1. KINESIOTAPING By: Kristin Levin AT, ATC, CKTP, PES

2. Objectives  Identify what Kinesio tape is and what it is used for  Indications and contraindications of the tape.  The theory behind muscle tapings and lymphatic tapings.  Corrective Taping Techniques.  Applications and removal of the tape.

3. Kinesio tape was developed in the early 1980s by Dr. Kenzo Kase.  Depending on how you apply the kinesiotape it can work in different ways.  It mimics the qualities of human skin. Being light and as flexible as the skin. This is to avoid the bodies perception of weight and avoids sensory stimuli.  Kinesiotape works by subcutaneously lifting the skin.  Enhances muscular, joint and circulatory function by facilitating a muscle, inhibiting a muscle, working with the lymph system to help with edema.  Can be used in all phases of an injury acute, subacute and rehabilitative.

4. General rules  The tape can be worn 24 hours a day and left on for 3-5 days.  You want to make sure the skin is free from lotion and oils for the tape to adhere properly.  Can shower and ice over the area.  Towel dry. DO NOT USE A HAIR BLOWER to the tape.  Moist heat is ok but dry heat is not.  Pull the tape off gently, do not yank like a band- aid.

5. The Tape  Non latex. 100% cotton with an acrylic heat activated adhesive.  No medications  Water resistant  Has a stretch in the longitudinal direction only.  Has about a 10-15 % stretch on the paper.  Can stretch to 40-60% of its resting length  The thickness and the weight are similar to the skin.  Does not restrict ROM.  There is no difference with the different color tapes.  New FP tape Higher grade cotton with increased breathability  Lighter weight with a new weave process for improved comfort  Brings nano-touch micro-stimulation to epidermis and layers beneath; improved grip and lift Kinesio FP Tape is more forgiving to initial application errors; easier to re- position

6. Precautions  Diabetes  Kidney disease  Congestive heart failure  CAD or Bruits in the carotid artery  Fragile or healing skin ( milk of magnesia in elderly can be benificial)  May need MD clearance to tape if these conditions are present

7. Contraindications  Over an active malignancy site  Over active cellulitis or skin infection  Open wounds  Deep vein thrombosis

8.  Practice tearing the paper and seeing the elasticity of the tape. Also note the differences between the two tapes.

9. Physiological effects  Skin  Circulatory/ Lymph system  Fascia  Muscle  Joint

10. Skin  The body is made up of 3 layers: the endodoerm, mesoderm and the ectoderm. Because all three layers are interconnected, Kinesiotape can treat the entire body from the outside in.  Kinesiotape effects the sensors of the skin through its application process. Through the manipulation of these sensors the kinesiotape can change the healing processes of the body.  Kinesiotape can reduce pain by alleviating pressure on the neural and sensory receptors and reduce swelling by increasing fluid movement.

12. Circulatory/ Lymphatic System  Kinesiotape can speed lymphatic drainage and flow by increasing the amount of space beneath the skin, creating a more efficient exchange of lymph and bodily fluids between different tissues.  Reduces edema  Equalizes temperature  The tape lifting the skin causes convolutions which creates a channel of low pressure in the congested areas.  Decreases pain

14. Fascia  Fascia is fibrous and a connective tissue.  With all the layers of fascia connected, by taping the skin it can effect the deepest layer of fascia.  Collagen or fat exists between each layer of skin. If the person is not moving sufficiently the collagen may act as glue and adhere the surfaces together.

15. Muscle  By understanding the science of muscle movement one can better envision the way that kinesiotape will effect the muscles function.  Must evaluate and decided if pain is coming from a muscle weakness or a tightness and tape accordingly.  Kinesiotape can relieve muscle pain, increase ROM, normalize length/tension ratios to create optimal force, assist with tissue recovery and reduce fatigue.

16. Joint  Can improve joint alignment and biomechanics  Facilitate ligament and tendon function  Enhance kinesthetic awareness.  Correct muscle imbalance

17. Getting ready to tape  Different tape cuts for different body parts and applications  I strip  Y stip  X cut  Fan cut Round edges of tape, except ends of fan cut.

