Patellar Taping: Difference between revisions
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== Purpose<br> == | == Purpose<br> == | ||
The | The McConnell taping technique was developed to correct altered patellofemoral kinematics and permit participation in normal daily activity <ref name="twee">Aditya Derasari, Timothy J. Brindle, Katharine E. Alter, Frances T. Sheehan., McConnell Taping Shifts the Patella Inferiorly in Patients With Patellofemoral Pain: A Dynamic Magnetic Resonance Imaging Study, Physical Therapy, 2010; 90 (3): 411 – 420</ref> and to allow the patient to engage in physical therapy exercise pain free. Although there are several variations of the taping procedure recommended, depending on the specific needs of the patient (eg, glide, tilt, and/or rotation), as reported by McConnell, nearly all patients require a medial glide of their patellas. <ref name="een">Ronald P. Pfeiffer, Mark DeBeliso, Kevin G. Shea, Lorrie Kelley, Bobbie Irmischer and Chad Harris., Kinematic MRI Assessment of McConnell Taping Before and After Exercise, The American Journal of Sports Medicine, 2004; 32: 621 – 628</ref> | ||
McConnell taping is accomplished by way of application of specialized adhesive tape applied across the anterior aspect of the patella, pulling from lateral to medial, to in effect “medialize” the patellofemoral joint (PFJ). Once applied the patients should experience a reduction in their symptoms associated with PFPS, thus enabling them to engage in physical therapy exercise. As such, the ability of the strapping procedure to maintain the medialized position of the patella is critical for the duration of the physical activity. <ref name="een">Ronald P. Pfeiffer, Mark DeBeliso, Kevin G. Shea, Lorrie Kelley, Bobbie Irmischer and Chad Harris., Kinematic MRI Assessment of McConnell Taping Before and After Exercise, The American Journal of Sports Medicine, 2004; 32: 621 – 628</ref> | |||
McConnell taping is accomplished by way of application of specialized adhesive tape applied across the anterior aspect of the patella, pulling from lateral to medial, to in effect “medialize” the patellofemoral joint (PFJ). Once applied the patients should experience a reduction in their symptoms associated with PFPS, thus enabling them to engage in physical therapy exercise. As such, the ability of the strapping procedure to maintain the medialized position of the patella is critical for the duration of the physical activity. <ref name="een">Ronald P. Pfeiffer, Mark DeBeliso, Kevin G. Shea, Lorrie Kelley, Bobbie Irmischer and Chad Harris., Kinematic MRI Assessment of McConnell Taping Before and After Exercise, The American Journal of Sports Medicine, 2004; 32: 621 – 628</ref> | |||
== Indications == | == Indications == | ||
Revision as of 12:17, 27 November 2016
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Description[edit | edit source]
Patellar taping was originally developed by Jenny McConnell and is a simple, inexpensive self management strategy.
The aim of patellar taping is to create a mechanical realignment in order to correct malalignments of the patella and to reduce pain.
Clinically Relevant Anatomy[edit | edit source]
The patella needs to fit into the patella grove. A tilt or a lateral glide is when the lateral ligament is to strong and the quadriceps to weak to hold the patella in his grove. The patella is locked out of his normal position, this causes pain. When there is too much force on the lateral side of the femur and relaxation of cartilage, that's called chondromalacia. To increase the pain, the patella has to put into the patella grove. This can be done by a tape or a brace.
Purpose
[edit | edit source]
The McConnell taping technique was developed to correct altered patellofemoral kinematics and permit participation in normal daily activity [1] and to allow the patient to engage in physical therapy exercise pain free. Although there are several variations of the taping procedure recommended, depending on the specific needs of the patient (eg, glide, tilt, and/or rotation), as reported by McConnell, nearly all patients require a medial glide of their patellas. [2]
McConnell taping is accomplished by way of application of specialized adhesive tape applied across the anterior aspect of the patella, pulling from lateral to medial, to in effect “medialize” the patellofemoral joint (PFJ). Once applied the patients should experience a reduction in their symptoms associated with PFPS, thus enabling them to engage in physical therapy exercise. As such, the ability of the strapping procedure to maintain the medialized position of the patella is critical for the duration of the physical activity. [2]
Indications[edit | edit source]
Evidence shows that Patellar taping may be used as a treatment for Knee Osteoarthritis, Patellofemoral Pain Syndrome and Chondromalacia Patellae.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
In most of the cases these symptoms aggravate during physical activities such as: ascending and descending stairs, kneeling, running and squatting.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Application[edit | edit source]
Begin lying on your back, with the knee slightly bent, but completely relaxed and a foam roller or rolled up towel under the knee.
