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Medical MarketingFascial Movement Techniques

FMT 2019Brad Norris Director of Education - ROCKTAPE Canada

M.Ed. ( Biomechanics ), NKT, Exercise Physiologist / Kinesiologist Poliquin Strength Coach, D.Ac ( Functional Acupuncture ), FST, Soft Tissue Release

( STR / MMR )

Instructor

ROCKTAPE MOVEMENT MANIFESTO

WHAT ?

HOW ?

WHY ?

Taping Movement -Not Simply Muscle

Cotton AthleticTaping

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A point subtracted every time they used a hand, knee or other body part for support.

CAN MOVEMENT PROJECT YOUR LONGEVITY ?

Each point increase in a person's test score was linked with a 21

percent reduction in their risk of death.

THE THREE R’s A MOVEMENT CHECKLIST

Move Well First Then Move OftenThen Load Regularly

MOVEMENT is both an output and an input.

That means MOVEMENT is very powerful.

• Pain, stiffness, poor mobility are protective outputs of the nervous system in response to a ‘perceived’ threat.

• If the nervous system thinks a particular movement is threatening it can simply prevent us from making it.

• When the brain receives a danger signal from the body, it will need to ask: ‘How dangerous is this really?’ ‘How much strength can I grant?’

• The ability to fully express potential strength, power, flexibility, endurance and coordination is limited by the brains ‘perception’ of threat associated with the chosen movements.

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History of Kinesiology Taping

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2008 Sum m er O lym pics

Popularity started to grow…

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Does it really work?16

Kenzo Kase, 1980 founded Kinesio Taping Method

Kinesiology Taping can assist our bodies’ own healing mechanisms.

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3 Main Effects

Can tape appliaction alter the perception of pain

and proprioceptive representation of the

painful body part in the primary sensory cortex?

Pain MitigationTape can effectively

create a mechnaical lift on tissues to support

improved fascial and vascular mechanics.

DecompressionConnecting skin and by extension, fascia, to the

brain can prime thalamic input, enhance

perception of the affected area and

improve motor control

Neuro-Sensory

TAPE TO PERFORM PARADIGM

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Conventional Taping

• Limits ROM• Vascular Considerations• Comfort Issues• Loss of tension /effectiveness

over short period of time• Detraining effect to

muscles/joints supported• Bulky

Kinesiology Taping• Vascular Improvement• Comfortable • Allows for full functional range• Limits atrophy• Provides afferent sensory input• Enhances restoration of normal

kinetic chain function• Decreased compensatory reactions

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Largest organ of your body

THE SCIENCE OF FASCIA

• The complex is composed of connective tissue and fibroblasts as well as specialized nerve receptors.

• This once thought to be rigid tissue, is now known to have its own contractile properties and plays a much more vital role in motor control and force transmission than previously thought.

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it’s alive

fascia sensesrichest sensory organ

fascia transmits force

globally

continuousinterconnected

web

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Skin Brain Connection

Paus, Ralf., Schmelz, Martin., Biro, Tamas., Steinhoff, Martin. Frontiers in pruritus research: scratching the brain for more effective itch therapy. J Clin Invest. 2006; 116(5): 1174-1186.

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PATELLAR TAPING EFFECTS ON THE CNS

Effects of Patellar Taping on Brain Activity During Knee Joint Proprioception Tests Using functional Magnetic Resonance Imaging

Michael J.Callaghan, Shane McKie, Paul Richardson, Jacqueline A.Oldham

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research shows that kinesthetic guidance can be translated into behavior 30 times faster than visual guidance can and many thousands of times fasterthan audio guidance.

(Birdwhistell, 1971)

NEUROPLASTICITY

TAPING A THUNDER JACKET

REDUCING THE THREAT WITH A ROCKTAPE HUG

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Sensory Input for Motor Output

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500 nerve cells per 1 sq.cm of skin

WRINKLES / CONVULSIONS

• Wrinkles in tape provide sensory - reflex recoil driving changes at a neurological level

• This causes regions of decompression and pressure variations

• Demo on T-Shirt

MECHANORECEPTOR EFFECT –A NEUROSENSORY MODEL

Dermoneuromodulation ( DNM ) - Diane Jacobs PT

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Perry N ickelston - Stop Chasing Pain

Pain is a request for change.

A conscious correlate of the implicit perception that tissue is in danger.

