Kinesio Taping for the Upper Extremity

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Kinesio Taping for the Upper Extremity

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1. Kinesio Taping for the Upper Extremity Marjorie Talacko, OTR/L, CHT As taught by Ruth Coopee, MOT OTR/L CHT MLD/CDT CKTI Course in May 15-16, 2004, Framingham, MA

2. Kinesio Tape Elastic cotton tape applied to the skin Facilitates Neurosensory Lymphatics Muscles Modifies functional biomechanics Reduces pain

3. Taping Options Athletic Tape Used to immobilize and protect from injury McConnell Tape White under-tape to protect skin with top brown tape applied to reposition soft tissue and bone to restore and retrain normal biomechanics Kinesio Tape Is elastic in one direction and used to facilitate and modify biomechanics and reduce pain

4. Kinesio Tape’s Features Glue in wave pattern allows skin to breathe Elastic, up to 30 to 40% of resting length Stretches only along longitudinal axis Applied to base paper with 10% stretch Heat sensitive non latex adhesive Can be worn 3 – 5 days Not perceived on skin, light and thin

5. Kinesio Tape’s Functions Relieves pain in skin and muscles (Stimulates/lifts skin, reduces pressure) Supports muscles tendon unit in movement With movement, will remove congestion of interstitial fluid or subcutaneous hemorrhage (Lifts skin, improves drainage and blood flow) Corrects misalignment of a joint

6. Kinesio Tape Facilitates Better anatomical alignment of muscle/joint during movement ( with exercise and ADL’s) The performance of a weakened muscle by correcting the anatomical position (as with postural alignment problems) Kinesthetic awareness of proper posture and structural alignment

7. Kinesio Tape’s Limitations Needs good skin contact clip thick hair, clean skin with soap, water and facecloth or use skin prep pad Apply 20 – 30 minutes before exercise to allow adhesive to bond with perspiration or for active sports may need spray adhesive such as tuff skin or tincture of benzoin Patient’s willingness to wear tape for multiple days or in public Limited clinical studies in English Costs approximately $15 per roll

8. Precautions and Contraindications As with physical agent modalities: Do not apply over or near malignancy/cancer Avoid neck in carotid artery disease Do not apply to area of infection or cellulitis Do not use over open wound Use caution with fragile skin Respect acupuncture points for pregnancy Stimulation of the upper trapezius, and medial aspect of lower leg may induce labor

9. Kinesio Tape’s assist to Skin Function Gently stimulates the mechanical receptors in the skin surface and may activate the descending inhibitory system (the gate control theory) Decreases pressure on chemical receptors where taped

10. Kinesio Tape’s assist to Lymphatic Function The tape lifts the skin and forms convolutions along the longitudinal axis This increases the space between the skin and muscles and promotes the flow of lymphatic fluid Think pull of the tape toward the anchor to “pull the fluid out”

11. Kinesio Tape’s assist to Muscle Function Assists a weak muscle or muscle group tape from origin to insertion so that the tape pulls toward the origin, assisting in contraction as the tape recoils Think of the tape as a “bungee cord” to assist the muscle

12. Kinesio Tape’s assist to Muscle Function Inhibits muscle spasm Tape from insertion to origin; as the tape recoils it stimulates the GTO and fascia and prevents overwork. Think “take tension off the painful spasm”

13. Kinesio Tape’s assist to Joint Function Adjusts misalignment caused by shortened muscles Normalizes muscle tone and abnormality of fascia involved Inhibits hyper-mobility Relieves pain Think “stabilize”

14. Kinesio Tape Cutting Techniques “I” cut for stabilizing joints or muscle “Y” to surround muscle belly / fibers “X” shape to stabilize a joint or for muscles “Fan” to reduce edema, drawing fluid toward the anchor

15. Kinesio Tape Application Anchor end of tape with NO tension Pull off paper stretch (10 to 25%) is the most effective tension Tape may be moderately stretched (50%) if applied to non-stretched skin (i.e., can’t move joint) but prior to taping, massage and mobilize tissue to decrease sheering forces of the tape on skin Tape applied with all the stretch taken (75-100%) is used primarily in “Correction Technique”

