Handi Knee Taping

HANDI
Making non-drug
interventions easier
to find and use
Taping: knee osteoarthritis

Intervention
Application of strong, adhesive tape or strapping aiming to realign the patella and unload
painful soft tissues.
Indication
Chronic pain related to knee osteoarthritis (OA).
Knee OA is the most common

cause of knee pain in people
older than 50.
Malalignment of the patella, with abnormal distribution of force on the lateral facet, is
thought to contribute to pain in knee osteoarthritis. Taping increases patellofemoral
contact area, decreasing joint stress and thereby reducing pain.
Taping is a very effective pain-relieving strategy and can assist participation in other
strongly recommended therapies for knee osteoarthritis, such as cardiovascular and
resistance land-based and aquatic exercises.
Precautions
A physiotherapist experienced in assessment and taping techniques should show the

patient how to apply the tape:
Precise placement of tape is needed for maximum benefit.
Taping is not recommended as a sole intervention:
Exercise programs and weight loss (for overweight patients) are strongly
recommended in conjunction with any other therapy.
Skin care is important:
Use hypoallergenic tape to protect the skin from direct contact from rigid strapping
tape
The majority of skin damage is done during tape removal, so remove and re-apply
tape less frequently in older patients
Ensure tape is removed slowly and carefully. Hand cream may be applied to the skin
after tape removal
If skin irritation occurs, a skin preparation (spray, roll-on, plastic film or even calamine
lotion, which must dry first) can be applied prior to tape application.
Adverse Effects
Taping is associated with negligible adverse effects, which generally include minor skin
irritation.
Availability
Physiotherapist visit (unsubsidised) is approximately $7080.

Physiotherapists typically use an adhesive, non-stretch (rigid) sports tape (e.g. Leuko
Sportstape Premium Plus, Beiersdorf, 38mm) to restrict undesired motion and improve
patella positioning. This is used in combination with a hypoallergenic underlay tape such
as Fixomull (Beiersdorf), which is available for around $1020. Both tapes are available
over the counter from pharmacies.
Pre-cut tape such as KT Tape is available at around $20 per package. Packages contain
1020 applications of strong, pre-cut elastic tape that can be used in the pool or shower.
This tape is not rigid it so initially may not be as effective in reducing pain. Depending on
usage, a package may last 4060 days.
www.racgp.org.au/handi
Reprinted with permission from The Royal Australian College of General Practitioners, October 2013.
HANDI
Making non-drug
to find and use
Description
Tape is applied before painful activities, such as exercise; however, each application can
be left in place for days to weeks, depending on adhesion durability.
Before applying tape it may be necessary to shave the skin, which should be done 12
hours before application.
Ensure the skin is thoroughly cleaned and dried before applying tape.
Before applying the tape, ask the patient to perform a symptom-provoking activity such
as a step-down so the level of pain can be re-assessed following tape application.
Better results will be obtained if immediate reductions in pain can be obtained with tape.
Apply the tape with the patient either lying or sitting on the edge of a chair, with the leg
extended and thigh muscles relaxed.
Several different taping methods can be used. The choice will depend on which
combination is most effective in reducing the patients pain. Prior to placing each piece
of rigid tape, place several strips of hypoallergenic tape across the knee region to cover
the patella and the medial and lateral knee regions.
A 2-3 step method
This taping method consists of steps 1 and 2, with or without step 3.
1. Medial tilt and medial glide
Figure 1. Medial tilt and medial glide
Start the tape in the middle of the patella at the

level of its superior aspect, lift the skin on the
medial side of the knee towards the patella and pull
the tape medially. Fix the tape to the medial aspect
of the knee just short of the hamstring tendons,
ensuring there is some slight wrinkling of the skin
(Figure 1). This tilts the lateral patellar border away
from the femur.
2. Anteroposterior tilt and medial glide
Start the rigid tape on the lateral aspect of the knee
at the level of the superior aspect of the patella.
Gently lift the skin on the medial side of the knee
towards the patella as you pull the tape medially.
Fix the tape to the medial aspect of the knee just
short of the hamstring tendons, ensuring there is
some slight wrinkling of the skin (Figure 2).
Figure 2. Anteroposterior tilt and medial glide
Refer to training video 1 for a demonstration of

steps 1 and 2 .
3. Unloading the infrapatellar fat pad and reducing
stretch of inflamed soft tissue
Commence the tape at the tibial tubercle and lift
the soft tissue towards the patella, while firmly
pulling the tape to the medial joint line. Repeat with
a second piece of tape, but firmly pull the tape
toward the lateral joint line (Figure 3).
Figure 3. Unloading of the infrapatellar pad
Refer to training video 2 for a demonstration of

step 3.
HANDI
Making non-drug
to find and use
Tips and Challenges
Patients can be taught to self-tape, enhancing their ability to self-manage.

Patients with concurrent hand OA may find taping difficult. Pre-cut tape could offer
some advantages.
Even tape that does not exert appreciable force on the patella can provide some pain
relief. This may be due to a sensory or placebo effect.
Taping has been shown to have immediate and short-term pain-reducing effects while it
in being worn, but also to provide benefits for some weeks after tape removal.
Training
Video 1 Steps 1 and 2 (refer to HANDI website)
Grading
NHMRC Level 1 Evidence (for pain relief).
References
Hochberg MC, Altman RD, April KT, Guyatt G, McGowan J, Towheed T, Welch V, Wells
G, Tugwell P. American College of Rheumatology 2012 Recommendations for the Use
of Nonpharmacologic and Pharmacologic Therapies in Osteoarthritis of the Hand, Hip
and Knee. Arthritis Care & Research 2012 Apr; 64(4): 465-74
Video 2 Step 3 (refer to HANDI website)
Page CJ, Hinman RS, Bennell KL. Review Article: Physiotherapy management of knee
osteoarthritis. International Journal of Rheumatic Diseases 2011; 14: 145-151
Warden SJ, Hinman RS, Watson MA Jr, Avin KG, Bialocerkowski AE, Crossley KM.
Patellar Taping and Bracing for the Treatment of Chronic Knee Pain: A Systematic
Review and Meta-Analysis. Arthritis & Rheumatism 2008 Jan 15; 59(1): 78-83
Knee taping intervention

The RACGP gratefully acknowledge the contribution of Professor Kim Bennell and Professor Jenny McConnell in the
development of this intervention.

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HANDI

Taping: knee osteoarthritis

Chronic pain related to knee osteoarthritis (OA).

Knee OA is the most common

A physiotherapist experienced in assessment and taping techniques should show the

Physiotherapist visit (unsubsidised) is approximately $7080.

Figure 1. Medial tilt and medial glide

Start the tape in the middle of the patella at the

Figure 2. Anteroposterior tilt and medial glide

Refer to training video 1 for a demonstration of

Figure 3. Unloading of the infrapatellar pad

Refer to training video 2 for a demonstration of

Tips and Challenges

Patients can be taught to self-tape, enhancing their ability to self-manage.

Video 1 Steps 1 and 2 (refer to HANDI website)

NHMRC Level 1 Evidence (for pain relief).

Video 2 Step 3 (refer to HANDI website)

Knee taping intervention

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