The Tale of the Tape.

SUBJECTIVE

Many of you know that I was, “back in the old days”, the manager and trainer for Benton football and basketball during junior high and high school. I even did it for a while at Ouachita Baptist. I had a client a few years ago who had gone to Benton schools with me with that told a colleague of mine, “Adam's been doing this since 7^th grade”. I laughed but thought that wasn't entirely inaccurate. I got into being the manager partially because I had asthma, partially because I wasn't the most athletic guy around, and partially because I wanted to continue being around my friends while they participated in sports even though I didn't. I learned to fix helmets, I learned to keep the game books for the basketball games. I learned to re-engineer things that were meant to do one thing and make them do another. I learned to “line” a football field. I learned to work with others. I learned about tape.

OBJECTIVE

Many people think that taping ankles is a large part of athletic training and sports medicine. It's a visible thing but very small in the grand scheme. However, tape was where I began to learn about sports medicine. I considered athletic training but early in college changed my mind towards being a physical therapist and taking care of sports injuries that way. I like air conditioning way too much to spend each summer at 2-a-days.

As I said, taping ankles began my interest in sports medicine. The basic principle was this: ankles are skinny with little muscle around them. They are prone to being injured –especially if you have previously sprained an ankle. So, you take a plane white roll of 2 inch wide cotton fiber tape and wrap the ankle in a particular pattern (basketweaves, figure-8s, heel locks) and low and behold! You've taped an ankle! Back in my geekier days when I went to “trainer camp” in high school we'd have contests for time and lack of wrinkles. Personal best: 38 seconds. The tape helped give the ankle stability during the football, basketball, or baseball game. Neat idea. It's been done for years. However research shows –even 20 years ago-- that after 30 minutes the tape has lost 50% of its effectiveness because the tape has stretched out from walking around on it, it's pulled away from the skin, it's gotten wrinkled. Essentially, it's become a sock made of tape. Weak ankles now are best supported with a lace-up ankle brace. Talk to a physical therapist or athletic trainer. They can point you towards a good lace-up ankle brace.

Regardless, tape got me interested in my profession. I was helping people. The basic principle of the taping is part of the basis of my my physical therapy career: stabilize the joint! By stabilizing the ankle, it could be kept healthy and strong and supposedly free from injury. Stabilization of the ankle, of the shoulder, of the knee, of the low back,of the wrist involves strengthening the muscles that attach to and cross that joint. We do this via several different types of exercise including propioceptive exercises that help retrain the nerves around the joint as much as the affected muscles.

ASSESSMENT

The phrase “everything old is new again” comes to mind because one of the new movements in physical therapy and sports medicine is –get this-- tape! It's called “Kinesio Tape”. This is a different kind of tape than what I used on ankles 20 years ago. This tape stretches, it bonds to the skin better, it very much has a less is more aspect to it, but doesn't support or attempt to hold the ankle or shoulder or neck or back like the white tape did. What it does instead is provides a cuing to the muscles that reminds you to hold the shoulder or neck in a certain posture. Or helps with swelling in a the knee or arm. It's kind of it's own proprioceptive exercise. If you think back to the Summer Olympics in 2008, one of the members of the US Women's Beach Volleyball team wore tape on her right shoulder while she played. This tape can do some really neat stuff. It helps very well with swelling, and plantar fasciitis, and knee pain. We've even had some neat results with low back pain and the tape. Remember how I said that the white tape had lost it's effectiveness after 30 minutes? The kinesio tape lasts 2-3 days and withstands showers and sleeping with it on your back or leg or knee. You can also teach the client how to apply it and use it themselves.

PLAN

The use of kinesio tape is a neat new front in physical therapy...and not just our sports medicine clients. It has great potential on many back clients, total knees, rotator cuff tears. But as with any physical therapy treatment: there is no single magic bullet. All conditions need some type of exercise and manual therapy. The tape is an excellent adjunct to help with the healing. Check with your local physical therapist to see if they offer kinesio tape.

APC

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A Note on the Format

SOAP Notes are the industry standard in healthcare.  The Subjective section relates to the client's perception of what's going on, essentially: what's today's subject.  The Objective section gives you the information on the client treatment including what happened on that treatment and any measurable data. Ideally it supports the subject.  The Assessment section assesses how the client's reaction to the Objective portion. The Plan is what's going to happen after the treatment or on the next encounter.

Adam P. Carson, DPT, OCS