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Compression Band Therapy

FMT RockFloss

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RockTape and the presenter for this seminar have financial associations with the manufacturer of

commercial products used in this seminar.

You are not required to purchase the supplies or products used in this course.

Provider/Financial Disclaimer

Instructor

Brad Norris Director of Clinical Education / Events – Team Promotion - ROCKTAPE Canada

M.Ed.( Biomechanics ), NKT, Clinical Exercise Physiologist / KinesiologistPoliquin Strength Coach – Level 3, Performance Acupuncture, FST,

Soft Tissue Release

ROCKTAPE MOVEMENT MANIFESTO

WHAT ?

HOW ?

WHY ?

The Three “ R’s “ A Movement Checklist

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Functional Movement Pyramid

Skill / Technical

Functional capacity

Foundational Movement

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- Someone important

We are a movement company that dabbles in tape.

“

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Movement Pyramid

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FMT RockFloss - OutlineThe Science

Treatment Considerations

All in One Application

Tissue Glide/Mobility

Pattern Assist

External Cueing - Movement Coaching

Case Study

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Movement Matters

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The Intervention

Compressional Floss Bands

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What is it?Compressional Band Therapy (aka Tack and Floss, Voodoo Floss, Blood Flow Restriction, etc) is a manual technique that has been shown to improve range of motion, fluid dynamics, pain mitigation, and improved recovery rates

CompressionShear

Fluid PumpNeurosensory Stimulation

Placebo?14

Why?Although patients have seen notable improvements after treatment

using protocols and standards from various blogs and company

websites, no medical journals or practices have any set

protocols on tension of the band, wrapping techniques, or

movement programs to dictate the proper use of floss bands.

The lack of protocols can lead to inaccurate results and

varied effects. The scarcity of evidence on floss bands warrants

further investigation.

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Compression Floss History

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History

The oldest known illustration of

compression bandages dates back to the

Neolithic Age (5000–2500 BC)

Mural paintings in the Tassili caves (Sahara),

5000–2500 BC. The development of synthetic elastomers gave rise to latex-free compression

stockings. Synthetic (spandex, polyurethane and nylon) stockings are still the ideal

form of material to use today because of the relative resistance to moisture from sweat.

Today there are more than 200 different brands of graduated compression stockings.

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The Floss Bands

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RockFloss - 2 Sizes

Large (4”)Small (2”)

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Tissue Preparation ConsiderationsFloss is made out of latex rubber

How to decrease skin reactions:

1. Ask and Inform2. Over clothing

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Cleaning Floss Generally speaking, if flossing is performed on intact skin only, floss can be treated as noncritical reusable medical devices that need to be cleaned and then disinfected with an appropriate low-level disinfectant.

Alcohol Cavicide

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Non Negotiable

COMFORTSAFETY

PRACTICAL

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Properly performed procedures contribute to:

1. Improved range of motion2. Pain reduction3. Reduced fluid congestion4. Joint Centration - Improved Joint Relationships

Benefits of Flossing

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Mechanisms

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Mechanical Theory

ShearingCompression Move

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Mechanical - Compression/Shear

Separating LayersShear

Compression

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Grapefruit Analogy

Thomas Myers “We have one muscle in 600, or so, Compartments.”

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Skin/Fascia Continuity

Three-dimensional model of continuity between the skin and tendon provided by the sliding system (Guimberteau et al., 2010) 28

Cutaneous Connection

Strolling under the Skin - Gimberteau

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T/L Jxt Shear - Langevin et al.

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MSK Ultrasound TutorialSkin

Superficial Fascia

Deep Fascia

Muscle

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31Langevin et al.

Fascial Gliding - Control vs. LBP

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Densification• Indicates an increase in the density of fascia. This is

able to modify the mechanical proprieties of fascia, without altering its general structure.

