As sound research continues to mount, patients and their therapists are increasingly turning to kinesiology taping as a way to modulate pain, correct problematic biomechanics and reduce edema. Emerging theories even suggest a sensory gating effect, in which the enhanced sensory stimulation produced by therapeutic tape decreases the patient's perception of their own pain.
Tammara Moore, DPT, has been a physical therapist since 1989 and in private practice almost that long. She's founder and clinic director of Sports + Orthopedic Leaders Physical Therapy (SOLPT), a two-location practice based in Oakland, CA. SOLPT treats a mostly athletic population rehabbing from sports injuries or those looking for a competitive edge. A robust sports performance program featuring athletic trainers, personal trainers and massage therapists compliments traditional orthopedic rehab. SOLPT also handles geriatric, pediatric and post-surgical cases. In addition, Dr. Moore is a certified instructor for SpiderTech, teaching therapists across the country the reasoning behind therapeutic taping for diverse orthopedic conditions, along with application methods and adjunctive rehab programs to enhance the effect of the modality.
ADVANCE spoke with Dr. Moore to learn more about her background and how she incorporates kinesiology taping into her day-to-day practice.
ADVANCE: How did you first come to be interested in kinesiology taping?
Moore: As a sports medicine and orthopedic physical therapist, I'm always interested in evidence-based ways to enhance the care I provide. As textbooks and in-services on therapeutic and kinesiology taping began to emerge in the last decade, I became motivated to investigate the theory and the reasoning behind the modality.
ADVANCE: Can you briefly explain the clinical rationale behind kinesiology taping?
Moore: When we use tape for an injury we're aiming for three therapeutic objectives: reduce pain, reduce swelling, and support the area during healing. We typically see a reduction of about 20-30 percent of fluid in the area after the first application. In some cases the effects can be quite dramatic--it's not uncommon to remove a section of tape and notice a "zebra effect" in which bruising under the taped area has been eliminated, while it remains visible in the untaped area.And of course there is a psychological component to this as well-a lot of times, people come in fearful and in pain; this gives them something useful so they become an active participant in their therapy, and also serves as a constant reminder of the injured area during sports and daily living.
ADVANCE: What conditions will you use tape for in the clinic?
Moore: I would estimate that I use tape on 10-20 percent of my patients. Anyone that presents with a fairly acute injury, or has an area that needs some support-i.e., hamstring tear, ankle sprain, virtually any traumatic injury resulting in bruising or ecchymosis. Almost every sore shoulder I'll tape. It's also very effective with chronic pain patients, and there is some evidence now of a sensory gating effect, whereby constantly stimulating the Merkel cells is akin to lightly touching a patient and will assist in pain modulation.If someone has a biomechanical flaw or needs neuromuscular retraining, the tape can hold the muscle in a shortened position to support the area and serve as an unconscious "reminder" to the patient during rehab and range of motion activities. Regardless of the reasoning, we never tape in isolation-this is an adjunctive modality that's used in combination with our traditional sports rehab protocols.
ADVANCE: Is there a specific way to apply it?
Moore: The skill set is actually rather easy to learn and therapists can master it quickly. We even teach it to family members so patients can continue benefiting from it long-term after we no longer see them in the clinic.The true skill lies in the clinical reasoning behind it. If you're using tape in a structural way, you want to allow compression to the area; if you're going for a microcirculatory effect you want a lifting of the patient's skin as they move, to facilitate fluid exchange. If you're going for sensory afferent stimulation or to alter muscle recruitment patterns, you apply it slightly differently. It depends on the ultimate goal.The tape stays on for about 5 days, at which time we'll either change it, instruct them to have a family member re-apply it, or discontinue if it's no longer producing a benefit.
ADVANCE: Are more therapists becoming interested?
Moore: I think many therapists initially feel that something as simple as tape can't help the often complex and inter-related issues that their patients present with. That skepticism is warranted. But as research keeps coming out, they're beginning to wonder what's behind it and motivated to learn more.
ADVANCE: How do you get reimbursed for the time and materials?
Moore: SOLPT is a 30-percent cash-pay operation. We're fortunate that our patients see the value that we provide and will pay out of pocket. Specifically as it applies to taping, we'll usually charge the patient for the materials, and because the application time is only a few minutes, we won't charge for the time. There is a CPT code for strapping, but we don't bother coding for it. If we explain the charge structure beforehand, patients rarely have an issue with it.
ADVANCE: Any closing thoughts?
Moore: I'd say the overall message surrounding rehabilitative taping is that our clinical reasoning is beginning to justify the results that athletes have been realizing for some time now. There wasn't a lot of evidence at first, but what we're learning now is that there really is solid research behind this modality. It helps increase range of motion and relieves pain. There's also great work being done in the area of lymphedema, scar tissue reduction, hand therapy, not to mention the work into neuroplasticity and persistent pain, where this is truly groundbreaking.Is taping a miracle cure? Of course not--but if you can modulate pain and get a person moving again, you can get them actively involved in therapy while decreasing your treatment times and improving your clinical outcomes. One of our 80-year-old patients shattered her ankle in a glider accident and was in chronic pain that wouldn't resolve through traditional methods. After several sessions of taping the area we were able to reduce her pain by 50 percent, and to her, that was a life-changing improvement.
(Source: Advance)
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