Movement Science Unit 13 Taping and Bracing

Question 1

What causes Patellofemoral Pain Syndrome (PFPS)?

What aggravates this?

Answer 1

Abnormal biomechanics in LE kinetic chain

Aggravated by:
- Prolonged sitting (“Movie goers sign”)
- Squatting
- Stair climbing
- Stair descending

Question 2

What are the S/S of Patellofemoral Pain Syndrome?

Answer 2

• Pain worse with walking, squatting, kneeling, running and/or sitting
• Swelling in the knee
• A grinding or popping sensation
• “Knee buckling” occurs when knee cannot bear weight

Question 3

With PFPS, what direction would the paterlla track if there was Patellofemoral instability?

Answer 3

Usually tracks in a lateral direction

Question 4

What can Patellofemoral Pain syndrome cause? What are the can be done for treatment?

Answer 4

Causes:
- Decreased hip strength
- Decreased quad strength
- Poor patellar tracking
- Ankle mobility (Hypo/Hyper)

Treatment:
- Strengthen gluteals
- Strengthen quads
- Patellar taping/brace to increase or control ankle motion

Question 5

What are the Normative Q Ankle values for men and women?

What can a High Q Angle cause?

Answer 5

Men: 13°
Women: 18°

This causes the quads to pull on the patella, which leads to poor tracking predisposition for pain

Question 6

What are the structural variables that increase the Q-Angle?

Answer 6

• Coxa vara
• Femoral antertorsion or Femoral IR
• Genu Valgus
• External Tibial Rotation
• Lateral Displacement of the Tibial Tuberosity
• Pes Planus, Calcaneal Eversion, Hind-foot pronation

We cannot truly assess the Q-Angle if the patella is out of position. Use the trochlear groove between the medial and lateral femoral condyles

Question 7

What are the forces at the Patellofemoral Joint?

Answer 7

• As the knee flexes, the contact areas move proximally on the undersurface of the patella
• Ideally, in full extension there is no patella to femur contact

Question 8

What is the relationship between Patellofemoral Joint and Joint Reaction Forces?

Answer 8

As the quad force increases, the Joint Reaction Force Increases

Question 9

At what degrees in the Patellofemoral Joint under the greatest stress?

Answer 9

• Greatest in Closed Chain Squat at 90°
• Least amount in Close Chain < 45°
• OKC EXT-VR lowest at 90° - steadily increases at the knee extends
• OCK EXT-CR (isokinetic machine) under constant stress throughout with peak stress at 0°

OKC = Open kinetic Chain

Question 10

Proper Patellar Tracking is Dependent on the Integrity of what structures?

Answer 10

• Medial Retinaculum
• VMO sufficiency
• Prominent lateral femoral condyle or normal trochlear groove

Question 11

What are some Factors that produce Abnormal Patellar Alignment and Motion?

Answer 11

• Anything that increases the Q-Angle
• Tight/weak Rectus Femoris
• Tight TFL and IT Band
• Weak VMO
• Weak Hip Stabilizers
• Hind-foot pronation
• Excessive pelvic tilt

Question 12

What are the 3 Main Taping Techniques recognized within the therapeutic community?

Answer 12

• Prophylactic Athletic Taping
• McConnell and Mulligan Taping
• Kinesiotaping Method

Question 13

Why should Therapist use Prophylactic Athletic Taping?

Answer 13

• Limits or assist motion in ACUTE injurines or injury prevention
• Compressive force to the skin, joint and muscles
• This may require pre-tape or adhesive
• Has a limited wear time
• Often contains latex

Not rehabilitative

Question 14

Why should therapist use McConnell and Mulligan taping?

Answer 14

• Limits normal ROM
• This requires combination of tapes: extremely rigid tape placed over a cotton mesh
• This has a limited wear time
• Joint strapping with limit pathological movement
• Latex and non-latex adhesives

Question 15

With McConnell Taping, If we are trying to correct the Patellar Position of Lateral Glide, where would we apply the tape?

Answer 15

We would apply tape to Lateral Border of the patella

Question 16

With McConnell Taping, If we are trying to correct the Patellar Position of Lateral Tilt, where would we apply the tape?

Answer 16

We would apply tape to Middle of Patella to Medial Femoral Condyle (MFC)

Question 17

With McConnell Taping, If we are trying to correct the Patellar Position of External Rotation, where would we apply the tape?

Answer 17

We would apply tape to Middle of Inferior border of Patella to MFC

Question 18

Why should a therapist use Kinesiotaping?

Answer 18

• This type allows practitioner to target specific tissues
• Allows normal ROM
• Its therapeutic benefits are achieved by tissue glide, decompression, or compression
• Can be worn 3-5 days with “good skin tolerance”

With Kinisiotaping, we should use a test patch (1-2 blocks with no tension in the abdomen or treament area. Evaluate the sensitivity after a few hours or days)

Question 19

What are the benefits of Kinesiotaping?

