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The Effect of the Mulligan Knee Taping Technique on Patellofemoral Pain and Lower Limb
Biomechanics
Anne Hickey, Diana Hopper, Toby Hall and Catherine Y. Wild
Am J Sports Med published online February 22, 2016
DOI: 10.1177/0363546516629418

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 AJSM PreView, published on February 22, 2016 as doi:10.1177/0363546516629418

The Effect of the Mulligan Knee

Taping Technique on Patellofemoral
Pain and Lower Limb Biomechanics
Anne Hickey,* BSc(Hons), Diana Hopper,* PhD, Toby Hall,* PhD, MSc, and Catherine Y. Wild,*y PhD
Investigation performed at Curtin University, Bentley, Australia

Background: Patellofemoral pain (PFP) affects 25% of the general population, occurring 2 times more often in females compared
with males. Taping is a valuable component of the management plan for altering lower limb biomechanics and providing pain
relief; however, the effects of alternative taping techniques, such as Mulligan knee taping, appear yet to be researched.
Purpose: To determine whether the Mulligan knee taping technique altered levels of perceived knee pain and lower limb biome-
chanics during a single-legged squat (SLSq) in adult females with PFP.
Study Design: Controlled laboratory study.
Methods: A total of 20 female patients with PFP, aged 18 to 35 years, participated in this study. Participants performed 3 to 5
SLSq on their most symptomatic limb during a taped (Mulligan knee taping technique) and nontaped (control) condition. During
the eccentric phase of the SLSq, the 3-dimensional kinematics (250 Hz) of the knee and hip and the ground-reaction forces (1000
Hz) and muscle activation patterns (1000 Hz) of the gluteus medius, vastus lateralis, and vastus medialis oblique were measured.
Participants’ perceived maximum knee pain was also recorded after the completion of each squat.
Results: Between-condition differences were found for hip kinematics and gluteus medius activation but not for kinetics or vastus
medialis oblique and vastus lateralis muscle activity (timing and activation). Compared with the nontaped condition, the Mulligan
knee taping technique significantly (P = .001) reduced perceived pain during the SLSq (mean 6 SD: 2.29 6 1.79 and 1.29 6 1.28,
respectively). In the taped condition compared with the control, the onset timing of the gluteus medius occurred significantly ear-
lier (120.6 6 113.0 and 156.6 6 91.6 ms, respectively; P = .023) and peak hip internal rotation was significantly reduced (6.38° 6
7.31° and 8.34° 6 7.92°, respectively; P = .002).
Conclusion: The Mulligan knee taping technique successfully reduced knee pain in participants with PFP. This is the first study to
establish a link between Mulligan knee taping and the reduction of PFP in conjunction with decreased hip internal rotation and
earlier activation of gluteus medius.
Clinical Relevance: The Mulligan knee taping technique may benefit the clinical environment by providing an alternative
evidence-based treatment plan for PFP.
Keywords: retropatellar pain; lower limb; biomechanics; single-legged squat

Patellofemoral pain (PFP) occurs in 25% of the general pop-
ulation,8,21 being twice as prevalent in females than
males,7,17 and is encountered frequently by sports medicine
practitioners.15,22 Symptoms usually occur in the anterior
y cal factor proposed to contribute to PFP. For example, in peo-
Address correspondence to Catherine Y. Wild, PhD, School of Phys-
iotherapy and Exercise Science, Curtin University, Bentley, WA 6102 Aus-
tralia (email: catherine.wild@curtin.edu.au).
*School of Physiotherapy and Exercise Science, Curtin University,
Bentley, Australia.
One or more of the authors has declared the following potential con-
flict of interest or source of funding: This study was supported by a grant
from the International Mulligan Concepts Teachers Association. T.H. is
a Certified Mulligan Concept teacher and provides courses in the Mulli-
gan Concept, for which he receives a teacher’s fee.
The American Journal of Sports Medicine, Vol. XX, No. X
DOI: 10.1177/0363546516629418
Ó 2016 The Author(s)
knee and are exacerbated by patellofemoral joint loading2,19
such as during squatting and negotiating stairs.2,14,19
Inequity of activity28,32 or onset timing17 between the
vastus lateralis and vastus medialis oblique muscles during
knee loading may cause patellar maltracking, a biomechani-
ple with PFP, onset of vastus lateralis activation was found
to significantly precede vastus medialis oblique during stair
negotiation.12,25 Evidence suggests that a 5-millisecond delay
in onset of vastus medialis oblique activation relative to
vastus lateralis increases patellofemoral joint loading, thus
supporting the link between abnormal vastus medialis obli-
que and vastus lateralis muscle activation and PFP.34
Despite this evidence, not all studies reported delayed activa-
tion of vastus medialis oblique.9
In regard to management of PFP, level 1 evidence sup-
ports patellar taping,3,10,39 which is included in the best

