Lessons Learned One clinician looks past the hype to realize the potential of therapeutic taping By Jayson Goo, ATC, MA, CKTI Vol 22 • Issue 18 • Page 30 Sept 5, 2011 Equipment Spotlight I first entered the world of elastic therapeutic tape with a tremendous amount of trepidation and doubt However, following years of using this treatment and witnessing its success first-hand, I have since transformed into a true believer and one of the biggest proponents of its use It didn't take long for me to start me down this path My first two experiences with elastic therapeutic tape-applied to a dislocated shoulder and a strained elbow-showed positive results Both injuries improved dramatically The dislocated shoulder that had a half-inch sulcus two days after injury, reduced significantly and the athlete was able to play the next day and participate in a tournament the following weekend, My co-worker, who suffered from elbow pain after several exhausting weekends of softball, reported that his pain had disappeared and he had regained full range of motion shortly after using the tape These two cases alone did not sell me 100 percent on the effectiveness of elastic therapeutic tape-at least not yet But it elicited a "wow" factor that peaked my curiosity and compelled me to learn how a piece of tape could possible cause such positive results Evolution of Taping Certified athletic trainers (ATC) can fix most any and all problems with standard 1' ½" white athletic strapping tape Clinical ATCs are experts in the application and have used athletic strapping tapes Athletic strapping, which involves a variety of materials from cloth straps, underwrap, adhesive sprays, and variety of adhesive backed cloth tapes of varying tensile strength and elasticities, is designed to bridge over an affected area and limit its range of motion Taping, binding or strapping as we know it originates with our earliest ancestors who wrapped or covered themselves for warmth and discovered that injuries, aches and pains responded well to being covered and supported This evolved eventually into the art of strapping with cloth strips and with that the dawn of adhesives athletic taping was born The success of prophylactic bracing now on the market is based on the art of athletic taping and binding of body parts Elastic therapeutic tape has given us a new type of tape not entirely unrelated to the ATC experience The evidence-based McConnell approach, named after Jenny McConnell, started with the idea to change dysfunctional patella tracking by pulling the patella into place to relieve pain then prescribing exercise to establish a corrective muscular pattern The McConnell approach has evolved into techniques that can be applied to the entire body The McConnell technique requires the use of an adhesive undertape for skin protection and a high tensile strength non-elastic cloth tape with a strong adhesive The use of elastic therapeutic tape is one of the most recent tape innovations in therapeutic modalities The original elastic therapeutic tape, developed in the 1970s, has given the therapeutic world a modality that can stand alone or can be used in conjunction with other modalities and may applied to many dysfunctions The tape is a cotton fiber material designed to stretch only lengthwise A medical grade acrylic adhesive is applied in a wave form to the back of the tape during manufacturing and the tape is placed on a paper backing to maintain the integrity of the adhesive The adhesive is applied in a wave form in order to provide more lift to the skin, this lift is a crucial design element of elastic therapeutic tape Elastic therapeutic tape has been embraced by physiotherapists worldwide in a variety of therapeutic settings, applications and approaches Now almost 40-odd years after its invention, the scholarly community has taken notice of elastic therapeutic tape and has begun to research elastic therapeutic tape Therapists that use elastic therapeutic tape are still exploring the uses and boundaries of this modality As with most new innovations there still is a need to establish the science behind the techniques The original purpose and concept of elastic therapeutic tape was to maintain a stretch in the soft tissues over the joints that were to be adjusted Elastic therapeutic tape is currently used around the world by therapeutic professionals that have a wide variety of backgrounds Once the methods of the applications are understood they are easily applied to various therapeutic concepts The basic premise is that when elastic therapeutic tape is applied properly, it lifts the skin, causing a loosening of the tissue over the specific joint that had been mobilized Creation space between the skin and muscle is created by the recoil of an adhesive elastic tape creating tension on the connective fascia between the structures The effect of elastic therapeutic tape on fascia is much like a drop of water falling into a still pond Changes in fascial tensegrity affect the entire biotensegrity of the body The mechanical lifting of the skin creates space between and also creates a stress on the underlying fascia that results in an elongation of the fasical tissue Fascial therapists using elastic therapeutic tape can help to maintain the desired changes in fascial tensegrity after the client leaves the office Scar tissue which is a binding of fascia can also be reduced with elastic therapeutic tape Elastic therapeutic tape can apply a low stress over time to the bound tissue which is an accepted method of reducing hardened scar Lymphatic System Relief The creation of this space in the dermis relieves pressure on the lymphatic capillaries and allows for better lymphatic drainage Lymphatic therapists have found that creation of space between the skin and the muscle allows for less restrictive flow of lymph through areas of congestion therefore increasing lymphatic flow from edematous areas Lymphatic taping assists in reduction of swelling and edema caused by soft tissue injury, mastectomy and breast engorgement in lactating women The resulting decrease of pressure from the removal on lymphatic fluid from an area results in greater blood flow expediting healing Reduction of fluid in edematous tissue also results in a normalization of pressure in the affected area, with the decrease of pressure, stimulation of these neural receptors is also reduced resulting which often leads to reduction of pain Once pain is reduced proprioceptive and kinesthetic feedback to the brain increases the affected body part can return to normal function This in turn enables entire body to return to a "normal" biomechanical function The reduction of swelling in soft tissue muscles, tendons and joints also enables the patient to regain their range of motion, which allows a longer muscle contraction at the beginning of progressive resistive exercises Different techniques in application of elastic therapeutic tape allow the practitioner to choose whether he wishes