Upload
others
View
4
Download
0
Embed Size (px)
Citation preview
1
Therapeutic Taping
Dr. Heather Moore, DPT, CKTP
Total Performance Physical Therapy
www.totalperformancept.com
Provider Disclaimer
• Allied Health Education and the presenter of this
webinar do not have any financial or other
associations with the manufacturers of any products
or suppliers of commercial services that may be
discussed or displayed in this presentation.
• There was no commercial support for this
presentation.
• The views expressed in this presentation are the
views and opinions of the presenter.
• Participants must use discretion when using the
information contained in this presentation.
Introduction to Kinesiology
Taping No one correct way to tape – there are a
number of different tapes and taping techniques depending on what anatomical part and/or movement is in question
Many different methods and types of tape available for use in the clinic
Lots of self help videos that allow for patients to do it themselves
Able to keep the benefits of treatment going long after leaving the clinic
2
Introduction to Kinesiology
Taping Limited by lack of research
Insurance companies do not
reimburse for taping alone
Easy to teach patients how to do it
Will not harm the patient if it is
performed incorrectly
The Tape
Kinesiology tape has elastic properties
so the paper on the back of the tape
can be easily torn without tearing the
tape itself
Most manufacturers will tell you not to
rip the tape off your skin to remove it.
Try rolling it off.
When applying the tape try not to get
wrinkles in the tape
The Tape
Try when applying the tape to not touch the adhesive part of the tape. It will decrease the longevity of the tape
Try as you are setting the tape not to get wrinkles in the tap
Never pull the tape to 100% of its stretch
Try not to reset the tape. Once you have laid the tape down try not to pull it off the skin to reposition it
3
The Tape
Once you activate the adhesive by
rubbing the tape you may not
reposition it. If you need to remove it
then you will need to cut another piece
of tape and start the technique over
again.
Different types of Taping
Techniques Prophylactic Athletic Taping
McConnell Taping
Kinesiology Taping
Kinesiology Taping
Provides support and stability without restricting the joint
Relieves pressure
Mimics the properties of skin
◦ Same thickness as skin and inherent elastic properties
Stretches to 120-140% of its original length
Assists in coordination and movement
Cotton and elastic
Facilitates joint motion
Corrects the alignment of weak muscles
Increases circulation by lifting the skin
Decreases edema
4
McConnell Taping
Unload soft tissue
Decrease pain
Uses 2 pieces of tape, one that is therapeutic one that is not
Restricts motion
Patellar taping most widely used and studied
Limited wear time
Poor adhesive qualities when wet
Athletic Tape
Limiting of the movement
Off loading the stress on the ligament and joint
Utilizes prewrap under the tape
Widely sold at drug stores
Patients often confuse this for Kinesiology tape
Primary purpose is not rehabilitative
Acute injuries and injury prevention
Different types of tape
Kinesio Tex tape
Spyder tech tape
KT tape
Perform Tex Tape
Rock Tape
5
Kinesio Tex Tape
Taping generally for specific muscles
and conditions
Lasts 2-3 days
Heat activated
Emphasis on evaluation of muscles
prior to application
Cotton and elastic
Tape has 10% stretch when on paper
Kinesio Tex Tape
Spyder Tech Tape
Precut tape patterns
Cotton and elastic
Numbered sections make it easy for
the patients and clinicians to apply
Difficult to cut and make more specific
to an individual or situation
6
Spyder Tech Tape
KT Tape
Precut ‘I’ strips
Edges are pre rounded
Very little stretch
Hard to cut
Sold in running stores due to ease of
application and no cutting required
KT Tape
7
Perform Tex Tape
Diamond shaped pattern
Encourages mechanical transduction
at the superficial and deep layers
Has better wicking properties
Increases skin breathability
Better for people who have skin
irritations
Perform Tex Tape
Rock Tape
Longer lasting – 5 days
Able to cut into any length
Heat activated
Tape for movement not muscles
Improves sports performance
8
Rock Tape
Taping Reimbursement
Not reimbursed by insurance
companies
Strapping codes MAY be used but
often are denied
Can tape prior to treatment and do
neuromuscular reed
Benefits of Taping
Increase circulation
Decrease pain
Increase joint position
Provides support to joints and muscles
Continue treatment outside of the clinic
Improve athletic performance
Used on all populations
Easy to teach patients how to tape
themselves
9
Benefits of taping
Can last for multiple days
Does not limit motion
Able to shower and maintain daily
activities
Reduce swelling and inflammation
Accelerate recovery and healing from
intense exercise
Delay fatigue and improve endurance
Benefits of Taping
Improve posture
Prevent overuse and over contraction
of working muscles
Can be used during the acute,
chronic, subacute and rehabilitative
phases
Can be used with other modalities
such as heat, ice, manual therapy,
electro stimulation
Benefits of Taping
Has both immediate and long term responses
Mimics the property of skin
Lifts the skin allowing for decreased pain
Targets different receptors within the somatosensory system
Alleviates pain
