1. Therapeutic Taping for the Foot and Ankle
Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP
Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS

2. Scott & Dyanna Rezac - Taping Foot & Ankle
Plantar Fascia Unload Gastroc/Soleus/Achilles Complex Unload Athletic Training & Modified Kinesio® Technique (also achilles tendonosis, gastroc strain)
Step 1: With foot in dorsiflexion, begin tape at transverse arch on plantar aspect of foot. Apply maximal stretch to calcaneus. Can also fan and/or direct to 1st ray for improved 1st distribution.
Step 2: Split tape and apply to medial and lateral aspects of the gastroc/soleus complex with moderate stretch.
Very effective when combined with navicular lift
Scott & Dyanna Rezac - Taping Foot & Ankle

3. Scott & Dyanna Rezac - Taping Foot & Ankle
Low Dye Tape on Medial Longitudinal Arch Controls Pronation During Stance, Running, Walking
Vicenzion B et al. Initial effects of anti-pronation tape on the medial longitudinal arch during walking and running. British Journal of Sports Med Dec;39(12):939-43
17 subjects who were asymptomatic and exhibited a navicular drop greater than 10 mm.
The augmented LowDye tape was effective in controlling pronation during both static and dynamic activity. Tape induced changes in static foot posture paralleled those during walking and jogging.
Scott & Dyanna Rezac - Taping Foot & Ankle

4. Low Dye Tape Increased Lateral Midfoot Plantar Pressures
Vicenzino B et al. Plantar foot pressures after the augmented low dye taping technique. J Athl Train Jul-Sep;42(3):
Within-subjects, repeated-measures randomized control trial utilizing 15 women and 7 men who were asymptomatic.
The ALD predominantly increased plantar pressures in the lateral midfoot during walking and jogging. In addition, tape reduced mean maximum pressure at the medial forefoot and at the medial rearfoot during walking.
Scott & Dyanna Rezac - Taping Foot & Ankle

5. Scott & Dyanna Rezac - Taping Foot & Ankle
Calcaneal tape vs sham, stretching, and no treatment on Plantar Fascia Pain Calcaneal Tape More Effective
Hyland MR; Webber-Gaffney A; Cohen L; Lichtman PT J Orthop Sports Phys Ther 2006 Jun; Vol. 36 (6), pp
Randomized controlled trial of 41 subjects with plantar heel pain 1)calcaneal taping , 2)sham taping, 3) plantar fascia stretching and 4) control for the short-term management of plantar heel pain.
Calcaneal taping was shown to be a more effective tool for the relief of plantar heel pain than stretching, sham taping, or no treatment but no change on PSFS.
Scott & Dyanna Rezac - Taping Foot & Ankle

6. Navicular Lift McConnell Technique
Stability and deceleration of pronation moment during stance
Similar to a “chopat” for the foot
Step 1: No stretch from lateral dorsum to navicular tubercle
Step2: Maximal stretch from tubercle to anteriolateral tibia
Scott & Dyanna Rezac - Taping Foot & Ankle

7. Distal Fibular Glide Mulligan Technique
Improve DF
Tension ATFL to prevent lateral ankle sprain
Step 1: Tape from slightly anterior and distal to distal fibula
Step2: maximal stretch in a posterior and proximal direction around the posterior calf while applying a posterosuperior glide
Same technique can be used for superior tib-fib
Scott & Dyanna Rezac - Taping Foot & Ankle

8. Mulligan Fibular Glide Taping Decreased Ankle Injury
Moiler K, Hall T, Robinson K. The role of fibular tape in the prevention of ankle injury in basketball: A pilot study. J Orthop Sports Phys Ther Sep;36(9):661-8.
443 measured basketball exposures resulted in 11 ankle injuries. All injuries occurred in subjects with a history of previous ankle sprain. Significantly less ankle injuries were sustained by members of the FRT condition
This study provides preliminary data regarding the prophylactic effects of FRT on ankle injury in male basketball players.
Scott & Dyanna Rezac - Taping Foot & Ankle

9. Athletic Ankle Taping Postural Sway Improved Faster
Matsusaka N et al. Effect of ankle disk training combined with tactile stimulation to the leg and foot on functional instability of the ankle. Am J Sports Med 2001 Jan-Feb; Vol. 29 (1), pp
Twenty-two university students with unilateral functional instability of the ankle. 2 Groups 1) Tape 2) No tape
In group 1, postural sway values decreased significantly after 4 weeks and WNL after not more than 6 weeks. In group 2, the values did not improve significantly until after 6 weeks and WNL until 8 weeks. The findings suggest that this was due to an increased afferent input from skin receptors that were stimulated by the traction of the adhesive tape
Scott & Dyanna Rezac - Taping Foot & Ankle

10. Scott & Dyanna Rezac - Taping Foot & Ankle
Achilles Space Correction Kinesio® Tape utilizing McConnell/Mulligan Concepts
Step 1: Cut a 3-square piece of tape and remove backing from middle 1/3 of tape.
Step 2: With foot in DF, stretch maximally horizontally across the Achilles tendon.
Step 3: Lie down two ends without stretch.
Very effective when combined with gastroc/soleus/plantar fascia unload.
Scott & Dyanna Rezac - Taping Foot & Ankle

11. Transverse Arch Support
Metatarsalgia
Enhance transverse arch support
Step 1: Stretch maximally across plantar transverse arch (metatarsal heads).
Step2: Lie down end without stretch on dorsal aspect of foot.
Scott & Dyanna Rezac - Taping Foot & Ankle