to influence the contractility a particular muscle either by inhibition or facilitation In his book Positional Release Techniques, researcher and author Leon Chaitow states that pressure directed away from the belly of a muscle toward golgi tendon organs produces relaxation of the muscle, while pressure toward the belly of a muscle strengthens the elastic therapeutic tape's stretching properties can produce this positive or negative pressure through a pulling effect Ligament Help Elastic therapeutic tape can also be used prophylactically to help prevent over lengthening of tendon or ligamentous structures When applied with the correct amount of tension, elastic therapeutic tape provides amplification from the skin stretch receptors to the brain The elastic therapeutic tape applied to the skin on a stretch stimulates the tension receptors When the skin actually goes into a stretch, information is sent to the brain that the skin is going into an overstretch when it is actually still in a normal range For example, when the Achilles tendon is taped and the foot is plantar flexed, the stretched tape over the Achilles tendon sends information to the brain that the skin receptors are being overstretched and the brain responds by reducing the range of motion so that the skin does not go into an overstretch This same effect can be uses in taping of ligaments There are many reports of elastic therapeutic tape being used prophylactically to tape knees and ankles Gray Cook suggests in Movement, Functional Movement Systems: Screening, Assessment, Corrective Strategies, that the use of functional tapings can be used to help reset movement patterns The first step in functional movement is to achieve a proper static standing posture Static standing posture is an expression on the body's ability to maintain stability in all of its parts Once this is achieved the client can then move with the proper biomechanics through the desired motion from the ideal starting point In an effort to elicit proper functional movement patterns we have begun applying the tape along the fascial lines described by Tom Myers in Anatomy Trains to achieve a proper static standing posture Elastic therapeutic tape applied in this manner helps to prevent the establishment of poor motor movements in the rehabilitating athlete Elastic therapeutic tape is a modality when properly used and applied can help clients reach their therapeutic goals in a timelier manner In my daily practice I commonly use elastic therapeutic tape in muscle, fascial, biomechanical, orthopedic and postural issues In the hands of a properly trained therapist elastic therapeutic taping is a powerful modality that can be employed in all patient populations Jayson Goo, ATC, MA, CKTI, a National Athletic Board Certified Athletic Trainer, graduated from the University of Hawaii and earned his master's degree in human performance with a specialty in corrective therapy from San Jose State University Jayson also is an active Certified Kinesio Taping Instructor Since 1983, he has served as an athletic trainer at the University of Hawaii (Manoa) Athletics Department and has been to Japan as a consultant to Japan Athletics Osaka Fitness Club He is active year-round providing athletic training services to the University of Hawaii's sports teams and directing rehabilitation programs for athletes from all sports, and he continues to help numerous athletes, both amateur and professional, to extend their athletic careers Taping Education for Clinicians By Joanne Stapensea, MSc Elastic therapeutic tape is made by several different manufacturers, and comes in a variety of formats, including rolls, precut strips of varying lengths and precut applications for specific body parts Practitioners who are new to taping need to learn about the different types of tape, as well as the principles of taping and proper application techniques Fortunately, there is a wide variety of resources available to meet all levels of interest Certification programs For those with an education budget, or day certification programs that include CME credits are offered by the major tape manufacturers-Kinesio Tape, KT Tape, RockTape and SpiderTech Tape Dates and locations are available on each manufacturer's website Online resources For those who prefer to surf the web, TheraTape.com, a website specializing in taping, has created the TheraTape Education Center, a comprehensive online collection of kinesiology taping information This free online resource includes detailed information about each of the major brands of tape, as well as the different tape formats A videos section includes more than 100 instructional videos, categorized by body part In addition, 65 printable application instructions are also available for downloading and/or printing The TheraTape Health Professional's Resource Center is a special page within the Theratape Education Center that contains information especially for clinicians The resource area, which is continually updated, contains a plethora of information for health professionals, including downloadable documents, including research, product monographs and educational guides; billing information, including insurance codes and guidelines for submitting claims; patient education materials; and continuing professional education opportunities Blogs There are two educational blogs devoted exclusively to taping Each of these resources contains a wide variety of posts about taping products, applications and techniques Published for more than two years, AthleticTapeInfo.com is the largest collection of taping informational posts available online KinesiologyTapeInfo.com is a newly launched blog devoted exclusively to taping information for both consumers and professionals Instruction manuals No taping practitioner's library would be complete without a selection of taping manuals Best known are the five manuals and DVD pertaining expressly to the Kinesio Taping Method, developed by Dr Kenzo Kase These excellent resources provide in-depth explanations of the mechanisms by which Kinesio Tape works, as well as detailed instructions for taping a wide variety of injuries and health conditions A more recent addition to the scene is the RockTape PowerTaping Manual, which covers both therapeutic taping and taping to enhance athletic performance This has become a favorite of coaches and trainers working with elite athletes Detailed descriptions and pricing information about all of these manuals can be found at www.theratape.com/kinesiology-taping-instruction-manuals.html Elastic therapeutic taping can provide a valuable additional modality for patients and a lucrative addition to any therapy practice Taking the time to learn about all aspects of taping is an investment that will pay off for many years Joanne Stapensea is the owner of TheraTape.com, an e-commerce website specializing in kinesiology tape and kinesiology taping education 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