Kinesiology Taping Seminar

ALL RIGHTS RESERVED © AMIR SHEFFER Introduction Kinesiology Taping – applying sticky cotton-based tapes on the skin in order to affect and improve the musculoskeletal system In this seminar we’ll study how to use correctly kinesiology / elastic taping The methods learnt in the seminar are under a consistant research Practice makes perfect – the more you tape, the better you understand the methods

rd 1st day 2nd day 3 day The method mechanics 6 tissue taping techniques Injury and healing process and phases The fascia system Advances cutting Building a treatment Main cutting techniques Practice of common strategy orthopedic injuries Applications directions Practice Treating scar tissues ROM testing and correction * Affecting other systems Practice

Clinical Therapeutic Application of Kinesio Taping Method Kinesio Taping for Lymphoedema & Chronic Swelling Anatomy Trains

Youtube channel for inspiration and ideas: John Gibbons

White tape – stabilizing limbs to restrain movement and motions. Wears off easily, not water proof, torn easily McConnel – mainly to restrict ROM Kinesilogy Tape – elastic, flexible. The goal is to encourage movement at all levels of tissues. Gentle affections that goes deeply and for long term. Used also for non-orthopedic issues.

Kinesio Tex – The original tape developed by Dr. Kenzo Kase. Classic / Gold FP – used mainly for lymph correction and fascia correction. Can be used for other puproses but usually wears off easily. Can be ordered online. KT Tape – pre-cut tapes. Can be helpful for some purposes. On the other hand, can be wasted because it’s pre-cut.

ALL RIGHTS RESERVED © AMIR SHEFFER How does it work? Applying the tape on the skin causes a chain reaction that affects all tissues Our body is made of layers, and the most superficial is the epidermis Under (and inside) the epidermis there are sensors that send signs to the main nervous system, in reaction to touch, temperature, load etc. The tape activates the senses and so we can “tell” the nervous system what to do. By applying different stimulation we can teach the body what we’d like it to do and by so, to improve the systems function.

ALL RIGHTS RESERVED © AMIR SHEFFER Taping Goals 1. Motion improvement – to reduce pain and restore balance (homeostasis) 2. Pain reduction 3. Restore balance between different systems (+ balance of the temperature and liquids between layers) 4. Improving range of motions

As long as the tape is on the skin – it’s affecting. The affect continues also after we remove the tape, but it fades slowly. Taping keeps the patient’s improvemend between the sessions We NEVER know how a tape was applied only based on the final picture

ALL RIGHTS RESERVED © AMIR SHEFFER Tapes colors Tapes come in different colors. The difference is only the color (of the same company) – the rest is the same (the fabtic, the glue and the texture). The colors were added due to the theory that colors affect our subconscious. The original colors are: •Blue – has a cooling effect, good for warm inflammations or warm weather •Red / pink – stimulates activity, warming effect, good for cold areas or pain that goes worse in cold weather •Black – accumulates heat, good for sweaty areas, athletes, tendons, ligaments, muscles •Begie / white – neutral color Sometimes on different patients, different color will stick better / worse You can also let the patient choose the color

ALL RIGHTS RESERVED © AMIR SHEFFER Macro / Micro approach The tape always affects the Fascia System The fascia is EVERYWHERE in the body. It’s a connective tissue that connects all the other tissues, and therefore it’s a part of them (skin, blood vessles, nerves, bones, tendons, muscles, etc.). It’s like a map on a table, but also goes INSIDE the table. Macro approach – affecting large areas of fascia (“screening”) Micro approach – treating and affecting a local problem and area. If we affect BOTH macro and micro – we treat the body correctly.

Skin Fascia Lymph system (+nerves) Muscles (+tendons, ligaments) Joints (bones) Qi (meridians)

We can use taping with many other treating metods, such as: •Acupuncture •Massage (on a dry skin, if you use oil you need to clean it well) •Shiatsu / Tui-Na •Physical Therapy •Chiropractic, OrsthepoaticS •Cupping * •So-tai (a lot in common)

ALL RIGHTS RESERVED © AMIR SHEFFER How and when to combine the Taping By your need – you can use taping before or after the session You can use taping as a diagnosis tool (movement testing) Watch out not to do overdoing I do not recommend to use taping on an area of cupping / guasha in the same treatment – it can cause over stimulation.

