Therapeutic Taping for the Hip & Knee Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS

Medial Knee Proprioception Adapted from McConnell Medial Glide with Elastic Tape Single strip, 3-4 squares Apply from superior and lateral patellar borders, maximal pull medially May use a second strip for added reinforcement Avoid popliteal fossa Useful in conjunction with medial proprioceptive strips Scott & Dyanna Rezac - Taping Hip & Knee

Medial Knee Proprioception Medial Glide with medial proprioception strips Scott & Dyanna Rezac - Taping Hip & Knee

McConnell Patellar Taping McConnell method involves evaluating the static alignment of the patella including tilt, glide and rotation Correction strips are applied to “correct” this malalignment Medial / Lateral Glide Medial / Lateral Tilt J-Tape Radiographic and MRI studies show no change in patella with taping Generally, the medial glide (providing proprioceptive input to the medial knee) has been shown to be the most effective; however, can use this technique in any direction about the patella for proprioceptive input. Scott & Dyanna Rezac - Taping Hip & Knee

McConnell Taping Improved Knee Extensor Moment PFPS Ernst GP, Kawaguchi J, Saliba E. Effect of patellar taping on knee kinetics of patients with patellofemoral pain syndrome. J Orthop Sports Phys Ther 1999 Nov; Vol. 29 (11), pp. 661-7. 14 women (24.4 +/- 5.8 years) with PFPS performed a single-leg vertical jump and lateral step-up during 4 knee conditions: patellar tape, placebo tape, no tape, and the uninvolved knee. Patellar taping significantly improved extensor moment and power vs no tape or placebo, but not vertical jump. Scott & Dyanna Rezac - Taping Hip & Knee

McConnell Taping Improved Pain / Disability with OA Hinnan R, Crossley K, McConnell J, Bennell K. Efficacy of knee tape in the management of osteoarthritis of the knee: blinded randomised controlled trial. BMJ 19; 327(7407): 135. 2003 87 patients with OA as defined by College of Rheumatology Patients reported significant improvement in primary outcomes and most secondary outcomes with therapeutic taping technique Therapeutic knee taping is an efficacious treatment for the management of pain and disability in patients with knee osteoarthritis. Scott & Dyanna Rezac - Taping Hip & Knee

Scott & Dyanna Rezac - Taping Hip & Knee Quad Facilitation Kinesio® Taping Technique Apply a single strip on quadriceps mod to max stretch Split around patella with no stretch Can augment with medial proprioceptive strips Scott & Dyanna Rezac - Taping Hip & Knee

Kinesio® Taping Patellar Dislocation Pain/Edema Osterhues, D 2004 The use of Kinesio® Taping in the management of traumatic patella dislocation. A case study. Physiotherapy Theory and Practice. Dec 20 (4): 267-270 Case study 49 year old female s/p traumatic patellar dislocation After 5 weeks of taping (Y quad facil), with NSAIDs, IFC, R0M and ice she returned to all activities with minimal pain and edema and normal gait. Scott & Dyanna Rezac - Taping Hip & Knee

Kinesio® Taping PFPS Improved Pain / Function Brandon R, Paradiso L 2005 The use of Kinesio® Tape in patients diagnosed with Patellofemoral pain (PFP) Kinsesio Taping Association website, not published 3 Case studies 91 y/o female s/p L ORIF and secondary PFS x 2 weeks No pain with gait or at night, immediate relief following taping 56 y/o female 3-4 yr hx of PFS No pain with walking, ascend/descend stairs and less pain at end of day with taping 12 y/o female 1 yr hx of PFS No pain with running or ADL with tapin Results demonstrate 3 cases of positive improvements in pain and function immediately following taping Scott & Dyanna Rezac - Taping Hip & Knee

Kinesio® Taping Improved Strength/ROM ACL Repair Murray, H 2000 Kinesio® Taping, Muscle Strength and ROM after ACL Repair. Journal of Orthopedic and Sports Physical Therapy 30(1) 2 subjects s/p ACL RepairSignificant improvement in AROM and EMG amplitude between no tape / athletic tape and kinesio tape groups Authors speculate this is due to increase in mechanoreceptors Scott & Dyanna Rezac - Taping Hip & Knee

Kinesio® Taping PFPS Improved Function with Both Tapes Jancaitis G et al 2006 Short Term Effects of Kinesio® Taping on Symptoms of PFPS University of Virginia study submitting for Platform Presentation with NATA and publication Randomized controlled trial 14 subjects between 18-50 years old with + hx of PFS Baseline measurements, taped with Kinesio Tape or sham tape (cross strip above & below patella) and measured on initial taping and 2 days later LE Functional & Visual Analogue Scale, 1 & 10 step down Reduction in pain in 10 step down test for both groups Scott & Dyanna Rezac - Taping Hip & Knee

PFPS / Medial Knee Proprioception Which to choose? Evidence supports improved pain, function and edema, but not actual change in patellar alignment or muscle facilitation Use clinical objective measures to validate technique use Have seen best results in clinic with medial glide with medial proprioception strips Utilize * sign tests to validate Scott & Dyanna Rezac - Taping Hip & Knee

