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Tibial Internal Rotator Activation Taping
Tibial Internal Rotator Activation Taping is a taping technique used in order to increase the activity of the muscles that assist in proper ankle rotation and stability during movements. This technique utilizes a combination of strips of kinesiology tape, which is positioned on the inside and outside of the tibia/lower leg in order to create a supportive environment for the internal and external rotators of the tibia. This taping technique works to increase proprioception, improve muscular activation and
Transcript
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This is Brent of the Brookbush Institute at the Independent Training Spot, doing
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tibial internal rotator taping. So generally i use taping to reinforce
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activation techniques done within the session. This particular taping is the
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combination of VMO and popliteus activation tapings, to reinforce that
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tibial internal rotator activation exercise which I created a video for
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previously. Now generally the individuals who would receive this technique, or
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receive this taping at the end of their session, are those individuals who maybe
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had feet turn out, or knees bow in in their overhead squat assessment, a lot of
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those individuals come in and they have either ankle, knee, or hip pathology. This
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particular technique seems to also be very effective for those individuals who
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have knee pain, whether it's anterior knee pain, medial knee pain, or lateral
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knee pain. I think just having the tape around the knee creates a little bit of
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maybe distraction, maybe extra proprioceptive input that helps reduce
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the sensation of pain. I'm going to have my friend Jordan come out, he's going to
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help me demonstrate this technique. Now I went ahead and pre-cut my strips here,
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you're going to need a foam roll or a dowel, because both of these tapings are
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done with just a little bit of knee flexion. If you don't use a little bit of
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knee flexion, actually as soon as Jordan would go into let's say full knee
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flexion, like went down into a kneeling position, the tape would rip right off. So
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first thing we're going to start with is this VMO taping. I'm going to go ahead
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and pull his shorts up a little bit to about mid-thigh. Now for Jordan i went
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ahead and i cut a strip to about seven boxes long. Now for most individuals
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Jordan's fairly tall, i think five or six boxes will be sufficient. You guys know
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that I generally don't like to put a whole lot of tension in the tape, as I'm
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stretching the tape, or applying the tape, I would rather put the muscle in as
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short a position as possible, and allow just the return to neutral position to
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create the tension within the tape. I think that's just a little bit more consistent.
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It also doesn't allow for so much tension in the tape, that the tape pulls
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itself off. You guys can see here I've rounded my corners. I'm going to go ahead
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and take about three centimeters and rip the paper off, so that I have my anchor. The
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tricky one about the VMO taping is, number one getting somebody to hold that
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foot in, so that they have that tibial internal rotation, and then making sure
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you have the angle right. If you start like this and try to stretch the tape
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around, you're going to end up with little wrinkles in the tape. But if you
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kind of measure out where you want to go, and then apply your anchor at that angle,
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and what you guys can see I'm doing here is my anchor is right over his tibial
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tuberosity. I like to to get the tibial tuberosity in there as the insertion of
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the vastus medialis oblique. I'm going to make sure he's turned in and then I'm
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going to go ahead and use tape off tension along his VMO, and remember
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your VMO is a fairly long muscle, despite the fact that we call it the teardrop
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muscle and we only think of it being this long. The VMO goes all the way up
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into those adductor tendons. Alright make sure we give a little friction rub
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here, Heat up that adhesive. The adhesive is heat activated. Once i'm pretty sure
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that i got that nice and stuck on, i'll go ahead and pull down his shorts over
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the tape so that he doesn't catch the end, and then i'm going to have Jordan go
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ahead and turn over. Now instead of having the foam roll or bolster under
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his knee to create that little bit of knee flexion, I'm just going to have it
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underneath his ankles. Now for the popliteus taping, you're actually going
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to cut a little shorter tape. So this is about one, two, three, four, a little over
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five squares, might be a little smaller for shorter people. You're going to bring
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this foot in as far as you can, he's in a little bit of knee flexion,
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that will create the shortening. Alright and the popliteus tape I actually
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find works easier if you tear it in the middle, peel back like so, so now you take
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the tape and the paper here, and you pull it back so that you're going to lay the
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middle of the tape just over where you think the popliteus would be. So over the
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joint line, kind of with the anchors being over the medial gastroc, and right
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around the iliotibial band there. So I'm going to go ahead and put that down like
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this. I'm just going to go ahead and tape off their, paper off rather, cool. So now
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you can see this kind of goes from lateral to medial, superior to inferior,
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and what I've actually done even if we forget what muscles are actually playing
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a role in tibial internal rotation, is I've given him this little cue to keep his
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tibial from excessively externally rotating. Jordan you mind standing up on
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the table here.
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The reason i like this tape or this particular taping technique, besides
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the fact that people with knee pain generally feel really good when they put
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it on, is as soon as he went into extension, where do you feel a whole lot
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of tension, the back tape right, yeah. So he goes into full extension, he's got the
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popliteus tape pulling him into tibial internal rotation, and when he goes into
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flexion the VMO tape is pulling him into tibial internal rotation. So that's that
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constant little reminder to pull him out of, go ahead and show an excessive feet
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turn out, can you do that right. This is what we don't want to see. We don't want
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to see his feet just splay out, so even as he's walking I know he's
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demonstrating a squat now, even as he's walking he's getting that little signal
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to keep tibia in line and not excessively externally rotate. If I just
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did all of that activation work, and let's say I even did my release,
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stretching, mobilization, activation, and integration work. I now have this taping
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working for me as his therapist for a couple days hopefully, maybe even more.
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If he's very careful about not catching this tape with the edge of his
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clothing, this might even last three four or five days. That's a constant little
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reminder that's working for me as his therapist until he gets back for his
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next session, and as I mentioned before guys the carryover I've had with tape
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has been absolutely incredible. Thank you Jordan, guys I hope you have wonderful
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success with this particular technique. I think you're going to enjoy it. I think
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it's going to give you a new tool on trying to fix that feet turn out problem.
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i look forward to hearing about your outcomes.
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