Taping is great for many kinds of issues – orthopedic, lymph issues, inflammatory issues Chronic and acute Athletes (although most of the patients are not professionals athletes) Good for children, teenagers, adults and eldery, safe for use during pregnancy Can be used for babies – only if you attended a relevant seminar

Partial contraindications (consult a Definite contraindications doctor) •Malignant lesions / tumors • Diabetes •Skin infection / inflammation • Renal diseases • • Heart diseases Open wounds • Ischemic diseases •DVT • Gentle / cracked / healing skin • pregnancy

ALL RIGHTS RESERVED © AMIR SHEFFER The tape construction and parts Made of 100% cotton fabric Glue – in the top quality tapes there is no latex, and it’s hypoallergenic Paper off tension – the tension of the tape while it’s on the paper – 10%. The tension is reduced when peeling it off the paper. Can be stretched up to 60% of the original length (100% tension) Anchor – the first part applied to the skin. Anchors are always at 0% tension! Main anchor – the first part applied. Secondary anchor – the anchor at the end of the tape. The application direction will always be from the secondary to the main anchor. Anchor is 3-4 cm long. As the tape is longer, the anchor will be longer. Therapeutic zone – the area between the anchors, where the tape is active

Cut a 7 cm length tape, and then cut it to half (lengthwise). Tape it on your finger, main anchor below the nail, stretch 50% and tape it along your finger. Leave an anchor at the end. Try to stretch the tape in across direction – does it stretch?

Allergy test – for sensitive patients. Apply 0% on the wrist and watch if there’s an allergic reaction in 12 hours.

ALL RIGHTS RESERVED © AMIR SHEFFER Guiding lines for a correct taping Key guideline: Asses – Tape – Re-asses Treating both the pain and the cause Clean the skin well before taping (you can use alcohol) Round the tape corners Anchors are always with 0% tension Anchor is applied in a neutral position of the patient Hair – if hair prevents the tape from sticking, shave it. It it sticks, better leave the hair unshaved Use the proper tension to the desired action

ALL RIGHTS RESERVED © AMIR SHEFFER More Guidelines The therapeutic zone is applied while the tissue is stretched (if possible) While taping joints – reach the maximum ROM before taping (so there will be no over-stretch when the patient moves) After applying tape – rub and warm the tape 5-10 seconds to activate the glue You can strengthen the tips of the tape with a regular plaster, so it won’t wear off too quickly Apply the tape at least 60 minutes before physical activity, and guide the patient to warm up well. Removing the tape – do not tear the tape off the skin as it can cause reaction. Start by removing the tip of the tape, and then press on the skin and separate it gently from the tape. If it’s too painful – remove the tape in hot shower.

ALL RIGHTS RESERVED © AMIR SHEFFER Not To Do’s Don’t use a dry or damaged tape Do not apply on head hear, groin, armpit and main sensory areas Never force the patient to get into position with the tape itself If the tapes causes pain / tingling / itching in the taped area, remove the tape. *instruct the patient to wait 1-2 hours before removing the tape, sometimes it’s the necessary reaction of the tape and not an allergic reaction. Do not touch the sticky side of the tape (it ruins the glue)

I Strip

Y strip

X cut

Fan cut

Web cut

Basket weave cut

Connective tissue, connects all organs and tissues of the body. Without fascia there is no movement. Created at the moment of fertilization. A collagen tissue. Embriology: •Ectoderm – the superficial layer (brain, peripherial nervous system, epidermis, hair). •Mesodrm – the middle layer (dermis, muscles, skeleton, lymph, fascia) •Endoderm – the deep layer (bowls, respiratory, endocrine, urinary, hearing)

ALL RIGHTS RESERVED © AMIR SHEFFER The skin – no. 1 sensing organ The largest sensing oragn. Flexible – to enable movement. Breathing. Absorbing materials or preventing absobsion. There are sensors under the epidermis – sensitive to cold, warm, touch, tingling, pain, strass. The hair pores are also sensors The blood vessles are also sensored and react to stimulations. The skin, in different areas of the body, is sensored differently. Therefore you need to adjust the stretch of the tape according the the body area. For example – the front neck is more sensitive than the back of the neck.

ALL RIGHTS RESERVED © AMIR SHEFFER How taping affects pain Pain is multi-systematic, affected by different stimulations (visual, cognitive, emotional, neurological, stress) The tape increases the sensory reactions to “fix the problem” Taping affects the superfisial fasicam Stimulating an area causes a wide response, and not only local response.

