What’s the benefit of taping for neck pain

What’s the benefit of taping for neck pain

Taping is thought to have more of a neuro-physiological effect versus a actual mechanical effect on tissues. K-tape can benefit patients due to increased proprioception and increased postural stability. Taping can also affect blood circulation to the area by providing continuous stimulation to the skin and subcutaneous tissues.

When we have a sore area what do we do? Generally we rub it.

The tactile pressure and stimulation of the receptors in our skin make us feel better. The tape provides gentle tissue-sheering all day therefore providing a beneficial analgesic effect on the area. In addition, the tape gives us feedback to prevent painful and/or improper posturing. Tape can also be used to facilitate a muscle, inhibit a muscle or provide structural support to the joint.

Depending on the goal of the physio, k-tape will be applied with a muscle in a stretched or shortened position, and different tension is applied on the tape during application. Many areas or body parts can be treated effectively with this tape. Taping an unstable ankle can increase reaction time and help with rehabilitation and prevention of re-injury.

Taping a shoulder can help with posture correction and awareness. The tape can help facilitate or inhibit muscles as deemed necessary by the therapist. The stretchy qualities of the tape will allow full range of motion and stimulate proprioceptive rehabilitation of weak muscles.

Back pain can also be effectively treated using this taping technique. Tape can provide an analgesic effect by stimulation of receptors in the skin as well as helping the client by providing feedback when the client goes into a poor position or incorrect posture. The tape can inhibit over-reactive muscles causing us pain including levator scapulae, trapezius, paraspinal and erector spinae muscles.

Postural Neck Pain

Postural Neck Pain

Postural correction may be necessary in patients who have had a neurological dysfunction, but it may also be helpful for persons who do not have a clinical complaint. Poor posture can contribute to breathing problems, back, neck and shoulder pain, fatigue, indigestion and sleep problems.

In other instances, poor posture may be the result of pain, for which the person is trying to compensate. Physiotherapists are very concerned about the posture of their patients, as it can make a huge difference in a person’s recovery.

Correct posture allows you to keep the head in midline, bear weight, weight shift in all directions and have proper balance. You are guided in exercises and imagery that will help you keep your head, neck and spine in correct alignment.

Abnormal postures will be addressed with a number of techniques to improve posture. In some instances where muscle tone is compromised as a result of illness, such as Parkinson’s or stroke, we may use bolsters, pillows or wedges to stretch the muscles and aid in posture correction. Taping is another means of correcting posture. Taping the body in the correct postural position makes it difficult for the person to deviate.

Poor posture is usually accompanied by pain, therefore we can address this first with manual therapy, massage, or manipulation. Trigger point dry needling therapy to get rid of trigger points has been proven helpful in relieving pain and relaxing muscles. The individual is taught a series of exercises to progressively the muscles and aid in correcting posture. Most see results in fewer than 4 sessions.

​Poor ergonomics can also contribute to poor posture which in turn can contribute to some of the problems listed above. We can assist with the design of your home or office to make it more efficient and less challenging to your health. In most cases only simple adjustments may be required to help improve your posture and alleviate back pain for good.

Is Bracing Effective?

Is Bracing Effective?

Lateral epicondylitis, or tennis elbow, is one of my least favorite injuries.  It can be disabling, nagging, and sometimes even relentless!  A commonly recommended treatment involves the use of a tennis elbow strap.  There has been some support in the literature regarding these orthotics, however results in the literature have varied.

A nice new study published in a recent issue of JOSPT assessed the efficacy of these devices in a group of 52 subjects with lateral epicondylitis.  The study examined the amount of pain-free grip strength and maximum grip strength is subjects with a variety of tennis elbow straps, including a placebo strap.

How Do Tennis Elbow Straps Work?

The theory behind counter-force bracing is similar to the mechanics of a guitar.  When a finger is placed on a string along the neck of the guitar, it reduces tension on the string distal to the fret where your fingers are located.  A counter-force tennis elbow strap can be thought of as your fingers on the neck of the guitar (your forearm) and the extensor muscles, especially the extensor carpi radialis brevis, would be the guitar string, thus reducing tension of the muscles as they attach to the lateral epicondyle.  The authors of the study review this concept well.

Counter-force Bracing is Effective

Results indicate that strapping was effective in allowing subjects to produce significantly more pain-free force.  Subjects were able to produce 16% more strength without pain using a strap.  There was no difference between two of the devices they used (a strap vs. a sleeve with a built in strap), indicating the strap itself is likely the significant factor.  The image below on the left is just the strap and the image on the right is the sleeve with a built in strap:

One of my original concerns with the study involved the rest time between repetitions of grip strength.  As anyone that routinely assesses grip strength knows, the amount of force produced can drop significantly if the rest time between repetitions is not adequate.  However, the study design used a mean of 4 repetitions for each device and allowed 5 minutes of rest between testing sessions.  This was adequate for me and I was happy to see this methodology.

