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The MSing Link
267. Kinesiology Tape for MS: How It Works for Spasticity, Balance & Movement with Dr. Steve Capobianco
00:55:15
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- [00:00]
A
Hello thank you so much for tuning in today in this episode of the missing link i am joined by doctor steven capo bianco a chiropractor with over twenty years of experience and co founder of rock tape doctor capo bianco is a passionate educator and innovator in manual and movement therapy with advanced training including a postdoctoral diplomat in rehabilitation and and certification as a strength and conditioning specialist he's dedicated his career to helping people understand how simple tools like kinesiology tape can communicate with the nervous system to improve movement and reduce symptoms in today's episode we talk about what kinesiology tape actually is and how it works by communicating with your brain rather than just supporting supporting muscles which specific ms symptoms it can help with including spasticity balance issues and foot drop and the concept of predictive processing and why our brains sometimes create symptoms like tightness or weakness to protect us when they can't predict what's coming next.
- [01:22]
B
The big question is how does someone with ms actually improve their mobility strength energy independence the list goes on my name is doctor gretchen holley physical therapist and multiple sclerosis specialist welcome to the missing link podcast tune in as i share the top strategies and exercises to help you gain control over your life with ms using research driven insights and and advice from top industry experts whether you're newly diagnosed or have had ms for over thirty years whether you have relapsing ms or progressive ms this podcast is for you you're sure to feel empowered and inspired after each episode ready let's dive.
- [02:21]
A
Steve thank you so much for being with us.
- [02:23]
C
Today my pleasure i'm looking forward to.
- [02:25]
A
The conversation yeah i feel like there's so many so many different ways that you help people just as a person and through what you do on a day to day basis but also the products in your company so i'm super excited to dive into it before we do is it okay with you if i ask you a question from my.
- [02:42]
C
Interview deck i would love it i'm somewhat hesitant of what's going to be asked but i'll do the best i.
- [02:50]
A
Can let's go all right i'm going to shuffle not looking okay your question is it was upside down what is the nicest thing a stranger has ever done for you ah good one that's.
- [03:06]
C
A great one i like it i recently recently i mean about a year and a half probably closer to two years i had a complete reconstruction of my left shoulder i was bound to a brace for gosh i think it was two months or so i had some flights planned unfortunately and so getting on a plane where you know i generally manage myself one of the nicest things was without even you know asking you know this gentleman stood up and grabbed my bag put it up into my carry on into the cubby and just did so on his own accord so i thought that was a really cool example that people are much nicer than we give them credit for yeah.
- [03:53]
A
That is really nice because it's nice to also not have to ask for help when you so obviously need it for them to just do that yeah.
- [04:02]
C
Especially as a as a macho bigger dude where everyone thinks that person should be able to take care of themselves i was obviously needing help but they just saw it within you know seconds and applied it without any reference to you know any acknowledgement i just thought that was just a cool example of.
- [04:20]
A
Just humanity that is cool i love that what a good example i'm glad i picked that question for you awesome okay so as i mentioned i've got a ton of questions for you but before i dive into those can you share in case people don't know who you are who you are and what.
- [04:36]
C
You do yeah of course i don't expect anyone to know who i am i'm just a i guess i'm a canadian born chiropractor i've been practicing here in the us for the last twenty three years which is surprising to me and i guess where my professional journey took flight was being introduced to an individual that was refining what we now know as kinesiology tape he was an avid cyclist and an entrepreneur and he had injured his calf had a physical therapist apply some tape on his body but and it gave him some significant relief and not being a medical professional just an athlete he was really impressed but that tape fell off within minutes and him being the entrepreneur that he is decided to make that tape better and i was the only individual clinician in his area that was actually known for using this type of intervention so he approached me for some advice i tested his product i thought it was phenomenal and we ended up banding together and created the brand rock tape which is a form of kinesiology tape in two thousand nine i manage the education professional education what this tape is how it works what the science says and he managed the product development and we created a brand called rock tape which started with tape and expanded into multiple different tools that manual and movement therapists could use to help people feel and move better so that's what i'm known for i'm a chiropractor and one of the co founders of rockit that's that's.
