!  At the completion of this seminar you will be able to:

1.  Understand the proposed physiological mechanisms for the use of soft-tissue mobilization with tools (STMT)

2.  Use STMT for both the detection and treatment of common soft-tissue myofascia restrictions.

3.  Understand the unique properties of elastic kinesiology tape (K-Tape) and how it can be used clinically for therapeutic applications.

4.  Apply K-Tape for the support, neuromuscular re-education and or reduction of swelling in joints and muscles.

Dr. Denny Kolkebeck, DPT, etc

815-761-7262 Twitter: @MooseGym dennypt@comcast.net

The magic is not in the medicine, but in the patient’s body…the recuperative or self-corrective energy of nature.

What the treatment does is to stimulate natural functions or to remove what hinders them.

Miracles, C.S. Lewis 1940

! Gua Sha—”To scrape away disease”

! Bad blood (sha) brought to surface—petechia—via scraping tool over painful spot

! Body brought back into balance ! Tools of the trade:

! Buffalo Horn

! Soup Spoons ! Shaped pieces of Jade

!  Immigrants from China and Vietnam

! The Man, the Myth, the Legend: Dave Graston ! Machinist w/ bad knee after surgery

! Started using #2 pencil to massage knee…”ah-ha” moment

! Machined metal tools for Dr Sevier

! 2nd “ah-ha” $$$ " Graston Technique

! “Controlled micro trauma”

! Mechanical pressure and deformation of connective & vascular tissues leads to…

1.  # fibroblast production

2.  Inflammatory response

②  Inflammatory Response

!  Three Phases of Tissue Healing

1.  Inflammatory !  leukocyte & macrophage activity ! phagocytosis

!  vasodilation & vasopermeability

2.  Proliferative

!  angiogenesis (neovascularization)

!  fibroplasia of ground substance & collagen fibers (type III)

3.  Maturation & Remodeling

Mechanical Pressure

# Inflammation Phagocytosis & Vasopermeability

Neovascular & #Ground Sub &

Collagen

# Fibroblasts

# ECM # Ground Substance

# Collagen

# & size

Type III Δ

to Type I

! Patient is positioned with tissue to be treated in passively stretched position

! One-two drops lubricant applied to skin

! Tool worked along entire tissue moving from origin to insertion, insertion to origin and obliquely across tissue looking for myofascia restriction (soft-tissue crepitus)

!  Myofascia restriction worked on with STMT tool going into most restricted barrier

!  Literature suggests firm (yet tolerable) pressure for 3 minutes promotes greater degree of fibroblastic activity

!  Patient should be informed to expect tenderness, bruising (petechia) and mild swelling

!  Open Wound- Unhealed Suture Site/Sutures

!  Unhealed Fractures

!  Thrombophlebitis

!  Uncontrolled Hypertension

!  Kidney Dysfunction

!  Patient Intolerance/Non-compliance/Hypersensitivity

!  Hematoma

!  Osteomyelitis

!  Myositis Ossificans

!  Anti-Coagulant Medications

!  Cancer

!  Varicose Veins

!  Burn Scars

!  Acute Inflammatory Conditions (e.g. Synovitis)

!  Inflammatory Condition Secondary to Infection

!  Rheumatoid Arthritis

!  Pregnancy (consider inherent ligament laxity)

!  Osteoporosis

!  Properties: 1.  Can stretch longitudinally 55-60% of its resting length

!  Is produced w/ 25% tension already on paper backing !  Not designed to stretch horizontally !  Can last 3-5 days before polymer diminishes

!  Properties: 2.  Thickness of tape is ~ same as epidermis:~1mm

!  Limits body’s perception of weight

!  After10’ client rarely even notices it

!  Properties: 3.  Made up of polymer elastic strand wrapped by 100% cotton

fibers !  " Evaporation of body moisture

4.  No Latex in Tape!

!  Properties: 5.  Adhesive is 100% acrylic—heat activated

!  Adhesive becomes more adherent the longer it is worn

!  Adhesive applied in wave-like pattern… like fingerprint !  " Assists in lifting up skin

!  " Zones for moisture to escape

!  Minimal to no glue residue after removal

①  Facilitate Muscle Firing !  Tape will be applied from Origin "Insertion

!  Use 25-50% tension on tape

②  Inhibit Muscle Firing !  Tape will be applied from Insertion " Origin

!  Use 15-25% tension on tape

③  Reduce Swelling/Edema !  Tape applied from lymph drainage ducts to swollen area

!  Use 0-15% tension on tape

!  The percentages listed, tell you how much stretch is applied to the tape, relative to its maximal length—100%

!  e.g., You want pt’s ant tib to fire better. You cut a 10” long K-tape and apply it with 50% of the available stretch in the tape.

!  If a 10” piece of tape could be maximally stretched to 15”, you’re only applying ! of that available length to tissue (50% of 5”= 2 ! inches)

!  Food for thought: !  Do NOT start using a measuring tape!

!  Go by “Feel” of available stretch in the tape.

!  Less is More! !  It’s better to err on the side of having too little tension vs.

too much!

!  “Y” Strip

!  Can be used to either facilitate or inhibit muscle(s)

!  To facilitate: Use 25-50% tension on tape

!  To inhibit: Use 15-25% tension on tape

!  “Y” strips go around targeted muscle(s)

!  “Fan” Strip

!  Used for lymphatic drainage

!  Very light tension on tape when applied: 0-15%

!  “I” Strip

!  Can be used for almost any application

!  Minimal cutting

1.  Skin Prep

2.  Decide on what your goal for taping is $  i.e., inhibit/activate/edema reduction

3.  Select your K strip pattern

4.  Put target muscle(s) on passive stretch

5.  Apply tape with appropriate tension for desired outcome/goal

6.  “Heat” tape up

!  Skin should be clean, free of lubricant from STMT and have minimal to no hair.

!  Consider using tape adherent:

Think This: Not That!:

! Start and end your tape with NO tension on it. !  Just peel K-tape off paper backing.

①  Facilitate Muscle Firing: 25-50% tension !  Tape will be applied from Origin "Insertion

②  Inhibit Muscle Firing: 15-25% tension !  Tape will be applied from Insertion " Origin

③  Reduce Swelling/Edema: 0-15% tension !  Tape applied from lymph drainage ducts to swollen area

Rub it

Blow dry it