EVIDENCE INFORMED PRACTICE


Figure 8: The left picture (A) is without tape application. The right picture (B) is with tape application, shifting fascia from a caudal to cranial direction, offloading the injured facia and decreasing myofascial tension – in rest and during movement. [Adapted from Myers (4)]


patient can bend over (stretch). Re-test pain Assess how much pain is perceived in standing position and in stretched position (VAS).


MYOFASCIAL RELEASE FOR THE HAMSTRINGS AND CONNECTED FASCIA As described above, the hamstrings are closely connected to the lumbar fascia and release is often needed here to reduce myofascial tension that is transferred to the lumbar fascia. Shifting the fascia at the intermuscular septum brings a great effect to the hamstrings and connected fascia with the same effects on the Golgi organs and interstitial receptors.


Positioning of the patient and the treatment area As described above for myofascial release of the thoracolumbar area.


Tape application


Measure and cut the length of the tape from popliteal fossa to the upper third of the thigh.


The start of the tape has to be aligned in the projection of the intermuscular septum of the hamstrings, beginning slightly caudal of the popliteal fossa. The first 5cm are used as a good anchor of the tape and


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are applied without any stretch, and the lower hand is used to do this. Now shift the skin and fascia upwards by pulling the tape upwards with the upper hand and stretch the tape 100% (Fig. 9). The lower hand reinforces the upward shift by actively using the hand to shift the skin and fascia upwards.


Hold the stretch on the tape and apply it to the skin. The stretch should end at the ischial tuberal area. The rest of the tape should be applied without any stretch (Fig. 10). Now rub the tape to activate the acrylic adhesive for 5–10 seconds before the patient comes back into normal position. Apply the same technique to the other side of the hamstrings.


Check the tape application As described above for myofascial release of the thoracolumbar area.


Re-test ROM and pain


Immediately after the tape application, re-test ROM and pain levels, as described above for myofascial release of the thoracolumbar area.


Greater differences seen in ROM and pain from before to after tape application indicate higher levels of tension causing the problems, and larger effects of the tape.


Figure 10: Stretch and hold the tape, applying it to the skin ending at the ischio tuberal area.


23 TENSION AND PAIN


MYOFASCIAL TAPING CONTROLS MYOFASCIAL


Figure 9: Start the tape slightly caudal of the popliteal fossa.


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