- [06:21]
A
So awesome and i love how many different ways that you guys have to help people would you say that rock tape as well as some of your other products which i'll ask about too would you say that they're mostly designed for people with musculoskeletal injuries or you know people with ms it's more neurological and neuromuscular does it help those people as well like who is it meant for and who does it help if.
- [06:48]
C
You and this is why i love these conversations if you asked me this question and i'm not sure how long you've been in practice but being in practice twenty three years and prior to that i've been a strength and conditioning coach since i was twenty and i'm in my mid fifties my perspective has evolved which it should of course right and so if you ask me the question fifteen years ago when we started rock tape how i was using this tape was generally to manage musculoskeletal injuries my focus was as a mechanic someone's coming in with knee pain how do i use this tool and others to be able to influence their knee pain function and pain and so that's what most people think when it comes to tools like this is musculoskeletal but i love the fact that you talked about the neurological component of what we experience and and that includes musculoskeletal pain and dysfunction regardless if it's a neurologically based like someone that's experiencing symptoms associated with ms to someone that just rolled their ankle it's all neurologically based so i'm glad you asked that question because my answer now would be that the tools that we've created are probably most beneficial in communicating with the nervous system to be able to influence whatever the symptoms may be from pain to motor dysfunction and everything in between i like that.
- [08:17]
A
And i think what a lot of people might not know is how every muscle in our body is innervated by nerves so even if you don't have a neurological condition your nerves still deeply affect your muscles it's just a matter of what's causing the pain or injury.
- [08:36]
C
If you will yeah and i would totally agree with that and and we've learned more right we've learned more as it relates to how the brain the central governor interprets information from the body to be able to provide the most appropriate response and so the way that we're communicating the use of these tools including our hands including movement re education is really founded and based mostly on what we know about the brain as the central governor using that term again to be able to control all of our movements from muscle movement to endocrine function to our emotional status so i think it's critically important and i hope we get the opportunity to dive a little bit deeper in how a strip of tape or an instrument like a myofascial cup which used to be think as more mechanical tools quote unquote stabilizing a muscle or affecting some kind of lymphatics and you know system are more at least in our interpretation from what the evidence is telling us is that it's more about how these tools communicate with the brain providing the brain the information that it needs to make the.
- [09:51]
A
Best decision yeah absolutely so let's get into that and maybe first by saying or letting us know what does this tape look like if someone's having a hard time picturing what we're talking about what does it look like and maybe even like where do you put it.
- [10:10]
C
Both good questions so what it what it looks like and i'm assuming that you can see my screen and i can communicate it to those that might be just listening this type of tape and again someone in in my fifties if i'm communicating to this to anyone in that category of you know thirty five and and up what we recognize as athletic tape is generally that white cotton athletic tape that we would tape our ankles with once we rolled it on a soccer pitch so our knowledge and awareness of tape is generally focused on that traditional cotton athletic tape that's typically applied to stabilize or restrict range of motion to allow for better protection kinesiology tape or i could use the term elastic therapeutic tape those are the two most well recognized terms for this this type of tape and most appropriate actually because and you might fall into this trap i know i have that i would in the past reference it as kinesio tape i'm going to kinesio tape your knee and kinesio tape is a brand just like rock tape is just like kt is so these are brands within the category of tape of elastic therapeutic tape so this tape is cotton and nylon woven together the nylon is what provides the elasticity but if you just took it out of the box this is the strip of tape i cut for this demonstration is the tape is applied on top of a paper backing so it looks and feels rigid until you remove the paper backing so i'll remove the paper backing just by splitting the paper breaking the paper backing apart to expose the adhesive so as i said it's cotton and nylon the nylon is what provides the elasticity and the adhesive is basically an acrylic based adhesive the same adhesive that we would use with most traditional wound bandages so it's tape that stretches typically in one direction does not stretch in the opposite direction the horizontal vector and you would apply it on let me be clear on this one because this is where we're still stuck in the muscular anatomical mindset is that i need to take the quadricep to be able to affect my knee or i need to take my rotator cuff muscles to affect my shoulder and so we're still thinking that we're taping muscles i'm going to suggest that we should be considering what area of the body are we going to be moving or are we trying to influence and just tape that area of the body versus focusing on what muscles tendons ligament or whatever other structure you're thinking of and we can expand on that conversation because let me be clear this tape is not a cure it's not the fix it's not any of those things it's really used to complement what we know and you're the expert in this in this field is that movement and getting people confidence in moving is the best tool that we know of right now and this tape if it provides you more comfort it provides you more awareness on the area of the body that you're trying to move more fluidly then that then that's how you apply it you apply it to the area that you're going to be using in some type of movement.
