et al., 2013). MTrPs are often seen
* Corresponding author. Department of Physical Therapy, Recanati School for
Community Health Professions, Faculty of Health Sciences, Ben-Gurion University
of the Negev, POB 653, Beer Sheva, 84105, Israel.
E-mail address: kalichman@hotmail.com (L. Kalichman).
2013; Halski et al., 2015). Several techniques have been proposed
to treat myofascial pain, including manual therapy (myofascial
release, massage, neuromuscular techniques), psychosocial in-
terventions (educational programs, behavioral cognitive therapy,
autogenic training), general exercises and therapeutic modalities
(ultrasound, interferential therapy, transcutaneous electrical nerve
stimulation, pulsed shortwave therapy and laser therapy) (Halski
et al., 2015; Wu et al., 2015). Invasive treatment includes dry
needling, injections of local anesthetics, corticosteroids and botu-
linum toxins (Halski et al., 2015; Sciotti et al., 2001).
Recently, Wu et al. suggested Kinesio taping as a possible ther-
apeutic modality for myofascial pain (Wu et al., 2015). Kinesio
taping is a therapeutic taping technique developed by Dr. Kenzo

https://doi.org/10.1016/j.jbmt.2017.11.005
1360-8592/© 2017 Elsevier Ltd. All rights reserved.
 L. Kalichman et al. / Journal of Bodywork & Movement Therapies 22 (2018) 700e706
Kase (Japan, 1979). The exact mechanisms of kinesio taping are
unknown, but there is evidence that kinesio taping may improve
blood circulation and lymph flow and increase tissue mobility and
healing rates (Shim et al., 2003; Wu et al., 2015; Yoshida and
Kahanov, 2007), hence kinesio taping, can theoretically be useful
in treating people with musculoskeletal problems (Kalron and Bar-
Sela, 2013; Montalvo et al., 2014). Chao et al. assessed the effects of
manual pain release and the combined use of manual pain release
and kinesio taping on pain intensity, pressure pain sensitivity,
muscle stiffness and EMG signals in subjects with upper trapezius
MTrPs. Both groups showed similar improvements in pain intensity
after an intervention. A follow-up evaluation of a manual release
plus kinesio taping treatment group demonstrated a greater effect
on muscle stiffness and contraction amplitude (Chao et al., 2016).
Nevertheless, very little is known at present as to the influence of
kinesio taping on myofascial pain. The aim of this study was to
evaluate the immediate and short-term effect of kinesio taping on
MTrPs’ pressure pain threshold (PPT) in the upper trapezius and
gastrocnemius muscles.
2. Methods
2.1. Study design
Two parallel randomized groups, single-blinded, sham-
controlled trials (one evaluating the upper trapezius and one the
gastrocnemius muscles) were simultaneously performed.
2.2. Setting
Department of Physical Therapy, Recanati School for Commu-
nity Health Professions, Faculty of Health Sciences at Ben-Gurion
University of the Negev, Beer-Sheva, Israel.
2.3. Sample
Apparently healthy physical therapy students, males and fe-
males, (without known chronic or acute diseases) were asked to
participate in the study. Participation was voluntary. Students were
not compensated for their time.
2.4. Inclusion criteria
 Men and women aged 18e35.
 Good general health (no chronic diseases).
 No active trauma disorder in the lower limb or shoulder/neck.
 The presence of at least one MTrP in the upper trapezius and/or
gastrocnemius muscles.
2.5. Exclusion criteria
 Any neurological conditions or active systemic diseases (dia-
betes, peripheral vascular disease, cancer, rheumatoid arthritis)
impairing sensation/pain perception.
 A fracture that had reduced the normal ankle and shoulder
range of motion within six months prior to study recruitment.
 Pregnancy
 Sensitivity to kinesio taping.
 Scars in the taping area during the acute phase. Skin sensitivity
and fungal infection in the taping area.
701
2.6. Sample size estimation
Calculations were performed using the PS Power and Sample
Size Calculation (version 3) software. Our main outcome measure
was PPT, a continuous variable. The ratio of active intervention
subjects to controls was 1:1. In a previous study (Pecos-Martin
et al., 2015), the response within each group was normally
distributed with a standard deviation of 0.6. If the true difference in
the experimental and control means is 0.8, 10 active intervention
and 10 control subjects are needed to reject the null hypothesis
with power equal to 0.8. The Type I error probability associated
with the null hypothesis was 0.05. We recruited 30 different sub-
jects for each study, 15 to the controls and 15 to the intervention
groups. For the upper trapezius muscle study, we recruited two
additional subjects. In total, 62 students were recruited.
2.7. Ethical considerations
Participation in the study was voluntary. Participants were
informed of the aims and procedures of the study and signed
consent forms prior to inclusion. The study was approved by the
Ethics Committee of the Recanati School for Community Health
Professions.
2.8. Allocation and blinding
Participants in each study were randomly assigned to a research
(N ¼ 15) or control (N ¼ 15) group. Randomization was carried out
by utilizing concealed envelopes, prepared in advance. Each subject
at the completion of the baseline examination received a closed
envelope with the allocation. The envelope was then delivered to
the therapist (who had applied the kinesio taping). The subject was
blinded to the type of intervention.
2.9. Demographic data collection
Prior to evaluations and intervention, all subjects completed a
demographic questionnaire in order to collect data on age, sex,
height, weight, smoking, and leisure physical activity habits. Body
