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

2. 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

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

4. 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

5. 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
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

6. 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):
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

7. 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

8. 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):
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

9. 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

10. 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

11. 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 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

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

22. 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

23. 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 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

24. 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

25. 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

26. 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

27. 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

28. 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

29. Questions, Comments, Discussion
Scott & Dyanna Rezac - Taping Hip & Knee