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What kind of taping do I need?

Taping or strapping is commonly used in the sporting community and the effects and roles are widely understood and accepted. In recent years, taping has evolved beyond restricting the range of motion of a joint to prevent a recurring injury by stabilizing the structure with an external support. There are now techniques like Kinesio Taping and Functional Fascial Taping, which has become more popular and more well-accepted in the sports scene.

A commonality in all three taping techniques is that taping in itself is thought to enhance the proprioception or kinaesthetic feedback. This improved feedback enables the muscles to “fire” more appropriately as postulated in the earlier activation of VMO when a lateral tracking patella in clients with patello-femoral joint pain, is taped in a more neutral position. Another benefit of improved feedback can also enhance the awareness of the joint position so that a feed forward action of muscle contraction can occur prior to a re-injury. An example would be placing a simple piece of rigid tape on the outer side of an ankle while getting them to balance on a wobble board. The strip of tape would provide the information that inversion is occurring, hence the peroneal muscles would be activated to prevent this movement, averting a re-injury.

Restrictive taping: What and When

Restrictive taping as the name suggest, is to restrict range of motion of a particular joint. This can be for one direction or multi direction, depending on the direction and degree of instability. This type of taping is used to protect unstable joints, where repeated or severe ligament damage has resulted in the stretching of the ligaments and/or joint capsule, thus leading to joint laxity. In such cases, an elastic brace will not provide enough support as the brace “gives” and will not limit the joint from moving into the unstable range.

Restrictive taping is most commonly used when the athlete is recovering from a ligament or muscle strain. The tape acts as an external support to prevent the joint from going into the end range of the movement that would cause pain. The most common areas that this form of taping is used are ankle, shoulder and knees.

Kinesio Taping

Kinesio taping was popularized in the 2008 Olympics where a lot of the swimmers, runners and jumpers were having these colorful and fancy looking tapes pasted on them. Some even thought that it was a fashion statement. However, the real history of Kinesio taping started in Japan, some 25years ago by Dr Kenzo Kase. The method of taping uses a uniquely designed and patented tape for the treatment of muscular disorders and lymphedema reduction. The use of the tape was to assist and give support to prevent over contraction of the muscle or to help decrease swelling. This enables the tape to help speed up the rate of healing for injured muscles.

Functional fascial taping (FFT)

Functional fascial taping was developed by Ron Alexander, an Australian remdial massage therapist who worked with the Australian ballet. Whilst he found the restrictive taping useful in preventing the recurrence in injury, it was not functional for his ballerinas as they required a full range of movement of their injured joints/muscles to perform their dance. Hence, FFT was created to allow the continuation of functional range and activity without pain. Most musculoskeletal conditions are multifactorial in nature, and pain can be a hurdle in a successful rehabilitation. FFT provides physiotherapists with another tool to manage their clients’ pain and increase compliance.

Essentially, FFT affects the connective tissues. When tape is applied, it applies a sustained load on to the fascia in a direction that allows the muscles under the fascia to glide better. This has been observed on ultrasound. The direction of tape applied is guided by the direction of load that reduces the pain. Anecdotally, it is also found that if the tape is applied appropriately, pain disappears and the range of motion increases with the functional activity. The latter is likely due to the increase muscle gliding with FFT. As with many techniques, the physiological reasons for their effects are still largely unknown although research is still being done.

FFT can be applied on any area of the body and does not need to be on a joint. FFT has been greatly applied in dance medicine but in recent years have migrated to be extensively used in the area of sports. However, the usage of FFT has been generally limited to rehabilitation where pain would inhibit the proper activation of muscles. Though such techniques have been employed to help athletes go about their sport with no pain, it is not recommended for frequent use as it doesn’t solve the problem.

Conclusion

Taping is a great adjunct to getting us back to sports if applied properly. However, please discuss with your therapist whether you are ready to get back to sports following your injury. It’s always safer to complete your rehabilitation and taping can be used to slowly give you the confidence to get back to sports.

Reference:

  1. Gary B Wilkerson. Biomechanical and neuromuscular effects of ankle taping and bracing. Journal of Athletic training 2002;37(4): 436-445
  2. Gilleard W, Mc Connell J, Parsons D. The effect of patella taping on the onset of vastus medialis obliques and vastus lateralis muscle activity in persons with patellofemoral pain. Phys Ther 1998; 78:25-32
  3. McConnell J. The management of chondromalacia patellae: a long term solution. Aust J Physio 1986; 32: 215-23
  4. Bockrath K, Wooden C, Worrell, et al. Effects of patellar taping on patellar position and perceived pain. Med Sci Sports Exerc 1993; 25: 989-92
  5. Abstracts accepted at the Fascia Research Congress
  6. Functional Fascial Taping real time ultrasound investigation
  7. Functional Fascial Taping for lower back pain: a case report
  8. Efficacy of Functional Fascial Taping for the treatment of non-specific low back pain

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