1
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2 Hickey et al
practice guidelines for PFP.4 Additionally, tailored taping
such as the McConnell concept28,29 appears superior to
untailored taping. The effects of McConnell patellar taping
on participants with PFP have been shown to improve
onset of vastus medialis oblique activation during stair or
step negotiation11 and a single-legged squat (SLSq).31
This supports the notion that patellar taping facilitates
vastus medialis oblique activation.31
In the gluteus medius, similar to the knee muscles,
delayed onset and reduced duration of activation have
been correlated with PFP during stair negotiation.5 Despite
this evidence, no research is available pertaining to the
effects of knee taping on gluteal muscle activation in
patients with PFP, therefore highlighting the need for fur-
ther investigation.
Mulligan knee taping is an alternative technique pro-
posed for managing PFP33 that aims to indirectly correct
patellar maltracking by changing hip rotation, a factor in
PFP.36 Rigid tape is applied under tension in a spiral
around the knee, avoiding the patella completely. The
aim is to alter tibiofemoral rotation, which is believed to
reduce hip internal rotation. This procedure has been
shown to significantly reduce peak knee and hip shear
forces in adolescent ballet dancers during ballet-specific
movements.20 Similarly, Howe et al24 reported a reduction
in hip shear forces and knee and hip moments in female
recreational runners (N = 29). However, currently no evi-
dence is available on the effectiveness of the Mulligan
knee taping technique on pain, lower limb biomechanics,
or muscle activation patterns in PFP.
Therefore, the purpose of this study was to determine
whether the Mulligan knee taping technique altered pain
and lower limb biomechanics during an SLSq in adult
females with PFP. It was hypothesized that during an
SLSq, the Mulligan knee taping technique would decrease
knee pain, alter peak joint angles, and decrease peak joint
forces and moments at the knee and hip as well as alter the
timing and activation of vastus lateralis, vastus medialis
oblique, and gluteus medius muscles.
METHODS
Participants
Twenty females with PFP, aged 18 to 35 years (mean age,
22.7 6 2.7 years; height, 169.2 6 6.2 cm; and mass, 65.5 6
12.1 kg), participated in this study. Recruitment occurred
through local sporting clubs, a local university, and the com-
munity. Participants were screened, using an activity-based
assessment, for signs and symptoms indicative of PFP by
a qualified physical therapist. Female volunteers were
included if they had a minimum 8-week history of anterior
or retropatellar pain, insidious in nature, which was aggra-
vated by a minimum of 2 of the following activities: stair
climbing, squatting, jumping, running, prolonged sitting or
kneeling, and/or isometric quadriceps holds. Females were
excluded from the study if they had a history of knee osteoar-
thritis, patellar tendinitis or tendinopathy, patellar subluxa-
tions or dislocations, lower limb surgery or fractures,
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The American Journal of Sports Medicine
ligamentous or soft tissue injury, neurological deficits, and/
