Therapeutic Taping for Therapeutic Taping for the Shoulderthe Shoulder
Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTPDr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP
Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEASDr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS
Scott & Dyanna Rezac - Shoulder Taping2
Taping Hemiplegic ShoulderTaping Hemiplegic ShoulderLimits Shoulder PainLimits Shoulder Pain
• Griffin A, Bernhardt J. Strapping the hemiplegic shoulder prevents development of pain during rehabilitation: a randomized controlled trial. Clinical Rehabilitation 2006; 20: 287/295.
• Therapeutic strapping limited development of shoulder pain during rehabilitation in hemiplegic shoulders.
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Kinesio® Taping Pediatric Neuro InsultKinesio® Taping Pediatric Neuro InsultImproved UE FunctionImproved UE Function
• Yasukawa A, Patel P, Sisung C. Pilot Study Investigating the Effects of Kinesio® Taping in an Acute Pediatric Rehabilitation Setting. Am J Occup Ther; 60 (1): 104-10 1654-1989.
• 15 children (10 F, 5 M) ages 4-16 at Rehab Institute of Chicago following neurological insult (brain tumor, encephalitis, SCI, CVA, TBI) with UE involvement
• Had statistically significant improvement in function
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Kinesio® Tape Shoulder PainKinesio® Tape Shoulder PainImprove Pain & FunctionImprove Pain & Function
• Frazier S, Whitman J, Smith M “Utilization of Kinesio® Tex Tape in Patients with Shoulder Pain or Dysfunction: A Case Series” Regis University, Advance Healing, Summer 2006
• 5 male patients: 2 shoulder pain, 1 RTC, 1 impingement, 1 s/p acromioplasty
• All patients demonstrated improvements in function, pain & disability
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Kinesio® Tape CostochondritisKinesio® Tape CostochondritisDecreased PainDecreased Pain
• Aspegren D “Conservative treatment of a female college volleyball player with costochondritis” Journal of Manipulative & Physiological Therapeutics, May2007; 30 (4): 321-5
• 21 year-old female college volleyball player with 8 months of costochondral pain
• Results: Patient reported 70% reduction in pain after 4 treatments over two weeks
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DeltoidDeltoid
• Athletic & Kinesio® Technique– Split strip mod to
max stretch along anterior and posterior borders of deltoid
– Single strip over muscle belly mod to max stretch
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Glenohumeral Laxity / Anterior InstabilityGlenohumeral Laxity / Anterior Instability
• Acute Phase/Edema Kinesio® Technique– Two multiple split
strips (cut one 2” piece into 4-6 strips leaving last square intact)
– Place with minimal to no stretch in perpendicular fashion
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Glenohumeral Laxity / Anterior InstabilityGlenohumeral Laxity / Anterior Instability
Subacute / Chronic Phases• Kinesio® Deltoid Tape• Mulligan & Kinesio® Technique
– 2-4 Single strips applied with maximal pull from anterior to posterior over superior and lateral aspects of shoulder
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Multiaxial InstabilityMultiaxial Instability
• Kinesio® Technique similar to Athletic Training Shoulder stabilizing strip– Single strip 3-4 inches proximal to ac
joint to 3-4 inches below deltoid tuberosity mod to max stretch with arm at 90 degrees abduction
– Bring arm into ADD and rub down
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Subacromial BursitisSubacromial Bursitis
• Mulligan, Athletic Training & Kinesio® Technique
• 2-4 Space Corrections over subacromial space
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Acromioclavicular Joint SprainAcromioclavicular Joint Sprain
• Athletic Training, McConnell & Kinesio®
• 2-4 diamond cut outs over ac joint– Kinesio® uses donut strip– Athletic uses donut cut-out– McConnell approximates tissue
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Acromioclavicular SeparationAcromioclavicular Separation
• Athletic Training & Mulligan• Single strip posterior to anterior
across ac joint maximal stretch approximating ac joint
• Can apply multiple strips depending on degree of separation