- [13:37]
A
So with multiple sclerosis it's very common to have muscle weakness as well as spasticity or maybe it's not even spasticity it's just tight muscles would you use a tape like this more so to help relieve the muscle tightness or to help activate the weak muscle so that you can get more out of it or both okay if there's another or what's the no it was both yeah.
- [14:05]
C
My answer to that would be both and this is what confuses a lot of people but this is where we should dive into more of the neurology and what the evidence is telling us mind you i just wrote a blog on ms as it relates to kinesiology tape and and perhaps you could share that with your with your followers but my point is that there's limited at least in my opinion there's limited formal research tying kinesiology tape with the ms community and what is available and we could talk about some of these papers is still exciting and it's providing some or shedding some light of how this tape could influence you know dexterity and balance and those types of things but if we really harness what we're learning about the nervous system as we discussed at the beginning a strip of tape applied to a specific area of the body granted we might think that we're trying to influence the the activation of a specific muscle or we're trying to decrease the tone of that of that muscle that might be either increased in tone or even spastic the evidence is saying if we can provide the brain with a new and novel stimulus a stimulus that it's not used to that provides a better connection to that body part that it's having difficulty seeing and that's the best way that i can communicate it is that if the brain has a blind spot of where the calf is because the connection is limited and we're talking about demyelination that communication is compromised due to the sequela of ms then we're going to try to provide a different route of information to the brain using the skin in this case to be able to influence the brain's awareness of where that body part is and this is the beauty is that then the brain makes the decision what with this new information and with more confidence of where that body part is i might the i the brain might decrease the tone of the muscle that is overactive trying to protect the you know the system or it might help to activate that muscle to be able to improve your motor function so there really isn't and this is this is where the confusion may lie anyone that's in the clinical realm that might be listening we were once taught that we would tape that if we take from the origin of the muscle to the insertion we could either inhibit or facilitate that muscle yeah most of that evidence has been debunked and so that should not be a method of approach that one uses to be able to influence the brain that being said a lot of people would say yeah sometimes i would see an activation or an inhibition of a muscle but it really didn't follow the instructions that we were once given that really ties into what i just said is that just by applying a strip of tape over an area don't over complicate it thinking that you're trying to turn on or turn off a muscle like a light switch just provide the brain with some new and novel stimulus that it could use to make a better decision so that's that to me simplifies taping for the end user someone that's experiencing symptoms that that has ms could potentially use this and i'm not using this as a prescription i want you to use use this in conjunction with whomever you're working with but you could simply apply a strip of tape over an area that you're experiencing spasm or tightness or lack of function and see if that stimulus provides the brain the information that it needs and you the individual is the best one to be able to make.
- [17:53]
A
That assessment right because it's something that you would feel right correct correct so.
- [17:58]
C
The tape because of its elasticity right when you apply it to the skin we have multiple visuals for this and you can see many of these on our youtube page or our rocktape dot com or we do provide some you know information but apply this to the skin just like any elastic band it will recoil it will pull back to the center and what that does using my skin and my forearm as the example it will create a mechanical lift of the skin and it creates stretch to the skin on the ends and all of that is stimulating receptors almost like keys on a keyboard that are communicating information of where that body part is to the brain so it's basically using the mechanical stretch qualities of the tape to be able to provide that.
- [18:48]
A
Stimulus to the area it's so fascinating i think you're explaining that in such a great way that at least i can get a really good visual of it it's so basically when we're not able to let's just say activate a muscle or use a muscle in the way that we want especially as it relates to neurological reasons it could be because our brain isn't really understanding or communicating with that muscle so by using this tape it's a way to tell our brain hey here's where this muscle is let's use this muscle is that.