or an allergy to rigid strapping tape. Subjects were also
excluded if they were involved in a current rehabilitation pro-
gram or had received Mulligan knee taping previously. The
Curtin University Human Research Ethics Committee
approved (PT260/2013) this study, and all participants pro-
vided written informed consent before testing.
Experimental Protocol
Upon arrival to the Motion Analysis Laboratory, participants
underwent anthropometric measures of height (calibrated
stadiometer; to the nearest 0.1 cm) and body mass (calibrated
bathroom scales; to the nearest 0.2 kg). Forty-two retroreflec-
tive markers (12.7-mm diameter) were secured to each par-
ticipant for a static calibration trial, based on a modified
version of the University of Western Australia static lower
limb marker set (Figure 1, A and B). Specific markers were
then removed for the dynamic trials (SLSq trials), based on
a modified version of the University of Western Australia
dynamic lower limb marker set (Figure 1, C and D), allowing
3-dimensional (3D) motion of each participant’s test limb to
be captured. The 3D motion of each participant’s test limb
was recorded with an 18-camera passive 3D motion analysis
system (250 Hz; Vicon; Oxford Metrics Inc). A calibrated mul-
tichannel force platform embedded in the laboratory floor
(1000 Hz; Advanced Mechanical Technology Inc) was used
to collect the 3 orthogonal components (vertical, anterior-
posterior, and medial-lateral) of the ground-reaction force
(GRF) generated by each participant during the SLSq.
Muscle activity of the gluteus medius, vastus lateralis,
and vastus medialis oblique during the movement task
was recorded after standard preparation. Electrode place-
ment sites for each of the 3 muscle bellies included vastus
lateralis, placed at two-thirds of the distance from the
anterior superior iliac spine to the lateral side of the
patella (while the subject was seated with the knee in
slight flexion); vastus medialis oblique, placed at 80% of
the distance from the anterior superior iliac spine to the
joint space at the anterior border of the medial ligament
(while the subject was seated with the knee in slight flex-
ion); and gluteus medius, placed at 50% of the distance
from the iliac crest to the greater trochanter (while the
subject was lying on her side).13 All electrode placement
sites were then confirmed via isometric contractions of
each muscle (leg extension for vastus lateralis and vastus
medialis oblique and hip abduction for gluteus medius).
After standard preparation (shave, abrade, alcohol swab),
2 bipolar Ag-AgCl surface electrodes (2-cm interelectrode
spacing; Blue Sensor Type M-OO-S; Medico Testing Solu-
tions) were placed over each electrode placement site in
line with the orientation of the muscle fibers, and a refer-
ence electrode was placed on the tibial tuberosity of the
test limb. Data regarding muscle activity of the gluteus
medius, vastus lateralis, and vastus medialis oblique of
the test limb were collected with an 8-channel Octopus
Cable Telemetric system (1000 Hz; bandwidth, 10-500 Hz;
Bortec Electronics Inc). Kinematic, kinetic, and electromyo-
graphic (EMG) data were time synchronized by use of Vicon
Nexus software.
AJSM Vol. XX, No. X, XXXX Mulligan Taping and Patellofemoral Pain 3

