In the October issue of Hands on, a weak Gluteus Medius was strapped in a facilitation method as part of the treatment of an Iliotibial Band Friction Syndrome.
As part of the examination of a patient with this syndrome, the structure which is always very tight is the Iliotibial Band. The Ober’s test may be positive although this is not often the case. On palpation the whole length of the Iliotibial Band has trigger points. It is interesting to note that if the runner straightens the arm down the leg, there is usually an accumulation of trigger points at the level of the end of the fingers.
Therefore the aim of the second part of the taping method used is to unload the lateral fascia. The following is one way to achieve this.
In order to inhibit this tight structure, the tape must be placed on the skin with tension at both ends. The centre section, which has a 30% stretch, is then put into place. The two stretched ends will therefore pull away from the centre. This in turn will stretch the fascia and inhibit the trigger points.
In order to inhibit the area, the fascia must be strapped in its lengthened position. Each end is applied in a different starting position in order to obtain the greatest fascial stretch.
A piece of 50mm Leukotape K is measured along the Iliotibial Band. The tape is then cut 20% shorter.
The method is as follows:
1.a. In side lying with the symptomatic limb on top, the hip is placed in some
extension and adduction.
b. The knee is flexed.
c. The top end of the tape (5cms) is applied with tension.
2.a. In side lying the hip is flexed
b. The knee is extended
c. The bottom end of the tape (5cms) is applied with tension
3.a. The hip now remains in flexion
b. The knee is flexed in order to take pressure off the fascia.
c. The paper is removed
4.a. The limb is then put on stretch with the hip in extension/adduction and the
knee in extension.
b. The tape is placed on the skin
The taping of the Tensor Fascia Lata is done in standing with the hip in lateral rotation and slight extension. Inhibiting tape is along the whole length of the muscle in the same manner as used for the iliotibial Band.
Please forward any queries or comments with respect to injuries, techniques or Leuko products to askleuko@bsnmedical.com for advice from the Leuko Strapping Panel, who are members of the South African Society of Physiotherapy. Selected questions will be loaded onto the BSN Medical website www.bsnmedical.co.za for reference purposes.
Refer to the Leuko Strapping Guide for basic guidelines.
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