mass index (BMI) was calculated based on self-reported height and
weight.
2.10. MTrPs evaluation
The upper trapezius and gastrocnemius muscles were evaluated
since according to the literature, these muscles are most prone to
develop MTrPs (Bae, 2014; Ozmen et al., 2016). Publications
reporting on the diagnosis of MTrPs indicate that the upper
trapezius is the muscle in which MTrPs occur most frequently
(Grieve et al., 2013). MTrPs, located within the upper trapezius
muscle may cause neck, shoulder pain, or migraines (Halski et al.,
2015). MTrPs in the gastrocnemius muscle also frequently appear
generating a significant effect on lower limb activity and activities
of daily living. Evidence has shown a possible relationship between
latent MTrPs in the soleus and restricted ankle range of motion
(Grieve et al., 2011). The nociceptive stimulation of latent MTrPs in
the gastrocnemius muscle may be associated with the develop-
ment of local muscle cramps (Grieve et al., 2013).
Examiners were senior year physical therapy students with
minimum experience in MTrPs’ evaluation. Hence, prior to the
study, they were trained by an experienced myofascial practitioner
(L.K.) as to how to assess the MTrPs found in the upper trapezius
and gastrocnemius muscles. Each examiner assessed the MTrPs of
at least five subjects prior to the commencement of the study.
Studies have shown that interrater reliability when examining
702 L. Kalichman et al. / Journal of Bodywork & Movement Therapies 22 (2018) 700e706
MTrPs is low or moderate (Gerwin et al., 1997; Myburgh et al.,
2011). Therefore, in order to reduce the possibility of bias, the ex-
amination was separately performed by two examiners (I.L. and
I.B.). Only consistent diagnoses between examiners were regarded
as MTrPs. Once a diagnosis proved that MTrPs were present, the
MTrP site and contralateral spot (used for control PPT evaluation)
were marked with a permanent marker. If MTrPs were found on
both sides, one side was chosen for the kinesio taping application
and the other side, a spot few centimeters away from the MTrP, was
selected for PPT evaluation.
2.11. Kinesio taping application
Examiners were trained in performing a kinesio taping appli-
cation (using a Black Classic Kinesio Tex tape) and were supervised
by an experienced senior physical therapist (E.V.), a Certified
Kinesio Taping Instructor (CKTI®). Kinesio taping was applied to the
gastrocnemius or upper trapezius muscles using three “I” strips
arranged into a star shape (space correction, tension on base
application) directly above the MTrP. The “I” strip was divided into
three parts: Two ends without tension and the middle 3rd with
tension. The middle part, with the tension, was placed first, as Dr.
Kase's concept for “space correction”. Each strip was stretched to
approximately 30% of the available tension (protocol was modified
from Halski et al.'s study (Halski et al., 2015)). A similar application
was used as sham kinesio taping in the control group where kinesio
taping was applied to the same area but below the MTrPs or its taut
band. In both groups, a hole was cut into the middle of the star-
shaped taping and used for PPT evaluation (Fig. 1).
2.12. PPT evaluation
Pressure algometry is a method used in evaluating the sensi-
tivity of MTrPs. This method reliably produces consistent readings
of the pain reaction point (“the point at which subjects reported
that the pressure hurt a lot”) and to a lesser degree, for pain
threshold (“the point at which the pressure first turned to pain”)
Fig. 1. Example of the kinesio taping application on the upper trapezius (left image) and gastrocnemius muscles (right image).
(Reeves et al., 1986). Digital pressure algometry demonstrated high
reliability (Park et al., 2011). Specifically, pressure algometry as an
index for MTrP sensitivity showed highly significant inter-rater and
intra-rater experimenter reliability (Reeves et al., 1986). PPT is
defined as minimum pressure inducing pain or discomfort (Fischer,
1987).
Both sides (the side with the MTrP and another side) were tested
for PPT by a single examiner (I.B.) using an electronic hand-held
type 2 algometer (2004.11.30, Somedic company). The examiner
applied pressure at a rate of 1 kg/cm2/second and instructed the
subject to: “Tell me when you feel the slightest pain”. Each exam-
ination comprised three PPT tests with the average scores docu-
mented as outcomes. This method has been shown to have high
interrater and intra-rater reliability (Reeves et al., 1986). Algometer
evaluations were performed on both limbs to avoid patient bias. To
reduce the possibility of compliance or measurement biases, sub-
jects were blinded to the results (during the evaluation they situ-
ated were in a prone position).
Each participant was examined three times:
 The first evaluation was completed in the area of the MTrPs
before the kinesio taping application and simultaneously on the
same area of the opposite limb (shoulder or calf).
 The second evaluation was completed 20 min after the kinesio
taping application.
 The third evaluation was completed 24 h later.
2.13. Data analysis
The SPSS statistical package performed all statistical analyses
(Version 17). The significance level was set at P < 0.05. Descriptive
statistics were used to characterize the study sample. We subse-
quently performed a Shapiro-Wilk Normality test to check the
normal distribution of the data. Since distribution was normal, the
outcome variables (PPT scores) were compared between the MTrP
and the contralateral side and between the MTrPs sides in the
 L. Kalichman et al. / Journal of Bodywork & Movement Therapies 22 (2018) 700e706 703

