Physio.co.uk: The need to know about posture and taping

@Physiocouk #manchesterphysio facebook.com/physiocouk

WelcomeThe “need to know” about posture and taping with Katie Emmett & Kate Hindley

3@Physiocouk #manchesterphysio facebook.com/physiocouk

Let’s connectWebsite: www.physio.co.ukTwitter: @physiocoukFacebook: www.facebook.com/physiocouk

Katie’s LinkedIn: www.linkedin.com/katieemmettKate’s LinkedIn: www.linkedin.com/katehindley

Aims of today

To learn about posture

To learn different types of posture How k-tape works

How to apply k-tape for posture

Itinerary10.00 - 10.30 Arrival /Induction

10.30 – 11.15 Theory: Posture

11.15 – 12.00 Posture workshop

12.00 – 12.30 Lunch

12.30 - 13.30 Theory: Taping

13.30 - 14.00 Taping Application

14.00 - 14.15 Break

14.15 - 16.00 Case studies / Practical workshops

Theory: Posture

Evolution of human posture

Evolution of human posture • 6 million years ago: Becoming bipedal

• 6 million years ago: Leg support

• 4.1 million years ago: Strong knee

• 2.5 million years ago: Curved spine

• 1.95 million years ago: Hip support

• 1.9 million years ago: Fully bipedal

• 1.89 million years ago : Long leg

Benefits and Costs

Benefits of walking & upright posture

As environments changed, walking on two legs helped early humans survive by:

• Making it easier to pick fruits and other food from low-lying branches

• Freeing hands for carrying food, tools or babies• Enabling early humans to appear larger and more intimidating• Helping early humans cover wide, open landscapes quickly

and efficiently

Costs of walking & upright posture

Back pain and other skeletal problems are relatively common in modern humans, an unfortunate side effect of walking upright.

Distributing all our weight on just two limbs can have painful consequences: • Lower back pain• Slipped disks• Arthritis in hips and knees• Collapsed foot arches.

Benefits and Costs

What is posture?

Definition Good posture

• Standing with the head balanced effortlessly above the spine• Straight and vertical except for the slight natural curves in the

lower back and neck• Slight S-shape • Recognised as being associated with good appearance, good

health, strength, athleticism, and stamina.

Definition Bad posture

• Commonly described position in which the head and shoulders are placed forward of the spine

• Excessive S-shape or a C-shape• Referred to as a slouched, or hunchback posture• Regarded as a poor appearance, associated with backaches of

all types, poor health, poor breathing and tiredness

Life style OccupationSedentary livingTechnology

Why has our posture changed?And what does it mean for us?

Scoliosis

Sway back

Flat back

Upper crossed syndrome

Lumbar lordosis

Thoracic kyphosis

Lower cross syndrome

Ideal / normal

Different types of posture

Posture Examples

Sway Back

Flat Back

Upper Crossed Syndrome

Lower Crossed Syndrome

Kyphosis - Lordosis

Scoliosis

The idealposture

Posture Workshop

How can we help your posture?

AssessmentsObservation

Strength Ax movement

Palpate

How can we help your posture?Treatments

Massage

Mobilisations Passive stretching Muscle energy techniques

Taping

Posture educationExercise programmes/pilates

Evidence of posture and treatment

Exercise programmes

PilatesTaping

PilatesEmery et al (2009) looked at nineteen subjects (9 controls, 10 experimental) that were assessed twice, 12 weeks apart, during which the experimental group was submitted to a Pilates training program (two 1-h sessions per week). The Pilates training program was effective in improving abdominal strength and upper spine posture as well as in stabilising core posture as shoulder flexion movements were performed.

Pilates

Kuo, Tully and Galea (2009) found that Immediately after a Pilates based exercise program (twice weekly for 10 weeks) for older adults (over 60) stood with slightly decreased thoracic flexion and sat with slight increased lumbar extension, however, No differences were found during a follow up period.

Exercise programmes

Lynch (2009) recruited 28 elite level collegiate swimmers with a forward head round shoulder posture. The experimental group were given postural exercises involving strengthening of the lower and middle fibres of trapezius and serratus anterior and stretching of pectoralis minor and cervical extensors. Assessments were made on postural position, shoulder pain and function, and maximal strength of muscles around the shoulder blade.

The results revealed that the experimental group had decreased forward head and shoulder position and reduced pain, suggesting that posture did improve after an exercise programme.

Theory: Taping

Taping is an adjunct to our services that can offer support, immobilisation or proprioceptive feedback depending upon what is required for the individual

2 main types:

K-tape = elasticated tape with acrylic glue

Zinc Oxide = non stretch cotton with a zinc oxide adhesive

What is taping?

