Re: KT for torticollis (Full Version)

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Sebastian Asselbergs -> Re: KT for torticollis (February 1, 2007 11:32:00 AM)

Drew, Drew, Drew. Having trouble reading my posts? Now it has become a challenge on whose tape suggesion is better? Oh my goodness - a p*ssing match!

Drew, check and see if you can find the sentences with a questionmark at their end - in my posts. You see? Those with "new technical knowledge" and such....try to answer some of them, since they refer to statements YOU made.

Furthermore, WHERE do you see me using the word "kinesiotaping"? (pssst: this is a question too...)


Drew, even IF a technique goes "counter" to what the course teaches - WHAT argument do YOU have that the course's technique is any better? Anything at all? Since there is no research or other evidence - except your word....

And Drew - I have NEVER had a patient complain (6 month old or 87 year old) about the removal of the tape - NEVER. The Ultrafix (the base-tape I use) under the Leuko-tape does a great job of adhering without hurting on removal.

And please, please! Think! WHO came up with kinesiotaping? An UNTRAINED person - because they were the first; and likely with some trial and error. Now you imply that that was a unique event and no-one else can come up with it without a course....My goodness....

Don't you see that you are just working very hard here to justify your course fees?



Andrew M. Ball PT PhD -> Re: KT for torticollis (February 1, 2007 12:14:00 PM)

Sebastian,

I politely ignored your questions because I didn't want to point out the obvious and make you look foolish. If you insist, however, so be it . . .

You'd use Leukotape over Ultrafix on an infant's neck?!?!? Forget that it's not possible to tape in an inhibitory fashion with those materials (although it is possible to yank and pull on the contralateral side --- or irritate an infants fragile skin --- especially with the repeated "trail and error" approach suggested earlier in this thread), suggesting that you really don't completely understand the properties of the kinesiotape versus leukotape. It's no wonder that you're holding fast to the idea that you can figure it out . . . you don't realize what you don't know.

I think about your taping suggestion of an infant with torticollis using Ultrafix and Leukotape and one word comes to mind . . .

OUCH!

I'm not all that surprised at the "yank-it-back" to neutral approach, considering that none of the clinicians, other than me (and correct me if I'm wrong), that have offered a solution have ever been pediatric clinicians in the first place. It's even what I may have thought to do before having taken a kinesiotaping course (yes, I just called myself "historically ignorant").

NEWSFLASH --- Inhibitory SCM Kinesiotaping is a heck of a lot more gentile than using Ultrafix and leukotape to yank on the contralateral side. How about we get past the Ultrafix/Leukotape suggestion being too ridiculous to consider --- and THEN we can talk about the effectiveness of gentile inhibitory SCM kinesiotaping? I'd be happy to share information about how, in my experience, more efficient outcomes (in terms of number of visits to successful outcome) when inhibitory SCM kinesiotaping was incorporated into the treatment program.

The next thought is that you've proven my point that new technical knowledge IS required and that SCM inhibition kinesiotaping is NOT self-evident to the average clinician --- but I suppose that point is self-evident to most reading the thread by now.

I am NOT a kinesiotaping instructor. I teach courses on evidence-based pediatric and adult neurorehabilitation. Kinesiotaping is not a topic covered in any of my courses. Nevertheless, I think that TexasPT would agree that exploration of a kinesiotaping course would be in her best interest should she continue to treat kids with torticollis.

Unless TexasPT would like to share some concluding thoughts, I think we're done here.

Drew



SJBird55 -> Re: KT for torticollis (February 1, 2007 4:25:00 PM)

Yeah... TexasPT... you definitely SHOULD register for a kinesiotaping course - a course that is unproven and lacking evidence. Oh, there are LOTS of testimonials... and if you go to the CSM, you'll find the vendor there ready to share all the special properties of the tape AND LOTS of testimonials. Weak research or research only funded by their very own institute is readily available too!

HeHe Drew even has his own testimonials! Good to know.

If we look at the history of McConnell taping (basically the combination of that nice soft white protective tape with a top layer of Leukotape), it is very, very interesting that studies have shown that no one needs any special training... a patella can be yanked even the wrong theoretical way and respond to the tape in a positive fashion... and doing nothing with the forces of the tape but just slapping it on will have an effect... hmmm... apparently proprioceptive information is proprioceptive information.... hmmm...

