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Therapeutic Taping for the Foot and Ankle

Therapeutic Taping for the Foot and Ankle. Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP Dr. Scott Rezac , PT, DPT, OCS, CSCS, CKTP, CEAS.

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Therapeutic Taping for the Foot and Ankle

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  1. Therapeutic Tapingfor theFoot and Ankle Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS

  2. Plantar Fascia UnloadGastroc/Soleus/Achilles Complex UnloadAthletic Training & Modified Kinesio® Technique(also achillestendonosis, gastroc strain) Step 1: With foot in dorsiflexion, begin tape at transverse arch on plantar aspect of foot. Apply maximal stretch to calcaneus. Can also fan and/or direct to 1st ray for improved 1st distribution. Step 2: Split tape and apply to medial and lateral aspects of the gastroc/soleus complex with moderate stretch. Very effective when combined with navicular lift Scott & Dyanna Rezac - Taping Foot & Ankle

  3. Low Dye Tape on Medial Longitudinal ArchControls Pronation During Stance, Running, Walking • Vicenzion B et al. Initial effects of anti-pronation tape on the medial longitudinal arch during walking and running. British Journal of Sports Med. 2005 Dec;39(12):939-43 • 17 subjects who were asymptomatic and exhibited a navicular drop greater than 10 mm. • The augmented LowDye tape was effective in controlling pronation during both static and dynamic activity. Tape induced changes in static foot posture paralleled those during walking and jogging. Scott & Dyanna Rezac - Taping Foot & Ankle

  4. Low Dye Tape Increased Lateral Midfoot Plantar Pressures • Vicenzino B et al. Plantar foot pressures after the augmented low dye taping technique. J Athl Train. 2007 Jul-Sep;42(3):374-80. • Within-subjects, repeated-measures randomized control trial utilizing 15 women and 7 men who were asymptomatic. • The ALD predominantly increased plantar pressures in the lateral midfoot during walking and jogging. In addition, tape reduced mean maximum pressure at the medial forefoot and at the medial rearfoot during walking. Scott & Dyanna Rezac - Taping Foot & Ankle

  5. Calcaneal tape vs sham, stretching, and no treatment on Plantar Fascia PainCalcaneal Tape More Effective • Hyland MR; Webber-Gaffney A; Cohen L; Lichtman PT J Orthop Sports Phys Ther 2006 Jun; Vol. 36 (6), pp. 364-71. • Randomized controlled trial of 41 subjects with plantar heel pain 1)calcaneal taping , 2)sham taping, 3) plantar fascia stretching and 4) control for the short-term management of plantar heel pain. • Calcaneal taping was shown to be a more effective tool for the relief of plantar heel pain than stretching, sham taping, or no treatment but no change on PSFS. Scott & Dyanna Rezac - Taping Foot & Ankle

  6. Navicular LiftMcConnell Technique • Stability and deceleration of pronation moment during stance • Similar to a “chopat” for the foot Step 1: No stretch from lateral dorsum to navicular tubercle Step2: Maximal stretch from tubercle to anteriolateral tibia Scott & Dyanna Rezac - Taping Foot & Ankle

  7. Distal Fibular GlideMulligan Technique • Improve DF • Tension ATFL to prevent lateral ankle sprain Step 1: Tape from slightly anterior and distal to distal fibula Step2: maximal stretch in a posterior and proximal direction around the posterior calf while applying a posterosuperior glide Same technique can be used for superior tib-fib Scott & Dyanna Rezac - Taping Foot & Ankle

  8. Mulligan Fibular Glide TapingDecreased Ankle Injury • Moiler K, Hall T, Robinson K. The role of fibular tape in the prevention of ankle injury in basketball: A pilot study. J Orthop Sports Phys Ther. 2006 Sep;36(9):661-8. • 443 measured basketball exposures resulted in 11 ankle injuries. All injuries occurred in subjects with a history of previous ankle sprain. Significantly less ankle injuries were sustained by members of the FRT condition • This study provides preliminary data regarding the prophylactic effects of FRT on ankle injury in male basketball players. Scott & Dyanna Rezac - Taping Foot & Ankle

  9. Athletic Ankle Taping Postural Sway Improved Faster • Matsusaka N et al. Effect of ankle disk training combined with tactile stimulation to the leg and foot on functional instability of the ankle. Am J Sports Med 2001 Jan-Feb; Vol. 29 (1), pp. 25-30. • Twenty-two university students with unilateral functional instability of the ankle. 2 Groups 1) Tape 2) No tape • In group 1, postural sway values decreased significantly after 4 weeks and WNL after not more than 6 weeks. In group 2, the values did not improve significantly until after 6 weeks and WNL until 8 weeks. The findings suggest that this was due to an increased afferent input from skin receptors that were stimulated by the traction of the adhesive tape Scott & Dyanna Rezac - Taping Foot & Ankle

  10. Achilles Space CorrectionKinesio® Tape utilizing McConnell/Mulligan Concepts Step 1: Cut a 3-square piece of tape and remove backing from middle 1/3 of tape. Step 2: With foot in DF, stretch maximally horizontally across the Achilles tendon. Step 3: Lie down two ends without stretch. Very effective when combined with gastroc/soleus/plantar fascia unload. Scott & Dyanna Rezac - Taping Foot & Ankle

  11. Transverse Arch Support • Metatarsalgia • Enhance transverse arch support Step 1: Stretch maximally across plantar transverse arch (metatarsal heads). Step2: Lie down end without stretch on dorsal aspect of foot. Scott & Dyanna Rezac - Taping Foot & Ankle