research group and controls by using a repeated-measures
approach for the main effect of time and the group-by-time inter-
action (repeated measurements of a two-way ANOVA). We also
performed repeated measurements of a one-way ANOVA to sepa-
rately compare the three PPT measurements in each group and
each side.
3. Results
In total, 62 students from the Department of Physical Therapy
were recruited, 32 for the upper trapezius muscle study and 30 for
the gastrocnemius muscle study.
3.2. PPT data and comparison between groups
3.2.1. The upper trapezius muscle study
PPT values of the three evaluations of the active intervention
group (Fig. 2) and controls (Fig. 3) are shown in Table 2A. In the
controls, on both sides, a second evaluation showed lower PPT
values than the first (the spot was more sensitive). The third eval-
uation showed even lower values of PPT. The differences (calcu-
lated by a one-way repeated measurement ANOVA) in PPT values
between the three evaluations, were statistically significant on the

3.1. Demographic data

3.1.1. The upper trapezius muscle study (Table 1A)

The mean age of the subjects in the active intervention group
(N ¼ 16) was 25.44 ± 1.63 and 26.06 ± 1.88 in the sham kinesio
taping group (N ¼ 16). Mean BMI (kg/m2) was 21.88 ± 1.99 in the
active intervention group and 22.61 ± 2.16 in the sham kinesio
taping group. Shoulder pain, based on self-reported data appeared
in 5 (31.3%) students in the active intervention group and 7 (43.8%)
in the sham kinesio taping group. No difference was found between
groups in demographic parameters.