Latex free
10
Benefits of Taping
Helps with the lymphatic and
circulatory drainage as areas of high
pressure move to areas of low
pressure
Affects the fascia by lifting the skin
Improve biomechanics of joint
Promotes normal muscle function
Applications of Tape Indications
Pain
Swelling/Edema
Decreased ROM
Decreased strength
Improve athletic performance
Poor posture
Many more……
Applications of Tape
Contraindications Open wound
Unhealed surgery scar
Active malignancy site
Skin infections
DVTs
11
Application of tape
Need to have a pair of non stick scissors
Decide on the brand of tape you want to
use
Make sure to round the corners of the
tape after it is cut and ready for
application
Clean the area with an alcohol wipe
Women who use lotion will have
significantly less wear time with the tape
Application of Tape
Men with leg and body hair will want to
shave to increase adhesiveness and
wear time
Cut less than the actual length that
you will need as the tape will stretch
allowing for less to be more
After application rub the tape to
activate the adhesive and allow for
maximal wear time
Application of tape
Anchors – which are the ends of the tape depending on the pieces you cut
There is never any tension in the anchors
3 times of force used:◦ Minimal – very gentle stretch on the tape
◦ Moderate – About 50% of the stretch of the tape
◦ Maximal or heavy force – About 75% of the stretch of the tape
12
Types of Cuts
The “I” strip
◦ One long strip of tape
◦ Most aggressive of the taping cuts
◦ Used on linear muscles and ligaments or
to control gross motor movement
◦ Examples: Taping the IT Band, controlling
thoracic rotation
The “I” strip
Types of Cuts
The “X” strip
◦ Used for larger muscle groups
◦ Cut an “I” strip and then cut a slit at both
ends forming an X
◦ Typically used for larger, longer muscles
and movements
◦ Examples: biceps femoris
13
The “X” strip
Types of cuts
The “Y” strip
◦ Cut an “I” strip and then cut down the
middle about half way to ¾ of the way
down
◦ Often used to surround joints and muscles
◦ Example: The deltoid or controlling for
knee pain
The “Y” strip
14
Taping cuts
The fan cut
◦ Used for improving circulation
◦ Used to decrease swelling
◦ The fan strips creates channels that allow
fluids to move
◦ Fluid moves from areas of higher
pressure to areas of lower pressure
The fan cut
Taping Techniques
Shoulder instability
Lateral epicondylitis – Tennis elbow
Knee pain
Knee swelling
Plantar fasciitis
Ankle sprain with swelling
Upper trap inhibition/postural control
15
Taping for:
Shoulder Instability This technique can be used for
overhead athletes
Any type of shoulder pain
AC instability
Shoulder instability
Taping for:
Shoulder Instability Begin with the patient in sitting with
the arm in internal rotation
Cut 2 “I” strips
The first I strip attach medially to the
humeral head
Anchor with no tension
Apply moderate tension as you bring
the tape around the back of the
shoulder
Taping for:
Shoulder Instability Once you are at the lateral border of
the scapula stop the moderate tension and then apply the anchor with no tension
For the second “I” strip tear a piece in the middle. Then with moderate to heavy tension, place the tape down on the acromium
Lay the 2 anchors down with no tension
16
Taping for:
Shoulder Instability The patient should be able to move
their arm freely and with less pain or
the same pain then prior to the tape
application
Taping for:
Shoulder Instability
Video for taping for shoulder instability
Taping for:
Lateral Epicondylitis Commonly known as tennis elbow
Can be worn while playing tennis
Excessive arm hair in men proves to
be difficult in keeping the tape
adhered
17
Taping for:
Lateral Epicondylitis Begin by cutting 2 “Y” strips
Measure one from the wrist to the
elbow
Measure the other one from the lateral
epicondyle around to the medial
epicondyle
Have the patient in sitting and have
them in shoulder flexion, elbow
extension and wrist flexion
Taping for:
Lateral Epicondylitis Begin taping near the thumb just
superior to the wrist
Have the patient maintain the position
as splay the 2 tails of the “Y” out so
that they are on either side of the
epicondyle
Moderate tension is used
Then anchor with no tension
Taping for:
Lateral Epicondylitis Start the second smaller “Y” strip on
the outside of the elbow just above the
lateral epicondyle
Angle one tail below the crease in the
elbow with moderate force
Angle one tail above the crease in the
elbow with moderate tension
Anchor both tails with no tension
18
Taping for:
Lateral Epicondylitis Make sure the patient has full range of
motion and no more pain then usual
after taping
Taping for:
Lateral Epicondylitis
Video for taping for lateral
epicondylitis
Taping for:
Knee pain and swelling
19
Taping for knee swelling
Begin by positioning the patient
The patient should be relaxed with the
knee in extension. The knee should
be relaxed so if the patient is unable to
achieve full extension then put them in
a comfortable position
Make sure the area is clean and free
from unhealed scars or open wounds
Taping for knee swelling
Cut 2 fan cuts
The cuts should be big enough to
extend from the super patella to the
tibial tuberosity
Want to cut almost exact length
needed since the stretch on the tape
will be minimal
Start one fan cut superior and medial
to the patella.