Lorim er M oseley .

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Pain Gate Theory of Pain

Melzack, Ronald, and Patrick D. Wall. "Pain mechanisms: a new theory."

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Nociception Affects Motor Output

A Review on Sensory-motor Interaction With Focuson Clinical Implications

Jo Nijs, PT, MPT, PhD,*w z Liesbeth Daenen, PT, MSc,*w yPatrick Cras, MD, PhD,yJ Filip Struyf, PT, MSc,*w Nathalie Roussel, PT, MPT, PhD,w y

and Rob A.B. Oostendorp, PT, MPT, PhDz

Objectives: Research has provided us with an increased under-standing of nociception-motor interaction. Nociception-motor inter-action is most often processed without conscious thoughts. Hence,in many cases neither patients nor clinicians are aware of theinteraction. It is aimed at reviewing the scientific literature onnociception-motor interaction, with emphasis on clinical implications.

Methods: Narrative review.

Results: Chronic nociceptive stimuli result in cortical relay of themotor output in humans, and a reduced activity of the painfulmuscle. Nociception-induced motor inhibition might prevent effectivemotor retraining. In addition, the sympathetic nervous systemresponds to chronic nociception with enhanced sympathetic activa-tion. Not only motor and sympathetic output pathways are affectedby nociceptive input, afferent pathways (proprioception, somatosen-sory processing) are influenced by tonic muscle nociception as well.

Discussion: The clinical consequence of the shift in thinking is tostop trying to restore normal motor control in case of chronicnociception. Activation of central nociceptive inhibitory mechan-isms, by decreasing nociceptive input, might address nociception-motor interactions.

Key Words: nociception, pain, musculoskeletal disorders, centralsensitization, motor control, movement

(Clin J Pain 2012;28:175–181)

Imagine walking with bare feet in your living room.Suddenly, you step on a tack with your left foot, and

immediately change your walking movement by pullingaway one leg (ie, you flex the left foot, knee, and hip joint).This is an example of an involuntary innate response to the

integration of sensory information at the subconsciouslevel. Nociceptors in the foot send signals to the spinal cord,where the signals diverge, activating multiple excitatoryinterneurons, which in turn excite a and g motor neuronsand subsequent contraction of the flexor muscles of thestimulated limb.1 Simultaneously, other interneurons exciteinhibitory interneurons that relax the extensor muscles, andthe crossed extensor reflex helps maintaining balance when1 foot is lifted from the ground.1,2

The flexor reflex is a simple example of nociception-motor interaction: nociception triggers a motor responsecharacterized by stimulation of certain muscles and inhibi-tion of others. However, the interaction between nociceptionand motor output is far more complex. Especially in cases ofchronic nociception (defined as chronic activation of non-adapting polymodal nociceptors), central nervous systemadaptations arise and motor output is affected in many ways.Clinicians observe daily the large effect of chronic nocicep-tion on motor function. Patients with subacute and chronicbenign pain in musculoskeletal disorders present changes inmovement performance and motor control strategies.3,4

Neurophysiological research has provided us with anincreased understanding of nociception-motor interaction.Nociception-motor interaction is most often processedunconsciously. Hence, in many cases neither patients norclinicians are aware of the interaction. Yet, nociception-motor interaction may prevent normal movement coordi-nation in the presence of chronic nociception.

This study aimed at reviewing our current under-standing of nociception-motor interaction, and at explain-ing to clinicians the potential clinical implications of thesecomplex processes. First, the target populations are defined.Next, the neurophysiology of nociception-motor inter-action is explained, including the way ongoing nociceptionaffects motor and proprioceptive pathways. The role of thesympathetic nervous system in mediating nociception-motor interaction is explained. These mechanisms aretranslated to clinical practice by explaining how they mayaffect the outcome of motor retraining programs. Finally,priorities for further research in this area are highlighted.

TARGET POPULATIONSNociception-motor interaction is of relevance to clin-

icians working with a variety of patients with subacute andchronic musculoskeletal pain. These include patients withlow back pain,3 (chronic) whiplash-associated disorders,4,5

insidious onset neck pain, osteoarthritis, complex regionalpain syndrome,6 chronic widespread pain,7 fibromyalgia,8

Clin J Pain ! Volume 28, Number 2, February 2012 www.clinicalpain.com | 175

Copyright r 2012 by Lippincott Williams & Wilkins

Received for publication May 31, 2010; revised November 22, 2010;accepted May 24, 2011.

