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Why KinesiologyTaping and otherPassive Modalities
are not always evil.
Thursday: 10.45 – 11.30am
Paul Coker@paul_the_physio @Rockdocuk
KINESIOLOGY TAPING AND OTHER PASSIVE INTERVENTIONS ARE NOT ALWAYS EVIL.
Paul Coker. BSc Hons Physio, MSc Manual Therapy, Rocktape Instructor, Movement Optimist, Biased Human.
DO YOU AGREE OR DISAGREE?
PASSIVE INTERVENTIONS ARE NOT ALWAYS EVIL.
WHAT IS AN ‘ACTIVE’ TREATMENT?
▸ Loosely defined as: Any treatment where is the patient is moving.
▸ Exercise of all forms.
▸ In particular exercise done with the aim of reducing pain and rehabilitating injury/dysfunction.
NOT ALL PASSIVE TREATMENTS ARE EVIL
NOT ALL PASSIVE TREATMENTS ARE EVIL
WHAT IS A ‘PASSIVE’ TREATMENT?
▸ Any treatment that is done TO the patient.
▸ Basically anything that isn’t exercise.
▸ Examples; Ultrasound, Acupuncture, Massage, Cupping, Manual therapy, Kinesiology tape, IASTM….
IS FOAM ROLLING AN ACTIVE OR PASSIVE THERAPY?
IS BLOOD FLOW RESTRICTION TRAINING AN ACTIVE OR PASSIVE THERAPY?
IS PAIN EDUCATION AN ACTIVE OR PASSIVE
THERAPY?
ACTIVE VS
PASSIVEPOORLY DEFINED TERMS……
‘FASHIONABLE’ PASSIVE TREATMENTS
▸ Kinesiology Tape: Stretchy magic tape.
▸ IASTM: Rubbing people with metal.
▸ Cupping: Sucking on skin.
▸ Floss Bands: Really tight compression.
▸ Vibration Guns: Shaking soft bits.
▸ Manual Therapy: Wiggling stuff.
▸ Acupuncture: Therapeutic stabbing.
TO BE FAIR
The essence of the debate does not seem to stem from peer reviewed academic sources. Instead it would seem that it can be traced to social media.
Roger Kerry In Touch 2019
HANDS-ON, HANDS-OFF: IS THAT EVEN A THING?
REASONS NOT TO USE▸ Ineffective, therefore should not be used.
▸ Effective, therefore should not be used.
▸ Patients body image and sense of resilience harmed.
▸ Therapist and/or modality dependency.
▸Distracting from ‘the important parts’ of treatment.
THE MOST OVER REFERENCED KINESIO TAPE PAPER OF ALL TIME?
Contrary to prior research, the existing evidence shows that KT can improve lower limb muscle strength in individuals with muscle fatigue and chronic musculoskeletal diseases. The effect sizes produced in this meta-analysis show that KT may be superior to some existing treatments for these conditions.
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TAPE WORKS. HOWEVER YOU PUT IT ON!
No tape better. All 3 tapes better than no tape
TAPE WORKS. HOWEVER YOU PUT IT ON!
PAUL INGRAM WWW.PAINSCIENCE.COM
NEVERTHELESS, STUDIES HAVE OFTEN SHOWN THAT ALL THIS TAPING SEEMS TO HAVE AT LEAST SOME BENEFITS… BUT GENERALLY MINOR, BRIEF AND INCONSISTENT, PROBABLY SOMEWHERE IN THAT
MURKY GRAY ZONE BETWEEN PLACEBO AND REAL CURE. ITS VALUE IS UNCLEAR, AND MANY NEUTRAL
EXPERTS — MOST OF THEM, REALLY — HAVE DISMISSED IT AS PLACEBO ONLY.
CHANGE MOVEMENT
NEUROSENSORY STIMULATION
Changes neural input
REDUCEPAIN
MECHANISMEFFECT
DECOMPRESSIONLifts skin and superficial
fascia
ANYTHING THAT CHANGES YOUR BRAIN’S EVALUATION OF DANGER WILL CHANGE PAIN.
Prof Lorimer Moseley
NEUROLOGICALLY SPEAKING….
THREAT BUCKET ANALOGY
Pain: An unpleasant sensory and emotional experience associated with actual or potential tissue damage
The International Association for the Study of Pain (IASP) 2017
“EVERYONE IS TREATING NEUROLOGY: MOSTLY BY MISTAKE”
Dr Eric Cobb. Z-Health Performance
INPUT. PROCESS. OUTPUT.
NEUROLOGY 101
BODY MAPS▸ Motor, Sensory, Visual, Auditory and
Vestibular.
▸ Estimates of up to 12 virtual body maps within CNS.
▸ Overlapping and Interactive.
▸ Outrageously complex!
▸ Accurate/Optimal maps require full joint ROM, muscle function, neural mechanics…… and good sensory INPUT.
BUTLER & MOLSLEY NOI GROUP
‘Modern rehabilitation will be via normalisation of sensation, motor control & congruence of these factors’
GIVEN WHAT IS UNDERSTOOD ABOUT THE COMPLEXITIES OF PAIN NEURO-TAGS AND VIRTUAL BODY MAPS. IT APPEARS EVERY PERSON IN PAIN IS AS NEUROLOGICALLY
UNIQUE AS THEIR DNA.
PERHAPS IT IS TIME TO START TREATING THEM THAT WAY.
SKINPUTS………
WHY SENSATION REALLY MATTERS.
Inputs influence outputs.
MANUAL THERAPY / MECHANICAL STIMULUS
…IS IT NOT TIME TO REINVENT MANUAL THERAPY AND EXERCISE? COULD WE SIMPLY STOP TRYING TO STUDY OR “FIX” STRUCTURAL OR PURELY IMAGINARY “THINGS”? COULD WE NOT JUST REFRAME THEM AS A WAY WE CAN INTERACT MORE WITH THE ACTUAL PATIENT/CLIENT.
Øberg et al. 2015, Olesen 2015…
GOOD TREATMENTS. BAD MODELS
MANUAL THERAPY: EXPLOITING THE ROLE OF HUMAN TOUCH
In summary, the complex and multidimensional patient-provider interaction exploits manual therapy as a specific form of human touch. In this perspective, tactile stimulation induced by physiotherapist’s hands not only meet the patient’s expectations but represents a special tool to non-verbally communicate meaningful messages to patients' brain, able to produce analgesia, regulate patient’s emotions and reorganise mental representations. We hope that this change of perspective would offer to the physiotherapy community the opportunity to better appreciate the implicit working mechanisms
Musculoskeletal Science and Practice, Tommaso G et al, 2019
REASONS TO USE▸ Pain relief. Pharma free.
▸ Improved sensory input, sensitivity and mapping.
▸ Threat reduction.
▸ Facilitate/promote movement and loading.
▸ Empower and motivate patient.
Paul CokerBSc Hons Physiotherapy.
MSc Manual Therapy.Movement Optimist.
MANUAL THERAPY and
THERAPEUTIC MOVEMENTAn introduction to helping humans
to hurt less, move better and understand more
[email protected]. @PAUL_THE_PHYSIO.