ALL RIGHTS RESERVED © AMIR SHEFFER The lymph system Drains poisons and “trash” from the body When there’s a problem – the body recognizes it and sends fixing materials A ROM restriction is formed in order to prevent further injury and let the body repair the problem. In some cases – a “traffic jam” of the fixing materials is created – causing fluids accumulation and an inflammatory reaction – heat, edema and pain. The lymph correction with taping will stimulate the lymph system and help it to drain the fluids and “clear the traffic”

ALL RIGHTS RESERVED © AMIR SHEFFER Taping The Lymph System Super gentle stimulation – paper off tension (10-15% max). Stimulates the superficial fascia – affecting superficial blood vessles Reduces pain and edemas Balancing the temperature Improving fluids transfer between the tissues layers

Lymph Correction 10-15%tension on thpe tape Fan Cut anchor on a healthy area / lymph nodules area Tails “surrounding” the effected area You can use more than one tape

Origin Sacrum/Illiac Crest/Spinous Processes of lower lumbar/thoracic vertebrae Insertion Ribs Billateral action Lumbar Extension , stabilization Unlateral action Lateral flexion and rotation of the upper body

• Tape measuring – from below Iliac Crest to above 12th rib • Main anchor – below Iliac Crest, next to spine • Patient position – front flexion / rotation to opposite side • Apply tape upwards, 10-15% stretch

The stretch of the tape creates a “compression” effect of the superficial tissue The compression causes spacing in the deeper layers The convolutions are created by the stretch of the tape, with affects the tissue construction

ALL RIGHTS RESERVED © AMIR SHEFFER Tape Stretch Super Light 0-15% (lymph correction, traumas, hemorrhages) Paper off 10-15% (lymph, inhibition) Light 15-25% (inhibition) Moderate 25-35% (fascilitation) Severe 50-75% (mechanical / functional correction, ligaments and tendons) Full 75-100% (mechanical / functional correction, ligaments and tendons)

ALL RIGHTS RESERVED © AMIR SHEFFER Affecting Muscles The muscles are also sensore: oThe muscle fibers oGTO – Gongi Tendon Organ – sensors at the muscle-tendon junction. GTO sense external force applied on the muscles and send signs to the central nervous system that reacts to the force. When fore is applied on a muscle, the sensors balance the contra-force of the muscle. If the external force is too strong, there will be a relaxation reflex to prevent damage (muscle tear) By using taping we can stimulate those sensors, and to compress or decompress the muscles. That way, taping can affect muscles, joints, and body posture

Inhibition Facilitation

• The direction is opposite to the • The direction is with the muscle muscle action direction direction • Distal to Proximal (D->P) / • P->D / O->I Insersion to Origin (I->O) • Applied when the muscle is weak, to • Applied when the muscle is strengthen its action stressed or stiff (relaxation)

Origin Occipital bone, C7 vertebrae process Insertion Lateral third of clavicular, acromion Action Scapula raising, cervical extension, flexion and lateral rotation

Tape Measuring Acromion to spine

Main anchor Acromion

Patient position Flexion and lateral rotation of the head (opposite side) Taping tension 15-25% toward C7

Same measuring Cut the tape to Y strip Patient pose the same as previous Upper tail of Y strip along the crest of the muscle Lower tail along Spine of Scapula This form is more gentle and has more spread affection

Acromion to spine Tape measuring

Lateral to C7 process Main anchor

Flexion and lateral Patient position rotation of the head 25-25% toward Tape stretch acromion

Same taping measuring Cut the tape into Y strip Patient’s position the same as previous Upper tail along the crest of the muscle Lower tail along the spine of scapula

ALL RIGHTS RESERVED © AMIR SHEFFER Movement testing – macro approach Movement testing allows us to recognize and fix movement failures There are 6 tests, divided by body areas When the fascia is in perfect condition (very rare) all the test will be good Fixing range of motions improves the movement not only in the taped area, but also affects the whole screening area of the facia The tests can be passive (the therapist does the test) or active (the patient does) We can do both passive and active tests to improve our diagnosis

ALL RIGHTS RESERVED © AMIR SHEFFER Movement tests and anatomy trains “Anatomy train” – a proved connection of fascia in the same depth and cutting direction which makes a “train” No tissue works alone – all the tissues of the body work together Anatomy trains help us understand the connection between body parts and the affect at the macro level Movement tests also examines the relevant anatomy train Fixing the motions not only affects the local area, but also a wide area which mostly connected to anatomy trains (but not only).