Drew, your hole gets deeper and deeper each time you post - would you like a rope? Ah, but the question is, would you trust me to help pull you out? ;)



nari -> Re: KT for torticollis (February 1, 2007 6:01:00 PM)

SJ,

Good post.

Nobody needs special courses for McConnell, as placement of the tape does not matter much....it is the tape that talks to mechanoreceptors in the skin, not its anatomical placing. It certainly does not alter the considerable forces behind the patella's tracking. Resolve pain with a strip of tape, and a few exercises seem to work well. And that is using only Ultrafix/Fixomull or whatever.

Removing tape from skin is hardly traumatic if it is done with consideration. The only real ouch comes from removal off hairy skin and babies have a shortage of that - or ought to. At least on their neck regions....

Testimonials are a sure indicator of pseudoevidence. Which everyone knows.

Nari



Sebastian Asselbergs -> Re: KT for torticollis (February 1, 2007 11:24:00 PM)

Dear Drew, you have absolutely NO IDEA what my taping is all about - have you used it?

"It's not possible"....
Have you tried it? Have you seen any evidence of it being "bad"? Have you ANY idea what kind of inhibition or fascilitation can be obtained with the (my) tape technique? And WHERE is the evidence for yours? Remember, I am NOT making claims of being better than you - you are making claims of being better than those poor un-enlightened in the Kinesiotape-magic....

And where do you see that there is "yanking on the contra-lateral side"?

I have never irritated an infant's skin - ever. You seem to have some evidence of this happening. Care to share it? Or is it too personal an experience?

Geesh, it's not just a deep hole you are digging - you seem to be intent to close it over yourself...

Oh my. I will stop - I am getting embarrassed for PTs everywhere that YOU - supposedly MORE educated in research and its dissimination - can make such a fool of yourself. Don't worry, my boy, I will not bug you any longer - on this subject....



texaspt -> Re: KT for torticollis (February 2, 2007 2:18:00 AM)

Wow, I didn't realize this question would evoke such a hot topic. :) Thanks everyone for responding. I am going to wait a couple of weeks prior to initiating any taping - mom is extremely conservative in her approach to treatment of this infant... and the baby seems to be tolerating stetching well. My main concern was her positioning while traveling in the carseat - other things such as towel rolls, pillows etc are not working in keeping her positioned at or near midline. The main problem is her carseat, which has little recline to the backrest. In any event, I am attending a taping course this Spring. Dani Trees, PT



Andrew M. Ball PT PhD -> Re: KT for torticollis (January 28, 2007 3:10:00 PM)

Please be advised that the Kinesiotaping Association makes course participants sign legal agreements to not teach their techniques outside of a continuing education course. Furthermore, only those with the CKTI designation (level three certification plus oral exam) are permitted to teach courses.

Had you taken a kinesiotaping course, you surely would have learned the technique.

Although you may be able to find information regarding the technique for use in children in a book somewhere, I STRONGLY advise against using the technique for a child with torticollis until you've been trained . . . there is a fine line between using the technique to inhibit SCM spasticity and incorrect application of the tape in a way that FACILITATES the very SCM spasticity that should be avoided.

Stick with the standard HEP protocols until you've taken the course.

Dr. Andrew M. Ball, PT, DPT, PhD
(Level 2 Kinesiotaping Certified)



bonmar -> Re: KT for torticollis (January 29, 2007 1:58:00 PM)

Drew,

Are you saying that the Kinesiotaping Assoc will not allow a PT teach a patient how to kinesiotape? I am a bit confused about that comment. Could you please elaborate.

Thanks, Bonnie



Andrew M. Ball PT PhD -> Re: KT for torticollis (January 29, 2007 11:15:00 PM)

The kinesiotaping association prohibits certified clinicians from teaching the techniques in inservice, continuing education, or online forum settings.

Drew



dfjpt -> Re: KT for torticollis (January 30, 2007 2:11:00 AM)

So, basically they want to keep their expensive tape from escaping their expensive courses/money wringing strategies?

Kinesio tape is available online to anyone - you don't have to have gone to a taping seminar (where you will be taught to use vast gobs of it) - instead, go ahead and order some. It comes with some instruction suggestions on paper! (Wherein you are again taught to waste too much tape IMO..)

Figure out how to use small strips of it here and there to relieve pain. Then go ahead and show others your own techniques if you want! The stuff works well, and c'mon, no one can kill anyone by putting tape on them. This whole secrecy tape cult thing is totally annoying.