16. Kinesio Tape Application Complete evaluation and other treatments Prep skin (free of oil or moisture) Cut tape (X, Y, I, or Fan, round edges) Position the patient Anchor the tape securely without tension Apply tape (usually on elongated tissue) Adhere tape (lightly rub to activate glue)

17. Kinesio Tape Removal Tape can be worn up to 4 days at a time DO NOT use heater or blow dryer on tape as it activates adhesive and can damage skin Remove in direction of hair growth, rolling the tape off using the flat of your hand Pull the skin back with with your finger Tape may be removed while bathing or with lotion or soap to assist in separating adhesive from skin

18. Lab Time: Taping the Thoracic Outlet Pectoralis minor Origin: 3rd to 5th ribs, near their costal cartilages Insertion: medial border and superior surface of the coracoid process of the scapula Subclavius Origin: first rib Insertion: subclavian groove of clavicle

19. Kinesio Tape Application Thoracic outlet: Pectoralis minor Using a Y cut tape 2” wide, anchor at the coracoid process Abduct the humerus and apply the tape around the muscle ending at ribs 3-5

20. Kinesio Tape Application Lab Thoracic outlet Subclavius Using an I cut tape 1” wide, anchor just inferior to the lateral clavicle Horizontally abduct and externally rotate the humerus and apply tape inferior to clavicle ending at the sternum *Do not cross sternum and use caution with asthma

21. Kinesio Tape Application Lab Shoulder/scapular dysfunction - RTC impingement and forward scapula Pectoralis major Rhomboid Middle trapezius and infraspinatus Upper trapezius for protracted shoulder with tight upper and middle fibers Upper trapezius for spasm in superior fibers

22. Lab: Pectoralis Major Origin: Clavicular head: anterior surface of the medial half of the clavicle. Sternocostal head: anterior surface of the sternum, the superior six costal cartilages, and the Insertion: intertubercular groove of the humerus

23. Kinesio Tape Application Lab Shoulder/scapular dysfunction Pectoralis major Anchor at the proximal humerus insertion region Move the humerus into horizontal ABD and tape along clavicle Increase flexion/ABD and apply to the lateral margin of muscle

24. Lab: Rhomboids (Major) Origin: spinous processes of the T2 to T5 vertebrae Insertion: medial border of the scapula, inferior to the insertion of rhomboid minor muscle (Minor) Origin: nuchal ligaments and spinous processes of C7 to T1 vertebrae Insertion: medial border of the scapula, superior to the insertion of rhomboid major muscle

25. Kinesio Tape Application Lab Shoulder/scapular dysfunction Rhomboid Move shoulder into horizontal ADD Tear paper in center and pull to expose the center of the tape. Fold back edges from center and take ALL the stretch out of tape. Apply tape on angle of muscle pull Apply ends of tape without tension

26. Lab: Trapezius and Infraspinatus Trapezius Origin: arises, down the midline, from the external occipital protuberance, the nuchal ligament, the medial part of the superior nuchal line, and the spinous processes of the vertebrae C7-T12 Insertion: at the shoulders, into the lateral third of the clavicle, the acromion process, and into the spine of the scapula Infraspinatus Origin: infraspinous fossa of the scapula Insertion: middle facet of greater tubercle of the humerus

27. Kinesio Tape Application Lab Shoulder/scapular dysfunction Middle trapezius and infraspinatus (for winging and to retract the humerus): Anchor at the humerus at the end of the spine of the scapula Move the humerus into horizontal ADD and apply top tape along the spine of the scapula, ending at midline Now move the humerus into flexion and horizontal ADD and apply tape along inferior margin of muscle, ending at midline

