7 foot and ankle therapeutic tape2010

8/10/2019 7 Foot and Ankle Therapeutic Tape2010

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Therapeutic Taping

for the

Foot and nkle

Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP

Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS


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Scott & Dyanna Rezac - Taping Foot & Ankle 2

Plantar Fascia Unload

Gastroc/Soleus/Achilles Complex Unload

Athletic Training Modified Kinesio Technique

(also achilles tendonosis, gastroc strain)

Step 1: With foot in dorsiflexion, begintape at transverse arch on plantaraspect of foot. Apply maximal stretch to

calcaneus. Can also fan and/or directto 1stray for improved 1stdistribution.

Step 2: Split tape and apply to

medial and lateral aspects of thegastroc/soleus complex withmoderate stretch.

Very effective when combined withnavicular lift


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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 longitudinalarch during walking and running. British

Journal of Sports Med. 2005 Dec;39(12):939-

4317 subjects who were asymptomatic andexhibited a navicular drop greater than 10mm.The augmented LowDye tape was effective in

controlling pronation during both static anddynamic activity. Tape induced changes instatic foot posture paralleled those duringwalking and jogging.


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Low Dye Tape

Increased Lateral Midfoot Plantar Pressures

Vicenzino B et al. Plantar foot pressures afterthe augmented low dye taping technique.J

Athl Train. 2007 Jul-Sep;42(3):374-80.

Within-subjects, repeated-measuresrandomized control trial utilizing 15 womenand 7 men who were asymptomatic.The ALD predominantly increased plantarpressures in the lateral midfoot during

walking and jogging. In addition, tapereduced mean maximum pressure at themedial forefoot and at the medial rearfootduring walking.


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Calcaneal tape vs sham, stretching, and no

treatment on Plantar Fascia Pain

Calcaneal Tape More Effective

Hyland MR; Webber-Gaffney A; Cohen L;Lichtman PTJ Orthop Sports Phys Ther2006Jun; Vol. 36 (6), pp. 364-71.

Randomized controlled trial of 41 subjects withplantar heel pain 1)calcaneal taping , 2)shamtaping, 3) plantar fascia stretching and 4)control for the short-term management ofplantar heel pain.

Calcaneal taping was shown to be a moreeffective tool for the relief of plantar heel painthan stretching, sham taping, or no treatmentbut no change on PSFS.


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Navicular Lift

McConnell Technique

Stability and decelerationof pronation momentduring stance

Similar to a chopat for

the foot

Step 1: No stretch fromlateral dorsum tonavicular tubercle

Step2: Maximal stretch fromtubercle to anteriolateraltibia
http://images.google.com/imgres?imgurl=http://www.abledata.com/product_images/images/02A0388.JPG&imgrefurl=http://webhealth.com/wiki/Plantar_Fasciitis&h=270&w=270&sz=7&hl=en&start=18&tbnid=ZE0GDq3fpqpqNM:&tbnh=113&tbnw=113&prev=/images%3Fq%3Dplantar%2Bfasciitis%26gbv%3D2%26svnum%3D10%26hl%3Den%26sa%3DG


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Distal Fibular Glide

Mulligan Technique

Improve DFTension ATFL to prevent lateralankle sprain

Step 1: Tape from slightly anteriorand distal to distal fibula

Step2: maximal stretch in aposterior and proximal directionaround the posterior calf whileapplying a posterosuperior glide

Same technique can be used forsuperior tib-fib


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Mulligan Fibular Glide Taping

Decreased Ankle Injury

Moiler K, Hall T, Robinson K. The role of fibulartape in the prevention of ankle injury inbasketball: A pilot study. J Orthop Sports Phys

Ther. 2006 Sep;36(9):661-8.443 measured basketball exposures resulted in11 ankle injuries. All injuries occurred insubjects with a history of previous anklesprain. Significantly less ankle injuries weresustained by members of the FRT conditionThis study provides preliminary data regardingthe prophylactic effects of FRT on ankle injuryin male basketball players.


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Athletic Ankle Taping

Postural Sway Improved Faster

Matsusaka N et al. Effect of ankle disk trainingcombined with tactile stimulation to the leg andfoot on functional instability of the ankle. Am JSports Med 2001Jan-Feb; Vol. 29 (1), pp. 25-30.

Twenty-two university students with unilateralfunctional instability of the ankle. 2 Groups 1)Tape 2) No tapeIn group 1, postural sway values decreasedsignificantly after 4 weeks and WNL after notmore than 6 weeks. In group 2, the values did

not improve significantly until after 6 weeksand WNL until 8 weeks. The findings suggestthat this was due to an increased afferent inputfrom skin receptors that were stimulated by thetraction of the adhesive tape


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Achilles Space Correction

Kinesio Tape utilizing

McConnell/Mulligan Concepts

Step 1: Cut a 3-square piece of tapeand remove backing from middle1/3 of tape.

Step 2: With foot in DF, stretchmaximally horizontally acrossthe Achilles tendon.

Step 3: Lie down two ends

without stretch.

