FASCIAL TAPING

(6) prove an extremely useful treatment modality, they are temporary, with the unloaded state being the normal state of the tissue a majority of the time.

It is theorised that by applying tape using the FFT® method, a longer maintained stretch can influence both structure and function of the local fascial tissue. Whilst the method is currently undergoing a randomised controlled trial in Australia, previous real time ultrasound data demon- strates an alteration in the direction of movement of superficial AND deep fascial layers with FFT®. This alteration, in con- junction with the directional specificity, may provide an alteration in the afferent nociceptive activity of mechanoreceptors and would explain the frequent notable reductions in pain and increases in range observed.

How is it applied? Non stretch tape is normally applied in a functional position with minimal to moderate tension with a common aim of restricting a range of movement. FFT® is specifically applied following a local examination to elicit the most relieving digital pressure which allows the patient to gain further pain free range at the chosen area. This latter point is impor- tant, the reduction in pain is a primary aim of the technique and a degree of searching is necessary although common patterns seem to exist. Once this has been found, the tape is applied in a gathering technique reproducing the pain relieving direction of load. Movement is reassessed throughout and the techniques adjusted. Further applications of tape in different directions may be needed to gain maxi- mum effect, each direction of load is marked to allow easy reapplication of tape and the patient or a guardian is taught how to do this, along with appropriate warnings. Other aspects of the treatment for example manual therapy, can be applied before or after taping and rehabil- itative exercises can also be taught.

Tape can be tightened daily and it is then removed after a few days and replied to prevent skin irritation. The usual safety screening procedures common to all tradi- tional taping are equally applicable with FFT (see Box 1). If irritation is elicited the tape is removed until this has subsided and an appropriate hypoallergenic protec- tive film eg. Comfeel/Coloplast, is used.

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Figure 1: Fascial taping for low back pain

At reassessment the movement is checked and the best direction of taping elicited through functional testing, tape is then applied using the gathering technique.

In about 10% of patients an ache is reported or symptoms distal or proximal to the original may become apparent. These frequently settle within 24 hours. If not the patient is advised to loosen the tape until these symptoms settle and then to reply.

As symptoms improve the need for taping reduces with patients commonly needing taping for up to 3 weeks before discontin- uing the tape. However this may need to be longer and the key factor here is, if the area is accessible patients can self tape or a partner can be taught.

What does it work on? FFT® proves most effective with sub-acute to chronic injuries. Once the healing process has restored as much mechanical integrity to the area it is thought FFT® influences the local fascia to create its effect.

It has been used highly successfully in the management of plantar fasciiosis, anterior impingement of the ankle, Mortons neuro- mas (7), osteoarthritis of the knee, any muscle sprain, groin pain, low back pain (Figure 1), shoulder impingement, head- aches, tennis elbow and carpal tunnel syndrome (Figure 2). The tape in conjunc- tion with rehabilitative exercises have shortened return to function times signif- icantly and have frequently prevented the need for surgery.

SUMMARY Like many therapeutic interventions FFT® has been developed through clinical observation and experimentation. It has a wealth of anecdotal evidence to support its wide spread use and is currently sub- ject to a randomised controlled trial in

Figure 2: Fascial taping for carpal tunnel

low back pain patients. It provides an eas- ily applied medium in musculoskeletal injuries by which pain free range can be gained quickly allowing appropriate and effective rehabilitation to be conducted.

THE AUTHOR Ron Alexander founded the FFT® method in 1994 during his eight years as the principal soft tissue therapist for the Australian Ballet. The high performance levels and the flexibility required by the dancers provided the impetus for Ron to experiment with taping techniques. This lead to the discov- ery and development of a more functional way of applying tape to modify pain and increase range of movement allowing for rehabilitation. The Australian Ballet award- ed Ron the 'Lady Southey Scholarship for Excellence' and since this time he has gone on to expand the FFT® method.

References 1. MacDonald R. Taping Techniques, Principles and Practice. Butterworth-Heinemann 2004 ISBN 0750641509 2. Crossley K et al. Patellar taping: Is clinical success supported by scientific evidence? Manual Therapy 2000;5(3):142-150 3. Alexander CM et al. Does tape inhibit or facilitate the lower fibres of trapezius? Manual Therapy 2003;8(1):37-41 4. Byhring S and BK. Musculoskeletal injuries in the Norwegian National Ballet: a prospective cohort study. Scandinavian Journal of Medicine and Science in Sports 2002;12(6): 365-370 5. Myers T.

Anatomy Trains. Churchill

Livingstone 2001. ISBN 0443063516 6. Hunter D. Specific soft tissue mobilisation in the management of soft tissue dysfunction. Manual Therapy 1998;3(1):2-11 7. Spina R et al. The effect of Functional Fascial Taping on Morton’s Neuroma. The Australasian Chiropactic and Osteopathic Journal 2002;10:1

Ron Alexander is visiting the UK later this year to run a series of FFT courses. Please see the end of the case study for dates.

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