Sebastian Asselbergs -> Re: KT for torticollis (January 30, 2007 8:04:00 AM)

The embargo on teaching is only for certified clinicians.....That is good - it opens up the market for everyone else to share (as dfjpt pointed out so correctly) their clinical tidbits.

Application of tape does NOT require "new" anatomical, physiological, neurological, biomechanical or other knowledge. All necessary knowledge for the application is already available. Someone started with this tape-use as the first one, without a teacher or course... NO-ONE is holding any trade mark on "applying" tape.

Use your judgement, logic and available knowledge to apply - no harm has ever been reported from this type of taping.....



Andrew M. Ball PT PhD -> Re: KT for torticollis (January 30, 2007 8:51:00 AM)

Again, let me re-iterate, there is a fine line between using the technique to inhibit SCM spasticity and incorrect application of the tape in a way that FACILITATES the very SCM spasticity that should be avoided.

It does not require new anatomical, physiological, neurological, or biomechanical knowledge . . . but it DOES require new technical knowledge with respect to using the taping techniques for neurofacilitory or neuroinhibitory purposes. I have NEVER seen an untrained clinician apply kinesiotaping for torticollis correctly. Not ever. Usually, it's WAY to aggressive, on the wrong side of the neck, or facilitatory (e.g. encouraging the very torticollis that we the clinician are being paid to correct). For this technique, go to a course to learn how to do it correctly, or don't use it at all.

There is a WORLD of difference between "faking it" through using a little kinesiotaping for edema control on an adult, or in a facilitatory manner or an adult . . . versus in an inhibitory manner on an infant. "No harm no foul," you say? Let's hear you use that philosophy with a parent of a child with torticollis and craniomalformation . . . or are you REALLY honest enough to disclose that you haven't been trained and have a more likely chance of making the situation worse than better with your self-taught techniques?

Please.

This thread is clearly a lot of "chest pounding" devoid of reality. No one is that reckless to "just try it" with an infant with torticollis. If you think the techniques might be valuable, take the course (they're cheap), learn the techniques. If you do it correctly, you generally use LESS tape and save money.

Drew



Sebastian Asselbergs -> Re: KT for torticollis (January 30, 2007 10:33:00 AM)

Oh please Drew - get off your high horse!

This is such pseudo-science drivel: "new technical knowledge with respect to using the taping techniques for neurofacilitory or neuroinhibitory purposes." - sounds like its straight from the course flyer!

Can you assure me that this technique has been rigorously tested for all its applications BEFORE anyone used it? How did they start - what side effects did they record? Unless there is recorded stuff like that - there is NO leg to stand on for this alarmist behaviour.

Another doozie: "I have NEVER seen an untrained clinician apply kinesiotaping for torticollis correctly. Not ever." And this means exactly what? How many did you see? How bad was the effect? What was the case?

And your statement:
"There is a WORLD of difference between ...(....)versus in an inhibitory manner on an infant."
No sh*t sherlock. And this is the "new technological knowledge"? What PT would see this ANY different than you?....Geesh.

You are so full of yourself - YOU talk about chest pounding devoid of reality.....



SJBird55 -> Re: KT for torticollis (January 31, 2007 12:33:00 AM)

I really don't know a ton about kinesiotaping, but Drew... geesh... are you telling me that if a parent thought the tape was not beneficial or the infant was responding worse that the parent wouldn't just take the tape off?

You don't have kids, do you? Well, let me tell you something that is really, really simple. If a parent believes that something is actually hurting a kid and the parent can control that issue, the parent will step in and do what parents do. So... if a little piece of tape seems to be making an infant more uncomfortable, ummm... the parent will take the tape off! Simple... don't go scaring poor TexasPT over a piece of tape. Geesh...

I've actually never read in any peer-reviewed journals that kinesiotaping is effective or harmful for anything. So, if there really isn't anything published on the effectiveness... and there isn't anything published in harm directly linked to kinesiotaping and the technique utilized... ummm, Drew, technically you are just spouting out your own opinion of the matter. Opinon is nice, but it isn't anything proven to be true.



Andrew M. Ball PT PhD -> Re: KT for torticollis (January 31, 2007 7:21:00 AM)

Kinesiotaping is too new to have any good research out on it yet, and yes, I have my opinions on the subject, but ya'll are missing the point.