Answer 19

• It Mechanically Decompresses the skin and the underlying tissues it is applied to
• It stimulates all sensory nerves in the skin and underlying tisseus
• Tissue decompression relieves pressure, allows better circulation and reduces swelling at the site of the injury

Question 20

What are the Contraindications of Kinesiotaping?

Answer 20

• Fragile or healing skin
• Malignant sites
• Cellulitis or infected areas
• Known taping allergies

Question 21

What are the precautions for kinesiotaping?

Answer 21

• DM
• Kidney disease
• CHF
• Asthma
• High or low blood pressure
• Open wounds
• Pregnancy

Question 22

Before using Kinesiotape, how should the skin be prepaired?

Answer 22

• The skin should be clean and dry
• The skin should be free from oils or creams
• The skin should be clipped or shaved if there is any dense or matted hair

Question 23

What are the K-Tape Basic Cuts?

Answer 23

Question 24

K-Tape Terminology

What is the Anchor?

Answer 24

The beginning of application, 0% tension applied in neutral position

Question 25

# K-Tape Terminology What is End?

Answer 25

The last part laid down, 0% tension applied in stretching positions

Question 26

# K-Tape Terminology What is Therapeutic Zone/

Answer 26

The Zone between the anchor and end; applied to target tissue

Question 27

# K-Tape Terminology What is Target Tissue?

Answer 27

The tissue requiring treatment

Question 28

# K-Tape Terminology What is stretch?

Answer 28

The position of the body of excursion of the skin to limit folds

Question 29

# K-Tape Terminology What is Therapeutic Direction Recoil?

Answer 29

When the tape recoils toward the anchor or toward the center (50% of tension or below)

Question 30

With K-Tape, how is Pain Taping applied?

Answer 30

Pain Taping requires between 1-3 pieces of K-tape. These are stabilization strips and the decompression strip - Stabilization strips run along the length of the area being tapes (no stretch, 0%); Decompression strips are applied perpendicular to the stabilization strip (stretched up to 50% in the middle and applied over the area of greatest pain

Question 31

What are the benefits of Fluid Dynamic Taping?

Answer 31

- It helps improve the fluid handled by the lymphatic system. This is beneficial during acute injuries as well as during the recovery of strenuous exercise and training - Also has a neurological effect that supports normal movement

Question 32

With K-Taping, how is Fluid Dynamic Taping Applied?

Answer 32

- Cut two strips of K-tape (2'' or 4'' width can be used) that would cover the affected area of swelling. (Pre-cut fan tapes can also be used to save time) - (If not useing pre-cut tape) Cut "fingers" lengthwise into the strips of tape, leaving approximately 2'' of one end ot the tape uncut - Place the anchor (uncut end) toward the periphery of the swollen area and then "fan out" the fingers of the tape so they cover a good portion of the swollen area. Rub the tape to activate the adhesive

Question 33

Why is Posture Taping important with K-Taping?

Answer 33

Improving posture is a central theme in the practices of most manual therapists because loss of ideal posture represents a structural problem that affects stability, movement, joint mechanics and efficient muscle function - Posture is at the core of many pain syndromes, headaches, joint and muscle pain that can lead to acute and chronic injuries

Question 34

With K-tape, how Posture Taping applied?

Answer 34

*The client is placed in a corrected posture (but not exaggerated) and the tape is applied while they maintain that posture, we are taping a specific movement pattern not a muscle* - Apply the K-tape along the fascical line(s) that will facilitate the intended posture - Apply the strip(s) of tape with 0% or paper off tension

Question 35

With K-Tape, what is the approach with Nerve Entrapment Taping?

Answer 35

This utilizes a single long strip that begins at the spine or most proximal entrapment site and follows the affected nerve distally through as much of its length as possible. - The nerve that is affected should be lengthened through stretching and the tape should be applied with paper-off tension - This should be coupled with treatments that will reduce the nerve entrapement, including treatment of the mechanical interfaces as well as gliders and tensioners

Question 36

With Kinesio-Taping, how should the tape be applied with Overactive Muscle Correction? and what percent of tension?

Answer 36

- Applied Distal to Proximal - 15-25% tension

Question 37

With Kinesio-Taping, how should the tape be applied with Underactive Muscle Correction? and what percent of tension?

Answer 37

- Applied Proxial to Distal - 15-35% tension

Question 38

# Kinesio-Tape With Lymphatic and Pain Application, what percent of Tension should the tape be applied?

Answer 38

0-15%

Question 39

# Kinesio-Tape With Muscle lengthening/Relaxation , what percent of tension should the tape be applied?

Answer 39

15-25%

Question 40

# Kinesio-Tape With Muscle Strengthening/Facilitation, what percent of tension should be applied?

Answer 40

25-35%

Question 41

# Kinesio-Tape With Mechanical Corrections techniques, what percent of tension should be applied?

Answer 41

50-75%

Question 42

# Kinesio-Tape With Ligament Techniques, what is the percent of tension that should be applied?

Answer 42

75-100%