- [19:21]
C
Right that's exactly how and that's how i you know i'm communicating to patients and clients that yeah i'm not expecting them to know which mechanoreceptor we're stimulating you know is it the paccinii or the merkel disk like none of that is gonna land right so when i'm communicating to the patient or client the individual i'm trying to make sense to this so i use concepts like i'm shining a flashlight i got this from diane jacobs who created this this technique which would be a great interview in my opinion her name is diane jacobs she's a canadian physiotherapist that created a technique called dermal neuromodulation d n m and so she talks a lot about shining a kinesthetic a touch flashlight on an area that your brain can't see i use the blind spot concept all the time if you're driving down the road and you can't see your blind spot or you're not confident in your blind spot are you going to move in that direction without any added concern and so the answer should be no if you can't see something you're not going to move effectively and this is what we're trying to communicate when it comes to any touch therapy my hands to a strip of tape to an instrument to a cup it's providing a stimulus to the brain so then the brain can better see that body part.
- [20:49]
A
It'S kind of reminding me of when someone with ms or otherwise might have numbness or lack of sensation in their feet and so they can't feel their shoes or feel the ground so they might have specific insoles that can help with that is that something that this tape could help with as well where it's sensation versus muscle of course and.
- [21:12]
C
Just going back to like the blind spot concept is that we're providing a sensory stimulus to provide the brain some more information of where it is and in fact one of the papers that i referenced for my blog article was verdeo i always you know especially for someone that has my name you know butchered most of the time i'm not very good with most of the names of the principal authors of these papers but it was a recent recent study twenty twenty four twenty five where they basically taped a single strip of tape applied to the bottom of the foot of those experiencing ms improve their balance and improve sensation of that area of the body and i think they use two point discrimination using just a simple screening tool to identify is the brain better able to appreciate where that body part is in space so the answer is yes like a simple strip of tape is it going to be across the board absolutely not but the risk to reward ratio really is in your favor putting a simple strip of tape on the bottom of your foot that you could self apply if you had to and then assess what is my balance like and that's a good a good measure of you know can you feel where your foot is in space because your foot is critically important as you know as it relates to your sense of balance so the answer is yes and the evidence is starting to kind of support this idea that tape could influence someone's sensory system yeah you.
- [22:42]
A
Know it almost sounds too good to be true like really like tape can do all of this however i will say i work with so many patients and clients with ms and one reason why i thought to interview you for my podcast is because one in particular has pretty extreme spasticity and she's tried all the stretching lots of different types of strategies and things to help and the only thing that she's found after years of trying these things to help has been kinesiology tape and spasticity can be one of the most debilitating symptoms of ms so for her that was a huge game changer so it sounds too good to be true maybe like oh tape can do this but it actually can and there's people who are experiencing this type of relief listen i've.
- [23:29]
C
Been in this space quite a long time so i've had the amazing outcomes where i had cases of of individuals and this is we're not talking specifically the ms but frozen shoulder diagnosed with frozen shoulder have moved in a dysfunctional way for five years before i simply put a strip of tape on their shoulder and whatever stimulus that provided gave the brain enough confidence to move through full range of motion right there in my in my office and that person almost fell to their knees you know convinced that this was going to be the way that they were going to move the rest of their life remember they were diagnosed with with something and literally behaved like a frozen shoulder patient for five years and a simple stimulus like a strip of tape provided a significant outcome did not fix the individual what we did is we we used movement to now re educate the brain of this new range of motion that they just acquired a good colleague of mine uses the term well i should tell you who it is his name is tim brown is a chiropractor from california southern california and he always says tape is a tool that allows you to do the reps necessary to be able to get better so the tape isn't the fix it's just something that allows you to accomplish the goal more effectively and some people respond are super responders just like some are when it comes to any type of manual therapy some respond very effectively and some don't and so i always go by the risk reward if it's something as simple as this could give you a good outcome it's worth at least a try but i always stack it or layer it with information because i want them to understand what this take does and how it could influence them because i'm not shying away from the placebo effect either right so i want to stress this point a lot of the research that's done the limitations always state well it could have been a placebo effect and i was like well so be it let's take advantage of the placebo effect if it's something that you know will influence your ability to move and feel so i leverage the two together and i really take advantage of the safety profile of something like this to be able to potentially get the outcomes.