Figure 1. (A) Anterior view of marker placements for static calibration trial. Marker placement sites for both the right and left limbs
according to a modified version of the University of Western Australia lower limb static marker set include anterior superior iliac
spine; posterior superior iliac spine; lateral thigh rig (3 markers); medial and lateral femoral condyles; lateral tibia rig (3 markers);
posterior tibia (superior and inferior); anterior tibia; medial and lateral malleoli; calcaneus; superior and inferior calcaneus; first
metatarsal head; fifth metatarsal head; and midway between the first and fifth metatarsal head. (B) Posterior view of marker place-
ments for static calibration trial. (C) anterior view of marker placements for dynamic trials. Specific markers are removed before
the dynamic trials. Marker placement sites for both the right and left limbs according to a modified version of the University of
Western Australia lower limb dynamic marker set include the anterior superior iliac spine, posterior superior iliac spine, lateral
thigh rig, lateral tibia rig, calcaneus, first metatarsal head, and fifth metatarsal head. (D) Posterior view of marker placements
for dynamic trials.

Mulligan Taping Technique
After marker and electrode placement, taping was applied
to each participant’s test limb (Figure 2), defined as the
participant’s most symptomatic limb. The order of the tap-
ing condition (Mulligan technique) and the control (no
tape) was randomized by use of a random number genera-
tor. Mulligan knee taping was applied with the patient
standing and the leg placed such that the hip and knee
were internally rotated and knee flexed to 20°. While the
participant was in this position, 2 superimposed layers of
38-mm rigid tape were applied in a spiral fashion under
tension from the lateral aspect of the neck of fibula, ending
on the anterolateral aspect of the femur. The tape passed
over the tibia, inferior to the medial joint line and behind
the knee. Once the patient assumed a normal standing
position, the tape became tighter, altering rotation at the
tibiofemoral joint and hence inducing hip external rota-
tion. To minimize variability among participants, all tap-
ing was performed by the chief investigator (A.H.), who
had expertise in this method of taping.
Single-Legged Squat
After a standardized warm-up and task familiarization,
each participant performed 3 to 5 viable SLSq on the test
limb. Each squat was performed at a comfortable pace to
a depth of 45° of knee flexion. During each trial, partici-
pants were instructed to place their arms across their chest
as well as flex their nonweightbearing limb to approxi-
mately 90° of knee flexion, with neutral hip alignment.
Participants were provided with 5 to 10 minutes of rest
before testing began and between each testing procedure
to ensure that skin sensation returned to normal level38
as well as to allow ample rest to avoid fatigue. Maximum
perceived knee pain during the performance of an SLSq
was recorded by use of a verbal numeric rating scale
from 0 to 10 (0 = no pain, 10 = maximal pain), which is
a practical, reliable, and valid method of calculating per-
ceived pain.26
Data Processing
After data collection, a 3D model of each participant’s test
limb was created with a custom-written Labview program
(Labview v2011 SP1; National Instruments), based on each
participant’s static calibration trial and inertial proper-
ties.16 The kinematic, GRF, free moment, and center of
pressure data were filtered by use of a zero-phase-shift,
fourth-order, low-pass Butterworth digital filter (fc =
10 Hz; determined via residual analysis)40 before the lower
limb kinematics, joint forces, and moments were calcu-
lated.6 The peak 3D knee and hip joint angles, forces,
and external joint moments (normalized to body mass) dis-
played by each participant during the eccentric phase of
the SLSq were calculated.
Raw EMG signals were demeaned (zero-offset removal),
full-wave rectified, and then filtered using a zero-phase-shift,
second-order, low-pass Butterworth filter (fc = 20 Hz) to
obtain linear envelopes (mV) closely representing the muscle
tension curves. The timing of the onset of muscle activation
relative to the beginning of the SLSq (eccentric phase; deter-
mined with an integrated profile method),1 as well as the
peak amplitude of each muscle, was calculated.