From the *Department of Human Physiology, Faculty of PhysicalEducation & Physiotherapy, Vrije Universiteit Brussel; wDivision ofMusculoskeletal Physiotherapy, Department of Health CareSciences, Artesis University College Antwerp; zDepartment ofPhysical Medicine and Physiotherapy, University Hospital Brussels;yDepartment of Neurology, Faculty of Medicine, University ofAntwerp; JDepartment of Neurology, University HospitalAntwerp, Belgium; and zResearch Centre of Allied Health Sciences,Scientific Institute for Quality of Healthcare, Radboud UniversityNijmegen Medical Centre, The Netherlands.

The authors declare no conflict of interest.Reprints: Jo Nijs, PT, MPT, PhD, Artesis University College Antwerp,

Van Aertselaerstraat 31, B-2170 Merksem, Belgium (e-mail: Jo.Nijs@vub.ac.be).

REVIEW ARTICLE

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- Gray Cook

Pain changes movement in unpredictable ways.

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PAIN AFFECTS MOVEMENT

“ Patterns involving pain should be treated with manual therapy techniques.

Exercise in that pattern should not be used until the patterns is pain free “

Gray Cook, PT

THE DECOMPRESSION EFFECT HOW DOES KINESIOLOGY TAPE WORK ?

BenefitDecreased Swelling / Improved Fluid Dynamics / Improved

Fascial Mechanics

DECOMPRESSION EFFECT Joint Centration – Optimizing Joint Mechanics

Reminder of optimal congruent position of a joint

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Benefit - Improved recovery rates with

removal of exercise by-products

THE PERFORMANCE RECOVERY EFFECT

RESEARCH REVIEW

RESEARCH

The ROCKTAPE Difference

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Why ROCKTAPE is Different?

• 180% Stretch • Highest quality materials• Longer lasting unique adhesive• Tighter weave• Rainbow of colors / designs• Less expensive• Personalised/ branded tape• Various sizes (10cm, 5cm, 2.5cm, Clinical)• Power Taping method

• If we teach you a technique your learn a technique – if we teach you a concept / philosophy, you learn a thousand techniques

• We believe there is no ‘right way’ to tape for any given problem

• Like every good therapy, taping sometimes takes a little experimentation and customisation to get the best result

24hr / day up to 5 days

• Stickier • Greater Stretch • Greater Recoil

STRETCHIERMORE STRETCH

Get comfortable with the tape

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The smallest dose that will produce a desired outcome.

Minimally Effective Dose

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In some cases, mild/moderate skin reactions can occur. These include redness, itchiness, hives or swelling. Immediately remove the tape if you feel any skin reaction above and consult your physician if symptoms are severe or do not improve in 2 days.

Do not Tape• Open Wounds• Skin Lesions• Rashes• Clients Unable to

Communicate• Decreased sensation -

Neuropathies• Adhesive Allergies• Over Active Cancer Site• Kidney/Heart Congestion• Front of the neck

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Caution• History - past skin irritation• Test Patch - no tape

experience• Medication - blood thinners• Female hormone cycle• Skin Type - fair skin• Extreme heat - car seat

heater, hot hot showers

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Too Much Stretch

Blister / TractionNon Uniform

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Skin Prep Basics

• Clean Skin (skin free of oils/lotions)

• Alcohol wipes • Apply on light body hair or

trimmed hair

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Application Basics• Stretch the body area if you

can• Round the Corners• Avoid Handling Glue as

much as possible• Do not stretch ends of tape• Minimal Stretch on center of

tape (already has 15-20%)• Apply 2 hours before activity• No wrinkles in the tape• End Tape on Skin• Rub in adhesive

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Round your edges

2.1.

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Tearing paper back - mid tape

1. 2.

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Tearing paper back - end of tape

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Never stretch ends of tape

#Never

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Removal Method

Credit: Rick Daigle

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Stretch the SkinStabilization StripsDecompression Strip

3 main steps

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Stretch the SkinPre-stretch is applied to the skin to engage the receptors and preload the elastic quality of the organ

1.

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Stabilization StripsStimulate skin mechanoreceptors

Mitigate pain

Improve tactile threshold/awareness

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Decompression Strip

Increases biomechanical lifting effect on skin and superficial fascia (over focal point area)

Adds to increased mechanical disruption of local receptors

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REHAB SPECIFIC TAPING (RST) / REGIONALLY SPECIFIC

WHEN TO USE RST?