18. Cont..  Want to measure and tape to the length of muscle (where possible).  There are two ways to remove the paper backing the roll method and the tear method.  Decide whether you want to facilitate or inhibit a muscle  Facilitation- Improves muscle contraction of a weakened muscle  Inhibition- Relaxes an over contracted muscle. Keep in mind the length tension curve, too much overlap of the actin and myosin or too little overlap reduces tension  Tape for the pain and the cause of the pain.

19. Taping  Kinesiotape is generally applied to stretched tissue.  Less is more  No tension on the anchors.

20.  “Paper off tension” – Tape is applied with the 10-15% tension off the paper.  Tension greater than 50% are used for corrective techniques only.  Facilitation -P to D (O to I) applied with 15-35% tension  Inhibition- D to P (I to O) applied with 15 to 25% tension  Therapeutic direction is the recoil of the tape towards the anchor.  Therapeutic zone is the targeted tissue.

21. After application, lightly rub the tape to activate the heat activated adhesive.  Tape stays best if adhered 30-40 min prior to workout or swim  If excessively hairy may need to trim or shave area

22. Tape removal  Remove tape in the direction of the hair growth  Pull the skin back from the tape  Tape can be removed while bathing.  Soap, lotion or oil can also be applied to help remove the tape.

23.  If the tape is itching or increasing pain have athlete remove tape.  If sensitive to tape try a test patch first on hand.  Do not put tape on nape of hair, through axilla or groin.  Avoid trigger points in pregnant females.  Never use the tape to pull body part into position.  Taping possibilities are endless!

24. Applications

25. Quadriceps Femoris Application  Originates AIIS and inserts into the tibial tuberosity  Starting position- hip extension and knee flexion  Measure and cut a Y strip  Apply 15-35% tension P to D  Adhere anchor to AIIS or belly of quadriceps muscle  Apply tension through therapeutic zone to the musculotendinous junction  Split the tails around the patella and end without any tension at tibial tuberosity.  This was done to facilitate the quadriceps.

26. Deltoid  Originates clavicle/spine of scapula and inserts into deltoid tubricle.  Measure and cut a Y strip.  Anchor tape at deltoid tubricle, Horiz Abd for one tail and Horiz ADD for other tail. Anchor at clavicle/spine of scapula  Apply 15-25% tension through therapeutic zone  Taping Distal to Proximal = inhibition

27. Lymphatic application  The goal is to guide the inflammation to a lymph node to be removed through superficial lymphatic pathways… if an area is congested or overwhelmed may not get desired results.  Anchor proximally (no tension)  Apply 10-15% tension on tails over the effected area  Ending with no tension  Repeat with second fan so that they cross

28. Corrective Techniques  Mechanical correction- it is a positional hold with 50- 75% tension with inward downward pressure  Fascia correction- oscillating tissue( side to side or long to short) with 15-35% tension  Space correction- lifting technique with 25-50% tension.  Ligament/tendon correction- Proprioceptive, decreases stress on a ligament or tendon. 50-75% tension on a tendon to stimulate golgi tendon receptors for support, and 75-100% on a ligament for joint protection.

29. Fascia Correction – IT band  First we will inhibit the IT band with an I strip placed just below gerdys tubercle, apply 15-25% tension ending TFL or AIC.  Identify tight or painful zone. Next we cut a Y strip and anchor base near target zone with the tails perform long to short or side to side with about 15-35% tension with targeted tissue in the middle.  Base more specific area, tails a larger area.

30. Space Correction- Shin  Cut 2-4 strips for the size of the targeted tissue.  Place over the effected area with 25-50% tension  Creating a star shape.  The tape has an additive effect so the more strips you use the less tension each should have.

31. Ligament/ Tendon Correction  MCL- have athlete standing with slight bend in knee anchor near tibial tuberosity, no tension until over MCL then place 75-100% tension over MCL and no tension the rest of the way.  Achilles tendon- Anchor at plantar surface of calcaneus. Place 50-75% tension over Achilles tendon. If continuing into muscular part of gastroc use appropriate tension.

32. References  Kase, Kenzo, Jim Wallis and Tsuyoshi Kase. Clinical Therapeutic Applications of the Kinesio Taping Method. 2 nd edition. Ken Ikai Co Ltd.,2003  Kase,Kenzo. KT1/KT2 workbook. Kinesio taping Association.,2008