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CHAPTER 11 ● Radiologic Evaluation of the Knee 3
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Focus On
Patellar Taping
Developed by Jenny McConnell in the 1980s, patellar taping
is utilized in the management of patellofemoral pain.1 The
theory behind the use of patellar taping is that precise appli-
cation of force via tape will shift the patella into correct align-
ment, thus providing correct biomechanics for pain relief and
reconditioning of knee musculature.1 McConnell’s tech-
niques address evaluation of patella position through glide,
tilt, and rotation components.1
In her 1986 clinical study, McConnell tested 35 patients
with a history of knee pain.3 Treatment programs were de-
signed for each patient including patellar taping, among other
exercises and techniques.3 Initial outcomes were promising,
with 32 patients reportedly pain-free within two to seven treat-
ment sessions.3 After 6 months, 14 of the patients remained
active and symptom-free.
Studies have used plain film radiography to determine
whether there are any changes in patellofemoral congruency
and patella rotation angles and patients’ perceived pain with
the taping method.3,4 In most cases, the Merchant view, in
which the patient is supine and the knee is flexed 45 degrees,
was utilized.3–5 At least two studies reported that the tape was
effective in moving the patella medially and maintaining the
patellar position after exercise.3 Other studies, however,
found that although the taping was effective initially in pro-
viding proper patellar alignment, it was unable to maintain
the positional relationship during exercise.4 Further unfavor-
able outcomes were revealed by a computed tomography
(CT) study that concluded that patellar taping did not sig-
nificantly affect patellofemoral lateralization or tilt.6
Use of the Merchant view for these studies has been criti-
cized because it uses a 45-degree knee angle, at which point
the patella has already engaged in the patellofemoral groove.5
The axial view (Laurin view) has also been criticized because
of the difficulty of positioning the knee in less than 45 degrees
of flexion during the plain film series.5 In this manner, the
patellar position in other ranges is not known, particularly in
the range of 0 to 30 degrees, considered specific for diagnosis
of patellar malalignment.5
Researchers considering these important points conducted
a study using magnetic resonance imaging (MRI) to compare
static measurements of patellar position.5 They used the
patellofemoral congruence angle, lateral patellar displacement,
and lateral patellar angle at eight angles of knee flexion in pa-
tients after patellar taping, in patients after bracing, and in a
control group of patients with patellofemoral pain.5 Results
revealed that patellar taping affected the patellofemoral con-
gruence angle and lateral patellar displacement at 10 degrees
of knee flexion.5
Most studies conducted found that use of patellar taping was
associated with significant decreases in subjective reports of
pain.3,6 The data support the existence of a subpopulation of pa-
tients with patellofemoral pain who demonstrate “normal”
patellofemoral alignment of 0 degrees at 5- to 30-degrees of flex-
ion, or a negative angle at 10, 15, or 45 degrees.5 This finding
leads to the suggestion that some subjects originally had
patellofemoral alignment that was within normal limits and that
their pain was not the result of patellofemoral malalignment in
the first place.5 Proof to support the finding of subjective pain
reduction remains elusive; however, many therapists continue
to use the taping methods simply because pain reduction in
most cases resulted in greater functional use of the knee.
Salsich et al. demonstrated in their research a reduction
in pain of 92.6% following the application of tape. Clinically,
it is understood that a reduction in pain can lead to better
functional mobility and this was supported by their study.
Patients displayed increased knee extensor moments, knee
flexion angles, and cadence during stair ambulation.7 An-
other form of pain reduction can be in the application of heat
to an affected area. Thermotherapy and taping were found to
be more effective than taping alone in the management of
pain in osteoarthritic knees with patellofemoral arthritis.8 Al-
though empirically taping is not strongly supported to change
the biomechanics of the patella, it is supported clinically and
widely practiced to improve functional mobility through pain
reduction.8
References
1. Prentice WE, Voight MI: Techniques in Musculoskeletal Rehabilitation.
New York: McGraw-Hill, 2001, pp. 557–559.
2. McConnell J: The management of chondromalacia patellae: A long term
solution. Aust J Physiother 32(4):215–223, 1986.
3. Bockrath K, et al: Effects of patella taping on patella position and perceived
pain. Med Sci Sports Exerc 25(9):982–992, 1993.
4. Larsen B, et al: Patellar taping: A radiographic examination of the medial glide
technique. Am J Sports Med 23(4):465–471, 1995.
5. Worrell T, et al: Effect of patellar taping and bracing on patellar position as
determined by MRI in patients with patellofemoral pain. J Athl Training
33(1):16–20, 1998.
6. Gigante A, et al: The effects of patellar taping on patellofemoral incongruence.
A computed tomography study. Am J Sports Med 29(1):88–92, 2001.
7. Salsich GB, et al: The effects of patellar taping on knee kinetics, kinematics,
and vastus lateralis muscle activity during stair ambulation in individuals with
patellofemoral pain. J Orthop Sports Phys Ther 32(1):3–10, 2002.
8. Manjusha V: Medial taping of patella with dynamic thermotherapy—A com-
bined treatment approach for osteoarthritis of knee joint. Indian J Occupational
Ther 37(2): 525–536. August, 2004.