3.1.2. The gastrocnemius muscle study (Table 1B)

The mean age of the subjects in the active intervention group
(N ¼ 15) was 24.93 ± 2.02 and 26.27 ± 1.79 in the sham kinesio
taping group (N ¼ 15). Mean BMI (kg/m2) was 21.58 ± 2.49 in the
active intervention group and 22.64 ± 3.04 in the sham kinesio
taping group. Calf pain, based on self-reported data, occurred in 5
students (31.3%) from the active intervention group and 7 (43.8%)
from the sham kinesio taping group. No difference was found be- Fig. 2. A graph plot of the mean PPT values of the active intervention group (upper
tween groups in demographic parameters. trapezius muscle study).

Table 1A
Descriptive statistics (upper trapezius study).

Variables Active intervention group (n ¼ 16) Sham kinesio taping group (n ¼ 16) Comparisons

(mean ± SD) (mean ± SD) (t-test)

Age (years) 25.44 ± 1.63 26.06 ± 1.88 t ¼ 1.005, p ¼ 0.323

BMI (kg/m2) 21.88 ± 1.99 22.61 ± 2.16 t ¼ 0.993, p ¼ 0.329
Studying (hours/week) 32.50 ± 7.30 36.38 ± 5.80 t ¼ 1.663, p ¼ 0.107

N (%) N (%) Pearson Chi-square

Sex (males) 6 (37.5%) 5 (31.3%) 0.139, p ¼ 0.710

Physical activity 13 (81.3%) 16 (100%) 3.310. p ¼ 0.069
Smoking 3 (8.8%) 0 (0.0%) 3.310. p ¼ 0.069
Shoulder pain 5 (31.3%) 7 (43.8%) 0.533, p ¼ 0.465

Table 1B
Descriptive statistics (gastrocnemius study).

Variables Active intervention group (n ¼ 15) Sham kinesio taping group (n ¼ 15) Comparisons (t-test)

(mean ± SD) (mean ± SD)

Age (years) 24.93 ± 2.02 26.27 ± 1.79 t ¼ 1.914, p ¼ 0.066

BMI (kg/m2) 21.58 ± 2.49 22.64 ± 3.04 t ¼ 1.041, p ¼ 0.307
Studying (hours/week) 32.73 ± 7.55 31.20 ± 9.14 t ¼ 0.501, p ¼ 0.620

