Kevin M. Wong, DC
The concept of taping has been around for many years and its effectiveness has been well-documented. Early pioneers of taping, such as Dr. Kenzo Kase, have paved the way for the understanding of how to utilize tape in the chiropractic profession. Historically, tape has been utilized within the chiropractic profession for athletes. High-performance athletic support, sports-injury recovery, functional support and movement enhancement are some of the major uses of the tape that come to mind. In fact, research has demonstrated the positive effects of using tape after ACL repairs:
"[When] applied to the anterior aspect of the thigh, [elastic therapeutic tape] could significantly enhance the joint active range of motion ... this increase is correlated with an increase in surface EMG of the muscles of the anterior compartment of the thigh, the quadriceps femoris muscle."1
Over the almost 15 years I have been teaching specific taping protocols, I am astounded by how many practitioners do not utilize taping in the treatment of their patients. It can help so many more patients than you are already helping, so let me share some of the core taping ideas for patients who come into your office daily. Please keep an open mind and let me teach you a bit about something that brings me considerable success in terms of patient care.
Why Tape at All?
I get this question all the time from DCs when I am teaching. Here is the simple explanation: As a chiropractor, you perform these wonderful adjustments all over the body. What happens when our patients leave us and go out of the office? They are potentially doing tons of activities that tend to pull their bones gradually back out of alignment. Taping supports the bones and joints you have just moved back in place, giving the body a chance to remember what it was like to be more stable. When done properly, it is also amazingly comfortable. The patient feels more relaxed and less worried.
Let me give you an example. We are all familiar with the three arches of the foot and how important they are to stabilizing the entire body. We are also aware that excessive foot pronation causes the arches of the feet to collapse over time. If the arches have fallen, the foot flattens and the biomechanics change. Stability is compromised from the ground up, affecting weight-bearing posture and all activities.
After you check the feet and adjust the bones accordingly, you're done, right? What happens when the patient gets off your adjusting table, stands up and walks out? The feet are experiencing overpronation, and those bones start falling immediately. It is not an instantaneous collapse, but it gradually happens again.
Depending on how much time goes by until the follow-up visit, this leads the patient back to square one with the feet back out of alignment again. Taping is so helpful in this case. The arch support and flexibility provided by taping allows the foot to drop into normal pronation, but not overpronate.
Do you adjust shoulders? Shoulder pain is such a pervasive problem. Generally we find people have their shoulders misaligned even though they are not complaining of pain. After you assess and treat the shoulder joints accordingly, you will notice that putting on two strips of tape (front to back and on the side) will provide excellent temporary support for the area.
Lower back, mid -back, neck, wrist, hips, sciatic and Achilles – you name it and you can usually tape it for functional support. Research has shown that taping can change blood flow, which is significant since that increased blood flow is a mechanism of healing.2 There are many resources that provide pictures and teach you how to use your tape more effectively. I myself took the time to get certified by a taping company. I was not excited about taking time out of practice and teaching, but I love what I learned and use it daily.
Aside from some of the functional taping applications described above, you can tape for sports performance enhancement. This requires a bit more training and understanding of the anatomy fascial patterns, also known as anatomy trains, but just think how much fun and rewarding it is to tape athletes up before their competition and help them perform better. It's very popular these days for tape to be applied in this manner.
The Right Kind of Tape
Throughout the years, medical or sports tape has been made with different materials. When you go out to the drug store or venture into the athletic training or sports departments at schools, you see representations of all of these types of tape. Some use pre-wrap while some tape very tightly to immobilize. There are also tons of taping techniques out there, so you need to choose your material wisely.
When you decide you are going to begin using tape in your practice, please make sure it is not the classic white medical tape that you buy from the drug store. That does not achieve the kind of results you can with elastic therapeutic tape. If you get the chance, sit down and experiment with some of the different types of tape. Each type has some differences and similarities. Choose the one the works best for you in your practice and with your patient base.
Ground Rules for Use
- Patients can leave the tape on while showering. I recommend they do not take a bath or go in the pool while wearing tape, as it will likely come off. (I believe certain tape companies make a water-resistant tape designed especially for water sports.)
- Depending on the type you use, it should last anywhere from 1-5 days. Remember, lasting for a long time is not necessarily a good thing. If the tape stretches too much, it loses the ability to support the area you are taping. Generally speaking, I tape my patients for athletic events or for support and expect the tape to last 2-3 days at most. Then I make sure they follow up with another office visit to see how their body is responding.
- If the skin underneath the tape becomes itchy or you suspect an allergic reaction, take it off immediately. We don't need any skin problems as a result of trying to help the patient.
I also suggest you have the patient buy tape from you if you plan on taping them more than once. I also teach some patients how to tape themselves so they can replace their tape or tape themselves up if they cannot get in to see me immediately.
Since taping has such wide applications for so many types of people with so many conditions, it can be a wonderful addition to your practice. No matter what your emphasis is – pediatrics, sports, geriatrics, industrial injuries, motor-vehicle accidents, etc. – you can use tape to support or enhance your rehabilitation of your patients' muscles, bones and joints.
References
- Murray H. Kinesio taping, muscle strength and ROM after ACL repair. Journal of Orthopedic and Sports Physical Therapy, 2000;30(1).
- Kase K. Illustrated Kinesio Taping, 3rd Edition. Ken'I Kai, Tokyo, 1994:90-91.
