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Various Exercise Protocols with and without the Use of Taping and Kinesio Taping in Individuals with Ankle Injuries
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Ebrahim Piri1    , Abbas Ghadimi KheshtMasjedi2 , Sajjad Ghadimi KheshtMasjedi2 , Mohsen Barghamadi *3 |
1- Ph.D Candidate in Sports Biomechanics, Department of Sport Biomechanics, Faculty of Educational Sciences and Psychology, Mohaghegh Ardabili University, Ardabil, Iran.
2- M.Sc in Sport Biomechanics, Department of Sport Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
3- Associate Professor in Sport Biomechanics, Department of Sport Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran. , barghamadi@uma.ac.ir |
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Keywords: Ankle Injuries [MeSH], Ankle Fractures [MeSH], Exercise [MeSH]
Article ID: Vol27-12 |
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Type of Study: Review Article |
Subject:
Sport Medicine and Corrective Exercises
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Abstract: (29 Views) |
Extended Abstract
Introduction
A significant objective of physical exercise is to attain and maintain physical fitness. However, one consequence of such physical exercises is the occurrence of physical injuries, which can impair an individual's athletic performance. The highest incidence of injury is related to musculoskeletal injuries (96.2%), with the lower extremity being the most frequently injured area. Within the lower extremity, the ankle area exhibits the highest prevalence (27.6%). The ankle joint is one of the most crucial joints in the lower body; its anatomical structure plays a vital role in supporting body weight and distributing it during activities such as walking, running, and jumping. One of the contributing factors to this injury is landing during athletic movements, which can generate impact forces ranging from 2 to 12 times body weight. These forces are frequently associated with lower extremity injury mechanisms. Among the common abnormalities observed in the ankle joint are inward and outward toe rotations. Misalignment of the knee and ankle joints can lead to conditions, such as osteoarthritis, wear and tear, and ankle sprains. Furthermore, an increase in surface stiffness correlates with an increase in foot stiffness, while a decrease in surface stiffness culminates in a decrease in foot stiffness. Upon landing subsequent to a vertical jump, ground reaction forces immediately induce rapid flexion of the ankle, knee, and hip joints. To counteract these forces, the lower extremity extensor muscles must generate torque. The force produced within the body as a result of landing is controlled by the body's inherent structures and mechanisms. This force increases the likelihood of injury when external loads on the body are high and these structures are unable to adequately modulate it. Lateral ankle ligament injuries are the most common ankle joint injuries, accounting for 38% to 48% of all ankle-related traumas and frequently preventing athletes from participating in sports activities. Approximately 70% of individuals develop chronic ankle instability following an initial lateral ankle sprain. Individuals with chronic ankle instability often experience pain, instability, or a subjective feeling of the ankle "giving way." The use of various rehabilitation exercises and diverse supportive tools can lead to improved injury and also prevent its recurrence. An ankle injury rehabilitation program commences after the acute phase, encompassing a sensorimotor and postural exercise regimen alongside range of motion and strengthening exercises.
One common method used to prevent re-injury and facilitate recovery in ankle injuries is taping. Kinesio taping serves as a non-invasive and effective approach by accelerating effective muscles’ recruitment. The kinesio taping with the mechanism of lifting the skin creates more space between the dermal layer and the underlying muscle. This increased space enhances blood flow to the injured area, ultimately culminating in pain reduction. This space also contains various nerve receptors that transmit specific information to the brain. Kinesio taping modulates the information these receptors send, leading to reduced reactive responses and less pain in the body. These processes collectively contribute to a potential decrease in pain and disability in individuals.
Despite the increasing use of taping in clinical practices, there remains uncertainty regarding its effectiveness. This study was conducted to review the effects of various exercise protocols with and without the use of taping and kinesio taping in individuals with ankle injuries.
Methods
A comprehensive search for relevant articles published between 2007 and 2023 was conducted in both Persian and English. Specialized databases utilized included PubMed, Scopus, ScienceDirect, Web of Science (WoS), Google Scholar, Islamic World Sciences Citation (ISC), Civilica, State Inpatient Database (SID), and Magiran. To extract pertinent articles, the following keywords were employed: "Ankle ligament," "Ankle injury," "Ankle sprain," "Corrective exercises," and "Taping." Ultimately, 57 related articles were selected based on pre-defined inclusion and exclusion criteria.
