Physio.co.uk: The need to know about posture and taping

@Physiocouk #manchesterphysio facebook.com/physiocouk

Welcome
The “need to know” about posture and taping
with Katie Emmett & Kate Hindley

3@Physiocouk #manchesterphysio facebook.com/physiocouk
Let’s connect
Website: www.physio.co.uk
Twitter: @physiocouk
Facebook: www.facebook.com/physiocouk
Katie’s LinkedIn: www.linkedin.com/katieemmett
Kate’s LinkedIn: www.linkedin.com/katehindley

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Aims of today
To learn about posture
To learn different types of posture
How k-tape works
How to apply k-tape for posture

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Itinerary
10.00 - 10.30 Arrival /Induction
10.30 – 11.15 Theory: Posture
11.15 – 12.00 Posture workshop
12.00 – 12.30 Lunch
12.30 - 13.30 Theory: Taping
13.30 - 14.00 Taping Application
14.00 - 14.15 Break
14.15 - 16.00 Case studies / Practical workshops

Theory: Posture

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Evolution of human
posture

Evolution of
human posture
• 6 million years ago: Becoming bipedal
• 6 million years ago: Leg support
• 4.1 million years ago: Strong knee
• 2.5 million years ago: Curved spine
• 1.95 million years ago: Hip support
• 1.9 million years ago: Fully bipedal
• 1.89 million years ago : Long leg

Benefits and Costs
Benefits of walking & upright posture
As environments changed, walking on two legs helped early
humans survive by:
• Making it easier to pick fruits and other food from low-lying
branches
• Freeing hands for carrying food, tools or babies
• Enabling early humans to appear larger and more intimidating
• Helping early humans cover wide, open landscapes quickly
and efficiently

Costs of walking & upright posture
Back pain and other skeletal problems are relatively common in
modern humans, an unfortunate side effect of walking upright.
Distributing all our weight on just two limbs can have painful
consequences:
• Lower back pain
• Slipped disks
• Arthritis in hips and knees
• Collapsed foot arches.
Benefits and Costs

11
What is posture?

Definition
Good posture
• Standing with the head balanced effortlessly above the spine
• Straight and vertical except for the slight natural curves in the
lower back and neck
• Slight S-shape
• Recognised as being associated with good appearance, good
health, strength, athleticism, and stamina.

Definition
Bad posture
• Commonly described position in which the head and
shoulders are placed forward of the spine
• Excessive S-shape or a C-shape
• Referred to as a slouched, or hunchback posture
• Regarded as a poor appearance, associated with backaches of
all types, poor health, poor breathing and tiredness

Life style
Occupation
Sedentary living
Technology
Why has our
posture changed?
And what does it mean for us?

Scoliosis
Sway back
Flat back
Upper crossed syndrome
Lumbar lordosis
Thoracic kyphosis
Lower cross syndrome Ideal / normal
Different types of
posture

Posture
Examples

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Sway Back

Flat Back

Upper
Crossed
Syndrome

Lower
Crossed
Syndrome

Kyphosis -
Lordosis

Scoliosis

The ideal
posture

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Posture Workshop

How can we help
your posture?
Assessments
Observation
Strength
Ax movement
Palpate

How can we help
your posture?
Treatments
Massage
Mobilisations
Passive stretching
Muscle energy techniques
Taping
Posture education
Exercise programmes/pilates

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Evidence of
posture and
treatment
Exerciseprogrammes
Pilates
Taping

Pilates
Emery et al (2009) looked at nineteen subjects (9 controls, 10
experimental) that were assessed twice, 12 weeks apart,
during which the experimental group was submitted to a
Pilates training program (two 1-h sessions per week). The
Pilates training program was effective in improving
abdominal strength and upper spine posture as well as in
stabilising core posture as shoulder flexion movements were
performed.

Pilates
Kuo, Tully and Galea (2009) found that Immediately after a
Pilates based exercise program (twice weekly for 10 weeks) for
older adults (over 60) stood with slightly decreased thoracic
flexion and sat with slight increased lumbar extension, however,
No differences were found during a follow up period.

Exercise
programmes
Lynch (2009) recruited 28 elite level collegiate swimmers with a forward head
round shoulder posture. The experimental group were given postural
exercises involving strengthening of the lower and middle fibres of trapezius
and serratus anterior and stretching of pectoralis minor and cervical
extensors. Assessments were made on postural position, shoulder pain and
function, and maximal strength of muscles around the shoulder blade.
The results revealed that the experimental group had decreased forward
head and shoulder position and reduced pain, suggesting that posture did
improve after an exercise programme.

Theory: Taping

Taping is an adjunct to our services that can offer support,
immobilisation or proprioceptive feedback depending upon
what is required for the individual
2 main types:
K-tape = elasticated tape with acrylic glue
Zinc Oxide = non stretch cotton with a zinc oxide adhesive
What is taping?