Very effective when combinedwith gastroc/soleus/plantarfascia unload.
http://images.google.com/imgres?imgurl=http://www.teamclinic.com/images/achilles_190.jpg&imgrefurl=http://www.teamclinic.com/sports_achilles.htm&h=151&w=190&sz=13&hl=en&start=7&tbnid=Wgx_P7h627dF_M:&tbnh=82&tbnw=103&prev=/images%3Fq%3Dachilles%2Btendonitis%26gbv%3D2%26svnum%3D10%26hl%3Den


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Transverse Arch Support

Metatarsalgia

Enhance transversearch support

Step 1: Stretch maximallyacross plantartransverse arch(metatarsal heads).

Step2: Lie down endwithout stretch ondorsal aspect of foot.
http://images.google.com/imgres?imgurl=http://www.d-med.com/aol/images/bmcmet.gif&imgrefurl=http://www.d-med.com/aol/html/bmc.html&h=212&w=165&sz=19&hl=en&start=16&tbnid=rhjeZrbOdHKxwM:&tbnh=106&tbnw=83&prev=/images%3Fq%3Dtransverse%2Barch%2Bfoot%26gbv%3D2%26svnum%3D10%26hl%3Den


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Scott & Dyanna Rezac - Taping Foot & Ankle13

Kinesio Neuroma Case Study

Eliminated Pain

Stahl, A. Clinicians Overview & CaseStudy: Post Operative Neuroma andRSD. 15th Annual Kinesio TapingInternational Symposium Review. (pp.

99-102) Tokyo, Japan: Kinesio TapingAssociation. 1999.Pt. s/p neuroma resectionsubsequently developed RSDFailed to manage pain with scar tissuemobilization, joint mobilization, e-

stim, US, nerve blocks, walking boot,ther ex.Pt was pain free within 24 hours


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Peroneal Facilitation

Kinesio Technique

Lateral Ankle SprainPeroneal StrainMod to max stretch fromlateral fibula to 1stMET(longus) or 5thMET(brevis)Tape with ankle in IV & DF

For active control of

peroneals for lateralstability to correct over-pronation

Great for ATF sprains withnavicular lift and/or EVstirrup
http://images.google.com/imgres?imgurl=http://mywebpages.comcast.net/wnor/latlegnerves.jpg&imgrefurl=http://mywebpages.comcast.net/wnor/latleg.htm&h=644&w=365&sz=23&hl=en&start=3&tbnid=tHyrFNZk8dw70M:&tbnh=137&tbnw=78&prev=/images%3Fq%3Dperoneal%2Bmuscle%26gbv%3D2%26ndsp%3D18%26svnum%3D10%26hl%3Den%26sa%3DN


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Eversion Stirrup

Biomechanical Correction

Athletic Taping Technique

Lateral ankle sprainCan be used with peronealfacilitation and/or

navicular lift

Step 1: begin at the medialcalcanceus and lie tapedown on plantar aspect ofthe calcaneus

Step2: stretch maximally upthe lateral aspect of thecalf to apply an EV force tothe ankle.
http://images.google.com/imgres?imgurl=http://www.pdrhealth.com/patient_education/images/BHG01RH19F01.GIF&imgrefurl=http://www.pdrhealth.com/patient_education/BHG01RH19.shtml&h=409&w=276&sz=20&hl=en&start=19&tbnid=nAPJBmDjB7AxVM:&tbnh=125&tbnw=84&prev=/images%3Fq%3Dlateral%2Bankle%2Bsprain%26start%3D18%26gbv%3D2%26ndsp%3D18%26svnum%3D10%26hl%3Den%26sa%3DNhttp://images.google.com/imgres?imgurl=http://www.latrobe.edu.au/podiatry/myofasc/myofascialpics/fig10.jpg&imgrefurl=http://www.latrobe.edu.au/podiatry/myofasc/tibialisposterior.html&h=490&w=283&sz=33&hl=en&start=3&tbnid=wY25fhBJIdlKYM:&tbnh=130&tbnw=75&prev=/images%3Fq%3Dposterior%2Btibialis%2Bmuscle%26svnum%3D10%26hl%3Den%26lr%3D%26sa%3DN


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Posterior Tibialis

Kinesio Technique

Medial ankle sprain

Tarsal Tunnel Syndrome

Tape with moderatestretch (facilitation) orminimal stretch(inhibition) in EV and DF
http://images.google.com/imgres?imgurl=http://www.latrobe.edu.au/podiatry/myofasc/myofascialpics/fig10.jpg&imgrefurl=http://www.latrobe.edu.au/podiatry/myofasc/tibialisposterior.html&h=490&w=283&sz=33&hl=en&start=3&tbnid=wY25fhBJIdlKYM:&tbnh=130&tbnw=75&prev=/images%3Fq%3Dposterior%2Btibialis%2Bmuscle%26svnum%3D10%26hl%3Den%26lr%3D%26sa%3DN


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Tibialis Anterior

Kinesio Technique

Facilitate DFInhibit with spacecorrection for shin

splintsWith foot in EV andPF, mod to max forfacilitation andminimal to no stretch

for inhibition
http://images.google.com/imgres?imgurl=http://content.answers.com/main/content/wp/en-commons/thumb/d/d9/250px-Tibialis_anterior.png&imgrefurl=http://www.answers.com/topic/tibialis-anterior-muscle&h=250&w=250&sz=41&hl=en&start=23&tbnid=7aAsOhbIx0YTFM:&tbnh=111&tbnw=111&prev=/images%3Fq%3Dtibialis%2Banterior%26start%3D18%26gbv%3D2%26ndsp%3D18%26svnum%3D10%26hl%3Den%26sa%3DN


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Tarsal Tunnel

Space Correction

Space correction of tarsaltunnel

Can be used withposterior tibialis

facilitation and/ornavicular lift.