Patient position Sitting up straight Therapist position Hands on the upper back and the upper sternum

Active test Patient flexes the neck (moving his head downward)

Visual examination The chin needs to go as close to the chest as possible without pain or compensation Physical examination The upper back fascia should move, or move just a bit Notice Does the head goes down directly, or tilts?

Main muscles Trapezius, Latissimus Dorsi, Levator Scapulae

Area affected Upper back, back of the neck, occiput, chest, ribs

Main muscle Longissimus Cervicis Proximal Transverse process of T1-4, Articulat process C4-7 Distal Transverse Process of C2-6 Actions Cervical extension. Important to stabilize the neck and head. A part of Longissumus chain that goes down to the lower back and is connected to the spineous erectors.

Tape measuring T1-2 to mastoid bone Tape cut Y strip Application Main anchor at T3-4 area. Move the head of the patient into flexion and lateral rotation Apply 15-25% tension on 1 of the tails towards mastoid, end with no tension Do the same to the other tail (rotate the head to the other side) Affect Longissimus Cervicis fascilitation

Patient position Sitting up straight Therapist position Hands on the upper back and the upper sternum Active test Patient extends his neck – brings his head backwards Visual examination The chin should be at the level of the top of the head or higher Physical examination The fascia of the sternum area should be flexible Notice pain or compensation Main muscles Scalenus Anterior (Scalenus medius, posterior, splenius capitis, splenius cervicis) Area affected Sternum line, back of the neck down to T5 along spineous erectors

Muscle Scalenus Anterior Proximal Anterior tuberosities of transverse process of C3-6 Distal Scalene Tuberlce of 1st rib Actions Unilateral: Lateral flexion Bilateral: Anterior flexion of the neck Respiratory supporting muscle

Tape From the center of the Clavicula towards the Measuring earlobe Tape Cutting Vertical cut alongside the tape into 2 equal I- Strip Taping 1st anchor will be 1cm under the centre of the clavicula while rotating the head towards the working direction, extension and side extension Taping along the muscle, 15-25% tension, 2nd anchor will be around C3-6 Effect Inhibition

Patient position Sitting up, the arm is raised to 90 degrees, elbow flexed Therapist position On arm supporting the scapula, the other hand holding the patient’s arm Active test take the patient’s arm backward and external- rotate the elbow Physical examination Arm should be at least 45 degrees backward, and 45 degrees external rotation Notice The therapist’s other hand prevents torso rotation Main muscles Biceps Brachii, Pectoralis, Deltoid, Rotator Cuffs, Teres, Tripceps, Brachioradialis Secondary – all arm, hand and palm muscles Area affected Back of the hands, back to the waist. Palmar part of hands, chest, sternum, ribs

Muscle Pectoralis Major Proximal Medial half of Clavicle, uppoer surface of 6-7 rib, lateral half of frontal Sternum, 1st-6th rib cartilage Distal Crest of greater tubercle of Humerus adjacent to Bicipital Groove Actions Adduction and internal rotation of the Humerus. The Clavicular head affects the Deltoid movement in the Humerus adduction The part that is connected to the sternum execute the medial rotation and the arm adduction

Tape From the Acromion until the centre of the Measuring Sternum Tape Cutting Y Cut Taping 1st Anchor on the Acromion lateral part while the patient hand in neutral position. Patient arm in 90 degrees (Also the elbow), Taping the upper tail parallel to the Clavicular lower border, 15-25% tension. Patient arm in 130 degrees, Taping the lower tail with 15-25% tension towards the 6th rib Effect Inhibition

ALL RIGHTS RESERVED © AMIR SHEFFER Agonist / Antagonist Every movement is affected by agonist muscles (doing the action) and antagonist muscles (controlling and balancing). In order to improve a movement, we need to determine whether we should strengthen the agonist, or relax the antagonist. In some cases, we have to do both “First relax the tight, then strengthen the weak” – Tom Myers (Anatomy Trains) True for most cases

Muscle Rhomboid Major Proximal Spinous Process of T2-5 Distal Vertebral border of Scapula below spine all the way to the inferior angle Actions Aadduction, Scapular lifting and medial rotation. Stabilizing muscle that works together with the Latissimus Dorsi