Clinical Implications

  • I like this study because bracing is simple, cheap, and effective.
  • Counter-force tennis elbow straps are effective at allowing patients with lateral epicondylitis to produce more grip strength with less pain.
  • The strap should be placed around 2.5 cm distal to the lateral epicondyle.
  • While it is unclear if the size of the strap is important, the study used straps that were between 5-8cm in width.  Considering there is some conflicting results in the literature, I would recommend you try to replicate the width of the strap.  There are some straps on the market that are very skinny.
  • Straps can be an effective way to allow people with lateral epicondyltis to return to athletics or weight lifting when painful gripping can severely limit activities.
Elbow Bursitis- What is it and What can i do about it?

Elbow Bursitis- What is it and What can i do about it?

The elbow contains a large, curved, pointy bone at the back called the olecranon, which is covered by the olecranon bursa, a small fluid-filled sac that allows smooth movement between the bone and overlying skin. Inflammation of this bursa leads to a condition called olecranon bursitis.

The causes of elbow bursitis may include trauma or a hard blow, excessive leaning on the elbow, infection through puncture wounds or insect bites, or conditions such as gout and rheumatoid arthritis. People in certain occupations such as plumbing or air conditioning technicians which involve a lot of crawling on the elbows are highly prone to this condition.

Swelling is your first symptom of elbow bursitis. As more and more liquid fills into the bursa, the swelling increases and can cause pain. This pain is generally mild, but can increase with direct pressure or bending of the elbow. If the bursa gets infected, your skin can become warm and red, and may spread to other parts of the arm or even the blood stream if not treated immediately.

Elbow bursitis can be diagnosed by reviewing your medical history and undergoing a thorough physical examination. Your doctor may also order an X-ray and biopsy of the bursa fluid to test for infection.

If bursitis is caused due to an infection, your doctor may recommend removal of fluid from the bursa with a needle and prescribe antibiotics. Elbow bursitis not caused from infections, can be treated with an elbow pad to cushion your elbows, avoiding activities that place direct pressure on the swollen elbow, taking anti-inflammatory medications to reduce swelling, or injection of corticosteroid medication directly into the bursa to relieve pain and swelling. When these methods do not help, the bursa is surgically removed.

Protection of your elbow from excessive friction may prevent bursitis, or an elbow pad can be used when you need to lean on your elbow while working

Golfers Elbow

Golfers Elbow

Eccentric training of the wrist extensors has been shown to be effective in treating chronic medial epicondylalgia. A study conducted by Tyler and others in 2014 studied the efficacy of adding eccentric exercise to standard physiotherapy consisting of ultrasound, cross-frictional massage and self-stretching, heat and ice.

The specific isolated eccentric wrist flexor strengthening exercise performed by the patients involved twisting a rubber bar (Flexbar, Hygenic Corportation, Akron OH) with concentric wrist flexion of the non-involved arm and releasing the twist by eccentrically contracting the wrist flexors of the involved arm. This was performed 3×15 twice daily. Changes in symptoms were assessed using the DASH questionnaire. (Disability of the Arm, Shoulder and Hand).

Symptoms related to  chronic medial epicondylalgia were markedly improved with the addition of an eccentric wrist flexor exercise to standard physical therapy

This novel exercise is an easy way to utilise eccentric training in the treatment of chronic medial epicondylalgia.

What’s the Latest with Tennis Elbow Strengthening?

What’s the Latest with Tennis Elbow Strengthening?

Load Management


Load management and activity modification are vital in the rehabilitation of tennis elbow. From the elite athlete to the weekend warrior this can often feel like the end of the world. This can be achieved by reducing the aggravating activities within possible occupational and recreational limits. Through use of appropriate education and communication the athlete can be


Tendon disorders have been closely studied in Australian physiotherapy circles. Researchers have found the following exercise protocol to be the most effective avenue to successfully recover from tendon issues.