Taping for knee swelling
Tear the tape and anchor the starting
piece superior and medial to the
patella but not on the patella
Then splay the fingers of the tape out
(approximately 4-5 depending on the
size of the knee) and with minimal
tension lay them down
Rub each of the finger-like extension
and the anchor to activate the heat
20
Taping for knee swelling
Take the next piece of tape and start the anchor at the superior lateral patella.
Do NOT tape the anchor on the patella
Splay the fingers going across the patella so that the fingers end on the medial aspect of the knee
Lay each finger down with minimal tension
Rub each of the extensions down to activate the heat
Taping for knee swelling
Important things to remember when
taping for knee swelling:
◦ There is minimal tension in the fan and no
tension in the anchor. The patient should
be able to maintain full range of motion
◦ Rounding the edges of each finger like
projection will allow for the tape to stay on
longer
◦ Do NOT begin your taping technique with
the anchor on the patella
Taping for knee swelling
It is important to instruct the patient on
proper care of the tape i.e. if the
edges start to curl up you should not
take a scissors and start trimming
them
You may also cut a small piece of tape
to apply at the end of both fans so that
it lasts longer and does not get caught
on clothing.
21
Taping for knee swelling
Who can benefit:
◦ Anyone with knee swelling
Total knee replacements if the scar has healed
After running if swelling is present
Chondromalacia patella
Ligament sprains
This is a safe and effective way to
begin draining fluid out of the knee
Taping for knee swelling
Video for knee swelling
Taping for knee pain
3 “I” strips, 2 long and one short
Moderate tension will be applied
through the tape so you can cut the
lengths a little shorter
For the longer pieces:
◦ One will begin inferior to the patella on the
medial aspect
◦ With moderate tension loop up and
around and end at the quad
22
Taping for knee pain
Once you reach the top of the quad
back of the tension and anchor with no
tension
For the second piece of tape begin on
the inferior lateral aspect of the quad.
Again, for either piece do not start on
the patella
Wrap the tape around the patella with
moderate force
Taping for knee pain
Once you reach the other piece of
tape back off the tension and anchor
with no tension
The third piece of tape is going to go
below the patella and extend medial
and lateral of the knee
Tear the tape in the middle on either
side leaving the middle part exposed.
Taping for knee pain
With heavy or close to maximal stretch
on the tape lay it down just below the
patella.
Then lay the 2 anchors down with no
tension
23
Taping for knee pain
Positioning the patient
◦ Have them sitting on a table with their leg
relaxed bent to about a 90 degree angle.
Their leg should be relaxed, the angle is
arbitrary
◦ Make sure the area is clean and free from
open wounds
◦ Make sure the patient is able to move with
less pain and the same or better range
after taping
Taping for knee pain
Who would benefit:
◦ Any patient experiencing knee pain
◦ Ligaments sprains
◦ IT Band tendinitis
◦ Runners knee
◦ And many more….