Zinc Oxide K Tape
• Mechanical method
• For functional immobilisation
• Restricts and protects range of
movement
• Aims to protect muscles and
tendons
• A sensory technique
• Offers full range of movement
• Normalises muscle function
Zinc Oxide vs K-tape

34
The Benefits
Pain relieving
Increases circulation
Decreases swelling
Increases or restricts movement
Decreases muscle tension
Improves posture
Provides support
Aids proprioception
Enhances performance
Early return to sport / activity
It looks good!

Infection
Open wounds
DVT in area
Renal problems
Heart failure
Skin irritation
Compromised sensation
Allergies to plasters
Cancer
Incorrect application may cause
or aggravate injury
Contraindications

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PLACEBO OR NOT?!

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How does K-Tape work?
The Decompression Effect
WRINKLES!

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How it works
The Fluid Effect = blood flow swelling
The Mechanical Effect = stability
The Neurological Effect =
Paingate theory
Reduced pressure on nerve endings
Reduced stretch response
Increased ‘active’ stabilisation

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Pre application
Ensure the skin is dry and clean
No hair
Wait 1-2 hours after swimming/ exercise/showering
Ensure K-tape has rounded edges and ‘anchors’ ready

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Application
For Pain Relief – stretch the muscle before applying tape. Apply tape
with no additional stretch.
For Structural Support – keep the muscle in a shortened position and
stretch the centre of the tape from 30-80%. The final 2-3″ at either end of
each strip must be applied with absolutely no stretch. Applying stretch to
the ends of the tape can quickly lead to skin irritation and abrasions.
To Reduce Swelling – lightly stretch both the muscle and the tape as the
tape is applied. As noted above, the final 2-3″ of each strip must be
applied with no additional stretch.

Should be able to move
Fine to shower
No rubbing
If any rash/irritation remove tape
After Care
Taping is not the solution – exercises must still be completed!
Remove after 3 days (Max!)

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Practical

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Neck taping

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Case Study:
Neck Pain
The office worker with forward head posture:
28 year old Natalie is an office worker. She has been
suffering with bilateral neck and upper trapezius pain for
3 months since another member of staff left the company,
leading to a heavy workload and overtime. She feels her
symptoms get worse as the working day/week goes on.
How would you tape this Natalie?

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Shoulder taping

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Case Study:
Shoulder
The builder with shoulder impingement
Bob is a 52 year old builder. Over the past 3 weeks he has
felt a gradual onset of sharp anterior shoulder pain,
especially when lifting and reaching at work. He
describes the pain as a ‘severe pinching feeling’ which
seems to be getting worse.
How would you tape Bob?

47
Lumbar spine
taping

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Case Study:
Lumbar spine
A new mum with a disc prolapse
35 year old Lisa is a new mum with an 8 week old baby. She
had some back pain during pregnancy, and then when her
baby was born she went to pick her up from her cot in a
rotated position resulting in sudden sharp lumbar and right
leg pain. She is struggling as she finds herself bending down a
lot to care for her baby.
How would you tape Lisa?

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Postural taping

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Case Study:
Neck Pain
The shop assistant with whiplash
Adam is 26 years old, and was recently involved in a car
accident. He was stationary when he was hit from behind,
leading to neck and back pain the next day. His symptoms
are slowly improving but work is aggravating his pain
when he is on his feet for long periods or stacking shelves.
How would you tape Adam?

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Evidence:
Taping and Posture

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Evidence
Evidence is conflicting however the following benefits have been found:
Improves power & strength in uninjured muscle
Reduces pain & improves function in PFJ pain and Plantar fasciitis
Improves pain, increases ROM and function for impingement
Increases muscle activity
Doesn’t decrease performance

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Cervical Spine
Gonzalez-Iglasias (2009) completed a study on patients with acute
whiplash symptoms receiving KT. The results demonstrated
statistically significant improvements in pain levels and ROM
immediately following application and 24 hours later.

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Lumbar Spine
Castro-Sanchez et al (2012) found in there study (albeit minimal
participants) that K- tape reduced disability and pain in
participants with non-specific LBP
Paoloni et al (2011) looked at 39 subjects and 3 groups: KT,
exercise, and KT and exercise. All 3 groups had a significant
reduction in pain and KT was found to help normalize lumbar
muscle function

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Shoulder
Murray (2010) found that KT can enhance scapula retraction. This was found to
significantly reduce pain, however the study was only carried out on 10 people.
Shoulder impingement:
Thelen et al (2008) concluded that KT may assist in immediate improvements
in pain free shoulder abduction (but overtime it seems to be no more effective
than sham in decreasing pain intensity or disability)
Lewis et al (2005) reported a statistically significant increased pain free
shoulder AROM with taping and increased pain free abduction

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Thanks for coming!
Don’t forget to follow us on Twitter: @physiocouk

Physio.co.uk: The need to know about posture and taping

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