Tape in the Clinical Toolbox
Kinesiotaping is a relatively new rehabilitative technique that is being used in North America. It was developed in Japan nearly 25 years ago by Dr. Kenzo Kase. In the early 1970's alternative treatments for orthopedic ailments were being used by Japanese health care professionals. Out of these alternative methods, Kinesiotaping became a widely accepted technique to assist health care professionals attain their desired outcome.
It has been used as a physiotherapy technique for a number of years and as a certified Orthotist it piqued my interest. We, as Orthotists, love the challenge of the mal-aligned joint; we do our best to re-align and support. However, all too often, the pathologies that require orthotic intervention are complex, and may benefit from more than an orthotic device.
There are two basic concepts that are used when applying Kinesiotape. If the muscle or joint is injured and requires support, the tape is pre-stretched while being applied to the skin. The basic premise for taping the weak muscle is to start the tape at the muscle's origin and end the tape at the muscle's insertion. As a result, the tape provides tension directly over the affected muscle so that as the muscle fibres contract, the stretched Kinesiotape supports the contraction by encouraging the muscle fibres and skin toward the point of origin. This particular application is used for supportive purposes as in the case of an acute injury or a weakened muscle (see figure 1 ).
The other technique of tape application is used to prevent over-contraction. In this application, the tape is applied to the skin over the muscle from insertion to origin. The basic principle in this case is to pre-stretch the skin over the muscle and then lay on the tape without very much stretch. As the muscle contracts, the tape will be compressed along its length and "remind" the muscle to return to its relaxed state (see figure 2 ).
In the particular instance pictured in this article, an infant with overactive tibialis posterior and underactive tibialis anterior was developmentally ready to pull to stand. Unfortunately, her standing attempts were on the lateral borders of both feet and because of her age and certain rapid growth, an alternative to AFO's was deemed appropriate by the team members involved in her management (see Figure Three ).
This presented itself as an indication for the application of Kinesiotape. After the application of the Kinsietape to the appropriate muscles, the foot position was significantly improved as seen in Figure Four .
As a practicing Orthotist with a current patient population of paediatrics with a diagnosis of Cerebral Palsy, I found the idea of tape application intriguing. For example, if a child with a diagnosis of Cerebral Palsy is prescribed a pair of articulated AFO's to prevent toe walking due to spastic or tight triceps surae muscle group, we may find that even the most wonderfully designed and custom manufactured AFO's do not correct the gait deviation. This may be caused by over active hamstrings, but it would be inappropriate to manage this by extending the orthoses above the knee. Perhaps an application of Kinesiotape to relax the hamstrings would be the perfect adjunct to the orthotic intervention of articulated AFO's!
I believe that there may be many different applications of the Kinesiotaping techniques that would benefit our patient populations. It is an alternative technique that is relatively new to North America and certainly new to the Orthotic field. As a result of its interesting application, there may be a place for this technique in our patient populations as we strive to treat the whole person, not just the specific pathological condition.
This article is reprinted from the ALIGNMENT with permission from CAPO
Krista Holdsworth, B.Sc. C.O. ©; OrthoProActive Consultants, Toronto, ON.
- Kase, K., Hashimoto, T., & Okane, T. (1996) KinesioTaping Perfect Manual. Ken Ikai, Co. Ltd. (Ed.), Japan.