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Therapeutic Taping for the Cervicothoracic , Maxillofacial & TMJ

Therapeutic Taping for the Cervicothoracic , Maxillofacial & TMJ. Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP Dr. Scott Rezac , PT, DPT, OCS, CSCS, CKTP, CEAS. Taping for C/S & T/S. Identify your Asterisk (*) Sign Tape for * sign, re-check

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Therapeutic Taping for the Cervicothoracic , Maxillofacial & TMJ

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  1. Therapeutic Tapingfor theCervicothoracic, Maxillofacial & TMJ Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS

  2. Taping for C/S & T/S • Identify your Asterisk (*) Sign • Tape for * sign, re-check • Spine tends to be more taping for function than pain (pain follows function) • Great adjunct to manual techniques to carry over following Rx. • Joint mobilization • Soft Tissue mobilization • PNF (scapular) • Capital Flexion Neuro Re-ed Scott & Dyanna Rezac - Taping Cervical Spine

  3. Sternocleidomastiod (SCM)Kinesio® Technique • Split strip in two, starting at mastoid, one strip to manubrium other to clavicle • Tape with cervical spine in contralateralsidebend and ipsilateral rotation • Facilitation or Inhibition Scott & Dyanna Rezac - Taping Cervical Spine

  4. Sternocleidomastiod (SCM)Kinesio® Technique Indications • Inhibit SCM to facilitate deep capital flexors (longis colli / longus capitis) • Correct Torticollis • Decrease SCM spasm, facilitate ROM • Decrease tension on TMJ • Headaches Testing • Capital Flexion • Posture • Pain / HA • ROM Scott & Dyanna Rezac - Taping Cervical Spine

  5. Posterior Cervicothoracic (Erector Spinae) MusclesMcConnell & Kinesio® Technique • Single strip to facilitate or inhibit over affected segments • Tape with spine in flexion • Unilateral or bilateral • Bilateral extension – facilitate both sides • Rotation – inhibit side with muscle spasm and facilitate contralateral side Scott & Dyanna Rezac - Taping Cervical Spine

  6. Posterior Cervicothoracic (Erector Spinae) MusclesMcConnell & Kinesio® Technique • Indications • Generally effective to tape C/S and T/S for enhanced postural correction • Bilaterally to decrease excess cervical lordosis • Vertebral rotations - Unilaterally to inhibit muscle spasm on contracted side and facilitate less active side • Improve painfree C/S and T/S extension or inhibit excessive extension • Testing • Posture • AROM / quality of motion • Pain • Segmental spinal motion Scott & Dyanna Rezac - Taping Cervical Spine

  7. Posterior SpineMulligan Technique • Following Joint Mobilization • 2” strip across the segment mobilized with moderate to maximum stretch • Can use this in conjunction with the McConnell & Kinesio® Erector Spinae Technique Scott & Dyanna Rezac - Taping Cervical Spine

  8. Posterior SpineMulligan Technique • Indications • Following Joint Mobilization for Stabilization • Improve thoracic extension • Testing • Posture • AROM / quality of motion • Pain • Segmental spinal motion Scott & Dyanna Rezac - Taping Cervical Spine

  9. Levator ScapulaeKinesio® Tape • Kinesio® Technique • Split strip starting at transverse processes C1-C4 one strip to the medial border of scapula, other to the superior angle with inhibition stretch • Tape with cervical spine in contralateral rotation and flexion • Modified Tape Practical Application • Single strip Scott & Dyanna Rezac - Taping Cervical Spine

  10. Upper / Middle TrapeziusKinesio® Technique • Kinesio® Technique • Split strip starting at the TP of the 2nd Vertebrae (below the hairline) with minimal stretch apply one strip to lateral clavicle / acromion, other strip to medial border of the scapula • Tape with cervical spine in contralateralsidebend • Indications – generally inhibition • Modified Tape Practical Application • Single strip Scott & Dyanna Rezac - Taping Cervical Spine

  11. Kinesio® Taping UTDecreased Pain, no change EMG • Murray H. Effect of Kinesio Taping on Upper Trapezius Muscle Tone and Cervical Discomfort. 15th Annual Kinesio Taping Symposium 2000 • Upper Trapezius inhibition • 15 subjects with neck pain • No significant difference with EMG • Subjective complaint of pain decreased with tape Scott & Dyanna Rezac - Taping Cervical Spine

  12. Effects of Tape on ScaptionDecreased UT / Increased LT EMG • Selkowitz DM et al. The effects of scapular taping on the surface electromyographic signal amplitude of shoulder girdle muscles during upper extremity elevation in individuals with suspected shoulder impingement syndrome. J Orthop Sports Phys Ther. 2007 Nov;37(11):694-702. • Scapular taping decreased upper trapezius and increased lower trapezius activity in people with suspected shoulder impingement during a functional overhead-reaching task, and decreased upper trapezius activity during shoulder scaption. Scott & Dyanna Rezac - Taping Cervical Spine

