the full PDF

TAPING
Are All Kinesiology Tapes
The Same?
By Ed Le Cara, PhD, DC, ATC, CSCS
I
n October 2013, I was presenting at the IronMan Triathlon Sports Medicine Conference
and was asked about the differences between
the various Kinesiology Tapes (K-Tapes) on
the market. A common misconception is that all
tapes ‘are about the same’. Clinicians have preferences for which tape they use. Some clinicians will
use tape that is pre-cut, while others say certain
K-tape brands have better adhesion - or maybe
cooler colors and prints. That is all well and good.
For me, the biggest difference is the education
and protocols associated with the brand. I want
to use products that are ‘open source’ and use the
best scientific evidence to drive their education in
addition to being the best product. I want to work
with companies that are willing to change their
stance on protocols and education based on new
findings and outcomes.
Taping Movement, Not Muscles
The injured area is not necessarily the dysfunctional or weak
tissue or joint. The injured area might be overused because the
synergists are not functioning correctly and the injured tissue
has to pick up the slack (i.e. overuse syndrome). This is common in patients that I see complaining of a piriformis problem.
In these patients they complain the piriformis is always tight
no matter how much they stretch, foam roll, or massage the
area. The real issue is the poor little piriformis is being asked
to contribute to hip stability because the glutes are inhibited.
If I hear the magic words, “it was better for a couple of days
but just goes right back to being tight” I know that there is a
stability issue that needs to be addressed. So in this case I
work to strengthen or activate the patients glutes. The result
is less stress on the piriformis and the tightness goes away.
Sometimes the injured area is displaying symptoms because of
dysfunction in a different part of the body places more stress
on the symptomatic tissue. This concept is coined Regional
Interdependence.
Regional Interdependence (RI) is a term used in physical
therapy but not often heard in chiropractic circles. RI describes
treatment directed at one area of the body to elicit changes in
another. Certain areas of the body may influence other areas
throughout the kinetic chain but have different impacts based
on how far away the two areas are. Tom Myers popularized
this concept with his book Anatomy Trains.
Anatomy trains describes the myofascial (or connective tissue)
connections within the body. In one example, Myers describes
the “Superficial Back Arm Line ” as originating at the occipital
18 I The American Chiropractor I JANUARY 2014
ridge, running along the spine of the scapula, and extending
to the deltoid tubercle of the humerus. The Superficial Back
Arm Line continues to the lateral epicondyle of the humerus
and extends to the dorsal surface of the fingers. In other words,
there is a continuous structural link from the back of the hand
to the neck and medial scapula border/spine.
Treating the Cause, Not the Symptoms
There are many conditions that are particularly difficult to get
patients over. One of those is the dreaded lateral epicondylitis (LE). How many of us have treated LE with laser, ART,
Graston, etc., but it didn’t fully recover? Perhaps lateral epicondylitis pain is actually just a symptom and not the source of
dysfunction. Perhaps the source of dysfunction is at the neck,
shoulder blade, or wrist. This may help explain why current
literature has validated the regional interdependence model.
For example:
•
•
•
One randomized pilot study and one randomized clinical
trial have shown that cervical and thoracic manipulation is
beneficial in those with lateral epicondylalgia.1,2
One pilot clinical trial has shown that cervico-thoracic mobilization is beneficial in those with lateral epicondylalgia.3
One randomized pilot study has shown wrist manipulation
is beneficial in those with lateral epicondylalgia.4
Where Does Kinesiology Tape Fit In?:
As part of a treatment plan, I not only evaluate the injured
area but also use the Anatomy Trains model to trace areas that
may be contributing to the symptoms. After identifying areas
of dysfunction and treating with soft tissue and manipulation
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TAPING
ʻʻ
The tape not only helps facilitate
the whole train but also reminds
the patient of the involved areas
and keeps them focused on their
home exercises by providing a
reminder that lasts as long as the
tape stays on.
ʼʼ
techniques, I then tape along the train. After the tape application, I prescribe the exercises required to fix the dysfunctional
area. The tape not only helps facilitate the whole train but
also reminds the patient of the involved areas and keeps them
focused on their home exercises by providing a reminder that
lasts as long as the tape stays on. If I do my job correctly, the
kinesiology tape application usually lasts at least 3-5 days.
References
1.
Fernández-Carnero J, Fernández-de-las-Peñas C, Cleland J.
Immediate hypoalgesic and motor effects after a single cervical
spine manipulation in subjects with lateral epicondylalgia. Journal Of Manipulative and Physiological Therapeutics. November
2.
3.
4.
2008;31(9):675-681.
Fernández-Carnero J, Cleland J, Touche. Examination of Motor
and Hypoalgesic Effects of Cervical vs Thoracic Spine Manipulation in Patients With Lateral Epicondylalgia: A Clinical
Trial. Journal Of Manipulative and Physiological Therapeutics.
September 2011;34(7):432-440.
Cleland J, Flynn T, Palmer J. Incorporation of manual therapy
directed at the cervicothoracic spine in patients with lateral
epicondylalgia: a pilot clinical trial. Journal Of Manual and
Manipulative Therapy (Journal Of Manual and Manipulative
Therapy). September 2005;13(3):143-151.
Struijs P, Damen P, Bakker E, Blankevoort L, Assendelft W,
van Dijk C. Manipulation of the wrist for management of lateral
epicondylitis: a randomized pilot study. Physical Therapy. July
2003;83(7):608-616.
Ed Le Cara, PhD, DC, ATC, CSCS is a chiropractic
clinician, educator and on the medical advisory board for
Rocktape. You can find more information about Rocktape at
www.rocktape.com . He provides live and online education
for movement professionals at www.HealthandWellnessProviders.com.
To contact him, email at [email protected] or follow
on Twitter: @drlecara. Shortly after the release of this article, he will
host a live webinar demonstrating different taping applications and
answer questions. Register for the webinar at www.SportsPlusBayArea.
com/TAC_regional _interdependence.
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