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4 Hickey et al
Figure 2. The Mulligan taping technique. Tape was applied
while participants stood with their hip and knee internally
rotated and the knee flexed to 20°. Rigid tape was applied
from the neck of fibula, passing anteriorly over the tibia to
secure internal rotation of the tibia at the knee, and passing
below the medial joint line and behind the knee. The chief
investigator (A.H.) secured the tape on the participant’s thigh,
and a second piece of rigid tape was then applied over the
top in the same manner.
Statistical Analyses
An a priori power analysis indicated that 20 participants
were sufficient to detect a standardized group difference
for an effect size of 0.6 (alpha level of .05, power level of
80%), whereby perceived knee pain was used as the primary
outcome variable.18,35 Descriptive data (mean 6 SD) were
calculated for demographic characteristics, including age,
height, and mass of the participants. The distribution of
the data was examined by use of plots as well as Kolmo-
gorov-Smirnov and Shapiro-Wilk tests. A series of paired t
tests were used to compare the differences between the
taped and control conditions in perceived pain levels as
well as the knee and hip joint angles, forces, moments,
and muscle activity during the eccentric phase of the
SLSq. All data were calculated by use of the SPSS package
(version 21; IBM Corp), and the alpha level was set at .05.
RESULTS
Participants experienced significantly less knee pain when
performing an SLSq with Mulligan knee tape applied, 1.29
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The American Journal of Sports Medicine
6 1.28, compared with the no tape condition, 2.29 6 1.79
(P = .001 [95% CI, 21.49 to 20.51]).
Overall, participants displayed significantly less peak
knee adduction (P = .023) and hip internal rotation align-
ment (P = .002) when Mulligan knee tape was applied com-
pared with the control condition (Table 1).
Despite these kinematic differences between conditions,
participants in the Mulligan knee tape compared with the
control condition displayed similar external peak knee
extension (4.57 6 2.40 vs 4.54 6 2.36 N
m/kg; P = .795
[95% CI, 20.29 to 0.22]), abduction (3.04 6 1.62 vs 2.87
6 1.69 N
m/kg; P = 0.097 [95% CI, 20.37 to 0.03]), and
internal rotation (0.11 6 0.56 vs 0.14 6 0.64 N
m/kg; P =
.874 [95% CI, 20.43 to 0.37]) joint moments. Participants
in the Mulligan knee tape compared with the control con-
dition also displayed no differences in external peak hip
extension (11.49 6 7.15 vs 11.99 6 8.16 N
m/kg; P = .744
[95% CI, 22.66 to 3.66]), abduction (11.74 6 4.01 vs
11.19 6 3.81 N
m/kg; P = .506 [95% CI, 22.22 to 1.13]),
or internal rotation (3.01 6 2.38 vs 3.39 6 2.20 N
m/kg;
P = 0.488 [95% CI, 21.50 to 0.74]). Similarly, participants
displayed no between-condition differences (P . .05) in the
3D joint forces acting at the knee and hip.
In terms of muscle activation, participants did display sig-
nificantly (P = .023) earlier activation of the gluteus medius
when the Mulligan knee tape was applied compared with
the control group (Table 2). However, no significant differen-
ces were detected in the peak amplitude of the vastus medi-
alis oblique, vastus lateralis, or gluteus medius muscles or
the onset timing of the vastus medialis oblique and vastus
lateralis relative to the start of the SLSq (Table 2).
DISCUSSION
This is the first study to investigate the Mulligan knee taping
technique in patients with PFP and its effect on knee pain, as
well as the 3D knee and hip joint angles, forces, moments and
muscle activation patterns. As hypothesized, the results of
this study indicated that Mulligan knee taping is effective
in reducing knee pain in participants with PFP when per-
forming a symptom-exacerbating task, such as an SLSq.
Despite this improvement, not all participants had reduced
pain with the application of Mulligan tape. In fact, 1 partici-
pant displayed greater knee pain with the Mulligan taping,
and 3 participants displayed no change between the condi-
tions. Thus, consistent with recommended clinical practice,33
it would be prudent to evaluate the effect of Mulligan tape on
pain during an SLSq or other functional provocative activi-
ties and remove the tape if it is not immediately effective.
While there appears to be no published literature regarding
the effectiveness of the Mulligan knee taping technique in
reducing knee pain in patients with PFP, this result is com-
parable with previous studies that have analyzed the McCon-
nell knee taping technique during similar tasks.31,32,35 Ng
and Cheng,35 Mostamand et al,32 and Mostamand et al31
reported a similar percentage improvement in pain reduction
with McConnell knee taping application during the perfor-
mance of an SLSq by participants (male and female) with
PFP.
AJSM Vol. XX, No. X, XXXX Mulligan Taping and Patellofemoral Pain 5