• Use RST when pain on movement is most significant presenting factor.

• Great as first taping intervention for mild /moderate joint sprains, muscle tears, overuse injuries etc.

• RST will reduce pain, stiffness, tightness, weakness etc

• RST will also support joint and act as a sensorimotor aid

• RST can help as a Corrective Exercise Tool

REHAB SPECIFIC TAPING ( RST ) – REGIONAL

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REHAB SPECIFIC TAPING 1 PLANTAR FASCIITIS

Taping Instructions • Place the foot in dorsiflexion – draw tape from the lower metatarsal ridge to the heel • Second strip - With 25 % stretch, draw tape from the lateral axis of the foot through the

medial arch of the foot

• Draw foot into plantarflexion as you apply tape to the top of the foot

FUNCTIONAL ASSESSMENT 1

SINGLE LEG STANCE

Activating the distal link – tweaking the foot

REHAB SPECIFIC TAPING 2 ACHILLES – CALF

Taping Instructions • Place the foot in dorsiflexion – draw tape from the lower metatarsal ridge through the heel,

across the Achilles and into the calf molding the tape carefully as you pass each structure • Second strip - With 25 % stretch, place a decompression strip over the pain center

• Pain marks the spot !

REHAB SPECIFIC TAPING 3 TIB ANTERIOR

Taping Instructions • Place the foot in plantarflexion – draw tape from the mid metatarsal ridge through the

retinaculum following the path of the tibial border along the shin • A decompression strip can be placed along the axis or fibular head - Pain marks the spot !

REHAB SPECIFIC TAPING 4 KNEE

Taping Instructions • Place the knee in flexion – draw tape from the lower angle of the patella in a medial arc to

the lateral hip • Second strip - draw tape from the lower angle of the patella in a lateral arc to the groin

forming a “ patellar basket “ • With 25 - 50 % stretch, place a decompression strip across the lower edge of the patella

REHAB SPECIFIC TAPING 5 HAMSTRING

Taping Instructions • Place the hip in extension – draw tape from the lower border of the glute across the pain

center to the medial / lateral border “ Xing “ over the pain center • Second strip - With 25 % stretch, place a decompression strip over the pain center

• Pain marks the spot !

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REHAB SPECIFIC TAPING

1.

REHAB SPECIFIC TAPING

REHAB SPECIFIC TAPING 6SHOULDER

Taping Instructions • Place the hand in back pocket – draw the tape from the deltoid tuberosity in an arc over the

anterior shoulder • Second strip - Place the hand in front pocket – draw the tape from the deltoid tuberosity in

an arc over the posterior shoulder creating “ deltoid basket “ • With 25 - 50 % stretch, place a decompression strip over the AC / cap of shoulder into the

lower border of the scapula

General Shoulder Pain 2

Taping Instructions • Draw a stabilization strip from the trap to the base of the deltoid • Draw a second stabilization strip in an arc from the anterior to posterior border /

aspect of the shoulder• With 25 - 50 % stretch, place a decompression strip across the cap of the shoulder

Step 1 Step 2 Step 3

REHAB SPECIFIC TAPING

REHAB SPECIFIC TAPINGAC Application

REHAB SPECIFIC TAPING 8UPPER BACK

Taping Instructions • Place the patient in a position of protraction / forward flexion of the head stretching the

platform – place tape bilaterally along the paraspinal axis • Second strip - With 25 % stretch, place a decompression strip ( Inside – out ) across the pain

center ( C7 ) Pain marks the spot !

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REHAB SPECIFIC TAPING 9 LOWER BACK

Taping Instructions • Place the patient in a position of forward flexion stretching the thoracolumbar platform –

place tape bilaterally along the paraspinal axis • Second strip - With 25 % stretch, place a decompression strip ( Inside – out ) across the pain

center ( C7 ) Pain marks the spot !

Lower Back 2 ( RST )

EDEMA CONTROL TAPING(ECT)

Biomechanical Lifting Effect

Convolusions -skin wrinkling effect

Contusion Care – Basket

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Edema / Inflammation Control Taping (ECT)

Jelly Fish Method

• Base over Lymph Node or Proximal to injury• Apply with 10% Stretch