Knee Hyper-extension Block Athletic Tape Tecnique Same as for elbow Two strips maximal stretch from mid-thigh to mid-calf Two single strips across joint Scott & Dyanna Rezac - Taping Hip & Knee

Patellar Fat Pad Unload Adapted from McConnell Technique Split strip attached to tibial tubercle with maximal, but equal pull medial and lateral Use step up/down, squat tests to validate Scott & Dyanna Rezac - Taping Hip & Knee

IT Band / Hip Bursa Unload Modified Kinesio® Taping Technique Maximal stretch 1-2 strips along IT Band Can also help facilitate lateral hip control Test pain with ambulation, Trendelenburg Scott & Dyanna Rezac - Taping Hip & Knee

IT Band / Hip Bursa Unload Trochanteric Bursa Used by Athletic, McConnell, Mulligan & Kinesio® Taping Space Correction 3-4 squares x 2-4 strips in multiple directions over bursa Test with * Sign Scott & Dyanna Rezac - Taping Hip & Knee

Pes Anserine Bursitis / Adductor Unload McConnell & Kinesio® Taping Techniques 1) 1-2 single strips minimal stretch over medial knee to distribute forces 2-4 space correction strips (3-4 squares) over pes anserine bursa * Sign Tests to validate Scott & Dyanna Rezac - Taping Hip & Knee

Hamstring (Kenso Kase, Japan)    うつ伏せになり、両脚はやや開きます。テープの基部をももの裏上部(お尻の下部）に固定する。    そのまま、ももの裏に沿って貼っていく。    Y字部分は一方をひざの外側側部に、もう一方をひざ内側側部に向かって貼っていく。    完成。 Scott & Dyanna Rezac - Taping Hip & Knee

Hamstrings (English Version) Kinesio® Taping Technique Inhibition - split strip minimal stretch along borders of hamstring Facilitation - split strip mod to max stretch Scott & Dyanna Rezac - Taping Hip & Knee

Hamstrings Modified Version Does not seem to make a clinical difference whether tape borders or along muscle belly 1-2 strips with moderate stretch over hamstring Can direct laterally s/p ACL medial hamstring graft Scott & Dyanna Rezac - Taping Hip & Knee

Hip External Rotation Facilitation Discussed for piriformis or gluteus medius in Lumbopelvic section Scott & Dyanna Rezac - Taping Hip & Knee

Scott & Dyanna Rezac - Taping Hip & Knee LE IR/ER Strapping Used mainly for Pediatric populations, but also useful for neurological (similar to Thera Togs) IR: start laterally on the calf and come medially spiral up the leg across the anterior pelvis ER: start medially on the calf and spiral up the leg laterally across the posterior pelvis Can apply unilaterally or bilaterally Also useful for correction of hip anteversion or retroversion Scott & Dyanna Rezac - Taping Hip & Knee

Scott & Dyanna Rezac - Taping Hip & Knee LE IR/ER Strapping Maguire, C et al. Hip abductor control in walking following stroke-the immediate effect of canes, taping, and TheraTogs on gait. Clinical Rehabilitation. Volume 24(1), p 37-45. Jan 2010. 13 patients s/p CVA Hip abductor taping and TheraTogs increased hemiplegic hip abductor activity and gait speed during walking compared with baseline and cane use. Scott & Dyanna Rezac - Taping Hip & Knee

Scott & Dyanna Rezac - Taping Hip & Knee Contusion / Edema Kinesio® Taping Technique Multiple splits strips 4-8 strips (with 2”) No stretch Great for TKA’s Scott & Dyanna Rezac - Taping Hip & Knee

Scott & Dyanna Rezac - Taping Hip & Knee Scar Tissue Only to be used on fully closed incisons, no open wounds Works similarly to Cica-care in that it lifts the surrounding tissues and helps the collagen fibers realign flat with surrounding tissue Lie tape along the scar without any stretch Great for long incisions as with a TKA Scott & Dyanna Rezac - Taping Hip & Knee

Clinical Evidence-Based Objective Assessments Gait Gait mechanics (at IC, MS, TS, etc) Trendelenberg LE IR, Q angle Genu Valgum Knee hyperextension Calcaneal, midfoot, forefoot position Stride Length Stance Time Distance Speed Assistive Device Scott & Dyanna Rezac - Taping Hip & Knee

Clinical Evidence-Based Objective Assessment (cont). Pain at rest with AROM previously aggravating positions / activities VAS (Visual Analog Scale) Outcome Measures LEFS (Lower Extremity Functional Scale) AROM MMT Scott & Dyanna Rezac - Taping Hip & Knee

Clinical Evidence-Based Objective Assessment (cont). Functional Tests (Asterisk Signs) Step up, step down, squat, SLS, jumping Less pain, more reps, improved range / height? Cutting, cross-overs, uneven surface ADLs Sit <> stand, stair negotiation, kneeling Scott & Dyanna Rezac - Taping Hip & Knee

Questions, Comments, Discussion www.rezacpt.com dyanna.rezac@rezacpt.com scott.rezac@rezacpt.com Scott & Dyanna Rezac - Taping Hip & Knee