Elastic Taping for Runner Injuries HueiMing Chai PT

Elastic Taping for Runner Injuries Huei-Ming Chai, PT Ph. D School of Physical Therapy National Taiwan University, Taipei, Taiwan June 23, 2008

Elastic Taping for Runner Injuries ü Kinesio tape and its properties – – development of elastic taping advocated effects of elastic taping principles of application Q and A • Common Runner Injuries and its Taping

Kinesio Taping • 1973 Kenzo Kase, D. C. • concept for development: to provide a better environment for self-healing • feature – elastic: able to be stretched up to 140%

Advocated Effects • to re-adjust muscle tension • to improve blood/lymph circulation • to relieve pain • to re-align joint position • to provide skin stimulation

Structure of Tape • backing material (背襯) – porosity (透氣性) – conformability (順膚性) • adhesive (膠): 醫療等級 – rubber based (乳膠系) – zinc oxide (氧化鋅系) 皮膚 背襯 膠 – silicone based (矽膠) – acrylate based (丙烯酸膠、壓克力膠): pressure-sensitive ( 感壓膠) • release agent (解捲因子)

Applied Force of Elastic Tape • stress-strain curve • creep phenomenon • commonly used – zero tension: 100 -110% of length – moderate tension: 120% of length – full tension: 140 -150% of length

Length-Tension Curve -- maximum isometric contraction tension total tension active tension resting length passive tension

Tensile Strength of Collagen Fiber plastic region clinical test elastic region physiological loading microtrauma strain yield point stress failure injury ultimate strain

Load Relaxation • Progressive decrease in load with time as the deformation of the structure remains constant stress As deformation remains constant time

Applied Shape of Elastic Taping I- band x-band Y-band fork-shaped

Applied Position of Elastic Tape • commonly used – parallel to the fibers: for support – perpendicular to the fibers: for fixation parallel perpendicular

Applied Direction of Elastic Tape recoil of tape muscle contraction direction of taping: origin to insertion muscle contraction direction of taping: insertion to origin

Other Considerations of Application • site to be applied – muscle – ligament – lymph note • size of tape • position of adjacent joints

Failure of Kinesio Taping • unable to hit the target – incorrect diagnosis – poor palpation – Inaccurate alignment of muscle • forget to place the injured tissue in the lengthening position

Q and A • How long it can be applied onto the skin? • Is it water-proof? • Is it appropriate for the hypersensitive skin? • Can it be used accompanying with other types of physical therapy? • Do I need to shave hairs before application of elastic tape? • Are there any differences among the tapes with various colors? • Can I used it for a healthy adult?

Elastic Taping for Runner Injuries • Kinesio tape and its properties ü Common Runner Injuries and its Taping – – – heel pad pain syndrome plantar fasciitis Achilles tendinitis iliotibial band syndrome patellofemoral pain syndrome low back pain

Running Cycle • stance phase foot strike mid-support take-off • swing phase follow-through forward swing foot descent

Shock Absorption at Foot Strike • ground reaction force at FS = 2. 5～ 3 BW • biomechanical requirements at FS – LE motions – cartilage or fat pad • heel pad, metatarsal pad, meniscus, IVD – extrinsic factors gel heel pad

Heel Pad Atrophy atrophy Poor recoil use of heel cup

Elastic Taping for Foot 1. plantar fascia 2. heel pad 3. arch support

Foot Motion during Mid-Support • foot pronation at mid-support in order to make the foot more mobile for further shock absorption • foot pronation medial and inferior glide of talus and internal rotation of tibia COG shifting medially energy consumption and time to re-supinaiton • strategy: hard counter for controlling COG motions counter

Pronated Foot • pronation of rearfoot with respect to forefoot (decreased arch) as foot is loaded • NOT structural flat foot • resulting in pain or dysfunction of foot or other WB joints 4. 6 cm NWB 3. 0 cm WB

Achilles Tendinitis • etiology: Achilles tendon tightness • predisposing factors – sudden change in intensity – uphill running • S/S – Achilles tendon pain or stiffness – unable to raise on the heel, deep squatting, or stretch Achilles tendon – enlargement of Achilles tendon

Architecture of Gastrocnemius • Changing fascicle angle improves muscle performance? • confinement? Gas m.

Arch Support in Pronated Foot • pronated foot lower arch plantar fascia stretched plantar fascia • A arch support would further stretch plantar fascia arch support

Re-supination at Take-off • re-supination at take-off in order to make the foot rigid and support the body weight – LE motions：subtalar joint supinaiton、midtarsal joint locked, first ray plantarflexion, and MP joint full extension – windlass effect of plantar fascia • ground reaction force momentum (= mv) – running speed – impact force (= Ft) accumulated at metatarsal heads metatarsalgia

Windlass Mechanism (Truss Model) Toe neutral plantar fascia PF of 1 st ray Toe extension plantar fascia

Plantar Fasciitis neutral foot plantar fascia pronated foot

Elastic Taping for Foot 1. plantar fascia 2. heel pad 3. arch support

Patellofemoral Pain Syndrome • chondromalacia patella • anterior knee pain, esp. downstairs • positive grinding test • management – – PT arthroscopy quadriceps strengthening elastic taping

Iliotibial Band Friction Syndrome • Iliotibial Band – origin：insertion of tensor fascia lata – insertion：Gerdy’s tubercle of tibia • S/S – lateral knee pain – pain at 15 -30 of knee flexion during one-leg squatting test • Management – stretch exercise – elastic taping ITB

Elastic Taping for Back Muscle Spasm • Patient’s position – forward bending with elbow on the knee • Type of taping – I- band for paravertebral muscle

Rotator Cuff Tendinitis • S/S – shoulder stiffness, pain, or weakness – unable to raise the arm or put the hand on sacrum – drop arm test • differentiation – – – supraspinatus infraspinatus teres minor subscapularis long head of the biceps brachialis

Elastic Taping for Supraspinatus

Elastic Taping for Deltoid Muscle

柴惠敏 hmchai@ntu. edu. tw http: //www. taiwanpt. net