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Kinesiology Taping for Shoulders

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Kinesiology tape benefits a wide variety of injuries and inflammatory conditions. The modality can be used to correct a movement deficiency, brace an unstable joint or assist with muscle re-education. The thin, stretchy, therapeutic tape can be worn without binding, constricting or restricting movement.

Kinesiology taping can either provide support or prevent over-contraction of muscles. When used for support, taping allows the patient to retain his full range of motion and normal biomechanics. When used to prevent over-contraction, the taping technique provides all-day facilitation of lymphatic drainage.

"In my practice, I have used several different types of taping methods to help a patient return to full functioning," said Brian Koczenasz, DPT, SCS, A.R.T., physical therapist with Performance Physical Therapy in Stamford, CT. "I have used McConnell taping techniques to help with patello-femoral issues and kinesiology tape to help with muscle re-education and athletic tape for injury prevention prior to athletic events."

Dr. Koczenasz's clinic is located inside a large athletic training facility and the majority of the patient caseload is sports-related, so he tends to use taping more than most physical therapists. "I find that it is very beneficial during the transition period between finishing up with formal rehabilitation and a full return to sports," he shared.

The main benefits of kinesiology taping include pain relief, lymphatic drainage with bruising and edema, and as a corrective alignment or reminder to the patient, according to Chris Keating, PT, DPT, a physical therapist with Strive Physical Therapy & Sports Rehabilitation in Marlton, NJ. The four main types of this taping are the Y, I, X, and fan shapes. The PT can adjust the amount of tension to suit the patient when applying the tape.

Because kinesiology tape is flexible, research shows the modality helps circulation flow and speeds healing. Kinesiology tape must be applied correctly, by a trained professional.

Kinesiology Tape Basics

Unlike traditional athletic tape, which is wrapped tightly around an injured area to provide rigid support and restrict movement, kinesiology tape provides dynamic support and allows a functional range of motion.

Kinesiology tape is applied directly over or around the periphery of the area, instead of being wrapped completely around an injured area. Kinesiology tape can be worn during intense exercise, showering, bathing or swimming. The therapeutic benefits last the entire time the patient wears the tape.

Because it's lightweight, breathable and flexible, kinesiology tape is an effective tool. And unlike athletic tape, therapeutic tape does not cause skin irritation from tight compression or moisture build-up.

Kinesiology tape is applied to a patient's shoulder when her arm is fully extended at 90 degrees. The PT gently presses the tape at the top of the shoulder area and unrolls down the length of the patient's arm to the elbow. Proper application ensures the tape will glide along the same direction as the patient's shoulder and arm muscles.

Kinesiology tape can be applied to neck or shoulder injuries to help speed recovery time. Kinesiology tape is available in various cuts and colors to treat several different muscle groups, including shoulders, knees, wrists, back and other common areas where sports injuries can occur. These cuts, in shapes such as X, Y and I, are designed to mimic the structure and makeup of the muscle fibers, so the tape can be placed along the length of the muscle and provide extra support for faster healing.

Kinesiology tape is used to help heal injuries or strains without the rigidity and inflexible properties of regular athletic tape. Because it is made of cotton, kinesiology tape is more breathable and allows for easy movement. The tape is safe to use while training or working out, and is both sweat proof and waterproof.

"I see kinesiology tape mainly as a bridge to other treatments," shared Dr. Keating. "The modality helps patients move on, rather than becoming dependent on the therapy." In Dr. Keating's experience, patients tend to get hooked on modalities such as TENS. But with taping, patients can be discharged more quickly because they are ready to stop wearing the tape.

Dr. Keating often uses kinesiology tape for patients with fibromyalgia. "Shoulder taping is an effective treatment for vague pain," he said. "It provides great sensory feedback."

With fibromyalgia, there is a central pain issue, and kinesiology tape can provide relief throughout day when applied properly, said Dr. Keating. With this patient population, he commonly uses the tape two times a week, and for about two to three weeks, then is able to discontinue use because the pain has been relieved enough for the patient to participate in strengthening exercises. He generally uses a Y strip from the deltoid to the front, and an I strip to unload the deltoid.