Inclusion criteria comprised articles investigating the application of various exercise protocols in individuals both pre- and post-ankle injury, and studies specifically addressing ankle ligament injuries and those utilizing exercise protocols for injury prevention.
Exclusion criteria included studies conducted on subjects with other bodily anomalies or a history of surgery (post-surgical rehabilitation), and the use of other supportive devices without considering the effect of taping in improving ankle injury.
Ultimately, 16 articles investigating the effects of various exercise protocols with and without the use of taping on improving ankle injuries, as well as their effects on individuals following ankle injury, were reviewed and analyzed.
The quality of eligible studies was assessed using the Downs and Black questionnaire. This questionnaire comprises 27 items and is a widely recognized tool for evaluating the quality of clinical studies. A key advantage of the Downs and Black questionnaire is its applicability to studies where participants are selected through both randomized and non-randomized methods.
Conclusion
Articles reviewed in the field of improving and preventing recurrent ankle ligament injuries have demonstrated that exercise protocols with the use of taping statistically significantly reduce the risk of lower extremity injury. This reduction is attributed to increased ankle muscle strength and improvements in selected kinetic variables, proprioception, and ankle function. However, studies on exercise protocols incorporating taping also revealed that the use of taping had no statistically significant effect on peak and mean compressive and shear forces within the ankle joint. Moreover, during landing after a single-leg hop, the use of kinesio taping aimed at stimulating the lymphatic system was not effective in reducing acute swelling. Fibular taping, with and without stretch, did not culminate in immediate spinal changes either. However, the use of taping did reduce sprains. The remaining studies on exercise protocols without the use of taping demonstrated that these exercises led to muscle strength recovery and improved proprioception and static balance, playing a significant role in ankle injury recovery. The quality of the articles was assessed using the Downs and Black questionnaire, revealing a total quality score of 75.53%.
Scientific evidence identifies taping as a recognized technique for improving injuries. Its effectiveness is attributed to factors such as facilitating afferent information, further stimulating cutaneous receptors involved in balance maintenance, and preserving proper joint alignment. The enhanced postural stability observed after applying taping to the skin can be explained by several mechanisms. One explanation is that the elastic tape continuously stretches the skin, which stimulates mechanoreceptors. This stimulation, in turn, increases proprioceptive input to the central nervous system, thereby improving joint position sense and ultimately leading to enhanced balance. Taping may influence neuromuscular reflexes involved in postural control and coordination. Additionally, taping could enhance postural control by altering muscle activity around the ankle joint. The reported benefits of using taping include facilitating the restoration of joint and muscle alignment by strengthening weak muscles, improving blood circulation and lymph through increased space between the skin and underlying connective tissue, reducing pain by inhibiting pain receptors, alleviating abnormal muscle tension, aiding in the recovery of fascial and muscle function, and enhancing proprioception through mechanoreceptor stimulation.
Funding
This study received no institutional funding.
Authors' Contributions
Ebrahim Piri: Project administration and design, project execution, data collection, data analysis, interpretation of results, drafting of the manuscript, and approval of the final manuscript.
Abbas Ghadimi KheshtMasjedi: Project administration and design, project execution, data collection, interpretation of results, and drafting of the manuscript.
Sajjad Ghadimi KheshtMasjedi: Project administration and design, project execution, data collection, interpretation of results, and drafting of the manuscript.
Mohsen Barghamadi: Project administration and design, project execution, data collection, data analysis, interpretation of results, drafting of the manuscript, and approval of the final manuscript.
Conflicts of Interest
No conflicts of interest.
Acknowledgments
We would like to thank all researchers in the field of sports pathology.
Key Message: Various exercise protocols with the use of taping are significantly effective in preventing the recurrent ankle ligament injuries.
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Piri E, Ghadimi KheshtMasjedi A, Ghadimi KheshtMasjedi S, Barghamadi M. Various Exercise Protocols with and without the Use of Taping and Kinesio Taping in Individuals with Ankle Injuries. J Gorgan Univ Med Sci 2025; 27 (2) :10-20 URL: http://goums.ac.ir/journal/article-1-4530-en.html
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