Tape From the spine towards the centre of the Measuring Scapula Tape Cutting X cut Taping Anchor with 2 tails without tension at T2-5. Patients arm in Adduction. Taping towards the Scapula under the spine, 15-35% tension Effect Psilitation

Patient position Laying on the back, straight legs and arms Therapist position Passive test – holds the patient’s back of the head and moves him to a sitting position Active test Patient sits up without using the hands Visual examination Movement should be smooth Notice If movement is not smooth (stuck), patient can’t sit up, compensations Main muscles Sacrospinalis, rectos abdominis, quadratus lumborum, iliocostalis lumborum, Psoas Major, Latissimus Dorsi Area affected Front – trapezius, chest, abdomen, groin, front thigh Back – trapezius, back to the pelvis

ALL RIGHTS RESERVED © AMIR SHEFFER Trunk Flexion Taping alternatives 2 main muscles groups affect the movement – the back muscles (iliocostalis lumborom) restrain the movement if tight; and the abdomen muscles (if weak) Most people have both groups involved After the active test, it’s recommended to test the abdomen muscles strength and then determine which group should be taped first

Muscle Rectus Abdominis Proximal Pubic crest and Symphysis Distal Costal cartilages of 5-7 ribs, Xyphoid Actions Anterior flexion of the spine vertebrae and the pelvis

Tape Measuring From the muscle lower border until the ribcage Tape Cutting 2 I strips Taping Main anchor under the muscle lower border. Patient will inhale to the belly in order to stretch the muscle. Taping with 15-35% tension towards the ribcage 2nd Anchor in the ribcage without tension Effect Psilitation

Patient position Laying on the back, ankle on opposite knee, relaxed hip rotation Therapist position In passive test – holds the opposite iliac crest and presses the knee downwards Active test The patient lets his knee and hip relax Visual examination Comparing sides Notice Range of motion + pelvis compensation Main muscles Gluteus Medius, Iliacus, sartorios, Hip adductios, Gluteus Maximus, TFL, Piriformis Area affected Pelvis / groin to below the knee (front, medial and lateral) Posterior view – lower back, pelvis, buttocks

Muscle Gluteus Medius Proximal Dorsal section, external surface Ilium between crest and posterior / anterior gluteal line, gluteal aponeurosis Distal Oblique ridge / lateral surface of Femoral Greater Trochanter Actions Thigh abduction. Critical muscle for walking

Tape Measuring From the Psis until the Greater Trochanter Tape Cutting I stip x2 Taping Tape 1: Patient lies on the side, legs straight. Main anchor above the Iliac Crest, 15-35% tension a bit after the Trochanter Tape 2: Patient leg in 90 degrees. Main anchor lateral to the Psis, 15-35% tension until the Trochanter Effect Psilitation

Patient position Laying on the back, hands and legs straight Passive test Therapist gently raises the patient’s STRAIGHT leg Notice Differences between the legs – which one is heavier / restraining? Is there any pain? Main muscles Gastrocnemius, Quadriceps, Rectus Femoris, Vastus, Hamstrings, Tibialis Anterior, solous, popliteus Secondary effect on all shin muscles, knee, and foot Area affected “trousers” – front and posterior Medial / lateral – mainly on the front half

Muscle Quadriceps Femoris Proximal - Rectus Femoris – anterior Inferior Iliac spine - Vastus intermedius – upper 2/3rd of anterior shaft of Femur - Vastus Medialis – distal half of intertrochanteric Line. - Vastus Lateralis – upper half of Linea Aspera. Distal Tibial Tuberosity via Patellar Ligament Actions Flexion of the thigh Extension of the knee

ASIS to Tibial Tuberosity. Fold the tape Tape Measuring about 3-4 cm above the quad depression.

Create Y cut on the short end of the tape Tape Cutting Main anchor under the ASIS. Taping Stretching the patients leg – outside the bed. Taping with 15-35% tension or until the split of the Y-Strip reaches the depression of the muscle. Returning the patients leg back to the bed, flexing the knee. The tails from both side of the patella to the Tuberosity without any tension Fascillitation Effect

Tape measuring – from the gluteus fold to the popliteal area Cut Y tails of 5-10 cm on one side of the tape

Fascilitation: Main anchor at the gluteus fold Patient moves the leg straight backwards (stretch) 25-35% stretch of the tape End with no tension on the Y tails, from both sides of the popliteal fossa Inhibition – anchor above popliteal, Y tails with no tensions, stretch the tape upwards to the gluteus fold. End with no tension