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The Two Tape Test

Over the years I have patched a lot of feet and see a lot of feet patched by others. When I first started, duct tape was the most commonly used tape. Along the way there has been Leukotape, Micropore, Elastikon, and finally, Kinesio-Tex. Sure, there have been others, but they have not stood the test of time.

The favorites for a long time have been duct tape and Elastikon. Duct tape is still used by some athletes. I don't use it because it is does not shape to the contours of the foot and toes - and so can cause problems with ridges and folds of the tape. Elastikon is still favored by many. It sticks well and can be shaped to the foot. It is seen on the feet of many runners.

But as much as I have liked Elastikon in the past, I now almost exclusively use Kinesio-Tex. Let me explain what the two-tape test done by Jakob has taught me.

Jacob Herrmann Taping Experiment

Several months ago I received an email from Jacob Herrmann. Here is what he wrote:

I don't like to bug you with this question but I'm getting desperate. I've studied your excellent written book and have researched online but never found a true solution for my problem. If you do not want to answer this then I understand and simply delete this email.

My issues are my heels. I always had calluses on the outer-bottom sides of my heels and they became a problem when I started to run ultras 3 years ago. Especially on 100 milers I am getting blisters underneath them despite carefully taping my feet.

About a year ago I started to remove those calluses with pumice and I got them all almost gone. The skin feels very soft; however, I still get those blisters underneath them despite of the skin being much softer.

What I then do is to cut off all the death skin on top and remove the blister. This always leaves a deep hole in my heel. During the healing process I use pumice, Footherapy's Apricot Walnut Foot Scrub and True Blue Spa's "Heel of Approval" heel treatment cream. Once the skin grows back it's again soft and nice; however, on my next 100 miler the whole process starts over and I get a blister underneath that area on my heels.

I've attached pictures of my last blisters, how I take care of them and how it looks once it's fixed. The way I fix this problem feels like I'm going around a circle. Any help is great appreciated.

So, I Emailed Jacob.

John: Have you reduced the callus to soft skin?

Jacob: Before I removed my calluses on my heels the skin was hard like a crust on top of the normal skin. After I started to remove it the skin was soft; the hard crust was gone but it wasn't as soft as the rest of the skin on my feet. I think I've made it better but not perfect. And yes, the same thing happens on both heels.

John: Many times with good skin care after a blister, the roof of the blister will reattach to the skin underneath. Have you given this a chance or do you simply cut off the top?

Jacob: When I fix my blister I cut off the whole piece including the roof.

John: I have seen a lot of heel blisters caused by the edge of the insole where it touches the inner side of the shoe. Do your insoles have a rough or thick edge at the point where the blisters form?

Jacob: I've checked my shoes and their edge of the insole, where it touches the inner side of the shoe, is not too bad at all. There is a bit of an edge but nothing major.

Meeting at Badwater

I talked to Jacob when we were both at Badwater. I gave Jacob some Kinesio-Tex tape and suggested he use it on one heel, while taping his other heel as usual. What I wanted to determine is whether there would be a difference in the tapes. I had my suspicions, but knew this was a perfect opportunity for a good test.

Jacob's Two-Tape Test

Here's an update what happened with my feet at the Mt. Disappointment 50 mile race.

As discussed I've taped one foot the way I always do with the Elastikon tape and the other with your Kinesio-Tex the way you showed me.

First up, the taping with the Kinesio-Tex is so much easier. It goes on very smoothly whereas with the Elastikon tape I always have to be so careful not to have wrinkles within the tape. I had the Kinesio tape on within 5 min where it took me over 10 minutes for the Elastikon tape. I really liked that.

The Kinesio tape also feels much smoother on the skin and it more comfortable to wear.

During the race both feet felt the same. However, around mile 30 my Elastikon tapped heel started to hurt like it usually does but the Kinesio tapped heel didn't hurt at all. I was super excited about that.

On the last few miles eventually both of my heels started to hurt but the Elastikon foot hurt more. Every time I hit a stone on that heel it shoot a pain through my leg whereas the other side I could feel the stone but it didn't hurt that much at all.

Also removing the Kinesio-Tex tape was super easy. It just came off like that. The Elastikon tape is always more complicated to remove. I have to pull it very slowly not to rip open the blister.

Once both tapes were gone I saw that both heels had blisters again; however, the heel with the Kinesio tape looks so much better. 

My Findings

First, a few comparisons. Elastikon is thicker than Kinesio-Tex and its surface is rougher. When properly applied, both stick equally well. Elastikon leaves a tape residue when removed where as Kinesio-Tex comes off with no residue left on the skin. Elastikon has some stretch and conforms well but Kinesio-Tex does it better. When properly applied, both do well in wet conditions. Both come in multiple widths. Kinesio-Tex has a paper backing to remove. Elastikon does not.

I have seen several instances where runners have had Elastikon tape on their feet and have had problems. Let me share what I suspected:

  • Elastikon is thicker and coarser.
  • The coarser surface of the tape tends to hold the sock against the tape.
  • The skin of the foot, held by the tape, is also held against the sock.
  • This increases tension on the tissue under the tape.
  • This leads to sore and painful tissue on the bottom of the feet.

At the past two Badwaters I attended to runners whose feet were patched with Elastikon. In each case, their complaint was sore and painful feet - to the point where they wanted to quit. In each case I removed the Elastikon, cleaned the foot, and then taped with Kinesio-Tex. In both cases, the runner went on to complete the race.

Here is why Kinesio-Tex shines. The less you add to the foot, the less chance of problems. Kinesio-Tex is thin and its surface is smooth. This allows it to be applied to toes without having to tape neighboring toes. It also means less bulk added to the foot. Extra bulk can change one's foot strike or gait. Kinesio-Tex stretches in its length and after application is meant to be rubbed for 30-45 seconds to help it bond to the skin.

In Jakob's case, the skin under the Kinesio-Tex taped foot was in better shape and less painful then the Elistikon. I know he will continue to experiment with different methods of figuring out what works for him.

Another Perspective

Some tapes are smoother than others. Duct tape is smooth but does not breathe or conform to the curves of the foot. Elastikon is coarse as well as thick. Kinesio-Tex, Leukotape and Endurotape are smooth.

Allow me to paint you a picture of why tape smoothness matters.

Picture the following: your skin's outer layer typically moves against the inner layers. Then you apply a non-smooth tape to the skin, pull on a sock, and finally put your foot inside a shoe. The tape sticks to the skin. As you run, the foot naturally moves a bit inside your shoes. However, the sock cannot move freely against the coarseness of the tape. This forces the tape to move with the sock, which stresses the outer later of skin against the inner layers. The result is very sore feet. Others may not agree, but I have seen too many runners with sore feet, many at the point of not being able to run any more, and the common denominator has been non-smooth tape.

I have made these observations when taping feet and seeing athletes' injured feet - and this affects the way I tape and the tapes I use.

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