Welcome colleagues,
Welcome to this first ETT Skin Approach to Taping Newsletter. This will be my new way of communicating and sharing knowledge. In these newsletters I will endeavour to post interesting news about tape research, relevant research from connecting fields, posts about brands and skincare, innovative taping ideas colleagues have demonstrated, and possibly repeat interesting practical ideas not all of you might be familiar with. Plan is to be leaving and closing the various ETT Facebook pages and groups in the near future.
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For those of you who are not aware, or do not know of the differences, this concise history about the development of the Skin Approach to Taping method.
History ETT Skin Approach.
I came into contact with Elastic Therapeutic Tape when I followed a Medical Taping Course in 2008. The MTC basic course was 2 days and considered to contain sufficient information to be able to start using in the clinic. However, I did find it to be very basic, with a lot of practice of applying tapes but with very little theory. The ‘statements’ made lacked any theoretical backing in my opinion. What I had learnt was definitely not really suited for treating children. I was persuaded to develop a course more suited for children myself. This became the MTC-Paediatric course.
The many changes
Due to the continuous increase in knowledge, the course changed, course readers became thicker, and it was advised that I should write a book. Many students actually received my book as their reader once it was published. This book, published in Dutch, Spanish and English in 2011-12 is no longer available. Too many things are no longer relevant, and I can no longer stand behind everything I wrote at the time. Meeting prof. Fukui and seeing his work at the WCPT conference in 2011 marked the beginning of my further development. Meeting colleague Fukui who had studied skin movement was game changing. Diane Jacobs and I had already been in discussion on the soma-simple forum online, and her work was also of the greatest importance to the development of the Skin Approach. Finally dr. J-C Guimberteau's work, his videos, and later his book, helped show us all what the human body really looks like in vivo. It helped me understand how the tape would influence the body.
For those who do not know dr. J-C Guimberteau's work, this link sends you to his video called Strolling under the Skin on YouTube. This video has become mandatory viewing for all those who have have taken part in ETT courses for many years now.
For those who are not familiar with Diane Jacobs or her method, her book called DermoNeuroModulating can be found in this link. Her book is a must have for every clinic.
Professor Fukui developed the Skin Taping method, a method based on his research of the physiological movement direction of skin. His book is highly recommended and a must have for everyone using elastic tape therapeutically.
At a certain point I did notice many differences in ideas and practices of many colleagues. It was becoming a true Babylonian Confusion. If I told someone, for example, that I could apply the ligament technique anywhere on the body, I would be told that this is definitely not correct. When looking closely, it seemed that there were 5 Models of thought, 5 hypotheses behind the various taping methods. The paper describing these Models can be found here.
Literature Discussed
Alarming mistakes were made in these two studies referenced here below. The journals referencing these studies, did not seem to notice that anything was wrong. Dear Kostas, I did check all the references in the journals referencing them, and I found no critical notes, just the mention of these studies.
Proprioceptive Neuromuscular Facilitation Kinesio Taping Improves Range of Motion of Ankle Dorsiflexion and Balance Ability in Chronic Stroke Patients. This is an interesting study to follow up. The effects of thinking PNF and applying tape in that manner is innovative. I would not be surprised if the use of mini- or medi tapes (more like the ones described in the study mentioned here below) would have had the same results. Is anyone interested in copying this research comparing PNF-tape to either medi-or mini-tapes? https://www.mdpi.com/2227-9032/9/11/1426
Effects of kinesio taping therapy on gait and surface electromyography in stroke patients with hemiplegia. What I love about this following study is the use of less tape; no more taping from origin to insertion. We know it is not (always) needed to achieve good results. It is all about the skin's direction of movement in conjunction with the direction of the tape application. It is about understanding the function of skin folds, knowing where the skin is adhered to deeper layers and understanding how skin moves. The mini-tapes are often 1/3 of the muscle length. You could call the ones used in this study medi-tapes as they are approx. 1/2 of the muscle length. Great to see this finally happening in research. https://www.ncbi.nlm.nih.gov/.../pdf/fphys-13-1040278.pdf
Research Suggestions
- What I suggest doing in the cases described above?
- On another topic altogether: I have found in the clinic, that using tape to influence muscle growth, is possible, but is it easy to research? Why not use the outcome of this study and translate it to the clinic? Anyone have a 3D-US to do such research?
Q & A's
Q. Why do you speak about stretching the skin and not about stretching the muscle before applying the muscle technique?
A. Dr. Guimberteau's work has shown us that epidermal cells change shape under stretch and that they come back to their original shape after the stretch is removed. Fukui, showed us that skin moves in certain physiological directions and does not always move in the same direction as the underlying muscle. As mechanoreceptors are found in the epidermal layer, the reasoning is that: A. applying tape (with or without stretch) to stretched skin holds the skin in place, when the skin stretch is removed. The brain must be receiving many signals, that 'something is happening down there', sending a message that the brain needs to pay attention. B. We know that muscles work together to create movement (a function). The direction of the skin during this movement/function, is what we need to take into account when we apply tape. We can apply a muscle technique to the epidermal skin layer covering any part of the body. If our goal is for the tape recoil to give the body a 'stimulus of direction', we will need to know Fukui's Skin Rules and stretch the tape very slightly (10% = "taking up the slack") as well. This was certainly the case for the medi-tape to address dorsiflexion of the ankle in the studies suggested above. The width of the tape might need trimming depending on the reactions you see after applying.
Tape Brands discussed
To my knowledge, the only brand selling 5 different skin coloured tapes is K-Tape. More information can be found online. https://www.k-tape.com/english/k-tape-my-skin.html
Thank you for reading all the way to the end. :) Hoping this Newsletter will entice you to stay onboard and want to learn more. Questions are always welcome. Esther de Ru
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