Technique Toolbox: Twisted taping
Spiral techniques for three lower limb conditions
By Leslie Trotter
Most practitioners understand the various theoretical uses for kinesiology tape, yet the precise physiological mechanism for how kinesiology tape seems to work remains elusive.
Suffice it to say that all of us intuitively understand that rubbing a bumped elbow helps mitigate pain by stimulating the mechanoreceptors.More recent studies seem to support the idea that “tape on skin” up-regulates the proprioceptive awareness to the brain.
I like taping spirals that follow fascial lines wherever possible. They consistently give me more positive feedback from patients. Following are spiral taping techniques that can be applied to three common conditions affecting the lower limb.
This can be greatly reduced with the use of a “knee basket.” The patient “pre-stretches” their skin by sitting with their knee at 90 degrees. Especially if this is your patient’s first tape application, use almost no stretch on the tape.
1. Start high up on the lateral quad, leaving yourself a long tail of tape so you can smoothly form around the edge of the patella. (Image: Patellar Pain 1)
2. Make sure you pass directly over the patellar tendon and end well onto the lateral gastrocnemius. (Image: Patellar Pain 2)
3. The second strip of tape starts high on the vastus medialis oblique (VMO) and follows a similar course as the first strip by crossing directly above the patella, and directly over the patellar tendon to end on the belly of the medial gastrocnemius. (Image: Patellar Pain figure 3)
The beauty of this taping technique is the inclusion of the muscles above and below the knee joint (see image: Patellar Pain figure 4). Knee discomfort of many kinds is seldom the result of one muscle group. Much to the patient’s amusement, this technique results in a rather wrinkly knee when they stand up but that’s an excellent source of proprioceptive feedback for the brain about the function of
Plantar fasciitis, in particular, is tricky to treat under the best of circumstances and it’s likely to haunt your patient for several months, or longer. One of the best protocols for an immediate change in symptoms seems a bit unorthodox, but it works much better than a simple strip of tape along the sole of the foot.
Keep the foot in a neutral posture during taping while applying only the slightest amount of stretch to the tape. Subsequent taping applications can include more stretch through the arch and along the Achilles but not the
1. The first strip starts on the dorsum of the foot, comes through the medial arch and ends along the tibialis anterior. This “sling” acts as a strong proprioceptive reminder to the muscles acting on the medial arch. (Image: Heel Pain 1)
2. The second strip starts at the metatarsals, continues along the sole of the foot, over the Achilles and straight between the gastrocs. (Image: Heel Pain 2)
There’s a strong connection between pronating feet, plantar fascia irritation and Achilles hypertonicity. This protocol “connects and communicates.”
Following an ankle sprain, it’s common to experience discomfort in the peroneal group and/or gastrocnemius. This “ankle stirrup” is a great way to “connect” problematic regions through tape.
1. Measure with a single strip long enough to reach onto the calf on each side. Fold the strip in the middle and rip the release paper to expose the adhesive to start the application in the arch of the foot. (Image: Ankle Sprain 1)
2. & 3. Pull each side of the tape towards the top of the foot, crossing just above each malleoli. (Image: Ankle Sprain 2)
4. End as far up each gastrocnemius as needed based on symptoms. (Image: Ankle Sprain 3)
Overall, I find it’s more effective to be generous with the tape rather than scant.
Dr. Leslie Trotter, DC, has been practicing for 25 years, specializing in gait biomechanics and treatment of lower limb MSK injuries. She is president of Rocktape Canada (www.rocktape.ca).