Rob Madden: Taping Challenges & Case Studies in Physiotherapy
December 13, 20174 min read
As the health and physiotherapy industry evolves it is good for us to reflect about where we are currently at and how things have changed. It certainly feels like physiotherapy and allied fields are at a critical time around truly finding their identity. Social media has pushed us to discuss and debate more, which has been shown to regularly cause disagreement between individuals in the same field. I generally stay out of these discussions but it is interesting to observe how things are moving forwards.
There are regular question marks over modalities - be it manipulation, acupuncture, massage, or taping. As we move more and more towards patient controlled / internal locus management it is natural that clients are encouraged to be self equipped with an individualised exercise and lifestyle management strategy; therefore allowing them to take responsibility for, and maintain control of their physical health. This is certainly an important philosophical position which I firmly agree with, however that certainly doesn't mean that we move away from modalities where we believe they can have a positive effect for our clients.
As I wrote in my previous blog "Common Myths and Misconceptions Around Taping In Sport" - there are many myths and misconceptions around taping, and this could also be said for other modalities. The way in which you communicate with the client is one of the most important things when using a particular modality like taping to ensure that the individual does not become overly dependent or fixated on that one solution.
We should encourage the use of something if it helps the individual but also promote the disuse of it after the recommended time period to allow that person to get back to ‘normal’ activity without the reliance of tape, or whatever other modality might have been used. In my experience, this aspect can be even harder in high performance sport which is where I have spent a lot of my career. Quite often the athlete may have been managed a certain way for years, and if they believe they need something around competition then it is probably a good idea to make sure you give it to them! It could negatively affect them if you were not to provide it or challenge them in that time and place. This is where communication between the support team is paramount and if those discussions do need to happen, they should away from the competition arena.
Overall, I would say that as my practice has moved naturally towards strength and conditioning and overall lifestyle coaching, I certainly find myself using less modalities than I used to at the start of my career. That saying, it is my opinion that it is enormously helpful to use things like SPORTTAPE at the right place and right time.
Recently I met a friendly chap who was in his 40s and enjoyed playing basketball with his children. He had developed some unilateral patella tendinopathy which had been confirmed by some imaging. I knew what he needed and I discussed this with him. I wanted him to refrain from basketball for a short period and begin some isometric loading work and progress towards through range work at the necessary loads and volumes for several weeks / months. He could gradually reintroduce basketball and ensure a good warm up incorporating some isometrics before playing too.
Now one particular challenge with this gentleman was he did not like pain in the slightest. He was complaining of a moderate amount of it with a single leg squat and when performing the exercises he could sense it too. To help combat this I used this classic method of taping (video below) and asked him to perform the single leg squat again. As a result pain was significantly less than before.
I was then able to coach him through the necessary tendon specific loading exercises with the tape on, and this further reduced his symptoms on squatting. In my opinion, this was a helpful strategy to getting ‘buy in’ for him to be committed to the recovery. We all know this is the most important factor in rehab! Others may argue of course that if I had persevered with the exercises alone for 1-2 weeks this would have likely reduced his symptoms without the tape. So which is the right way? Without taping would he have struggled more to load into slightly higher pain or been able to confidently perform the rehab outside of the clinic environment? I will leave you to come to your own conclusion!
In the next blog, Patrick Harding will carry on from this case study talking about the challenges of taping in sport and the potential physiological processes that could be influencing pain and function!
As always, the education team here at SPORTTAPE is always here to answer your questions and I hope this blog helped get a few people thinking and generates some discussion amongst yourself.
Rob Madden is a Medical Director at the SPORTTAPE Academy, and currently works as a Senior Physiotherapist at the CHHP Practice in London, Hintaa Performance and AJ Boxing.