Stuck on It

June 30, 2009

Navigating William Forsythe’s The Vertiginous Thrill of Exactitude last season, Houston Ballet corps member Hitomi Takeda took a serious fall, ending up with a lateral ankle sprain. With Stanton Welch’s world premiere of Marie and a tour of Spain on the horizon, an injury was the last thing Takeda needed. After a trip to the doctor, four days of rest, ice, compression, and elevation (the RICE protocol for injuries) and no signs of a limp, Takeda had her first application of Kinesio tape from Houston Ballet’s athletic trainer Mike Howard. The petite dancer sailed through Marie and the six-city tour without further strain. “I was wearing the Kinesio right under my tights,” she says.

Many dance medicine specialists and dancers have begun to use Kinesio. Developed more than 25 years ago, the method drew worldwide interest last summer when the U.S. Olympic volleyball player Kerri Walsh wore the tape to support her shoulder during the 2008 Games in Beijing. Unlike traditional athletic tape, the latex-free Kinesio stretches easily, and permits greater range of motion, making it popular with dancers. “The old way of taping tried to support ligaments, but we have learned it gave less support than we suspected,” says Dr. Rebecca Clearman, M.D., a physiatrist who works with Houston Ballet’s dancers. “Kinesio, on the other hand, helps dancers self-correct. If a dancer is hyper-extending, it can serve as a reminder.”

Kinesio can be used to stimulate or relax a muscle, depending on the direction of the recoil of the stretched tape, says Jennifer Janowski, a physical therapist at Chicago’s Athletico, a sports medicine physical therapy facility. Janowski has been working with Joffrey Ballet dancers for five years. “I use Kinesio on just about every dancer who walks through my door for all stages of injury, from recovery to prevention,” she says. “It’s like a brace, but better, because of the neuromuscular input.” She recommends getting the tape applied initially by a dance medicine professional with a knowledge of dance mechanics until the injured person learns how to use the tape correctly.

Whether relaxing or activating, the tape gets placed along the line of the muscle. For activating, the direction of the tape goes from muscle origin to insertion. “For supporting a fatigued Achilles tendon you would start the tape from the muscle belly and then run it to the Achilles,” Janowski says. “This would reinforce the Achilles to help prevent tendonitis.”

To relax a muscle, reverse the direction from insertion to origin. If a dancer has knee pain from overusing his quadriceps in jumping, for instance, Janowski tapes the quadriceps away from the activation point. This allows the tape recoil to pull back the fascia (the thin sheath tissue that encases all muscles) and relax the tension on the knee cap. The tape’s degree of stretch determines the strength of the recoil action, so each application can be tailored to a dancer’s needs. “Of course,” Janowski adds, “the dancer also should be reminded of the ways that their body mechanics are leading to these problems.”

Kinesio can also speed healing in an injury site. The tape improves lymphatic drainage by gently pulling the skin away from the fascia layer. “The application is done in a criss-cross pattern with finger-like projections coming out of the tape. This is close to the body’s own drainage system,” says Janowski.  

However, Kinesio has its limits. Most bone fractures need to be treated with a cast. The tape should not be used over an open wound, though once the wound heals, Kinesio can help reduce swelling. Clearman and Janowski agree that Kinesio hastens dancers’ safe return to the stage. “It allows you to perform while still protecting yourself,” says Janowski.

Takeda will be the first to admit that Kinesio is not a magic bullet. She still had to strengthen her ankle and make sure she was following the RICE procedure correctly. Six months after the injury, Takeda continues to use the tape from time to time. “I have to take care of myself and use ice periodically, but the tape keeps my ankle alignment in check. I don’t roll in as much anymore. And,” she adds with a smile, “I have finally learned how to put it on myself.”

Nancy Wozny writes about health and the arts from Houston, TX.


Photo: Amitava Sarkar, Courtesy Houston Ballet