SPORTS PODIATRY

The Kinesio®Taping MethodHere's a new treattnent modality for podiatry

By Lisa M. Schwne DPM, AiC

K inesio* Tex tape is a tapetliat was designed by chiro-practor Dr. Kenzo Kase. Dr.

Kase graduated from the NationalCollege of Chiropractic in thetlikago area, and began practice in1975. He devel-oped the tapeover 30 years agoin Japan and in-troduced it to theUnited States inthe 199()'s. Thishighly specitii,tape has beenused worldwidf,in many settings,tiom chiropracticoffices to atliletictraining rooms,physical therapyclinics and ath-letic fields.

Kinesed^ tape has a

paper hacking which

can be torn, folded

back, and removed in

different ways,

depending on the

desired application.

Unique Qualities of the TapeThis tape mimics skin—it is the

approximnte thickness of the epi-dermi.s, and when projierly applied,the body will not perceive itsweight. It is made of polymer elas-tic strands wrapped in lOO'Mi cottonfibers. This allows tor quick dryingof l)ody moisture. There is no latex,and the adhesive is lOO'Ki acrylic. Itis activated hy body heat and will

Figure 1: Wave Pattern of Kinesio* tape

become more adherent the longerit is worn. In the manufacturingprocess, the adhesive is applied tothe fibers of the tape in a wave-likepattern (Figure 1) to mimic thequalities of fingerprints on the fin-gertip. This wave pattern lifts theepidermis ¡ind also allows for mois-

ture to escape.The tape has

a paper backingwhich can betorn, folded back,and removed indifferent ways,depending on thetlesired applica-t ion. The tapecan be worn forthree to five days,iind be worn dur-ing athleticevents as seen inthe recent

(llympics. Due tothe fact that

there is nu glue residue, the tapemay be reapplied without any skinirritation.

Spray adhesive is generally notneeded, but can be utilized in cer-tain situations where immediateadhesion is required, or in high per-spiration areas. Since the adhesiveis not ruhber-based, tape removalmay be more difficult and mineraloil or milk of magnesia can be used.

The tapecomes in sev-eral sizes; themost com-monly usedsize is the 2inch width( n a t u r a l

Contiiiiu'd on page ¡SO

New Conceptsand Studies

"New Concepts" is aforum for the presen-tation of (1) new tech-nologies and productswhich have been thesubject of clinicalstudy, and (2) newstudies involving exist-ing products. Readersshould be aware thatPodiatry Manage-ment does not specifi-cally endorse anyof the technologies,concepts, or productsbeing discussed.

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Kinesio Taping Method...color). There are other widths avail-able: 1 inch (designed for smallerjoints and pédiatrie use) and 3 Inch(designed for larger joints/musclecoverage, and to offer a greateramount of support). Other colorsavailable are: blue, black, and red.The tape itself can stretch (onlylongitudinally) approximately 40-60% of its resting length. The ten-sion may be altered when applyingto the skin, depending on the de-sired effect and the techniquebeing used.

Skin PreparationSkin preparation is important to

the application process. The skinshould be clean and free of oils.Hair may also need to be clipped orshaved since the application worksby skin to tape contact. When deal-ing with athletics or areas that pro-duce excess moisture, the applica-tion should be done 30 minutesprior to exercise. Kinesio*Tex tape is water-resis-tant and may be utilizedeven when swimming,showering or with hy-drotherapy. Contraindi-cations to usage includethe possibility of tape al-lergy. Caution should beused in patients with dia-betes, venous insufficien-cy or peripheral neuropa- Hgure 2: y Stripthy. A patient's willing-ness to wear the tape, ora perception that thetape is not working, areissues that may be en-countered, so patient ed-ucation is important.

Kinesio' TapingConcepts

The tape has fivemajor functions:

1) Skin. Relieve painor pressure and improveproprioception (Endoge-nous Analgesic System).

2) C i r c u l a t o r y /Lymph. Remove conges-tion of lymphatic fluidand hemorrhages underthe skin. Promote natu-ral fluid flow betweenthe layers of tissue.

3) Fascia. Return to

TABLE 1

KINESIO* TEX TAPE:

Educates weak muscles

Prevents muscle fatigue

Relieves painimmobilization

Prevents cramping

Increases ROM

Decreases edema

Corrects joint problems

homeostasis to the fascial matrix.4) Muscle. Restore or promote

normal muscle function.5) Joint. Improve joint biome-

chanics and alignment.