If you've made up a taping technique using the kinesiotaping product then OWN IT as your own. If it works, great, but if it doesn't, don't rob the patient of a technique that might prove effective if provided by an adequately trained professional because they believe, in error, they've had it in the past. Sheesh guys, given the times ya'll have whined about a now non-compliant patient who came from a chiropractor or "shake-n-bake" physical therapist only to walk into your office months later insisting that "I've had physical therapy and I don't really know why I'm here other than I'm trying to avoid surgery," I'd expect a little less venom on the issue.

Or is it only unethical when YOU come up short?

And FYI, the inhibitory techniques for using kinesiotaping properly on an infant with torticollis ARE NOT self-evident to the average clinician. It takes more practice than you think to get it right. It's not rocket science --- once you've been shown how to do it correctly. So no, I'm not on a high-horse about this --- try again.

Go ahead and tape, but call it what it is, "some crap I just made up that I think will work" if the patient trusts you enough to run with that, more power to you, but to rob the patient of the informed information that while you've not been trained, there are others that are is, at least in my opinion, less than honest.

Drew



SJBird55 -> Re: KT for torticollis (January 31, 2007 8:50:00 AM)

Well, that's where you're missing the point, Drew. Technically, you may be considered an "adequately trained" professional, but the treatment in which you were adequately trained isn't proven. The "research" listed at the kinesiotape site was crap. Inhibitory techniques using kinesiotape are not proven to be effective (doesn't matter who applies the sticky stuff).

So, reality is... all anyone can really say is, "hey, I'd like to apply some special tape to see if a continual proprioceptive awareness through the skin provides any input to reduce the torticollis in your kid." THAT'S the only thing that is honest.

You can have an "adequately trained" person applying tape for an unproven technique OR you can have anyone appplying tape for any reason. Works out in the wash that either way, there is no guarantee that anything effective will actually result. The only probable chance of risk in taping an infant would be a potential for an allergic skin reaction.

Drew... sometimes I wonder about you. You paid to be a Level 2 taper... you made that educated, clinically responsible decision (in light of the importance of evidence based practice) based on what? One day, I think it would be fun to meet you - I just might be able to sell you dirt AND you'd be so proud of that dirt and you'd believe you got an awesome deal!!! :) This topic isn't about you, but I think jabbing at you is called for in this matter.



Andrew M. Ball PT PhD -> Re: KT for torticollis (January 31, 2007 9:43:00 AM)

Oy vay. You've lost it.

Drew



jbird007 -> Re: KT for torticollis (January 31, 2007 7:51:00 PM)

Do any PT's manipulate newborns/infants/toddlers?

JBird

btw, I pray for you Drew. sheeeeeesh



Sebastian Asselbergs -> Re: KT for torticollis (January 31, 2007 11:34:00 PM)

Drew, I can't keep going on this but this remark of yours goes to the heart of the matter:

"--- once you've been shown how to do it correctly. "

Who shows you how to do it correctly? Based on what level of real knowledge that is different than what the well-trained PT already has? Based on what priciple that is so different that only those who follow a course can do it? How did the course developer come to this knowledge?

You mention "new technical knowledge" - what does that mean? What does it entail? Where is it from?

Unless you answer these backed up with some REAL evidence - all YOU have is: "I have taken a course in taping" - no matter what level it is.


And you suggest that those who apply tape without having taken a course are "robbing the patient of the informed information" are less than honest....
Now, what "informed information" are you giving them? Since there is as you admit, no research on it....An elegant theoretical model?
What makes you think that those who apply tape without the course don't do the same thing?
Why would the "certified PT" be ANY more ethical that those who don't take the course?

You have made not-so-veiled accusations....It seems they are made to justify the money YOU spent on acouple of courses - courses WITHOUT any MORE evidence than those taping independently....



nari -> Re: KT for torticollis (February 1, 2007 7:50:00 AM)

In the meantime, texaspt is wondering: Wow, what did I do wrong with an innocent question??

Taping is no great skill and I would assume that every PT has been involved with taping, be it inhibitory or facilitatory or whatever, along the way. Why hasn't texaspt been given a simple reply?

Taping neuromodulates and works well for pain. Without any pain present, it still affects muscle tonicity. A few trials in the clinic, with a couple of strips, should be fairly quick and demonstrate at the same time how the mother can apply it; which is most important.


Nari



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