A. Stecco

Can be addressed via compressive/tangential stress

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Addressing Fluid LayerCompression

Shear

Fluid Layer

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Squeeze Film Fluid Theory

The Journal of the American Osteopathic Association, August 2013, Vol. 113, 600-610Max Roman, PhD; Hans Chaudhry, PhD; Bruce Bukiet, PhD; Antonio Stecco, MD; Thomas W. Findley, MD, PhD

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Neural - Brain Mapping

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We are treating human beings attached to the meat - along with a sensory and motor nervous system, previous experiences, history, emotions, etc…..

Not just a Piece of Meat

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Precision Training

Improve Sensory Map Change Body Awareness

Decrease PainImprove Motor Control

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Sensory-Motor Effects

Ruffini Endings (Corpuscles) Respond to sustained deep pressure and lateral (tangential) shear

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Over areas of broken skin (open wounds) or rashes, severe edema (swelling) Areas where there are large blood vessels, High fever with convulsions. Bleeding disordersPregnant women should never have flossing on the abdominal and sacral area. Varicose VeinsDermatitis Severe health issues (CHF, Renal Failure)Areas near large veins such as groin regionInfectionsSystemic inflammatory conditions (RA)

Contraindications

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Research

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Shoulder Flexibility

Perception is Reality

No real change in ROM from control

Perception of flexibility increased more for

the flossing group

Demonstrating a psychological increase in

GH flexion 42

Ankle ROM and Jump Performance

Demonstrating improved ankle dorsiflexion and plantar flexion ROM + Improved 1 leg jump performance

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Ankle Range of Motion

Small sample size

Demonstrated statistically improved

dorsiflexion post flossing44

Shoulder ROM and Power

Poor methodology led to ineffective

outcomes

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Recovery

Preliminary data to suggest compressional

therapy could be effective in managing recovery following induced DOMS

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Screening

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ScreenReScreen

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Screening, in medicine, is a strategy used in a population to identify the possible presence of an as-yet-undiagnosed disease in individuals without signs or symptoms

Screening

Wilson, JMG; Jungner, G (1968). "Principles and practice of screening for disease" (PDF). WHO Chronicle. Geneva: World Health Organization. 22 (11): 473Public Health Papers, #34.

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Screening Process

Tissue Glide:

1. ROM2. Pain Mitigation3. Movement Integrity4. Swelling Control (Girth

Measurement)

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The Approach

1. Explanation to the patient TEACH

2. Bilateral comparison ASYMMETRY

3. Be gentle and do not hurry SAFE

Houglum 2010, 191-193

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Skin as a Handle

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Skin/Fascial Screen

Local Global

Example: Shoulder ROM

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1. Fluid/Pain Management (50/50)

2. Functional

3. Tissue Glide

4. Targeted - X Pattern

5. External Cueing

Floss Apps

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Treatment Considerations

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Step 1: Tack down TissueStep 2: External Glide Step 3: Open Chain MovementStep 4: Closed Chain Movement (if able)

• Make it Meaningful

3 Step Process - All Apps

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Graded Exposure

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External Glide

• Glide Vectors (Optimal Direction)

• Position Progressions (Relaxed, Lengthened, Loaded) - Make them Meaningful

• Graded Mobilizations (Maitland, Mulligan, etc)

1. Longitudinal 2. Shearing 3. Unloading 4. Rotational Shearing 5. Flattening

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External Glide Vectors

Identify the Optimal (Preferential) Vector

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Internal Glide

Graded Exposure

• Open Chain - Non Weight Bearing

• Closed Chain - Weight Bearing (if able)

• Functional Patterns (Tri-Planar) - Meaningful

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Floss + Movement (Open Chain)

Dosage = 1 minNon Weight-Bearing

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Floss + Movement (Closed Chain)

Dosage = 1 minWeight Bearing (if able) 62

All in One Application

6 Application 1

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Goals of Application

Pain Mitigation

Range of Motion

Swelling Management64

Treatment Considerations

1. Comfortable - Depth Gauge2. External Glide - Mobilization Vectors/Grades3. Internal Glide - Meaningful Patterns (pain free) 4. Patient Position - Progressions/Regressions5. Dosage: 1.5 - 3 mins (Zein-Hammoud, Standley)