ATHLETIC TAPE:

Inhibits muscle movement

Restricts ¡oint ROM

Corrects joint problems by

Rests muscles to decrease pain

Figure 3:1 Strip

Figure 4: X Strip

Comparison of TapesThe practitioner must "unlearn"

traditional tape application meth-ods, as the techniques used toapply Kinesio* Tex tape are differ-

ent than traditional ath-letic or podiatric tapes.Results will be deter-mined by the practition-er's knowledge of properapplication. Utilizing ¿idifferent tape with dif-ferent physical qualitieswill not produce thrsame results.

Utilizing sharp scis-sors the tape can be cutinto various shapes (e.g.,"Y" (Figure 2), "I" (Figure3), "X" (Figure 4), "fan"(Figure 5), "web (Figure6), and "donut" (Figure7). These sliapes are de-termined by the locationof the treatment area,muscle shape, and thedesired effect. There arespecific corrective tech-niques that treat specific,conditions and Injury,but the techniques canbe modified slightly bvthe clinician with Kinc-sio* taping experience.Proper application willblend several elumentsof the Kinesio" tapingmethod, with each ele-ment having a specificfunction. The clinician

ContimieU on pa^e 152

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Kinesio Taping Method...evaluates the patient, determineswhich muscles are involved andinitiates treatment to that area.Then, if necessary, a sec-ondary corrective tech-nique can he used to as-sist in the treatment.

Tape & TissueStretch/Tension

For most of the basicapplications, the muscleand tissue should heplaced in a stretched po-sition. This allows forwrinkling or recoil sothe Kinesio* Tex tapewill create convolutionsin the skin, which aid innormal hlood and lym-phatic flow, Applying ina stretched position alsoallows full range of mo-tion for the patient. Thetape can be placed withvery little tension (15'Ki)all the way up to full

tension (100%). Many techniquesuse mid-ranges of tape tension. Thetape when peeled off the paperhacking will he longer than thepiece cut depending on how inuch

tension the practitioner ¡s using;this should be taken into considera-tion when cutting the appropriatesized strip.

Figure 5: Fan Strip

Figure 6: Wt'b Strip

Treatment of MusclesThere are two basic

application directionsfor treatment of muscles.For a weak muscle, thetape is applied from ori-gin to insertion of themuscle in order to facili-tate the muscle's func-tion. The tape is appliedwith 25-50% tension.For the overused spas-ming muscles, the tapeis applied from insertionto origin of the specificmuscle, with very littlftension or "paper offtape", which is 15-25%tension.

The 6 KT CorrectiveTechniques

The correct appHca-Continui'd on pa^c ¡S3

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Kinesio Taping Method...tion methods may overlap a bit.ind look similar, but should be de-termined l)y the patient'-s condi-tion and the best method to treatan area.

/) Mechtinical (Figure 8)riiis tcdinique uses a "Y" or "I"

strip, and is used to assist in the po-sitidiiiti^ of muscle, fascia, or jointslo stimuiate a sensation which re-sults in the body's adaptation to thestimulus. This technique uses moretension to stimulate the mechanore-ccptors. With inward pressure it af-fects the deeper tissue,functional support canbe maintained withoutlosing active range ofmotion. This techniquecan he used to eitherplace the tissue in the de-sired position, or providea lilocking action to limitjoint movement. Themethod uses either an "I"stii[) with tension in the l-i)íiirc 7: Domit Hole

Figure 8: Mechanical Technique

middle, or a "Y" strip with the tailsapplied to the tissue.

2) Fascia! (Figure 9)This corrective technique is

used to gather fascial tissue in orderto position it in a desired positionand alignment. It can hold or assistthe fascia from unwinding. It canbe used after massage or manualtherapy to hold the fascia in itspost-treatment position. The "Y"strip can be used differently fromthe mechanical technique; hy ap-plying the base of tbe tape, thepractitioner oscillates or vibratesthe tape during application.

3) Space (Figure W)This technique requires apply-

ing the Kinesio"' Tex tapedirectly over an area ofpain, inflammation orswelling. The tape de-creases pressure by tbelifting of the skin direct-ly over the treatmentarea. The "I" strip, Weh,or "Donut" hole can ac-complish this technique.Ihe tape can also be lay-

(jmtinni'il on /xixc IS4

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Kinesio Taping Method...ered, to look like a star pattern.

