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WelcomeThe “need to know” about posture and taping with Katie Emmett & Kate Hindley
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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
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Aims of today
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To learn about posture
To learn different types of posture How k-tape works
How to apply k-tape for posture
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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
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Theory: Posture
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Evolution of human posture
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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
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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
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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
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What is posture?
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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.
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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
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Life style OccupationSedentary livingTechnology
Why has our posture changed?And what does it mean for us?
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Scoliosis
Sway back
Flat back
Upper crossed syndrome
Lumbar lordosis
Thoracic kyphosis
Lower cross syndrome
Ideal / normal
Different types of posture
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Posture Examples
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Sway Back
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Flat Back
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Upper Crossed Syndrome
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Lower Crossed Syndrome
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Kyphosis - Lordosis
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Scoliosis
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The idealposture
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Posture Workshop
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How can we help your posture?
AssessmentsObservation
Strength Ax movement
Palpate
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How can we help your posture?Treatments
Massage
Mobilisations Passive stretching Muscle energy techniques
Taping
Posture educationExercise programmes/pilates
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Evidence of posture and treatment
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Exercise programmes
PilatesTaping
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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.
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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.
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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.
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Theory: Taping
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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?
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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
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The Benefits
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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!
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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
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PLACEBO OR NOT?!
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How does K-Tape work?The Decompression Effect
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WRINKLES!
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How it works
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The Fluid Effect = blood flow swellingThe Mechanical Effect = stability
The Neurological Effect =Paingate theoryReduced pressure on nerve endingsReduced stretch responseIncreased ‘active’ stabilisation
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Pre application
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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
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Application
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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.
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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!)
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Practical
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Neck taping
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Case Study: Neck Pain
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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?
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Shoulder taping
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Case Study:Shoulder
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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?
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Lumbar spine taping
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Case Study:Lumbar spine
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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?
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Postural taping
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Case Study: Neck Pain
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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?
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Evidence: Taping and Posture
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EvidenceEvidence is conflicting however the following benefits have
been found:
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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
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Cervical Spine
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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.
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Lumbar Spine
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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
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Shoulder
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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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Thanks for coming!Don’t forget to follow us on Twitter: @physiocouk
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