Start the tape in line with the middle of the knee cap at the outer aspect of the knee. Using your thumb on top of the sports tape, gently push the knee cap towards the inner aspect of the knee whilst simultaneously using your fingers to pull the skin at the inner aspect of the knee towards the knee cap. Finish this taping technique at the inner aspect of the knee ensuring you have created some wrinkling of the skin at the inner aspect of the knee. Repeat this process 1 - 3 times depending on the amount of support required. [3]
McConnell taping medialized the patella in participants who demonstrated lateral displacement at baseline and lateralized the patella in participants who demonstrated medial patellar displacement at baseline. [1]
The McConnell taping technique can also help keep the kneecap in alignment. This can help reestablish normal movement and allow the muscles that hold the kneecap in place to redevelop properly. [4]
Patellar taping is a useful treatment to reduce the main symptoms, mentioned in the clinical presentation.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title A well-known taping technique is the McConnell patellar taping technique. To demonstrate this technique I added the first movie. The second movie shows another taping technique especially for knee instability .
Main Advantages of Patella Taping[edit | edit source]
Pain Reduction[edit | edit source]
Almost all studies have demonstrated an immediate decrease in pain during provocative exercise. Studies also found that medial patellar tape induced a significantly greater pain reduction than the lateral patellar tape. Especially patients who suffer from knee osteoarthritis, patellofemoral pain syndrome and chronic knee pain experience a significant pain reduction.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Improvement in Disability[edit | edit source]
On patients with knee osteoarthritis research demonstrated that therapeutic patellar tape improves the disability of the knee. This advantage of therapeutic tape was maintained until three weeks after stopping treatment. Up until now, the long-term effects are not scientifically proven. Differences have been found between the experimental and the control group, however, the results are insignificant.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Effect on Quadriceps Function[edit | edit source]
Patellar taping demonstrated significantly greater concentric and eccentric quadriceps torque.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Another article found significantly greater knee extensor moments and power during weight-bearing activities such as vertical jump and lateral step up in taped conditions in PFPS subjects.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title There are several possible explanations but they need to be explored in further studies. This benefit is important for patients with PFPS, because decreased quadriceps contractions may lead to a diminution of the shock absorption during weight bearing thus further increasing the load on the patellofemoral joint. An increase in quadriceps muscle force can directly heighten the patellofemoral joint reaction force during gait, so patellar taping is very important for the treatment of PFPS.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Effect on Knee Joint during Gait[edit | edit source]
Patients with PFPS have significantly less knee flexion during gait and walk significantly slower. These factors will reduce the load on the patellofemoral joint and will decrease the demand on the quadriceps function. Patellar taping demonstrated a small but significant increase of knee flexion while the patients walk at two different speeds, up and down ramps and stairs.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Effect on the Activation/Timing of the Vastii[edit | edit source]
Patients with PFPS demonstrate decreased activation levels of the vastus medialis and the vastus lateralis. Coordinated contraction of these muscles is important for the patellar alignment during activity ( walk up and down the stairs). The benefit of the patella tape is the raise of the activation or timing of the vastus medialis relative to the vastus lateralis or conversely, the decrease activation of the vastus lateralis relative to the vastus medialis. During step down tasks the contraction of the vastus medialis occurred earlier in taped conditions. This earlier activation may alter the movement of the patella. This benefit should be further explored in order to be more confident of the results.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Re-align the Patella[edit | edit source]
The three most common radiographic measurements alignments of the patella are: the patellofemoral congruence angle (PFCA), the lateral patellofemoral angle (LPFA) and the lateral patellar displacement (LPD). The PFCA represents lateral patellar glide and lateral tilt, the LPFA represents lateral patellar tilt, while the LPD quantifies the position of the patella in the frontal plane relative to the medial femoral condyle in millimeters. A few studies have provided the evidence that medial patellar taping can confer a radiographic positional change of the patella in PFPS subjects. Researchers found a significant change in LPFA and LPD with patellar tape in PFPS subjects They suggest that this may be sufficient to create a subtle alternation in intra-articular or inter-osseous pressure. So patellar tape can influence patellar position in LPFA and LPD. The benefit of taping on the PFCA is not proven.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Recent Related Research (from Pubmed)[edit | edit source]
see tutorial on Adding PubMed Feed
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References[edit | edit source]
- ↑ 1.0 1.1 Aditya Derasari, Timothy J. Brindle, Katharine E. Alter, Frances T. Sheehan., McConnell Taping Shifts the Patella Inferiorly in Patients With Patellofemoral Pain: A Dynamic Magnetic Resonance Imaging Study, Physical Therapy, 2010; 90 (3): 411 – 420
- ↑ 2.0 2.1 Ronald P. Pfeiffer, Mark DeBeliso, Kevin G. Shea, Lorrie Kelley, Bobbie Irmischer and Chad Harris., Kinematic MRI Assessment of McConnell Taping Before and After Exercise, The American Journal of Sports Medicine, 2004; 32: 621 – 628
- ↑ http://www.physioadvisor.com.au/11343550/patella-taping-mcconnell-taping-physioadvisor.htm
- ↑ eMedecineHealth, Judy Dundas, Maria Essig, Pat Truman, William H. Blahd, Jr. McConnell taping technique, Updated: January 19, 2010. http://www.emedicinehealth.com/script/main/art.asp?articlekey=138626&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;ref=135246
