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This post is not satire. Seriously, it isn’t. I can understand why you might think it was, considering my past attempts at such. But you would be wrong.

No, it’s legit. The study I’m about to discuss was published in an actual medical journal by serious researchers. And I don’t think they are going to stop.

Does the color of kinesiology tape matter?

The study in question, published this month in BMC Sports Science, Medicine and Rehabilitation, is an investigation into the influence of kinesiology tape (KT) color on the primary outcome of athletic performance, or at least a lab simulation of it. Secondary outcomes included muscle strength and neuromuscular function. The online-only journal, which does charge authors a fair amount of money for publishing their research, is open-access. This includes the peer review process, meaning that the names of reviewers and the back and forth correspondence is provided for anyone to read. That’s pretty neat in my opinion, but it didn’t prevent this paper existing.

The authors point out in the introduction that the use of kinesiology tape by athletes is increasingly common. You’ve undoubtedly seen people, from the occasional jogger to the elite Olympic competitor, bedecked with colorful strips of this stretchy tape in patterns reminiscent of complex crop circles. There are several proposed mechanisms behind the tape’s perceived benefit:

Kinesiology tape has been proposed to enhance performance by supporting musculature, joints, and fascia without limiting range of motion. Additionally, kinesiology tape is believed to promote healing by facilitating lymphatic drainage, blood circulation, and corticomotor activity.

Though these products are popular, the explanations given by proponents are highly implausible and the evidence to date is resoundingly negative. The specific patterns, which proponents believe provide a unique benefit, are irrelevant. KT appears to be just a more expensive equivalent to the old-fashioned athletic tape traditionally used to help stabilize a joint or to provide compression bandaging to reduce swelling after an acute injury.

When it comes to pain relief or athletic performance, there may be a non-specific benefit that comes from expectation or, as has been skillfully argued by our own Paul Ingraham, the application of a novel sensory input. So kinesiology taping might serve as either a simple distraction from discomfort or a less impressive version of Dumbo’s magic feather, but there is no evidence to support benefit from unique “biomechanical tuning”. This would explain why perceived benefits tend to be transient as novel sensations quickly attenuate when continuously applied to the skin.

Seriously, what does color have to do with athletic performance?

The authors state that the data regarding KT use for pain or recovery after injury is negative. But in an attempt to explain its continued and increasing popularity, they figure that it must be more about performance enhancement. Here, they admit, the data is also mixed, although they leave out the fact that it’s the better studies that tend to have negative results. Perhaps, they argue, there is a color based psychological factor behind the disparity in research findings rather than any methodological divergence.

Now here is where we enter new territory, at least for me. There is apparently a literature on the effect of color on “sporting success”. The authors cite a study claiming to show that athletes wearing red are more likely to triumph over competitors in blue, even when skill level is taken into account. Other studies cited purportedly show increased success related to red uniforms in English soccer and rugby teams. They reveal a possible mechanism:

Indeed, the colour red has been proposed to enhance strength output and neuromuscular function in simple motor tasks via a threat-based response, thought beneficial during short bursts of activity.

Could this effect explain why athletes are lining up to use KT? Almost certainly not. There are bigger holes in this hypothesis than in the plot of The Last Jedi.

First off, there is no there there. The authors are looking for an explanation for a benefit that almost certainly doesn’t exist. The reason why some studies on KT show benefit in athletic performance is because they are crappy studies, not because those studies just happened to use red tape. I honestly am having trouble wrapping my head around how silly this study is.

Second, is the “red advantage” even real? I wasn’t able to access the cited studies, but the authors of this paper provide a potential weakness themselves. Perhaps players wearing red don’t perform better at all. Maybe they are more likely to win because their opponents play worse because the color red is intimidating. I found this discussion of the few studies on this phenomenon which postulates that there may also be a psychological effect on judges of competitive athletic performances. I don’t buy any of it personally.