  13. Effects of Endura Fix on Lower TrapeziusInhibits Muscle Activity • Alexander CM et al. Does tape facilitate or inhibit the lower fibres of trapezius? Man Ther. 2003 Feb;8(1):37-41. • The tape was found to inhibit lower trapezius activity. On average, the application of Endura Fix tape inhibited trapezius by 4%. The application of Endura Sports tape overlaying the Endura Fix tape inhibited trapezius on average by 22%. The inhibitory effect was negated once the tape was removed. Scott & Dyanna Rezac - Taping Cervical Spine

  14. Kinesio® Taping PostureDecreased Pain/Increased GH flexion • Murray H, Husk L, Garcia D. Effects of Kinesio Taping on Posture and Upper Extremity Pain. Presented at 16th Annual Kinesio Taping Symposium. 2001 • Unilateral rhomboid facilitation and pectoralis inhibition • 15 subjects • Pain complaints significantly decreased and GHJ AROM flexion increased by an average of 15 degrees Scott & Dyanna Rezac - Taping Cervical Spine

  15. Postural CorrectionMcConnell Technique • Enhance Force Couple • Can tape from scapula to contralateral pelvis • Unilateral or Bilateral • Carry-over PNF • Postural Correction • Scapular retraction and depression • Unilateral or bilateral Scott & Dyanna Rezac - Taping Cervical Spine

  16. Postural CorrectionDecreased Kyphosis • Greig AM et al. Postural taping decreases thoracic kyphosis but does not influence trunk muscle electromyographic activity or balance in women with osteoporosis. Man Ther, 2007 Apr • There was a significant effect of postural taping on thoracic kyphosis (p=0.026), with a greater reduction in thoracic kyphosis after taping compared with both control tape and no tape. No EMG or balance effects found. Scott & Dyanna Rezac - Taping Cervical Spine

  17. Scoliosis • Tape single strips moderate to maximum stretch on anterior rotated segments Scott & Dyanna Rezac - Taping Cervical Spine

  18. Rib Pain (Fracture/Subluxation)Athletic & Kinesio® Technique • Decrease pain, similar to immobilizer brace, but allows mobility of other segments • Single strip over affected rib light to moderate stretch • Cross strips unload with space corrections (max stretch across middle 1/3, no stretch on ends) on either side of fracture Scott & Dyanna Rezac - Taping Cervical Spine

  19. Maxillofacial (sinus)Kinesio® Technique • Edema strips no stretch • Single strip across frontal sinus • Split across nasal sinus Scott & Dyanna Rezac - Taping Cervical Spine

  20. TMJ Unload • Space correction • ½ strip or 1” tape • ~1.5 squares • Maximal pull over center 1/3, no pull on lateral 2/3 • Apply 2-4 strips in crossing directions Scott & Dyanna Rezac - Taping Cervical Spine

  21. C7-T1 Unload (Dowager’s Hump) • Decrease pressure / pain over C7-T1 joint • 2 - 4 space correction strips • Maximal stretch over middle 1/3, no stretch lateral 2/3 • Great carry-over following C7-T1 fascial release Scott & Dyanna Rezac - Taping Cervical Spine

  22. Clinical Evidence-Based • Gonzalez-Iglesias. Short-term effects of cervical kinesiotaping on pain and cervical ROM in patients with acute whiplash injury: a randomized clinical trial. JOSPT 2009. • Tension application vs sham • Increase in ROM and decrease in pain in tension group Scott & Dyanna Rezac - Taping Cervical Spine

  23. Clinical Evidence-Based • What was your Comparable or Asterisk (*) Sign? – recheck that after taping • Objective Assessment • Capital Flexion Tests – substitution of SCM / scalenes, mmHG (pressure) they can hold, number of reps, range they can perform and hold time • Posture – symmetry, improvement in excessive or decreased kyphosis or lordosis • AROM – Improvement in range, pain and quality of motion Scott & Dyanna Rezac - Taping Cervical Spine

  24. Clinical Evidence-Based • Objective Assessment • Outcome Measures - NDI (Neck Disability Index) • Pain / Headaches - at rest, with previously aggravating motions and / or activities • Frequency • Intensity • Duration • MMT – spine and UEs • Neurological Testing • Decreased radicular symptoms • Special Testing – Adson’s, Allen’s, ULT, Shoulder abduction test Scott & Dyanna Rezac - Taping Cervical Spine

  25. Clinical Evidence-Based • Functional Improvements • Positional Tolerance • Sitting – at computer, to drive, attend child’s sports activities • Standing with UE activity – washing dishes, at work • C/S Extension – overhead hanging curtains, changing lightbulb, painting, drywall • Activity Tolerance • Turning head for driving safely • Lifting – groceries, children, housework • Pushing/Pulling – lawnmower, vacuum, pushing a stroller or grocery cart Scott & Dyanna Rezac - Taping Cervical Spine

  26. Questions/Comments/Discussion? • dyanna.rezac@rezacpt.com • scott.rezac@rezacpt.com • www.rezacpt.com Scott & Dyanna Rezac - Taping Cervical Spine

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