In the great high school football movie, The Program, the coach asks a player down on the field… “Are you injured or are you hurt?” The player – confused, responds, “What does that mean?” Coach says “If you are hurt you can still play, if you are injured you can’t.”
This scene always resonated with me. This type of differentiation is also important for clinicians to ponder as well.
Just last week I was teaching a RockTape course. During the course a physical therapist from the group asked, “How do I tape for someone who is ACL deficient?” I responded with another question, “what is wrong with them?” She followed up by saying, “He doesn’t have an ACL!!” So, naturally I said, “No, what is wrong with him, what are the symptoms? Is there swelling, pain, instability, or an inefficient movement pattern…?”
As clinicians we often get caught up in the diagnosis. This can limit our critical thinking to some degree. Let me be clear – the diagnosis is imperative to know and understand, but it is just the beginning of quality care. In this example, we, as clinicians, cannot change the ACL condition. If that is the limiting factor, then refer the client to the best knee surgeon available. If surgery is not an option, then we must understand how we can influence the condition and make a movement diagnosis. So what’s the problem? Swelling, pain, range of motion, strength/stability, or coordination/movement pattern?
Determining these limiting factors will direct you in taping strategies.
- Swelling: Use a basket weave or “jellyfish” approach to maximize surface area coverage and move fluid.
- Pain: Use an “X” marks the spot method. A stability strip crossed by a decompression strip.
- Stability: Create a figure 8 pattern around the joint area.
- Movement Pattern: Screen the pattern (Squat, Lunge, Single Leg Stance) and then tape a fascial line corresponding to the deficit. If limb weakness or control is an issue, consider a lateral line or helical line.
Always remember that tape is a modality, a tool to help us move better. It gives us an opportunity to move better, but it is still critical to teach and develop habits or patterns of movement in your patient after applying the tape.