- [25:55]
A
That someone's looking for yeah absolutely especially for people with ms who obviously not everyone but a lot of them are on a lot of different medications so for this to not be a medication just something simple to try that's for sure a perk and i've heard you talk so you do a lot of speaking and i've heard you talk about predictive processing is that the same thing that we're talking about of just how our brain is interpreting movement or is that something different no it's within the.
- [26:25]
C
Same conversation if you will but what we're learning about the concept of predictive coding or predictive embodiment there's lots of terms that could be used but it just our better understanding and it's still a theory mind you but it's a theory based on quite a bit of evidence a lot of it is coming from any of those that want to dive deeper into this concept as you learn more about it come from lorimer mosley and david butler from the neuro orthopedic institute in australia they focused most of their attention on predictive coding as it relates to chronic pain sufferers those that are experiencing chronic pain musculoskeletal pain not just musculoskeletal pain but that's probably one of the bigger ones what we're learning about predictive coding is that just learning the the foundation of the brain the brain's number one job is to keep you keep us alive and the brain doesn't have any direct contact to the environment so how it provide gets information about the environment that it's in so it could better predict the future is through our nervous system and so if someone's nervous system like someone experiencing ms is compromised the information that it's getting leads the brain to now make assumptions or not be able to better predict the future to be able to make the most appropriate decision so that lack of information leads to increase in threat and that's the term that you'll hear quite a bit if the brain is under threat because it doesn't necessarily know where it is in space because of a lack of information coming from the body it will typically fill that void with either pain tightness or spasticity any way to protect you from moving because it can't necessarily predict where you're going to be in the near future that's what we're learning which is influencing how we're interacting with people it's influenced how i put a strip of tape on someone because in the past i was focusing my attention influencing the muscle now i'm trying to what stimulus would be most appropriate for this individual's brain so it can better see where it is in space so the brain can better predict where that body is going to be in the near future so it could make better decisions so predictive coding is critically important for pain as well as movement and the better the brain is aware of the body the better it will move and feel that.
- [29:10]
A
Is so fascinating and it's something that i see almost on a daily basis in the people that i work with who have ms specifically in situations like they're getting stronger from their exercises they're getting better balance but as soon as they step outside and they're on the sidewalk or uneven surfaces their body freezes and their mind freaks out there's this fear of falling or spasticity worsening so it's like their bodies and brain have learned okay this is not a safe environment yeah so that's that predictive you.
- [29:42]
C
Know that predictive capacity now becomes minimized in environments that it's not as confident in and confidence is the main component here the more confident the brain is in moving in known spaces the better your movement's going to be but if you get into any environment that's unknown or uncertain i always think of walking across and i use this image quite a bit in my education of walking across a rope bridge and it's a foggy day and you can't see the other side where that bridge should technically be attached to how confident are you going to walk across that bridge so the brain works in the same fashion if it can't predict the future it'll protect you any way that it can and regardless if you're affected by ms or not the nervous system will do the same thing it'll increase your pain because it's a great lever to protect you from moving it'll decrease your tone so decrease your motor capacity your ability to move it'll make you tighter or even spastic to protect you from your next step literally so it's an amazing system but it's all based on the brain's number one job which is to.
- [30:58]
A
Keep you alive yeah that's just so crazy that our body can literally produce those symptoms for the purpose or so it thinks of keeping us safe that's right so then how would you use tape or any of the other things that you offer you've mentioned the the cups that you have there's the massage gun it's not that's not what it's called but something like that there's lots.
- [31:22]
C
Of lots of tools and we can talk more specifically but ultimately we're probably best known for tape so let's focus our attention on using that as the touch stimulus so the question is how would i use this to influence someone's movement or what would yeah so if.
- [31:38]
A
They'Ve got that predictive coding where they're in a specific environment and their symptoms are worsening because their brain is trying to keep them safe but they need to get to their mailbox or they need to get to their car can tape be used in that situation specifically or is it more a sense of using tape as practice so that when you're in those situations you're okay your brain doesn't freak out i like the.