N (%) N (%) Pearson Chi-square

Sex (males) 5 (33.3%) 5 (33.3%) 0.000, p ¼ 1.000

Physical activity 14 (93.3%) 15 (100%) 1.034. p ¼ 0.309
Smoking 2 (13.3%) 2 (13.3%) 0.000, p ¼ 1.000
Shin pain 5 (31.3%) 7 (43.8%) 0.186, p ¼ 0.666
704 L. Kalichman et al. / Journal of Bodywork & Movement Therapies 22 (2018) 700e706
Fig. 3. A graph plot of the mean PPT values of the control group (upper trapezius
muscle study).
MTrPs’ side (F (2,28) ¼ 3.684, p ¼ 0.038) but not on the contra-
lateral side (F (2,28) ¼ 2.239, p ¼ 0.125). In a two-way ANOVA, there
were no significant differences between PPT measurements of the
MTrPs and the contralateral side (time-side interaction) (F
(2,28) ¼ 0.12, p ¼ 0.884).
In the active intervention group, a similar pattern was demon-
strated on the contralateral side. The second evaluation PPT was
lower than the first and the third PPT was even lower than the
second. The difference (calculated by a one-way repeated mea-
surement ANOVA, not shown in the tables) in PPT values between
the three evaluations was statistically significant (F (2,28) ¼ 7.373,
p ¼ 0.003). However, on the side of the kinesio taping application,
PPT values taken from the second evaluation at the MTrP site were
higher (the spot was less sensitive) and returned approximately to
the original values (similar to the first evaluation) after 24 h. No
significant differences were found between the three measure-
ments (by a one-way repeated measurement ANOVA) (F
(2,28) ¼ 1.116, p ¼ 0.342). In a two-way ANOVA, the difference
between the PPT measurements on the MTrPs side and the
contralateral side (time-side interaction) were significant (F
(2,28) ¼ 8.95, p ¼ 0.001). Also, the difference between the PPT
measurements on the MTrPs’ side in the active intervention group
vs. the controls (time-group interaction) was significant (F
(2,56) ¼ 3.24, p ¼ 0.047).
Table 2A
Comparison of PPT values evaluated three times between the treated side and another side and between active intervention subjects and controls (upper trapezius study).
Evaluation MTrP kinesio taping PPT (mean ± SD)
Cases (n ¼ 15) 1st 327.73 ± 146.90
2nd 361.87 ± 166.87
3rd 330.87 ± 179.09
Controls (n ¼ 15) 1st 296.80 ± 117.58
2nd 245.80 ± 99.97
3rd 236.93 ± 139.28
Comparisonb F (2,56) ¼ 3.24, p ¼ 0.047
Statistically significant differences marked bold.
a
Two-way repeated measurement ANOVA (evaluation number x treated side).
b
Two-way repeated measurement ANOVA (evaluation number x group).
Fig. 4. A graph plot of the mean PPT values of the active intervention group
(gastrocnemius muscle study).
3.2.2. The gastrocnemius muscle study
PPT values of the three evaluations of the active intervention
group (Fig. 4) and controls (Fig. 5) are shown in Table 2B. Our results
were very similar to the results found in the upper trapezius study.
In the controls, on both sides, the second evaluation showed lower
PPT values than the first (the spot was more sensitive). The third
evaluation showed even lower values of PPT. The differences
(calculated by a one-way repeated measurement ANOVA) in PPT
values between the three evaluations was statistically significant
on the MTrPs’ side (F (2,28) ¼ 11.129, p < 0.001) and the contra-
lateral side (F (2,28) ¼ 7.503, p ¼ 0.002). In the two-way ANOVA
measurement, no significant differences were found between the
MTrP and contralateral side (time-side interaction) (F (2,28) ¼ 2.37,
p ¼ 0.112).
In the active intervention group, the contralateral side showed a
similar pattern as the control group. The second evaluation PPT was
lower than the first. The third PPT was even lower than the second.
The differences (calculated by a one-way repeated measurement
ANOVA-not shown in the tables) in the PPT values between the
three evaluations were statistically significant (F (2,28) ¼ 9.232,
p ¼ 0.001), however, on the side of the kinesio taping application,
the PPT values of the second evaluation at the MTrP site, were
higher (the spot was less sensitive) and returned to approximately
the original values (similar to the first evaluation), after 24 h. No
Contralateral PPT (mean ± SD) Comparisonsa
398.60 ± 184.48 F (2,28) ¼ 8.95, p ¼ 0.001
332.73 ± 154.68
307.07 ± 139.92
324.33 ± 103.62 F (2,28) ¼ 0.12, p ¼ 0.884
289.07 ± 169.49
265.40 ± 156.91
F (2,56) ¼ 0.48, p ¼ 0.621
 L. Kalichman et al. / Journal of Bodywork & Movement Therapies 22 (2018) 700e706
Fig. 5. A graph plot of the mean PPT values of the control group (gastrocnemius
muscle study).
significant differences were found between the three measure-
ments (by a one-way repeated measurement ANOVA) (F
(2,28) ¼ 0.639, p ¼ 0.536). In the two-way ANOVA, the difference
between the PPT measurements on the MTrPs' side and the
contralateral side (time-side interaction) was significant (F
(2,28) ¼ 12.78, p < 0.001). Likewise, the difference between the PPT
measurements on the MTrPs’ side of the active intervention vs. the
controls (time-group interaction) was significant (F (2,56) ¼ 4.47,
p ¼ 0.016).
4. Discussion
Our results showed that at the site (upper trapezius or
gastrocnemius) contralateral to the MTrP, the participants who did