Step 1: Stretch maximmallyover tarsal tunnel, nostretch on ends

Step2: Can repeat 2-4 timesin different directions


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Hammertoe, Mallet Toe

Claw Toe Correction

Toe Deformities

Step 1: Start at the dorsum of thefoot and apply a mod to maxstretch across the joints inexcessive flexion (facilitation) andminima stretch across the joint in

excessive extension (inhibition).Can be done as a single 1 strip foreach toe or fan for several toes.

Step2: Cap around toes.
http://images.google.com/imgres?imgurl=http://health.yahoo.com/media/healthwise/h1736.jpg&imgrefurl=http://health.yahoo.com/topic/musculoskeletal/overview/article/healthwise/popup/hw143095&h=300&w=460&sz=11&hl=en&start=2&tbnid=19x-Pz3PzjdZGM:&tbnh=83&tbnw=128&prev=/images%3Fq%3DMallet%2Btoe%26gbv%3D2%26svnum%3D10%26hl%3Denhttp://images.google.com/imgres?imgurl=http://health.yahoo.com/media/healthwise/nr55551160.jpg&imgrefurl=http://health.yahoo.com/topic/musculoskeletal/overview/article/healthwise/popup/hw143095&h=300&w=460&sz=8&hl=en&start=1&tbnid=tWOFul4MQCIt9M:&tbnh=83&tbnw=128&prev=/images%3Fq%3DMallet%2Btoe%26gbv%3D2%26svnum%3D10%26hl%3Denhttp://www.drdanielbank.com/images/hammertoe.jpg


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Hallux Valgus

Correction

Can be augmented withnavicular liftValgus or Varus can beused on any toe.

Step 1: Begin medial on the 1stray, stretch moderately tomaximally along medal foot

to calcaneus (avoidpositioning 1stMTP at end-range of available motion).

Step2: Continue aroundposterior calcaneuslaterally and back to medialfoot on the dorsum ending

at the medial 1stray(starting point).

Step3: A small strip can beused around the toe tosecure ends without anystretch.
http://images.google.com/imgres?imgurl=http://www.merck.com/media/mmhe2/figures/fg072_4.gif&imgrefurl=http://www.merck.com/mmhe/sec05/ch072/ch072l.html&h=185&w=228&sz=11&hl=en&start=1&tbnid=65gpx5UIp8fzkM:&tbnh=88&tbnw=108&prev=/images%3Fq%3Dhallux%2Bvalgus%26svnum%3D10%26hl%3Den%26lr%3D


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Taping Toes

As with fingers, tape for what you want to accomplishExtension of DIP maximal stretch dorsal jointNormal motion of PIP no stretchFlexion of DIP maximal stretch volar jointCollateral ligament protection / Unload one joint X

strips on either side of joint, anchor the endsDecrease strain on flexor tendon tape with

moderate stretch on volar surface of digit up muscle toorigin

Immobilize a digit Buddy Tape two fingers

together with two 1 stripsSpace correction over entrapment site


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Edema / Lymphedema

Kinesio Technique

Edema ReductionFor acute ankle sprains or post-surgical foot/ankle.Anchor distally and lie strips without stretch aroundedema area without stretch.


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Clinical Evidence Based

Objective Assessments Gait

Gait mechanics (at IC, MS, TS, etc)

Heel Strike

DF, 1

st

ray extension Decreased toe clawing

Calcaneal, midfoot, forefoot position

Stride Length

Stance Time

Distance

Speed

Assistive Device


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Objective Assessment (cont).

Pain

at rest

with AROMpreviously aggravating positions / activities

VAS (Visual Analog Scale)

Neurological Symptoms

Outcome MeasuresLEFS (Lower Extremity Functional Scale)

AROM

MMT


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Objective Assessment (cont).

Functional Tests (AsteriskSigns)

Step up, step down, SLS,

jumping, running

Less pain, more reps, improvedrange / height?

Cutting, cross-overs, unevensurface

ADLsStair negotiation
http://images.google.com/imgres?imgurl=http://www.orthopedictechreview.com/issues/marapr05/pg36-2.jpg&imgrefurl=http://www.orthopedictechreview.com/issues/marapr05/pg36.htm&h=377&w=250&sz=12&hl=en&start=3&tbnid=xAnk-HZAYAI1sM:&tbnh=122&tbnw=81&prev=/images%3Fq%3Dbalance%2Bdisk%26gbv%3D2%26svnum%3D10%26hl%3Den


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Questions, Comments, Discussion

[email protected] [email protected]
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7 foot and ankle therapeutic tape2010

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