Zinc Oxide K Tape

• Mechanical method• For functional immobilisation• Restricts and protects range of

movement• Aims to protect muscles and

tendons

• A sensory technique• Offers full range of movement• Normalises muscle function

Zinc Oxide vs K-tape

The Benefits

Pain relieving

Increases circulation

Decreases swelling

Increases or restricts movementDecreases muscle tensionImproves posture

Provides support

Aids proprioception

Enhances performance

Early return to sport / activityIt looks good!

Infection

Open wounds

DVT in area

Renal problems

Heart failure

Skin irritation

Compromised sensation

Allergies to plasters

Cancer

Incorrect application may causeor aggravate injury

Contraindications

PLACEBO OR NOT?!

How does K-Tape work?The Decompression Effect

WRINKLES!

How it works

The Fluid Effect = blood flow swellingThe Mechanical Effect = stability

The Neurological Effect =Paingate theoryReduced pressure on nerve endingsReduced stretch responseIncreased ‘active’ stabilisation

Pre application

Ensure the skin is dry and clean

No hair

Wait 1-2 hours after swimming/ exercise/showering

Ensure K-tape has rounded edges and ‘anchors’ ready

Application

For Pain Relief – stretch the muscle before applying tape. Apply tape with no additional stretch.For Structural Support – keep the muscle in a shortened position and stretch the centre of the tape from 30-80%. The final 2-3″ at either end of each strip must be applied with absolutely no stretch. Applying stretch to the ends of the tape can quickly lead to skin irritation and abrasions.To Reduce Swelling – lightly stretch both the muscle and the tape as the tape is applied. As noted above, the final 2-3″ of each strip must be applied with no additional stretch.

Should be able to move

Fine to shower

No rubbing

If any rash/irritation remove tape

After CareTaping is not the solution – exercises must still be completed!

Remove after 3 days (Max!)

Practical

Neck taping

Case Study: Neck Pain

The office worker with forward head posture:

28 year old Natalie is an office worker. She has been suffering with bilateral neck and upper trapezius pain for 3 months since another member of staff left the company, leading to a heavy workload and overtime. She feels her symptoms get worse as the working day/week goes on.

How would you tape this Natalie?

Shoulder taping

Case Study:Shoulder

The builder with shoulder impingement

Bob is a 52 year old builder. Over the past 3 weeks he has felt a gradual onset of sharp anterior shoulder pain, especially when lifting and reaching at work. He describes the pain as a ‘severe pinching feeling’ which seems to be getting worse.

How would you tape Bob?

Lumbar spine taping

Case Study:Lumbar spine

A new mum with a disc prolapse

35 year old Lisa is a new mum with an 8 week old baby. She had some back pain during pregnancy, and then when her baby was born she went to pick her up from her cot in a rotated position resulting in sudden sharp lumbar and right leg pain. She is struggling as she finds herself bending down a lot to care for her baby.

How would you tape Lisa?

Postural taping

Case Study: Neck Pain

The shop assistant with whiplash

Adam is 26 years old, and was recently involved in a car accident. He was stationary when he was hit from behind, leading to neck and back pain the next day. His symptoms are slowly improving but work is aggravating his pain when he is on his feet for long periods or stacking shelves.

How would you tape Adam?

Evidence: Taping and Posture

EvidenceEvidence is conflicting however the following benefits have

been found:

Improves power & strength in uninjured muscleReduces pain & improves function in PFJ pain and Plantar fasciitis Improves pain, increases ROM and function for impingementIncreases muscle activity

Doesn’t decrease performance

Cervical Spine

Gonzalez-Iglasias (2009) completed a study on patients with acute whiplash symptoms receiving KT. The results demonstrated statistically significant improvements in pain levels and ROM immediately following application and 24 hours later.

Lumbar Spine

Castro-Sanchez et al (2012) found in there study (albeit minimal participants) that K- tape reduced disability and pain in participants with non-specific LBP

Paoloni et al (2011) looked at 39 subjects and 3 groups: KT, exercise, and KT and exercise. All 3 groups had a significant reduction in pain and KT was found to help normalize lumbar muscle function

Shoulder

Murray (2010) found that KT can enhance scapula retraction. This was found to significantly reduce pain, however the study was only carried out on 10 people.

Shoulder impingement:Thelen et al (2008) concluded that KT may assist in immediate improvements in pain free shoulder abduction (but overtime it seems to be no more effective than sham in decreasing pain intensity or disability)

Lewis et al (2005) reported a statistically significant increased pain free shoulder AROM with taping and increased pain free abduction

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Physio.co.uk: The need to know about posture and taping

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