  12. Morton’s Neuroma • Space correction to relieve pain from Morton’s neuroma / Metatarsalgia Step 1: Place with maximal stretch across site of most pain (usually between 2nd & 3rd or 3rd & 4th MTP on plantar surface, but can be used on dorsal surface if neuroma is on the superior aspect) Step2: Lie down ends without stretch Scott & Dyanna Rezac - Taping Foot & Ankle

  13. Kinesio® Neuroma Case StudyEliminated Pain • Stahl, A. Clinician’s Overview & Case Study: Post Operative Neuroma and RSD.  15th Annual Kinesio Taping International Symposium Review. (pp. 99-102) Tokyo, Japan: Kinesio Taping Association. 1999.       • Pt. s/p neuroma resection subsequently developed RSD • Failed to manage pain with scar tissue mobilization, joint mobilization, e-stim, US, nerve blocks, walking boot, ther ex. • Pt was pain free within 24 hours Scott & Dyanna Rezac - Taping Foot & Ankle

  14. Peroneal FacilitationKinesio® Technique • Lateral Ankle Sprain • Peroneal Strain • Mod to max stretch from lateral fibula to 1st MET (longus) or 5th MET (brevis) • Tape with ankle in IV & DF For active control of peroneals for lateral stability to correct over-pronation Great for ATF sprains with navicular lift and/or EV stirrup Scott & Dyanna Rezac - Taping Foot & Ankle

  15. Eversion Stirrup Biomechanical CorrectionAthletic Taping Technique • Lateral ankle sprain • Can be used with peroneal facilitation and/or navicular lift Step 1: begin at the medial calcanceus and lie tape down on plantar aspect of the calcaneus Step2: stretch maximally up the lateral aspect of the calf to apply an EV force to the ankle. Scott & Dyanna Rezac - Taping Foot & Ankle

  16. Posterior TibialisKinesio® Technique • Medial ankle sprain • Tarsal Tunnel Syndrome • Tape with moderate stretch (facilitation) or minimal stretch (inhibition) in EV and DF Scott & Dyanna Rezac - Taping Foot & Ankle

  17. Tibialis AnteriorKinesio® Technique • Facilitate DF • Inhibit with space correction for shin splints • With foot in EV and PF, mod to max for facilitation and minimal to no stretch for inhibition Scott & Dyanna Rezac - Taping Foot & Ankle

  18. Tarsal Tunnel Space Correction • Space correction of tarsal tunnel • Can be used with posterior tibialis facilitation and/or navicular lift. Step 1: Stretch maximmally over tarsal tunnel, no stretch on ends Step2: Can repeat 2-4 times in different directions Scott & Dyanna Rezac - Taping Foot & Ankle

  19. Hammertoe, Mallet Toe & Claw Toe Correction • Toe Deformities Step 1: Start at the dorsum of the foot and apply a mod to max stretch across the joints in excessive flexion (facilitation) and minima stretch across the joint in excessive extension (inhibition). Can be done as a single 1” strip for each toe or fan for several toes. Step2: Cap around toes. Scott & Dyanna Rezac - Taping Foot & Ankle

  20. Hallux ValgusCorrection • Can be augmented with navicular lift • Valgus or Varus can be used on any toe. Step 1: Begin medial on the 1st ray, stretch moderately to maximally along medal foot to calcaneus (avoid positioning 1st MTP at end-range of available motion). Step2: Continue around posterior calcaneus laterally and back to medial foot on the dorsum ending at the medial 1st ray (starting point). Step3: A small strip can be used around the toe to secure ends without any stretch. Scott & Dyanna Rezac - Taping Foot & Ankle

  21. Taping Toes • As with fingers, tape for what you want to accomplish • Extension of DIP – maximal stretch dorsal joint • Normal motion of PIP – no stretch • Flexion of DIP – maximal stretch volar joint • Collateral ligament protection / Unload one joint – X strips on either side of joint, anchor the ends • Decrease strain on flexor tendon – tape with moderate stretch on volar surface of digit up muscle to origin • Immobilize a digit – “Buddy Tape” two fingers together with two 1” strips • Space correction over entrapment site Scott & Dyanna Rezac - Taping Foot & Ankle

  22. Edema / LymphedemaKinesio® Technique • Edema Reduction • For acute ankle sprains or post-surgical foot/ankle. • Anchor distally and lie strips without stretch around • edema area without stretch. Scott & Dyanna Rezac - Taping Foot & Ankle

  23. Clinical Evidence Based • Objective Assessments • Gait • Gait mechanics (at IC, MS, TS, etc) • Heel Strike • DF, 1st ray extension • Decreased toe clawing • Calcaneal, midfoot, forefoot position • Stride Length • Stance Time • Distance • Speed • Assistive Device Scott & Dyanna Rezac - Taping Foot & Ankle

  24. Clinical Evidence Based • Objective Assessment (cont). • Pain • at rest • with AROM • previously aggravating positions / activities • VAS (Visual Analog Scale) • Neurological Symptoms • Outcome Measures • LEFS (Lower Extremity Functional Scale) • AROM • MMT Scott & Dyanna Rezac - Taping Foot & Ankle

  25. Clinical Evidence Based • Objective Assessment (cont). • Functional Tests (Asterisk Signs) • Step up, step down, SLS, jumping, running • Less pain, more reps, improved range / height? • Cutting, cross-overs, uneven surface • ADLs • Stair negotiation Scott & Dyanna Rezac - Taping Foot & Ankle

  26. Questions, Comments, Discussion dyanna.rezac@rezacpt.comscott.rezac@rezacpt.com www.rezacpt.com Scott & Dyanna Rezac - Taping Foot & Ankle

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