Elastic Taping

Jessica Rozeboom, PT, DPT, CKTP

&
Nicolle Samuels
PT, MSPT, CLT-LANA, CWS, CKTP
 Objectives
• Understand and experience elasticity and
interactive properties of elastic tape
• Understand basic theory for elastic taping
applications and appropriate terminology
• Understand precautions/contraindications to
elastic taping
• Observe basic application of Upper/Lower
Extremity
 History
• Invented in 1973 by Kenzo Kase, DC

• ‘88 Seoul Olympics

• US introduction in ‘95
Brands
 Supportive Evidence
• Claim: treatments are
virtually limitless and
taping can be utilized for
prevention of injury
• Conflicting/Contradictory
– Lack RCT, standardized
techniques/methods,
pathological studies
 Properties
• Mimics qualities of the skin
– 55-60% longitudinal stretch (~skin)
– 10-15% stretch when on the paper
– Thickness ~epidermis
• Adhesive – 100% acrylic – heat activated
• Latex free, water resistant
• Sizes: 1,2, or 3 inch (3” for edema)
• All colors are manufactured the same
– Color may affect absorption of energy from environment
(red vs blue)
• Can be worn 24 h/day safely and comfortably
Treatment Concepts
 Physiology
• 5 main physiological effects
– Skin
– Circulatory/lymphatic
– Fascia
– Muscle
– Joint
• Decreases pressure and inflammatory response
of mechano/neural receptors in skin
• Elasticity allows repositioning of skin, which then
effects fascia
– Due to interconnectivity, deeper m are affected as
well
 Impairment Concepts
• Overuse
– m is overworked, improper usage
• Inflammation
– Space between skin and tissues is compressed
• Constricts fluid flow and causes pain
• Pressure
– Pressure on skin stimulates pain receptors
• Brain interprets as pain
 Effects - muscle
– Relieves pain, ↑ ROM, normalize
length/tension ratios to create optimal force,
assist tissue recovery, reduces fatigue
• Improves m contraction of a weakened m
– facilitation
• Stimulates relaxation of an over-contracted m
– inhibition
 Length - Tension
• Length of m affects it’s function
– If too short – weak
– If too long – weak

– Actin/myosin need optimal overlap for proper fxn

– Tape doesn’t ‘strengthen’

• Equalizes length/tension ratio
 Effects - joint
• Improves jt biomechanics & alignment,
balances agonist, ↓protective m guarding and
pain, facilitate ligament and tendon fxn,
enhances kinesthetic awareness
 Effects – circulatory/lymphatic
• Enhances circulatory system via superficial
activation
• Restores epidermal tissue homeostasis
 Channeling Concept
• Subcutaneous lift of skin
– Creates space for fluid flow
– Convolutions (microscopic)
 Contraindications
• Active malignancy
• Cellulitis/skin infection
• Open wounds
• DVT
 Precautions
• DM
• Kidney disease
• CHF
• CAD
• Fragile skin
• Skin reaction/sensitivities
• Irradiated skin
• Sunburn
Taping
 Terminology
• Anchor: beginning of tape; no tension
• End: last part of tape laid down; no tension
• Base: central portion of tape
• Tails: split in tape for X, Y, or fan
• Therapeutic Zone: tape over the target tissue
• Therapeutic Direction: direction of recoil toward
anchor
• Tissue Stretch: elongation of target tissue
– Active or manually assisted
 Application
• Tape pain AND cause of pain
• Jt is moved through full ROM
prior to taping
• Trunk is usually taped bilaterally
• Tissue is in most stretched
position
• Less is more
• No tension on anchors
– The greater the tension, the longer
the anchors
 Application Tips
• Skin free of oils, moisture
– May prep skin with adhesive spray or ‘skin prep’ swab
• Hair may be clipped
• Apply tape 30 min prior to activity
• Rub tape to activate adhesive
• Removal
– in direction of hair growth
– use oil to break bond
– skin from tape
– wet
 Application Caution
• Do not blow dry tape
• Do not attach to nape of hair, through axilla,
or groin
• Do not ‘pull’ patient into position using the
tape
• Do not touch back of adhesive
• Do not utilize over open skin areas
• Remove if itching, burning or ↑ pain occurs
Muscle Shapes
 Tape Cuts

I Y X Fan
 Lab: Tape cuts
• I, X, Y, Fan
 Tension Percentage Guidelines
• Paper off 10-15%
• Light 15-25%
• Moderate 25-50%
• Severe 50-75%
• Full 75-100%

*No stretch is ever applied to anchor or end!