Taping for knee pain
Video for knee pain
24
Taping for:
Plantar fasciitis Position the patient in supine with the
foot in dorsiflexion hanging off the end
of the table
Make sure the area is clean
Make sure the area is free from open
wound and sores
Taping for plantar fasciitis
Cut an “I” strip
Measure from about the middle to ¾ of the gastroc to the metatarsal heads on the bottom of the foot
This will be a unique I strip as 1 part of it will be cut into a fan and one will be used as an “I” strip
The part used as a fan will have minimal tension in it
The part used on the achilles tendon and up the back of the calf will have moderate force applied
Taping for plantar fasciitis
The pivot point will be the calcaneous
or the heel
Cut 5 finger like projections into one
end of the tape
Tear right above the finger like
projections and anchor that with no
tension to the calcaneous
Then with moderate force place the
tape up the back of the calf
25
Taping for plantar fasciitis
Stop before the top of the calf
Apply the anchor with no tension
Take the fan piece extend the anchor onto the bottom of the calcaneous(heel) with no tension
With minimal tension place each one of the projections inline with the metatarsals
Rub each piece to activate the adhesive
Taping for plantar fasciitis
Cut another “I” strip
This one is going to go on the
metatarsal arch and be applied with
medium to heavy tension so you can
cut this piece a little shorter since you
will be applying significant stretch to it
Have the patient remain on their
stomach
Have the patient relax the foot
Taping for plantar fasciitis
Stating on the outside of the foot outside the 5th metatarsal
Anchor with no tension
Provide medium to heavy tension as you come across the arch
As you come to the first metatarsal anchor with no tension
You may also apply a small strip with no tension to keep the projections in place
26
Taping for plantar fasciitis
Things to remember
◦ This is a good one to teach your patients
at home since it comes off quickly
◦ Make sure you patient has full range of
motion and less or the same pain that you
did prior to taping
◦ Make sure you do not but the tape on
100% stretch
Taping for:
Plantar fasciitis
Video for taping for plantar fasciitis
Taping for:
Ankle sprain with swelling This is a generic technique that can be
done with any ankle sprain medial or
lateral
Further taping classes will get into
more specific techniques when taping
for more specific ligaments
This technique will help with pain and
also reduce the swelling
27
Taping for:
Ankle sprain with swelling Position the patient in sitting with the
ankle in neutral
The patient may also be in supine
Clean the area
Make sure there are not open wounds
in the area
Taping for:
Ankle sprain with swelling Measure for 2 fan strips going from
just above the medial and lateral
malleoli to the outside of the foot
Then cut the “I” strip so it is long
enough to go from one malleloli to the
other going underneath the foot
Begin by cutting the 2 fan strips
Start the anchor of one just above the
medial malleolus
Taping for:
Ankle sprain with swelling Apply the anchor with no tension
Bring the strips of the fan across the
foot and lay them down with minimal
tension
Try to anchor each fan strip with no
tension if possible
Begin the second fan strip just above
the lateral malleolus
Anchor with no tension
28
Taping for:
Ankle sprain with swelling Extend the fan projections across the
ankle with minimal tension
Anchor with no tension
With the patient maintaining as close
to neutral as they can take the long “I”
strip rip the middle piece off
With moderate to heavy tension place
the tape on the bottom of the foot
Taping for:
Ankle sprain with swelling Applying moderate force place the
tape across the arch of the foot
Then cross over the dorsum of the
foot tape above the malleoli
Once you reach the malleoli release
the tension
Anchor with no tension
Taping for:
Ankle sprain with swelling Take the other side of the tape and
with moderate to heavy tension come
across the dorsum of the foot and
above the malleoli
Once you reach the malleoli anchor
with no tension
At the end of the technique test the
range of motion and pain to make sure
the ROM remains and the pain is less
29
Taping for:
Ankle Sprain with swelling
Video for taping for Ankle Sprain with
swelling
Taping for:
UT Inhibition/Postural Correction Use this taping technique on people
with:
◦ Neck pain
◦ Poor posture
◦ Headaches
◦ Sitting at a computer all day
◦ Shoulder pain
Taping for:
UT Inhibition/Postural Correction Position your patient in sitting
Cut 2 “Y” strips
The first “Y” strip starts just above the spine of the scapula
Place the anchor down with no tension
Have the patient side bend the head away from the tape
Place one strip of the Y on the anterior part of the UT
30
Taping for:
UT Inhibition/Postural Correction The Y strip will go on the posterior part
of the upper trap
In each of the Y tails place moderate
tension and then have no tension in
anchor
For the second longer Y strip start in
the middle of the first Y strip and have
the patient bring the shoulder posterior
Taping for:
UT Inhibition/Postural Correction Have the strip follow the border of the
scapula down to the opposite inferior
border of the scapula
Apply medium to heavy pressure for
each of the tails and then no tension in
the anchor
Taping for:
UT Inhibition/Postural Correction
Video for taping for UT
Inhibition/Postural Correction