6. Education/Encourage - Psycho/Social

Manal Zein-Hammoud, PhD , Paul R. Standley, PhD. Modeled Osteopathic Manipulative Treatments: A Review of Their in Vitro Effects on Fibroblast

Tissue Preparations J Am Osteopath Assoc. 2015;115(8):490-502

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Application # 1 : All in One1. Screen2. IDENTIFY areas of focus = TARGET AREA3. Wrap over the area for 90 - 180 seconds = FLOSS

• 50/50 All In - 50% Overlap + 50% Tension• Distal to Proximal Bias

4. ADDRESS regions up/down stream to target tissue (30 seconds each) = RIPPLE

5. Total DOSAGE per Region = 90secs-5mins Seconds

SCREEN + IDENTIFY + FLOSS + RIPPLE66

Application Instructions

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Lower Extremity

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Movement Pattern Assistance

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Goals of Application

Mechanical Advantage Spring Effect

Influence Human MovementActive Assisted Movement

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Application # 2 : Pattern Assist App

Dorsi-Flexion

Toe-Off

Clinical/Movement Relevance:• Toe Walkers• Drop Foot• Jump Inefficiencies• Gait Retraining

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Pattern Assist Application1. Screen2. IDENTIFY areas of focus = TARGET AREA3. Wrap over the area for 90-180 seconds = FLOSS

• 20-70% All In • Lengthen target tissue (stretched position)• Distal to Proximal Bias• Directional Preference

4. ADDRESS regions up/down stream to target tissue (30 seconds each) = RIPPLE

5. Total DOSAGE per Region = 90secs-5mins Seconds

SCREEN + IDENTIFY + STRETCH + FLOSS + RIPPLE72

Calf (Plantar Flexion) Application

50-70% Tension - Only over Target TissueTissue Under Stretch

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Spring Effect (Active Assisted)

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Tib Ant (Dorsi-Flexion) ApplicationTissue Under Stretch

50-70% Tension - Only over Target Tissue

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Tissue Glide Application

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Application # 3 : Tissue Glide

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Goals of Application

Interlayer GlidingMobility

ROM

Directional PreferenceTissue Glide Vectors

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79Skin/Fascia Interface

Read Between the Lines

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Tissue Glide - External/Internal

SCREEN + IDENTIFY + FLOSS + RIPPLE

1. Screen2. IDENTIFY areas of focus = TARGET AREA3. Wrap over the area for 90-180 seconds = FLOSS

• 20-70% All In • Distal to Proximal Bias• Directional Preference

4. ADDRESS regions up/down stream to target tissue (30 seconds each) = RIPPLE

5. Total DOSAGE per Region = 90secs-5mins Seconds

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Glide Technique - Tissue Shear

Drag Tissue in Preferential Direction82

Therapist-Assisted Manipulation

Augmented External Glide

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Glide + Move

Address the area while moving through a meaningful pattern of movement that is complicated by lack of glide.

Meaningful Movement

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Upper Extremity

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Targeted Floss Application

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Goals of Application

Targeted EffectManual Therapy Progression

Localized

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Targeted Flossing - X Pattern

SCREEN + IDENTIFY + FLOSS + RIPPLE

1. Screen2. IDENTIFY areas of focus = TARGET AREA3. Wrap over the area for 90-180 seconds = FLOSS

• 20-70% Tension• Distal to Proximal Bias• Target Focused - X marks the spot

4. ADDRESS regions up/down stream to target tissue (30 seconds each) = RIPPLE

5. Total DOSAGE per Region = 90secs-5mins Seconds

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X-Pattern

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Augmented Self Myofascial Mobs

Self Myofascial Release

Hide the Ball Method 90

Thank you