Knee Pain: KT Tape, Backwards Running, and What Actually Changes the Load

Tape, braces and backwards running all change what the knee feels for a while. None of them change what's loading it. The knee is a hinge between a hip and a foot, and in the research the knee pain you can see coming shows up first as a hip pattern and a trunk pattern. We measure those, train them, and re-test the knee.

Key takeaways

• Kinesio tape tested no better than sham tape. It holds the knee. It doesn't change the load.
• Exercise reduces knee pain. The effect is real and it fades if the pattern doesn't change.
• Knee pain often has a hip mechanism. A 400-runner study saw it before the pain started.
• Trunk control predicted knee ligament injury in 277 athletes. The knee is the last link.

In this article

• The appeal of tape, and what it's actually doing
• Why the knee is rarely the problem
• What about backwards running?
• What exercise does, and what it needs to keep doing it
• Who this is for
• Where this piece comes from

The appeal of tape, and what it's actually doing

KT tape is everywhere because it does something you can feel. The knee feels supported, the pain drops, and you can get through the run. A brace does the same with more structure.

Here's the thing to know before you buy another roll. A systematic review of 12 randomised trials found Kinesio Taping no better than sham taping or active comparison treatments, and where it did come out ahead the effect sizes were small and probably not clinically worthwhile (PMID 24856938). Tape works about as well as tape that's applied wrong. That tells you the benefit is the feeling of support, not the mechanics.

Functional Patterns says it bluntly in their KT tape piece: tape addresses symptoms, not systems. We'd put it this way. Tape holds the knee. Nothing holds the hip that's loading the knee, because nothing can. The hip has to be trained.

Why the knee is rarely the problem

The knee is a hinge. It does one thing, bend and straighten, and it does it between two joints that do everything else. The hip above it rotates, adducts and extends. The foot below it pronates, supinates and loads. When either of those misbehaves, the hinge gets twisted, and a twisted hinge hurts.

The research sees this coming. A prospective study followed 400 healthy female runners and found that the ones who later developed patellofemoral pain, the pain at the front of the knee, had greater hip adduction at baseline (PMID 23274607). Their knees were fine when the study started. Their hips were already doing the thing that would hurt their knees.

And it isn't only the hip. A three-year study of 277 collegiate athletes measured how much the trunk moved after a sudden force release. The athletes who went on to injure a knee had more trunk displacement, and lateral trunk movement was the strongest single predictor of a knee ligament injury (PMID 17468378). The trunk wobbled, the knee paid.

So when someone walks in with knee pain, the knee is the last thing we assess.

What about backwards running?

Backwards running is a real tool and a popular one, and Functional Patterns has a piece on it. It changes the direction of load through the knee, shifts the work toward the hamstrings and glutes, and for a lot of people with pain at the front of the knee it feels better immediately.

That's worth something. It isn't the plan. It changes the load for the ten minutes you're running backwards and leaves the forward-running pattern, the walking pattern and the standing pattern exactly where they were. If the hip adducts when you run forwards, it still adducts after the backwards drill. Use it the way we do: as a way to feel what a different load is like, on the way to training the pattern that produces it.

What exercise does, and what it needs to keep doing it

Exercise helps knee pain. Pooled results from 44 trials show land-based exercise reduced knee osteoarthritis pain by 12 points on a 100-point scale and improved function by 10 points right after treatment (PMID 26405113). The same review found the pain benefit was smaller two to six months later. That fade is the interesting part. A programme that works and then wears off is a programme that changed the muscles without changing the pattern.

Our training for knee pain starts with gait video, because that's where hip adduction and trunk lean show up, in slow motion, every stride. Then we train the hip to control the leg from above and the foot to load from below, and we put it back into standing, walking and eventually running. Then we re-test the gait. If the hip still drops, the knee is still being loaded, pain or no pain, and the plan changes.

Who this is for

If you've got a drawer full of tape and a brace you wear to run, this is for you. Keep them for race day if you like. Then get the pattern measured, because tape can't hold a hip.

The Complimentary Consultation is $0 and includes a movement analysis. The Foundational Assessment at $279 adds gait video, AI posture analysis and an InBody scan, with a plan built from your numbers. Runners usually start on our run performance track from there.

Where this piece comes from

This article builds on two Functional Patterns pieces: "The Efficacy of KT Tape for Knee Pain" and "Backwards Running: Is it a Simple Approach to Knee Pain Relief?". Functional Patterns is the biomechanics system every practitioner at Kinetic Blueprint is certified in. The symptoms-versus-systems argument is theirs, as is the taping review they cite. The other research references, the measurements and the Austin studio are ours.

Kinetic Blueprint does not diagnose, treat, or cure any condition. A knee that locks, gives way, swells after an injury, or can't bear weight needs a licensed medical provider first.