Kinesiology Taping on Calf Tightness

This study aims to determine the effect of combined facilitatory Kinesiology and inhibitory Kinesiology taping on balance and ROM in university students with calf tightness. This study will also compare Inhibitory kinesiology taping on calf muscles with combined Inhibitory and Facilitatory kinesiology taping on tight Calf and weak Tibialis anterior respectively This randomized clinical trial will include 20 university students with calf tightness according to inclusion and exclusion criteria. Subjects will be assessed by using silfverskiold test for calf tightness and star excursion test for dynamic balance. Baseline measurements will be documented and the subjects will be randomly assigned to two interventions by Goldfish Bowl randomization method: Facilitatory kinesiology taping on calf muscles (Intervention 1 or group A) and Inhibitory kinesiology taping on calf Muscles combined with Facilitatory kinesiology taping on Tibialis Anterior (Intervention 2 or group B). Immediate effects of taping on balance will be assessed after 20 minutes. After that follow up will be maintained and participants will be assessed again after 72 hours. At the end, these measurements will be documented and compared with baseline readings. And changes will be noted down. The data will be entered and analyzed using SPSS 25.

Leg pain is considered one of the most common issues worldwide. It can be due to variety of factors like medial tibial stress syndrome, nerve compression, overuse, musculoskeletal disorders and arterial or venous disorders. According to the literature, muscle tightness is one of the most common factors responsible for leg pain.The area most prone to muscle tightness in lower limb is lower leg region specifically calf muscles. Calf tightness is a common problem in healthy population especially students who have to sit for prolong durations. Studies have reported venous insufficiency causing calf pain in female university students who wear high heels on habitual basis.

Prevalence of calf pain in patients with Ankle foot pathologies is 96.5%. For example, patients with talipes equinus, Achilles tendinopathies, metatarsalgia and mid foot arthritis present with restricted ankle ROM and pain in calf region. Certain systemic diseases can also cause calf tightness like, peripheral vascular disease, Deep Venous Thrombosis, muscle strain or tendon injuries. It can vary from mild to intense. It can be symptomatic (bruising, swelling or sudden pain) or asymptomatic. Furthermore, it has been shown to be a significant factor in postural and balance dysfunction accompanied by proprioception problems. Disturbed balance and proprioception can be attributed to decreased dorsiflexion range of motion that is basically a consequence of over activity of calf muscles.

Different strategies have been used to treat calf tightness that include RICE (Rest, Ice Compression Elevation) protocol, stretching, ankle mobilization, Proprioceptive Neuromuscular Facilitation, electrotherapy, soft tissue mobilization, Taping and other manual therapy techniques. Taping has remained really an effective treatment to release calf tightness. Literature has shown remarkable effects of Kinesiology Tape application in variety of musculoskeletal conditions like, plantar fasciitis, ankle sprain, medial tibial stress syndrome, general knee pain and low back pain.

Kinesiology tape is an elastic tape applied to skin with specific amount of tension as per requirement. The underlying mechanism investigated by several studies is the space enhancement and skin uplifting that increases the blood flow in the targeted area and promotes healing. According to the recent studies, kinesiology Taping significantly support weak muscles, decrease pain by lifting fascia, helps to reposition subluxated joint as well as enhance muscle function by increasing strength and proprioception.

As existing literature provide evidence, KT improves healing by fastening tissue repair and increasing vascularity. It can be attributed to increased amount of type III collagen fibers as documented in a recent study. A recent study conducted in 2021 on comparison between the conservative treatment and combined effects of KT with conservative treatment showed significant improvements in healing.KT has also remained an efficacious treatment for hallux valgus patients as it decreases the hallux angle and pain.

In addition to its effects in musculoskeletal conditions, KT has played significant role in lymphatic drainage and swelling or edema reduction. Tape is applied in a fan shaped pattern and the strips are called fan shaped strips or edema strips. According to a previous study, KT combined with manual lymphatic drainage significantly decreased the post-operative lymphedema in breast surgery patients than using manual lymphatic techniques only. Studies have been conducted that support the idea that KT plays a significant role in injury protection and prevention in sports. Moreover, its role in stroke is undeniably important causing improved integration of the three systems that maintain stability i.e. motor, sensory and CNS integration.

Different application methods of K Taping have been used in management of Soft Tissue Injuries. K Tape effectiveness mainly relies on its direction of application and its shapes as well. Shapes used can be I, Y, X, web or donut shaped. Applied direction effect has been used to achieve the desired function of KT that can be facilitation or inhibition of muscles. Taping from origin to insertion can be used to facilitate the weak muscles while taping from insertion to origin can be used to inhibit the over active or spastic muscles.

Conditions like scapula-thoracic dysfunction cause hyperactivity of the upper fibers of the trapezius which can be treated by using inhibitory kinesiology taping. It has been also very effective in treating the hyperactivity of vastas lateralis to treat patellofemoral pain syndrome and lateral patellar tracking. This inhibitory effect can be attributed to shortening effect of tape that decreases the tonic discharge and causes relaxation. In a recent study conducted on chronic stroke patients, two types of taping PNF-KT and A-KT were applied and significant increase in ankle dorsiflexion ROM and balance was observed but PNF-KT more significantly improved ankle DF-ROM and static balance than A-KT.The use of inhibitory kinesiology taping alone can also be used in chronic stroke patients to decrease the over activity of spastic muscles. In another study conducted on the comparison of effects of direction of application of kinesiology tape on sensation and postural control, improvement in sensation and sway speed was observed with facilitatory and inhibitory taping respectively. Furthermore facilitation taping improved two-point discrimination and increased the sensitivity of combined cortical sensation

Literature supports the use of either facilitatory or inhibitory taping on a certain muscle but no evidence to the best of researcher knowledge exists in literature supporting the simultaneous use of Inhibitory taping on tight muscles and Facilitatory Taping on Weak muscles. Furthermore the combined effect of Inhibitory and Facilitatory Taping on Balance and ankle ROM in Adults with Calf Tightness is still unclear. So, this study aims to evaluate the combined effect of simultaneous application of inhibitory taping on tight calf and facilitatory taping on tibialis anterior and how it improves balance and ROM.

Purpose of this study is to devise more efficient and time saving treatment strategy for clinicians and healthcare professionals. This study will help to improve Balance and Range of Motion in adults with calf tightness by comparing the effects of two Taping Strategies. This study will reduce the cost and time of patients by giving them better management option using Kinesiology Taping leading to fast recovery as well as reducing the risk of injuries and further complications.

Eligibility Criteria:
Inclusion Criteria:

* Both Male \& Female
* Age between 18 to 28 years old university students with Calf Tightness.

Exclusion Criteria:

* Students with plantar fascitis, history of fractures, bone spurs, any arthritis, any history of pain, trauma, or injury of the knee joint, triceps surae muscles or ankle joint 6 months prior to the study.
* Skin disease or self-reported hypersensitivity to tape application, including scar tissue in the acute phase.
* Any red flag (rheumatoid arthritis, metabolic diseases, psychological problem, fibromyalgia, Spinal fracture, previous spinal trauma, tumor etc) or subjects with chronic illness (musculoskeletal, systemic, psychological or any comorbidity i.e. diabetes, hypertension, hematological issues, etc