  • Muscle contraction whereby the targeted muscle does not move
  • 5 repetitions of 45 seconds, 2-3 times per day


  • Muscle contraction where the targeted muscle and limb is taken through its range of motion
  • 3-4 sets at a load of 15RM (repetitions max) – progressing to a load of 6RM, every second day
  • Initiation of high velocity (e.g plyometrics) movements in preparation for the return to sport phase.
  • Volume and intensity are progressed gradually using exercise to replicate the demands of the sport. E.g double leg boundsàsingle legs hopsà
  • This marks the return to play phase. Training drills and match simulation are undertaken to prepare the athlete for return to play. The athlete must be able to perform all competition drills in order to successfully return to play.
What Is Tennis Elbow?

What Is Tennis Elbow?

What is it?

Tennis Elbow, also known as lateral epicondylitis is an overuse injury of the forearm and the wrist extensors tendons, primarily the extensor carpi radialis brevis and common extensor tendon typically presents as progressive pain over the lateral aspect of the elbow.

It is primarily due to repetitive strain from tasks and activities that involve loaded and repeated gripping and/or wrist extension. It historically occurs in tennis players but can result from any sports that require repetitive wrist extension, radial deviation, and/or forearm supination. Relating to occupational and athletic population tennis elbow is often precipitated by poor mechanics, technique or improper equipment.


Patients will typically report:

  • Pain over the lateral elbow. It can typically occur 1-3 days after performing unaccustomed activity involving repetitive wrist movements
  • Decreased ability to perform tasks that involve gripping, forearm rotation or wrist movements due to pain
  • Pain when touching the lateral aspect of the elbow

Latest research indicates the following for optimal recovery:

  • Relative rest from aggravating activity as guided by the level of pain.
  • Ice (particularly after activity)
  • Ultrasound
  • Dry Needling
  • A graded exercise program initially focusing on isometric muscle strength
  • Bracing and/or taping

It is important to know that any tendon condition may take 12 to 24 months to completely resolve. Persistence and adherence to the recovery plan is vital for optimal rehabilitation and successful return to activity.

Rehabilitation  of Peroneal Tendinopathy

Rehabilitation of Peroneal Tendinopathy


1) Strengthening

As soon as it is comfortable to do so, you should start strengthening the Peroneal muscles. Strengthening helps the collagen fibres within the tendon to realign and also helps develop the strength needed for running.

Start with isometric exercises which are static contractions. An easy way of doing this is to sit on the ground with the legs out straight on the insides of a chair. Position the front two chair legs on the outsides of the feet. Push outwards with the feet, into the chair legs so there is no movement, but the muscles are contracting. Hold for 5 seconds, rest and repeat 5-10 times initially. This should only be performed if there is no pain. If it is painful, rest and try again in a few days.

The next step on is concentric strengthening which can be achieved using rehab (resistance) bands or ankle weights. With a band, tie it in a loop and place it around the  balls of the feet. Turn both feet outwards at the same time, against the bands resistance. Always do band exercises slowly and under control, especially on the way back to the starting point. Again this should be done without pain and with low reps to start with, which can be built up every couple of days. For examples, start with 12-15 reps, build to 25.

Concentric Peroneal strengthening can be achieved with ankle weights which should be wrapped around the forefoot. Lay on your side with the foot to be worked on top and turn the foot out so the toes point towards the ceiling (keep the ankles and heels together).

The final stage of strengthening is eccentric which is the hardest type of contraction for a muscle and really important when running to slow the pronation force on the foot. This is harder to do yourself, but with a partner is pretty straightforward. Sit on the floor with both legs out straight. The partner pronates (inverts) the foot so the sole of the foot faces inwards. As they do this, you try to slow them down. Don’t resist the movement completely, but just aim to control it. The stronger you get, the harder they can push! This is really hard on the muscles and tendons so definitely start with low rep (around 8-10 initially).

2) Stretching

It’s quite difficult to stretch the Peroneal muscles so personally I don’t worry about this. If you are having massage treatment then this is going to be just as, if not more effective than stretching for this injury.

I would however, recommend stretching the calf muscles daily. This is especially important if you overpronate as tight calf muscles can contribute to this and place more strain on the Peroneal tendons.

3) Correcting Causes

Whilst the tendon is resting, this is the ideal time to look at what might have caused you to develop the condition and what you can do about it to stop it coming back.

If you haven’t had a gait analysis I would highly recommend this for Peroneal injuries as they are so closely involved with foot biomechanics. This will make sure you are wearing suitable running shoes and determine if you maybe need additional insoles or orthotics. Or, if you have been running for a long time and not had your gait reassessed in a couple of years, then it is worth getting it checked again as things can change.

If you have old trainers it may be time to replace them as the support and cushioning will have worn out. 500 kms is the rule of thumb for when to change your running shoes.

