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TapingTechniquesforthePatellofemoralJoint
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JillMonson,PT,OCSMonsonOrthopaedicConsul=ng,LLC
PFJBracing
• PowersCM,WardSR,ChanLD,etal.Theeffectofbracingonpatellaalignmentandpatellofemoraljointcontactarea.MedSciSportsExerc.2004;36:1226-1232.
– Painreliefthoughttobetheresultofincreasedpatellofemoralcontactarea
– Perhapsd/tcompressionofthepatellaintothetrochleainducedbythebrace
2©MonsonOrthopaedicConsulOng,LLC2016
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PatellofemoralTaping
Study Interven=on Task Outcome
CrossleyJOrthopRes
2004
PTinterven=onw/orw/oPFtaping(PFpain)
Gait ImprovedKFwithgaitintapinggroup
BockrathMedSciSportExerc
1993PFTaping 8”Step-down 50%reduc=oninpainin
tapinggroup
WhiZnghamJOSPT2004
PTinterven=onw/orw/oPFtaping(PFpain)
8”Step-downSquaZngAggrava=ngAc=vi=es
Decreasedpainw/aggrava=ngtasksand
throughoutday,improvedreportedfunc=onintaping
group
ErnstJOSPT1999
Lateraltomedialtapingcomparedtosham Gait
Improvedkneeextensormomentandpowerintaping
group
PatellofemoralTaping• AminakaN,GribblePA(2005)AsystemaOcreviewoftheeffectsoftherapeuOctapingonpatellofemoralpainsyndrome.JAthlTrain40(4):341-351.• Conflic=ngevidence
• LesherJDetal(2006)DevelopmentofaclinicalpredicOonruleforclassifyingpaOentswithPFPsyndromewhorespondtopatellartaping.JOSPT36(11):854-866– (+)patellar=lt,>5°=bialvarusangula=on
– 83%likelihoodof50%reduc=oninpainw/steptest,squaZng
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TapingBasics• Applytapetoclean,dryskin(nolo3on)• 1stapplycoverroll(whitetape)– Protec=vebarrierfortheskin
• 2ndapplyleukotape(browntape)– Thistapecreatesthe“ac=on”bypullingthejoint/muscle
• TaketapeOFFif:– Skinorjointbecomesirritated
– Painincreases– Tapeisfallingoff
• Leavetapeonx3-4hours(canbe1-2daysifhelpful&tolerated-cau3ousandobservantwiththis!!)
– Wrapinsaranwrapwhilebathingtoextendlife5©MonsonOrthopaedicConsulOng,LLC2016
In-ClinicTrial• Reproducesymptomswithameasured,pain-genera=ngac=vity
• 8”step-downheeltapx3
• Specifypain:
» Loca=on
» Intensity(NPS)
» Timingofonset
• Applytapetechnique
• Re-testprovoca=veac=vityandre-assesssymptomresponse
6©MonsonOrthopaedicConsulOng,LLC2016
MedialGlide• Improvetracking,reducelateraloverload,reducelateralsubluxa7on
– Applytapelateraltomedialacrossproximal2/3rdofpatella
• Anchorapprox.3-4cmbelowlateralborder
– Translatethepatellamedialintothecentralaspectofthegroove,keepingthetapetaut
– Gatherposteromedialsoh=ssueandanchortapew/opullingmore
7©MonsonOrthopaedicConsulOng,LLC2016
MedialTilt
• Reducelateraloverload– Anchortapeatlateralaspectofpatella(atproximal2/3)
– Usethumb&pullofthetapeto=ltthepatellamedially
– Gatherposteromedialsoh=ssueandanchortape,withoutpullingmore
8©MonsonOrthopaedicConsulOng,LLC2016
PatellarUnloadingTechnique• UnloadgeneralPFjointcompression(Adddirec7onalelementsasappropriate)
– 2stripsoftape:1anchoredatmedialknee,1atlateralknee(alignedattheproximal2/3ofpatella)
– Gatherthetapeoverthepatellaandcreateanupwardpull
– Cinchthetapetogetherallthewaydowntothepatellawhilemaintainingupwardpull
– Anchortapetomedialsidew/orw/otransla=onalpull(persx’s)
9©MonsonOrthopaedicConsulOng,LLC2016
“Reverse”(lateralglide)Technique
• Torelievepainfromincreasedmedialcontactforces
– “Over-release”w/historyofbroadlateralre=nacularrelease
– “Medialfacetoverload”duesuspicionof:• Over-constrainedMPFLgrah• Over-medializedw/osteotomyprocedure
– THISWILLNOTBEAHIGHFREQUENCYTECHNIQUE!!
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LateralGlide:“ReverseTaping”
– Anchorjustdownfromthemedialborderofpatella&laytapeacrosstheproximal2/3orpatella
– Gentlytranslatethepatellainalateraldirec=ontocenteritinthegroovewithfingers,keepingtapetaut
– Anchortapearoundposterolateralaspectofkneewithoutpullingmore
11©MonsonOrthopaedicConsulOng,LLC2016
InfrapatellarFatPadUnloading
• “V”Technique:
• (2stripsoftape):kneeslightlyflexed
• Anchorthetapeat=bialtubercle(outlined)&pullitdiagonallyup&aroundthebackoftheknee(tapelineshouldbeinferiortothemarginofthefatpad)
• Pulltheiinfrapatellarskin&fatpadupward&inwardtowardthepatellaasyoufirmlypullthetapetowardtheanchorsitesaroundthebacksideoftheknee(apply1stripata=me)–anchorabovethepoplitealcrease
12©MonsonOrthopaedicConsulOng,LLC2016
BusinessDetails
• BillingforTapingTechniques• Whatwasyourpurposefortaping?
» Stabiliza=on» Neuromuscularre-educa=on» Paincontrol
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TapingLab
• Medialglide• Medial3lt
• “Reverse”lateralglide• Patellarunloading
• Infrapatellar“V”fatpadunloading
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