RESULT OF MYOFASCIAL TENSION
MYOFASCIAL PAIN SYNDROMES ARE THE
10 = maximum pain) to measure the effectiveness of each single tape application is effective and efficient. ROM and pain are most often interdependent, but they don’t necessarily need to be present at the same time. Hence, even if someone has no pain, Myofascial Taping will increase the ROM if the myofascial tension has been higher than normal.
GENERAL PROCEDURE FOR APPLYING MYOFASCIALTAPE The procedure for applying Myofascial Tape follows a certain series of steps: 1. A preliminary test of ROM and pain levels
2. Position the patient and the treatment area 3. Tape application
4. Check the tape application 5. Re-test ROM and pain levels.
Figure 5: Position the patient and the treatment area.
When using myofascial release to treat non-specific LBP, it is useful to apply the tape to two areas: the thoracolumbar fascia/erector spinae as well as the hamstrings and associated fascia – as detailed below.
MYOFASCIAL RELEASE FOR THE THORACOLUMBAR FASCIA/ERECTOR SPINAE Preliminary test of ROM and pain Test ROM Measure how far the patient can bend over. Test pain Assess how much pain is perceived in standing position and in stretched position (VAS).
Figure 6: Tape application. The first 5cm are used to fix the tape in place and are applied with no stretch.
Position the patient and the treatment area Let the patient bend over to stretch the muscle, fascia and skin of the affected structure as far as possible (as far as it is pain free) (Fig. 5).
If the patient cannot go into the stretched position without pain in standing, bring him/her into a position where his/her lumbar fascia is fairly stretched but supported, such as sitting on a chair and stretching the lumbar fascia as much as possible.
Figure 7: Tape application. The tape is stretched and applied to the skin using the left hand to actively help move skin and fascia upwards.
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Tape application Cut an i-stripe of approximately 20– 25cm. Align the tape in the direction of the erector spinae. Start 15cm below
the painful spot (micro-injuries) or at the posterior superior iliac spine (PSIS) if no painful spot (micro-injuries) is present. The first 5cm are used for a good fixation of the tape and are applied without any stretch. The lower hand is the fixing anchor. Now shift the skin and fascia upwards by pulling the tape upwards with the upper hand and stretching the tape 100% (Fig. 6). The left hand reinforces the upward
shift by actively helping to shift the skin and fascia upwards. Hold the stretch of the tape and apply it to the skin (Fig. 7). The stretch should end some 2–3cm higher than the painful spot. The rest of the tape should be applied without any stretch. Now rub the tape to activate the acrylic adhesive for 5–10 seconds, before the patient comes back into normal position. Pay attention to the ends of the tape, not rubbing them off. Apply the same technique to the other side of the thoracolumbar fascia and erector spinae.
Check the tape application You should be able to see a distinct difference in density of the tape with less density at the part where the tape is under tension. If the tape has not been stretched enough, no myofascial release effect will be created.
Tissue mechanics and effects The fascia is now shifted upwards in a caudal to cranial direction (along the fibre direction of the superficial back line), which facilitates the stretched position, offloads the micro-injuries mechanically and stimulates the Golgi organs to reduce muscle tension neurologically. The myofascial tension in the thoracolumbar fascia and its connected tissue is reduced, resulting in is less or no nociceptive signalling in rest as well as in motion, and increased (restored) range of motion (Fig. 8). The rest of the tape should be applied without any stretch-creating wrinkles (functional fascia lift) that would cause the Pacini receptors to increase the myofascial control or amplify it, respectively.
Re-test ROM and pain
Immediately after the tape application, re-test ROM and pain levels. Re-test ROM Measure how far the
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