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Clavicular Fracture (stable)Clavicular Fracture (stable)
• Athletic Training Technique• Non-displaced, stable fx• Single strip distal to proximal
clavicle max stretch across fracture site
• Can combine with space correction over site
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SupraspinatusSupraspinatus
• Kinesio® Technique– Shoulder in IR & horizontal
ADD– Split strip from the greater
tubercle of humerus with mod to max stretch tails along the borders of supraspinatus
• Modified Tape Practical Application– Over supraspinatus moderate
stretch with single strip tape
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InfraspinatusInfraspinatus
• Kinesio® Technique– Shoulder in IR &
horizontal ADD– Single strip from the
greater tubercle of humerus with mod to max stretch tails along the borders of infraspinatus
• Modified Tape Practical Application– Over infraspinatus, single
strip, mod to max stretch
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Teres MinorTeres Minor
• Kinesio® Technique– Shoulder in IR and
ABD– Split strip from
greater tubercle of humerus with mod to max stretch tails along the lateral border of scapula
• Modified Tape Practical Application– Single strip mod to
max stretch
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Bicipital TenosynovitisBicipital Tenosynovitis
• Kinesio® Technique– Bicep Unload
• Split strip with mod to max stretch from the radial tuberocity with tails to the coracoid process and supraglenoid tubercle of scapula
– Space Correction• Over long head of biceps
• Modified Tape Practical Application – single strip moderate stretch over
bicep
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Brachial Plexus NeuropraxiaBrachial Plexus Neuropraxia
• Single strip split proximally applied with min to mod stretch
• 1st tail along upper trapezius
• 2nd tail along inferior angle of scapula
• With shoulder in horizontal ADD apply along posterior brachium to forearm with diamond cut hole over olecranon
• Apply to point of most distal symptoms
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Pectoralis MinorPectoralis Minor
• Kinesio® Technique• Split strip from coracoid process of
scapula to ribs 2-5, minimal stretch• Generally for inhibition to improve
postural alignment (decrease forward pull on scapula)
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RhomboidRhomboid
• Kinesio® Technique
• Tape with scapula abducted / anteriorly rotated
• Double split strip sp T2-T5 to medial border of scapula between spine and inferior angle, maximal stretch middle of tape, no pull on tails
• Improve scapular stabilization / postural control
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Kinesio® Tape for Rhomboid Kinesio® Tape for Rhomboid Decreased Pain/Increased ROMDecreased Pain/Increased ROM
• Murray H, Husk L, Garcia D, 2001– Awaiting publication, presented at
16th Annual Kinesio® Taping Symposium
– “Effects of Kinesio® Taping on Posture and Upper Extremity Pain”
– Unilateral rhomboid facilitation and pectoralis inhibition
– 15 subjects– Pain complaints significantly
decreased and GHJ AROM flexion increased by an average of 15 degrees
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ScapularScapular
• McConnell Technique
• Scapular Stabilization
• Two single strips along borders of scapula pulling into retraction and depression
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Edema / LymphedemaEdema / Lymphedema
Kinesio® TechniquesEdema• Reduction through active joint motion
• Min to no stretch over edematous site• Fan shape most common, direction not important
Lymphatic Drainage• Direction of lymphatic flow• No stretch
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Clinical Evidence-BasedClinical Evidence-Based
• Objective Assessment (* Sign)– Special Tests: RTC,
impingement, instability– Pain at rest, with AROM and
previously aggravating motions
– MMT – GH and scapulothoracic
– AROM – range and painfree– GHS rhythm
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Clinical Evidence-BasedClinical Evidence-Based
• Objective Assessment (* Sign)– Functional Assessment
• Lifting (weight, reps)• ADL – grooming,
housework, dressing• Pushing / Pulling –
lawnmower, vacuum, grocery cart
• Overhead reaching
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