28. Kinesio Tape Application Lab Shoulder/scapular dysfunction Upper trapezius for protracted shoulder with tight upper and middle fibers Anchor at insertion of UT, anterior humerus, crossing distal clavicle Side bend neck away and apply along superior border of UT ending at mastoid process Drop shoulder and move humerus into horizontal ADD and apply across spine of scapula ending on thoracic spine

29. Kinesio Tape Application Lab Shoulder/scapular dysfunction Upper trapezius, alternate method for spasm in the superior fibers of the upper trapezius Anchor at the mastoid process Depress the shoulder while side bending the neck away. Apply tape along the superior fibers, ending at the acromion process

30. Kinesio Tape Application Lab Taping the hand: The buttonhole cut anchors many of the forearm applications of kinesio tape such as for lateral epicondylitis When applying tape to the hand, it is important that the ends are secured to prevent rolling of the edges with activity. Water resistant tape is best and a spray adherent is also recommended to increase wear time.

31. Kinesio Tape Application Lab Lateral epicondylitis Forearm extensors Anchor on palm DPC by placing fingers through the openings in tape Position wrist in maximum flexion with the elbow in flexion and apply tape over dorsum of hand to wrist. Locate the split proximal to the extensor muscle bellies Continue to apply the tape around the medial and lateral margins of the extensor muscle wad. When you are 3/4 up the forearm, extend the elbow and finish applying tape, ending at the lateral epicondyle.

32. Kinesio Tape Application Lab Lateral epicondylitis -Supinator Position the elbow in flexion and anchor tape just proximal to the elbow on an angle at the midline of the humerus Hyper-pronate the forearm, applying tape to cover lateral epicondyle and supinator, ending on the medial/ulnar side of the forearm

33. Kinesio Tape Application Lab Carpal Tunnel Syndrome Extend the wrist as much as tolerated and tear the paper to open the center of the tape. Apply with all the stretch taken up over the transverse carpal ligament. Flex the wrist and apply the ends without tension, overlapping to increase adherence.

34. Kinesio Tape Application Lab Lymphatic Correction Anchor tape in a secondary lymphatic pathway Remove paper backing along strips, staying close to skin to prevent “springing” of the strips Tape is applied one strip at a time to assure that the tissue is stretched at the site of placement

36. Kinesio Tape Application Lab+ Hand Edema Apply buttonhole, dorsal to volar the cuts around middle and ring fingers For volar aspect, wrist in extension and apply tape along palm, wrist and volar forearm to medial epicondyle For dorsal aspect, apply buttonhole volar to dorsal, flex wrist and apply tape from fingers to lateral epicondyle

37. Kinesio Tape Application Lab+ DeQuervains Place anchor just proximal to IP joint of thumb Flex elbow and thumb, ulnar deviate wrist and apply tape along radial side of wrist ending at mid forearm Secure the anchor with a “cross cut”* piece 1/2” wide (inelastic) *cross cut is cut across the roll, not lengthwise. Avoid any elastic pull around a digit.

38. Kinesio Tape Application Lab+ Retinacular ligament: This can support the wrist alone or in combination with a DeQuervain’s taping Wrist is positioned in ulnar deviation and the thumb in flexion The “correction” tape is placed on the radial side of the wrist with 100% stretch Move the wrist into flexion and extension to apply ends with no tension

39. Kinesio Tape Application Lab+ Medial Epicondylitis Anchor buttonhole cut on on hand dorsum with middle and ring fingers through the openings Extend the wrist and fingers and apply tape with split of the “Y” just proximal to the volar wrist, taping around flexor muscles 3/4 up the forearm Add elbow extension and finish application ending at the medial epicondyle

40. Kinesio Tape Application Lab+ Medial Epicondlyitis Pronator Hyper-supinate the forearm and tape to cover the medial epicondyle and pronator muscle ending on the proximal radial side of forearm

41. Kinesio Tape Application Options Support healing structures (tendon repair) Take pressure off nerves (TOS, CTS) Support tissues with tendonitis Correct postures, postural re-education Reinforce joint stability (ligament or arthritis) Reduce edema Modify scars And etc.

42. Thank You!

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