Therapeutic Taping for the Shoulder Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP Dr. Scott...

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Therapeutic Taping Therapeutic Taping for the Shoulder for the Shoulder Dr. Dyanna Haley-Rezac, PT, DPT, OCS, Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP CSCS, CKTP Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS CEAS

Transcript of Therapeutic Taping for the Shoulder Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP Dr. Scott...

Page 1: Therapeutic Taping for the Shoulder Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS.

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

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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

Page 6: Therapeutic Taping for the Shoulder Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS.

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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

Page 8: Therapeutic Taping for the Shoulder Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS.

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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

Page 10: Therapeutic Taping for the Shoulder Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS.

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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

Page 14: Therapeutic Taping for the Shoulder Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS.

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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

Page 15: Therapeutic Taping for the Shoulder Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS.

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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

Page 17: Therapeutic Taping for the Shoulder Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS.

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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)

Page 20: Therapeutic Taping for the Shoulder Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS.

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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

Page 25: Therapeutic Taping for the Shoulder Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS.

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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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