12. Scott & Dyanna Rezac - Taping Foot & Ankle
Morton’s Neuroma
Space correction to relieve pain from Morton’s neuroma / Metatarsalgia
Step 1: Place with maximal stretch across site of most pain (usually between 2nd & 3rd or 3rd & 4th MTP on plantar surface, but can be used on dorsal surface if neuroma is on the superior aspect)
Step2: Lie down ends without stretch
Scott & Dyanna Rezac - Taping Foot & Ankle

13. Kinesio® Neuroma Case Study Eliminated Pain
Stahl, A. Clinician’s Overview & Case Study: Post Operative Neuroma and RSD.  15th Annual Kinesio Taping International Symposium Review. (pp ) Tokyo, Japan: Kinesio Taping Association. 1999.      
Pt. s/p neuroma resection subsequently developed RSD
Failed to manage pain with scar tissue mobilization, joint mobilization, e-stim, US, nerve blocks, walking boot, ther ex.
Pt was pain free within 24 hours
Scott & Dyanna Rezac - Taping Foot & Ankle

14. Peroneal Facilitation Kinesio® Technique
Lateral Ankle Sprain
Peroneal Strain
Mod to max stretch from lateral fibula to 1st MET (longus) or 5th MET (brevis)
Tape with ankle in IV & DF
For active control of peroneals for lateral stability to correct over-pronation
Great for ATF sprains with navicular lift and/or EV stirrup
Scott & Dyanna Rezac - Taping Foot & Ankle

15. Eversion Stirrup Biomechanical Correction Athletic Taping Technique
Lateral ankle sprain
Can be used with peroneal facilitation and/or navicular lift
Step 1: begin at the medial calcanceus and lie tape down on plantar aspect of the calcaneus
Step2: stretch maximally up the lateral aspect of the calf to apply an EV force to the ankle.
Scott & Dyanna Rezac - Taping Foot & Ankle

16. Posterior Tibialis Kinesio® Technique
Medial ankle sprain
Tarsal Tunnel Syndrome
Tape with moderate stretch (facilitation) or minimal stretch (inhibition) in EV and DF
Scott & Dyanna Rezac - Taping Foot & Ankle

17. Tibialis Anterior Kinesio® Technique
Facilitate DF
Inhibit with space correction for shin splints
With foot in EV and PF, mod to max for facilitation and minimal to no stretch for inhibition
Scott & Dyanna Rezac - Taping Foot & Ankle

18. Tarsal Tunnel Space Correction
Space correction of tarsal tunnel
Can be used with posterior tibialis facilitation and/or navicular lift.
Step 1: Stretch maximmally over tarsal tunnel, no stretch on ends
Step2: Can repeat 2-4 times in different directions
Scott & Dyanna Rezac - Taping Foot & Ankle

19. Hammertoe, Mallet Toe & Claw Toe Correction
Toe Deformities
Step 1: Start at the dorsum of the foot and apply a mod to max stretch across the joints in excessive flexion (facilitation) and minima stretch across the joint in excessive extension (inhibition). Can be done as a single 1” strip for each toe or fan for several toes.
Step2: Cap around toes.
Scott & Dyanna Rezac - Taping Foot & Ankle

20. Hallux Valgus Correction
Can be augmented with navicular lift
Valgus or Varus can be used on any toe.
Step 1: Begin medial on the 1st ray, stretch moderately to maximally along medal foot to calcaneus (avoid positioning 1st MTP at end-range of available motion).
Step2: Continue around posterior calcaneus laterally and back to medial foot on the dorsum ending at the medial 1st ray (starting point).
Step3: A small strip can be used around the toe to secure ends without any stretch.
Scott & Dyanna Rezac - Taping Foot & Ankle

21. Scott & Dyanna Rezac - Taping Foot & Ankle
Taping Toes
As with fingers, tape for what you want to accomplish
Extension of DIP – maximal stretch dorsal joint
Normal motion of PIP – no stretch
Flexion of DIP – maximal stretch volar joint
Collateral ligament protection / Unload one joint – X strips on either side of joint, anchor the ends
Decrease strain on flexor tendon – tape with moderate stretch on volar surface of digit up muscle to origin
Immobilize a digit – “Buddy Tape” two fingers together with two 1” strips
Space correction over entrapment site
Scott & Dyanna Rezac - Taping Foot & Ankle

22. Edema / Lymphedema Kinesio® Technique
Edema Reduction
For acute ankle sprains or post-surgical foot/ankle.
Anchor distally and lie strips without stretch around
edema area without stretch.
Scott & Dyanna Rezac - Taping Foot & Ankle

23. Clinical Evidence Based
Objective Assessments
Gait
Gait mechanics (at IC, MS, TS, etc)
Heel Strike
DF, 1st ray extension
Decreased toe clawing
Calcaneal, midfoot, forefoot position
Stride Length
Stance Time
Distance
Speed
Assistive Device
Scott & Dyanna Rezac - Taping Foot & Ankle

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

25. Clinical Evidence Based
Objective Assessment (cont).
Functional Tests (Asterisk Signs)
Step up, step down, SLS, jumping, running
Less pain, more reps, improved range / height?
Cutting, cross-overs, uneven surface
ADLs
Stair negotiation
Scott & Dyanna Rezac - Taping Foot & Ankle

26. Questions, Comments, Discussion
Scott & Dyanna Rezac - Taping Foot & Ankle