- [32:07]
C
Latter because it takes the opportunity and i use the term layer or stack where you can apply the touch stimulus the safe novel stimulus to an area of the body that's going to be used and start to train it to build its confidence through space so the example would be in a clinical setting what i would do is the exercises like if we're trying to influence someone's ability to get up from a seated position walk a certain distance to accomplish a task that's what i would do with the tape so how do i decide on what areas of the body to tape well i i we get that assessment from the individual first and foremost like where do you feel you're limited in accomplishing that task and they might say when i go from sit to stand i feel like i'm gonna fall over so my balance is compromised so how do i influence balance i'm going to lean on what the evidence is telling me how about starting by just putting a strip of tape on the bottom of each of your feet to provide that sensory stimulus that when you go from sit to stand you get this different sense of where your foot is in space and the evidence is clear that it can potentially help with balance so we accomplished that one box so we'd start doing sit to stand exercises with the tape and eventually start to to to pull the tape back literally like where the individual starts to gain more ownership of their own body not relying on the tape again this is not the cure it it's meant to be something that helps you get the reps to be able to accomplish the task another example would be if if my calf is becomes you know i start to develop a spasm or a cramp in my calf accomplishing that distance of travel i might take the calf area so i'm using the calf as an example but whatever body part might be experiencing a lack of function i can apply that stimulus to that area without knowing the anatomy i just want to apply a stimulus to that area so if it's my calf i'm just going to have several inches of tape that will adequately cover that region of the body then perform the task in a safe environment that i know that there's no risk of falling and there would be someone else there once that person starts to get those reps in and gets more confidence then we start to bridge that to their home exercise what are they doing for their activities of daily living so that's.
- [34:36]
A
How i use it i love that and you mentioned too that this can be used so i feel like and maybe i'm mistaken but when kinesiology tape first came out it really was just used in clinics where it had to be applied by a physical therapist for example but now especially with rock tape anyone can purchase this and they can just use it in their own home is that correct that's correct and that.
- [35:03]
C
That applies to other brands as well so yeah i always tell people do your own research and you know anyone everyone should be informed so this is a great way to inform you know at least our model of approach when it comes to how we believe tape should be used to influence the conversation with the brain but there are other brands out there so i am i'm always you know very transparent saying please do your research you can do a side by side assessment of kt tape versus rock tape kinesio doesn't necessarily sell into the consumer retail world there are other brands that you can you can try so find ones that are available amazon is a great you know resource for a lot of people people as well right now so yes each and this this is this is true for other brands is that usually each box come with instructions of how to quickly and safely apply to each area of the body and we could talk about some of the the key components of making sure that it's safe for someone and the applications are pretty simple as i showed you just on the screen of tearing the paper backing off removing the you know the paper backing to expose the what we call the base we apply it to whatever area of the body i'm going to be applying this on my forearm so i fix the base i flip that back and i grab the paper backing and all i'm doing is i'm just laying this on my skin and making sure that it adheres to my body and so now i have a stimulus that's giving my brain more information of where my forearm is to be able to potentially improve the function of my elbow or my wrist or both to accomplish you know whatever task that my upper extremity needs for the end user or the individual experiencing these symptoms the application of this type of tape is pretty simplistic and most brands have quick you know instructions to be able to make everyone feel confident to be able to self.
- [37:02]
A
Apply and i'm super excited because you're actually coming into the missing link as our guest speaker in february i believe it is and we're going to do a demo and we're all going to have the tape hopefully by then and get to actually put it on some different muscles so that's really exciting yeah.
- [37:20]
C
And what i'm excited about just like we said yes you can go on amazon you can go to we don't generally sell through many retailers but we are an rei and a certain you know specialty run retailers you could start the process of just doing what i just showed you what i'm excited about when it comes to our training in february is that i'd like to show you some of the you know tricks to the trait things that i've learned that we've learned from what the evidence is telling us that you know it does it's not for everyone but there are certain things that you could potentially do with a strip of tape that could potentially influence that conversation to your brain so start with what is easy apply it to the body part allow that to do its thing to be able to communicate but if you if it's not loud enough and you need to amplify that conversation there are other things that we could do and we'll talk about that in february yeah i'm.