4) Ligament/Tetidon (Figure 11)This technique is used to create increased stimula-

tion over a ligament or tendon to stimulate themechanoreceptors. The "I" strip can be placed over the

area with 50-75%tension.

S) Functional(Figure 12)

This is usedto create a senso-ry stimulation toeither assist orlimit a motion.Using an "I"strip, put thejoint in the de-sired assisted po-sition first, thenapply the tapebase at the distalend of the limb.Flexion will beassisted as theperception of in-Hgurc 10: Space Technique

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Figure 9: I'iistiiil IL'(.IIII¡(|UI'

creased tension in positions of extension causes therepositioning of the joint to normalize perceived skintension.

^ 1

6) Lymphatic(Figure 13)

This tech-nique assists theremoval ofedema by direct-ing or "channel-ing" the fluidproximally. Di-rectional pull ofthe tape guidesthe exúdate toless congestedareas, throughsuperficial lym-phatic pathways.The tape applica-tion, via a "fiin"strip, is used tolift the skin su-perficially. Byproducing mus-

cle contraction and relaxation, the application will af-

Continued on page ¡56

Figure 11: IJganiciit/TeOíhmTecliiiiqiie

¡•igiire 12: Functional lechnique

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Kinesio Taping Method...feet both the superficial and deeperlymphatics. Under normal circum-stances, the body processes twoliters of lymphatic fluid per day.The lymph vessels carry away wasteproducts that are unable to betransported via the veins. The verysmall lymph collector vessels are at-tached to the skin via filaments andthe deeper lymph vessels, called an-gions, lie between the layers ofmuscle, like a string of pearls.

When there is movement ofmuscles, the various vessels are ableto transport the wastes more effi-ciently. Edema is usually a result ofthe inability of the lymph vessels tokeep up with fluid demand, due totrauma, infection or inflammation.The fan shape is placed on the ex-tremity with very little tension andthe base is placed slightly above thelymph node where drainage isbeing directed. If a DVT is suspect-ed, taping the extremity would becontra indica ted.

Podiatric ApplicationsThe Kinesio* taping method is

well-suited for podiatric lower ex-tremity issues. The tape can beused for many conditions. Kinesio*taping can be combined withmany different modalities, includ-ing massage therapy, physical ther-apy treatments, exercise prescrip-tion, and acupuncture, to name afew. The tape can be saturatedwith Biofreeze* spray, which alsohelps reduce pain. Post-op scarsthat are sensitive or enlarged canbe effectively treated with the tape

an "I" strip). Many of the

13: Lymphatic Icthniquc

techniques can be taught to pa-tients, so they can re-apply thetape regularly.

Podiatric Conditions That CanBenefit from Kinesio"" TapeMethods

1) Metatarsalgia/neuritis/neuroma:using a double "donut" hole in thewidth of the tape, it is applied over thetoes.

2) Plantar fasciitis: using a"Fan" strip the tape travels alongthe fascia from proximal to distal,(picture)

3) Hallux abducto valgus, Hal-lux Limitus, Turf Toe: the tape canreduce pain and take stress off thefirst ray.

4) Hammertoes: Using a func-tional correction, the toe can berepositioned against flexion or toomuch extension.

5) Tendonitis: Using variousstrips, the strip can travel from ori-gin to insertion for a weakened my-otendinous area, or from insertionto origin for an overstretched ten-don/muscle which will inhibit mus-cle function.

6) Ligament Sprains: The vari-ous techniques can combine thelymphatic taping with a functionaltechnique.

When used properly, Kinesiotaping applications can benefitmany patient populations seen ata podiatric office. The applicationof the tape can be hilled to insur-ance carriers, and the tape itsellcan be sold with some patient in-struction.

Ihe Kinesio Taping Associationhas guidelines on course work andseminars to become certified. Pleasevisit www.kinesiotaping.com formore information or details. •

I )r. Usa ,a s|X)rts medicinespecialist, haspracticed podi-a t r i c spor tsmedicine formore than 18years in theChicagolandarea witli (iumtt:Podiatry andSports Medicine Ass<K.iatcence includes working with nutiierousOlympic, professional, semi-profes.sionaland elite athletes. Dr. Schoene is a Hellowof the American (xillege of Toot anilAnkle Surgeons and of the AmericanAcademy ot PíHÜatríc Sjiorts Medicine,and a member of tlie American Acadenyof Podiatric Practice Management. She isalso a ikensed Certified Athletic I rainer.

Il r i ' \ i n ' n

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