*Need big anchors when using high tension
techniques – Rule of Thirds

Full stretch and recoil

 Lab Demo
• Tear method • Finger application

• Stretch/adhesive • Adhesive method

 Application Guide
• Facilitation
– P to D (O to I) applied with 15-50% tension
• Chronic m conditions, rehabilitation
• Inhibition
– D to P (I to O) applied with 15-25% tension
• Acute conditions/m spasm
Lab – muscle facilitation/inhibition
Facilitation of quadriceps (Y)
Inhibition of Gastroc/Soleus (Y)
Inhibition of Deltoid (Y)
Facilitation of Biceps Brachii (x)
 Mechanical Correction
• “positional hold”
– Influences stimulation of desired resting position
– Inhibits pathological movement
• Utilizes stretch and inward or downward
pressure
• 50-75% tension
– Preposition into desired position
• (don’t use tape to pull patient)
• Maintains AROM and circulation
 Lab
• Mechanical Correction – posture
– Bilateral on the trunk
 Space Correction
• Lifting
– ↓ pressure on target tissue
– Creates recoil and lift over target tissue
– Multi-strip star application has cumulative effect
• 25-50% tension in middle of base
• Sample technique
– ‘Star’: Four ‘I’ strip
 Lab
• Space Correction
– Greater trochanter
Tendon/Ligament Correction
• Proprioceptive
– Decreases stress on structures
– Produces a signal through the skin to
the brain for perception of normal
tension on target tissues
• Tendon: 50-75% tension
– Stimulate golgi tendon organ for jt protection
• Ligament: 50-100% tension
– Perceived perception of support. Primary
support to injured tissue at jt
 Lab
• Tendon/ligament correction
– Ligament (I): MCL
 Functional Correction
• ‘spring assist or limit’
– Provide sensory stimulation to either assist or limit a
motion
– Tension in tape applied through movement
– Pre-load motion to ↑stimulation of mechanoreceptors
– Prevention of tissue overstretch, jt hyper-mobility and
re-injury
• 50-75+% tension
• (bridge technique)
 Lab
• Functional correction
– Dorsiflexion - spring assist
 Scar Management Application
• ‘Applied Stress’ – reorients collagen
– Stress provided via
• Pressure
• Stretch
• Directional pull
• Assess manually for restrictions
 Scar Tissue
• Adhere to
– Tendons, ligaments, jt capsule, connective tissue,
and skin
• Unmanaged scar can cause:
– contractures and reduced ROM
– Deformities
– Pain/discomfort
– Decreased lymphatic flow
 Taping for Scars
• 25-50%
• Low stress over time to soften and remodel
• Reduces adhesions and pitting (orif pins, etc)
• Softens
• Flattens
• Improves pliability
• Reduces risk of contractures
 Lab
• Scars
– Alternating influence
 Circulatory/Lymphatic Correction
• Channeling
– Directional pull guides exudate to less congested
areas through superficial lymphatic pathways
– Anchor is typically applied proximally where flow
is desired
– Fan tails applied over congested area
• 10-25% tension
 Lymphatic Correction
• Directs fluid toward less congested lymphatic
pathway/LN
• Lifting effect causes negative pressure
(convolutions)
• Elastic effect tugs on lymph structures
allowing↑intake during active movement
 Fan Application

• Place base of fan cut slightly proximal to fluid,

directed to LN (octopus)
• Place pt skin in most stretched position
• Apply tails of fan with little to no tension over
area of edema (0-15%)
– Remember:‘Off the paper’ tension=25%!
• May criss-cross the tape forming a grid over
localized trauma
 Lymphatic Fan Method
• Applied utilizing FAN cut
• ¼ to ½ inch strips
– Novice: 3-4 strips
– Advanced 4-6 strips
Fans – Grid over ecchymosis
8/30 9/4
8/30
9/4
9/4
9/10
 Lab – lymphatic correction
• Fan

• Fan – grid
 Assess, Tape, Re-assess
• Assessment findings
• Goal of tx
• What cut, tension, direction to accomplish
goal?
 Patient Instruction

• Tape remains effective 3-5 days

• Maximally adhered in 20-30 minutes
– Avoid high level activity during this time
• Movement and perspiration
• If tails peel up, cut off any non-adhered ends and
leave remainder
• Can shower, just pat dry
• Could cause skin damage if removed prematurely
due to high level of adherence
 Tape Removal
• Premature, may damage skin as adhesive is
maximally adhered
• Easiest if tape is moistened
• Best to remove from top down (direction of body
hair)
• Lift tape from skin, applying tension b/w skin and
tape
• Push skin away from tape rather than pulling the
tape away from the skin
• Application of mineral oil or milk of magnesia may
assist in removal if tape remains strongly adhered
 Documentation
• Target tissue/anatomy to be effected
• Cut of tape
• Direction of application tension of tape
• Desired effect or tx goals
– Improve posture
– Decrease spasms
– Resolve edema
 Billing

• www.kinesiotaping.com/global/corporation/abo
ut/billing-codes.html

• 97112 NM Re Ed (timed)
• 97140 Manual (timed)
• 97110 Ther Ex (timed)

• (strapping codes are not allowed as those codes

are meant for ‘immobilization’)
~Thank You~