not receive the kinesio taping, noted a significant decrease in PPT
20 min after the first evaluation and a further decrease 24 h later,
thus, demonstrating that the evaluation sites become more sensi-
tive to pressure. This residual sensitivity was also reported by the
subjects. Sensitization of the PPT measurement site has been pre-
viously observed (Sjolund and Persson, 2007). In addition, it is
possible that this sensitization was caused by a previous palpation
performed by the researchers, in order to find the MTrPs. Whereas
the assessors were trained for MTrPs palpation, their lack of clinical
experience may have caused them to use more force than is usually
required for detecting MTrPs. The controls demonstrated a similar
Table 2B
Comparison of PPT values evaluated three times between the treated and another side and between active intervention subjects and controls (gastrocnemius study).
Evaluation MTrP kinesio taping PPT (mean ± SD)
Cases (n ¼ 15) 1st 228.20 ± 139.58
2nd 247.87 ± 107.48
3rd 219.33 ± 77.19
Controls (n ¼ 15) 1st 264.07 ± 91.78
2nd 196.80 ± 100.27
3rd 170.80 ± 61.19
Comparisonb F (2,56) ¼ 4.47, p ¼ 0.016
a
Two-way repeated measurement ANOVA (evaluation number x treated side).
b
Two-way repeated measurement ANOVA (evaluation number x group).
705
decrease in PPT at the MTrP spot (which received the kinesio taping
application below the MTrP site), thus demonstrating that the
application of kinesio taping below the MTrP site, does not change
tissue sensitivity.
On the other hand, when kinesio taping was applied directly
above the MTrP, a significantly different pattern of PPT change was
observed. PPT measured 20 min after a kinesio taping application,
was slightly lower than the measurement at baseline; values
returned to baseline level 24 h later. The difference between the
three measurements was not significant, we, therefore, cautiously
suggest that a kinesio taping application prevented the sensitiza-
tion of the MTrP site. Trends of PPT change were similar in the
upper trapezius and gastrocnemius muscle studies, making it less
plausible that the results occurred by chance or by error.
Post-treatment soreness is a common phenomenon ensuing
during the treatment of MTrPs. It is one of the main adverse ef-
fects associated with MTrP procedures, frequently occurring after
deep dry needling (Leon-Hernandez et al., 2016; Martin-Pintado-
Zugasti et al., 2015; Martin-Pintado-Zugasti et al., 2016, 2014).
Several studies have ascertained possible ways of reducing post-
treatment soreness, i.e. electrical nerve stimulation (Leon-
Hernandez et al., 2016), spray and stretch (Martin-Pintado
Zugasti et al., 2014) and ischemic compression (Martin-Pintado-
Zugasti et al., 2015). In our study, we found that a kinesio tap-
ing application (star application, space correction method, ten-
sion on base) may prevent sensitization which develops in non-
treated areas due to MTrPs palpation and PPT evaluation. It is,
therefore, possible that using this type of kinesio taping appli-
cation may prevent post-treatment soreness caused by dry
needling or other treatments. This hypothesis should be tested in
further interventional controlled clinical trials.
4.1. Limitations
Assessors were inexperienced in evaluating MTrPs, therefore,
the sensitization observed in this study may have been triggered by
excessive force during MTrPs palpation. Assessors were not blinded
to the research group, therefore, assessor bias was possible. On the
other hand, they were blinded to the results of previous measure-
ments and since these results conflicted with our initial hypothe-
ses, the chance of bias was low.
We used a star-shaped kinesio taping application with a small
hole cut in the middle to allow for PPT testing. This is not a classical
application, but we believe that this hole did not alter the effect of
the kinesio taping application.
5. Conclusions
Sensitivity felt at the area of MTrPs after palpation\treatment is
a well-known phenomenon. The results of this study showed that a
kinesio taping application (star shaped-tension on base) directly
Contralateral PPT (mean ± SD) Comparisonsa
244.20 ± 130.66 F (2,28) ¼ 12.78, p < 0.001
209.87 ± 88.72
148.53 ± 48.91
275.67 ± 106.20 F (2,28) ¼ 2.37, p ¼ 0.112
246.67 ± 117.12
176.80 ± 96.80
F (2,56) ¼ 0.31, p ¼ 0.969
706 L. Kalichman et al. / Journal of Bodywork & Movement Therapies 22 (2018) 700e706
above the MTrPs may prevent increased MTrP sensitivity
(decreased PPT) immediately after application and prevent further
sensitization 24 h later. The fact that two different muscles, one in
the upper extremity and the second in the lower extremity were
similarly affected by the kinesio taping application, ensures that the
results were not obtained in error or by chance. Further studies are
needed to directly test the effect of kinesio taping application on
post-treatment soreness.
Financial support
None.
Conflicts of interest
None.
Acknowledgements
The authors thank Mrs. Phyllis Curchack Kornspan for her
editorial services.
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