"I use kinesiology tape to eliminate pain, not for structural purposes," Dr. Keating explained. Applying kinesiology tape before taking a patient through a strengthening program can help recruit muscle groups to fire through the tactile feedback the tape provides. This, in turn, can help correct faulty neuromuscular firing patterns, according to Dr. Koczenasz.

Body Awareness

Kinesiology tape, used along the lumbar and thoracic paraspinals, can significantly help with postural corrections. The tape provides a constant reminder to sit upright and avoid a C-curved spine. "When the person is in a good postural position, they usually don't feel anything," observed Dr. Koczenasz. "When the patient moves into poor postural position, he will feel the tape pull tight, which should remind him to use the proper postural muscles."

Dr. Keating generally uses kinesiology tape for shoulder instability, postural issues and realignment purposes. "Because the patient wears the tape for a few days, it really helps with awareness of issues in the shoulder," he said. "I often use kinesiology tape for cuing patients to be aware of their body mechanics."

According to Dr. Keating, kinesiology tape is an appropriate solution for many of his patients because there are sensory and neurological components in an orthopedic clinic that athletic tape cannot address.

Dr. Koczenasz has used kinesiology tape post-surgically to help decrease swelling. "What I was taught when taking the kinesiotape courses was that the elastic recoil of the tape, when applied in a grid or lattice pattern causes the skin to dimple in the small squares not covered by tape," he explained. "That dimpling creates alternating spaces of increased/decreased pressure, which should create a flow of fluid allowing the lymph system to better absorb it."

Patients with subacromial impingement or tendonitis typically also have a component of altered neuromuscular firing patterns causing poor glenohumeral and scapulothoracic biomechanics, shared Dr. Koczenasz. Kinesiology tape can help provide a tactile feedback sensation which helps the patient feel how the shoulder and arm both should and should not be moving.

A muscle or muscle group can be activated or helped when the recoil of the tape is moving in the same direction as the pull of the muscle. "Inhibition can be achieved if the recoil is moving in the opposite direction as the pull of the muscle," said Dr. Koczenasz. "It is the tactile sensation of the tape on the skin when either activating or inhibiting that influences the muscle or muscle group."

Kinesiology taping is used to alleviate pain and swelling by lifting the skin, which serves to relieve pressure on the neural receptors, and allows the lymphatic system to drain more freely.

Dr. Keating has had success using kinesiology tape with bruising. He generally applies a wide strip in a spider formation. The theory is to apply when the area is stretched to create a breather under the skin. He feels the tape helps the lymphatic system to get up and working. "If a patient has a gnarly bruise, it helps to get it out of the area," he shared.

"When it comes to the traditional taping, most patients understand the benefits and do not need much education," shared Dr. Koczenasz. "When using kinesiology tape, patients do require some education about what it is and how it will benefit. After the first application, most patients will see the benefits."

According to Dr. Koczenasz, patients tend to be a little skeptical about using kinesiology tape, however, after a time or two, most can see the benefit of the modality.

Dr. Keating finds kinesiology tape to be exceptionally user-friendly. "There are social aspects of wearing tape that need to be considered as well. But with this tape, it simply comes off when it's done being effective Typically it's about three days of use and generally, the tape won't have any effect after that time."

Kinesiology tape is one of many useful tools in the PT toolbox. "It provides another option and works like extra security because it's easy to use and satisfies the patient's psychological component about their injury or condition," observed Dr. Keating. 

Rebecca Mayer is senior regional editor of ADVANCE.



 

i hope i can join your rehabilitation team of physiotherapy ,i'm specialized in pediatric physical therapy(INTENSIVE),it's from my pleasure to join your team and come to work in calefornia

mohamed el banna,  physicaltherapySeptember 03, 2011
cairo, CA




     

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