TABLE 1
Peak Knee and Hip Angles During the Eccentric Phase of a Single-Legged Squata

Mulligan Tape Group Control Group P Value (95% CI)

Knee angle, deg

Flexion 58.87 6 8.89 58.73 6 12.78 .941 (24.44 to 2.64)
Adduction 1.43 6 3.92 2.14 6 4.15 .023b (0.12 to 1.35)
Abduction 5.76 6 5.28 5.53 6 5.53 .604 (20.53 to 1.26)
Internal rotation 20.76 6 11.85 22.98 6 38.35 .716 (210.67 to 14.58)
External rotation 12.99 6 10.49 13.22 6 37.77 .971 (212.98 to 13.06)
Hip angle, deg
Flexion 54.69 6 13.32 54.10 6 14.82 .729 (24.32 to 1.69)
Adduction 16.23 6 6.42 16.11 6 7.38 .887 (21.96 to 1.35)
Abduction 0.87 6 2.96 1.26 6 2.85 .470 (20.72 to 1.47)
Internal rotation 6.38 6 7.31 8.34 6 7.92 .002b (0.81 to 3.05)
External rotation 2.52 6 8.08 2.03 6 8.17 .116 (20.001 to 1.16)

a
Data are reported as mean 6 SD.
b
Significant within-group difference (P  .05).

TABLE 2
Timing of Muscle Onset and Peak Muscle Activity During the Eccentric Phase of a Single-Legged Squata

Muscle Mulligan Tape Group Control Group P Value (95% CI)

Onset timing, ms
Gluteus medius 120.6 6 113.0 156.6 6 91.6 .023b (5.44 to 66.5)
Vastus lateralis 122.5 6 80.8 135.4 6 87.9 .174 (210.9 to 36.7)
Vastus medialis oblique 125.5 6 77.0 136.6 6 81.0 .308 (211.0 to 33.1)
Peak amplitude, mV
Gluteus medius 57.57 6 25.07 57.95 6 28.55 .870 (24.42 to 5.85)
Vastus lateralis 147.25 6 44.41 147.72 6 56.84 .921 (210.65 to 9.66)
Vastus medialis oblique 194.20 6 144.81 174.62 6 104.45 .184 (249.33 to 10.16)

a
Data are reported as mean 6 SD.
b
Significant within-group difference (P  .05).

While the outcomes in the present study and those in
the literature are consistent, the likely mechanism of
action between taping techniques appears variable. It has
been hypothesized that McConnell patellar taping opti-
mizes the patellar tracking pattern and alters the timing
and activation of the vastus medialis oblique and vastus
lateralis, subsequently resulting in a reduction of patello-
femoral pain.2,11,21,28,31 The changes achieved by the
McConnell taping technique are possibly due to the direct
influence that tape has on the patella, components of
which include medial glide, tilt, or rotation, individualized
to the requirements of the patient.28,29
Conversely, unlike the McConnell technique, the Mulli-
gan technique does not entail contact with the patella,33
which is thought to reduce PFP by altering tibiofemoral
rotation and reducing hip internal rotation.23 In support
of this argument, the positions of the knee and hip are sug-
gested to alter patellofemoral joint mechanics by increas-
ing lateral patellofemoral joint stress27,36 and thereby
contribute to PFP.30,37 To achieve this, Mulligan tape is
applied in such a way to create tension in external tibial
rotation at the knee, theoretically inducing internal tibial
rotation. Consequently, to achieve a normal position of
the foot during gait, the femur is forced to relatively
externally rotate to compensate for the tibiofemoral tape
tension.23 While no difference in tibial rotation was seen
as a result of taping, a reduction in hip internal rotation
was displayed in the taping condition compared with the
control (see Table 1). Interestingly, Howe et al24 reported
no difference in peak hip internal rotation angle between
the Mulligan knee taping and control (no tape) conditions
(18.2° for each group). However, unlike the subjects in
the present study, the subjects in the Howe et al study
were healthy without pain, which may explain the
between-study differences. Given this knowledge, it may
be theorized that the decreased hip internal rotation dis-
played by participants in the Mulligan knee taping condi-
tion was compensatory to reduce tibiofemoral tape tension,
potentially contributing to the decreased knee pain. Yet,
due to the uniqueness of this research, further investigation
is required to confirm this theory.
In contrast to the present study, previous research has
demonstrated Mulligan knee taping to reduce normalized
(to body mass) anteroposterior knee and hip joint forces,
mediolateral hip joint forces, and sagittal plane knee and
hip joint moments.20,24 These between-study differences
may be due to the low-impact nature of the SLSq used in
the present study compared with a dynamic landing