If this is all ok, take a look at your running program. Were you dramatically increasing mileage? Had you changed your route or added in more hill runs etc? Running on a road with a slant (so that one side is lower) could cause these problems.

If you’re struggling to find a reason for the injury, then I would recommend consulting a running coach to get them to look at your training plans and running technique. An experienced eye may be able to spot something you have missed.

4) Return to Running

Only return to running when completely pain free on a daily basis and once you are confident you have identified and addressed any causative factors.

Start with a very short jog (10 mins e.g.) and then have 2 days rest. Provided there is no recurrence of symptoms, then try another 10 minutes followed by another 2 days rest. If still ok, start to progress your running time, by 5 minutes at a time, running 2-3 times a week and only increasing every other run. Continue with this until you are back to your normal times / distances.


What is a Peroneal Tendinopathy?

What is a Peroneal Tendinopathy?

You have currently been training for a full marathon. In preparation for you marathon in a few months time you have been increasing your training regime more rapidly. After your most recent 10km training session at a higher intensity you have started to experience a dull pain around the back and outside of your ankle. Upon presenting to your local physio and after reviewing your symptoms it appears that you have a Peroneal Tendinopathy.
So what exactly is a Peroneal Tendinopathy?
Typically it has been found that individuals which undertake repetitive activities such as runners, dancers and basketball players results in an overuse injury. Irritation occurs to the Peroneal tendons (Peroneus Longus and Brevis) as a result of repeated movements at the ankle joint over a prolonged period of time. Both your Peroneus Longus and Brevis muscles assist in moving your foot in an upward and downward direction, moving the foot outwards and assisting in stabilising and balancing the foot and ankle.
Other factors, which predispose an individual to Peroneal injuries, include improper training, increase in training load, foot footwear choices and poor foot biomechanics.
Common symptoms one may experience includes:
-Pain around the back/ outside of the ankle joint during activity
-Swelling and tenderness behind the ankle bone
-Pain when pushing off the ball of your foot
-Pain while stretching the foot in both an upwards and downwards direction
The majority of Peroneal Tendinopathies tend to heal without the need for surgery. Since Tendinopathies occur as a result of overuse rest is often the best form of treatment though will often need to be used in conjunction with other forms of conservative treatments.
Here are 5 home remedies for you to reduce pain and discomfort on your ankle

Here are 5 home remedies for you to reduce pain and discomfort on your ankle

  1. Icing       
    your ankle may respond better to an alternating hot-and-cold therapy. Use two gel packs. One should apply heat for 20 minutes. Follow it with a cold pack for 20 minutes.
    Alternatively, you can  prepare ice packs. Apply the ice pack on your swelling ankle to reduce the amount of swelling will reduce your discomfort. Ensure that the ice rests directly on the swollen area. If the cold is too intense, place a small rag between the skin and the ice pack.
  2. Herbal Remedies
    Home remedies such as coconut and garlic oil help reduce pain and swelling when they soak directly into the skin. Mix 3 table spoon of coconut and garlic oil into a container and heat in the microwave for ten seconds, slightly warming the mixture. Generously massage the oil directly onto your ankle for ten minutes, allowing the oils to soak into your skin. Cabbage contains minerals and vitamins that are useful when ingested, as well as when they’re applied externally. Gather the outer layers, or leaves, of the cabbage plant. Blanch the leaves by boiling them in water and then immediately placing the leaves into a container of ice-cold water. Once the leaves have been blanched, wrap your entire foot and ankle, and allow them to rest for 30 minutes before removing.
  3. Dieting
    Changing your diet to relieve ankle pain can be effective over a longer term. If you are heavy, you may experience poor circulation and heightened stress in the ankles and other weight-bearing joints. If you are overweight and suffer from frequent strains or bone degeneration, losing weight can permanently end your ankle pain. Adding a joint supplement to your diet, such as glucosamine or chondroitin, may also help some people by protecting the ankle joint and surrounding tissue.
  4. Exercises
    Exercise is an ongoing home treatment that will serve as pain relief and prevention. To prevent future ankle injuries, and to strengthen an ankle that is already injured, range-of-motion exercises and stretches provide the most benefit. Only stretch or exercise the ankle once the pain has subsided.Range-of-motion exercises will increase the flexibility of tendons and ligaments that have tightened during an injury. Trace the alphabet with your toes, moving the ankle as much as possible throughout. Repeat at least ten times per day to strengthen your ankle and improve your flexibility.
  5. Orthopaedics treatment
    Seek for medical support if your pain still persists after trying out the suggested remedies. It is advisable to seek for professional help if your ankle pain is giving you symptoms that can be interpreted into serious health issues.