The study methodology (because you never just skip to the conclusion)

The study, a randomized crossover controlled trial, involved 32 healthy subjects aged 18 to 40 years. Five experimental conditions were included and allocated randomly:

(1) no kinesiology tape (control), (2) beige-coloured kinesiology tape applied with tension (sham A), (3) beige-coloured kinesiology tape applied with no tension (sham B), (4) red-coloured kinesiology tape applied with tension, and (5) blue-coloured kinesiology tape applied with tension (Team Tape®)

As stated earlier, the primary outcome that the researchers focused on was athletic performance, in this case distance on a single leg hop test. Secondary outcomes involved the measurement of knee extensor torque using isokinetic dynamometry and neuromuscular function of the quadriceps muscle as assessed by transcranial magnetic stimulation. Fancy. They also collected data on color preference to see if that played a role in outcome differences.

There weren’t any outcome differences

Nothing mattered. Tape color didn’t matter. Color preference didn’t matter. “Proper” placement of KT with tension didn’t matter. No effect on performance, strength, or function was found in any experimental round compared to the control round for any of the subjects. It was a solidly negative result that is in line with previous, and much better studies, showing that KT doesn’t have any specific benefit or much of a non-specific benefit either. And the effect of colored versus plain KT doesn’t deserve any ad hoc excuses.

And now for some ad hoc excuses

The following potential “plausible” explanations for why this study did not find an effect of color on the primary and secondary outcomes were provided:

  1. The subjects were not instructed to look at the color of the tape.
  2. Maybe they didn’t use enough tape.
  3. The color of the subject’s shorts and tee-shirts may have interfered.
  4. Maybe the real effect occurs in the performance of someone looking at the color of the kinesiology tape used by an opponent.
  5. Perhaps an effect would be found “in more functionally meaningful contexts across a range of sports and at a range of skill levels.”
  6. Maybe an effect would be found in injured subjects.
  7. I guess it’s possible that studies incorporating “a broader variety of tape manufacturers, patterns, tensions, and colours” just might find an effect?

No, further research is not required

Once again, this was not satire. This study happened and anyone with a basic understanding of physiology and psychology could have predicted the results. And anyone with a fair grasp of scientific skepticism could have predicted the conclusion made by the almost certainly well-meaning authors.

Doesn’t that ad hoc rescue sound awfully familiar? Similar logic is seen applied to all manner of pseudoscientific treatment modalities. Maybe the dose of the worthless herb was wrong? Or maybe they used the leaf instead of the flower? Maybe the skeptics in the room interfered with the psychic’s powers? We know it works, we just need to keep trying to find out in who!

To be fair, I don’t know if these researchers are true believers. I bet that they aren’t. If you read the paper, it is actually pretty clear that they think KT is bunk in my opinion. I think that they were being kind to a fault, however. Or, if you of a more cynical mind, setting themselves up for more publishable units of research. The bottom line is that this study fits nicely into the growing pile of research revealing that KT is just tape plus theatrics.

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  • Clay Jones, M.D. is a pediatrician and a regular contributor to the Science-Based Medicine blog. He primarily cares for healthy newborns and hospitalized children, and devotes his full time to educating pediatric residents and medical students. Dr. Jones first became aware of and interested in the incursion of pseudoscience into his chosen profession while completing his pediatric residency at Vanderbilt Children’s Hospital a decade ago. He has since focused his efforts on teaching the application of critical thinking and scientific skepticism to the practice of pediatric medicine. Dr. Jones has no conflicts of interest to disclose and no ties to the pharmaceutical industry. He can be found on Twitter as @SBMPediatrics and is the co-host of The Prism Podcast with fellow SBM contributor Grant Ritchey. The comments expressed by Dr. Jones are his own and do not represent the views or opinions of Newton-Wellesley Hospital or its administration.

Posted by Clay Jones

Clay Jones, M.D. is a pediatrician and a regular contributor to the Science-Based Medicine blog. He primarily cares for healthy newborns and hospitalized children, and devotes his full time to educating pediatric residents and medical students. Dr. Jones first became aware of and interested in the incursion of pseudoscience into his chosen profession while completing his pediatric residency at Vanderbilt Children’s Hospital a decade ago. He has since focused his efforts on teaching the application of critical thinking and scientific skepticism to the practice of pediatric medicine. Dr. Jones has no conflicts of interest to disclose and no ties to the pharmaceutical industry. He can be found on Twitter as @SBMPediatrics and is the co-host of The Prism Podcast with fellow SBM contributor Grant Ritchey. The comments expressed by Dr. Jones are his own and do not represent the views or opinions of Newton-Wellesley Hospital or its administration.