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6 Hickey et al
movement20 and running,24 and this factor requires fur-
ther investigation and clarification. Furthermore, moderate
evidence exists for an increase in external knee flexion
moments (small effect) after patellar taping, during the per-
formance of functional, symptom-exacerbating tasks.3
These between-study differences may be due to the fact
that patellar taping has a direct effect on the patella and
thus on knee extensor muscle activity.2,11,21,28,31 Therefore,
the mechanism for reducing knee pain is vastly different
between each taping technique.
Literature demonstrates that in contrast to Mulligan
taping, tape applied directly to the patella affects vastus
medialis oblique and vastus lateralis timing and activation
in persons with PFP.11,31 In a meta-analysis of patellar
taping, Barton et al3 reported moderate evidence to indi-
cate earlier vastus medialis oblique onset timing (large
effect) after patellar taping. It is theorized that this may
be a result of the cutaneous stimulation of the tape over
the vastus medialis oblique2 or a result of pain reduction
due to manual patellar realignment.12 Both of these theo-
ries would support the result seen in the present study,
as the Mulligan knee taping technique does not involve
application of tape over the vastus medialis oblique or
manual realignment of the patella,33 potentially indicating
that the activation and timing of vastus medialis oblique
and vastus lateralis may have no effect on knee pain in
PFP patients.
Individuals with PFP have been reported to display
delayed onset of gluteus medius activation compared
with healthy individuals.5 This study is the first to report
changes in timing of gluteus medius activation after an
intervention involving taping. Despite this, no change
was detected in vastus medialis oblique or vastus lateralis
activity (timing or activation) with tape application, indi-
cating that perceived pain reduction was not a result of
altered quadriceps muscle activity. This proposes a possible
relationship between earlier gluteus medius activation
induced by Mulligan knee taping and PFP reduction. It
is possible that delayed onset of gluteus medius activation
may allow increased hip adduction and internal rotation,
potentially a factor in PFP.5 However, this relationship
warrants further investigation to be confirmed.
This research was limited to analysis of knee and hip bio-
mechanics during the performance of a low-impact task;
therefore, the influence of Mulligan knee taping on pain
and the biomechanics of the entire lower limb kinetic chain
during a more dynamic task remains unknown. Further-
more, this research did not include a placebo condition,
nor did it provide a comparison to other evidence-based tap-
ing methods (McConnell patellar taping). Because partici-
pants were not blinded to the taping condition, further
research incorporating blinding and a placebo condition is
warranted. Finally, although participants performed task
familiarization after the tape was applied and before the
SLSq trials, it is acknowledged that the long-term effects
of the taping technique during exercise remain unknown.
Overall, application of Mulligan knee taping was found
to reduce perceived knee pain for participants with PFP
when performing an SLSq as well as contribute to
decreased hip internal rotation and an earlier onset of
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The American Journal of Sports Medicine
gluteus medius activity. This research has provided valu-
able insight into the effect of the Mulligan knee taping
technique on management of PFP and the underlying bio-
mechanical influence it may have on the lower limb.
ACKNOWLEDGMENT
The authors acknowledge Paul Davey, Jenny Lalor, and
Ashlee Howe for their contributions to this study. The
authors also thank the participants for their time, without
whom this study could not have been conducted.
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