- [38:15]
A
So excited troubleshooting seeing seeing all the different ways to use it so you mentioned just briefly safety and making sure that you know it's safe for everyone can you go further into that and then also share too is there anyone who this wouldn't be applicable for that maybe they shouldn't try to take it's.
- [38:32]
C
Super important as i said earlier the risk profile is very strong meaning that this i should say the safety profile is a better way of putting it is very strong the risks are very low it's an acrylic based glue so a lot of people will say well i i have allergies to certain adhesives well then i would say that that individual is already on one of the higher risk profiles that i would want to better understand so the acrylic based adhesive is the same that you would use in any type of wound bandage like a band aid over a wound so if you are allergic to that type of adhesive then i would say that this tape is probably not indicated for you there are those that say well i still want to see and so those that want to assess it in real time i'm just kind of cut a smaller strip here so i'm going to cut a small and i call this the test tape patch so it's basically a strip of tape of one to two inches square and then i would remove the paper backing just like i showed you earlier and affix this to whatever body part that i want to have the you know the tape on and within minutes if someone is truly allergic to the adhesive they will notice a few things itchiness redness potentially around the edges just irritation that would be an indicator that again you're not a candidate for this type of tape so that's first and foremost ruling out allergies either from your previous history or doing a test patch the other components of safety just come down to when you're applying it to your body and this is where i generally stress the point that less is more when we have tape like this we tried to echo what we've learned in the past with cotton athletic tape that we want to strap something down we want to lock it down tighter is better that's not what you want to do with this type of tape so when you're applying it to the skin you are applying it with no added stretch to the tape but you are stretching the body part so i'm trying to show you on videos that i'm taping my forearm i'm going to stretch the body part these are part of the instructions that we have and not stretch the tape so you're just literally laying the tape onto the skin just by removing the paper backing so that limits the amount of what people identify as shear stress or stretch to the skin which can lead to traction injuries so less is more less stretching of the tape more stretching of the body part to make it one more comfortable longer lasting this tape when applied to the body should last typically three to five days so we're talking about multiple days of that communication to your brain you can shower with this you can exercise with this you can do normal daily activities but it's intended to be on your body for three to five days if you put a lot of stretch on it that's that could be undue strain to the skin that could lead to irritation so it's not an allergy it's just due to the amount of stretch to the to the fabric so those are the two things that i generally focus attention on allergy and then in proper use meaning that we're overstretching the tape to potentially lead to more skin damage and most of these are very subtle but could be significant to.
- [41:58]
A
The individual my next question was going to be how long should this be left on for so you already touched on that so that was great i.
- [42:04]
C
Tried but yes and so the left on for three to five days depending on the adhesive level so we have three different levels of adhesive level one which is our gentle adhesive typically intended for pediatric and more geriatric skin like as the skin becomes more frail and thin they don't tolerate you know tapes in general so we have a less aggressive tape and a less aggressive adhesive which is number one most tape that you'll find online for the consumer is level two which is our standard adhesive most applicable for the majority of the population and then we have the extra sticky for our you know heavy movers i live in austin texas you know lots of you know heat and sweat that could potentially limit the adhesion of the tape so then extra sticky would be recommended for those individuals as long as their skin can tolerate so within those three to five to seven days depending on what type what type of tape you're using you also want to know when it comes to just my last point on safety how to remove the tape and removing the tape is not following our mom's recommendation of grip it and rip it when we're taking off a band aid just get it off you don't do that with this form of tape you're removing the tape and i'll use my arm again not pulling the tape perpendicular to the skin you can see how my skin is being lifted i'm moving it parallel to the skin and i'm just moving it in the direction of my hair growth and that just one is more comfortable and two not as damaging to my skin which could be one of the other reasons why people have skin reactions is that they remove the tape incorrectly.
- [43:49]
A
Right yeah even just watching you do that it looked much more comfortable once you did it the correct way okay so i think my last question that i have on my mind is so we've been talking a lot about using this tape for movement can it also be used for specific symptoms with ms one that's coming to my mind right away we mentioned spasticity earlier but also foot drop or drop foot can be super common as well as for other conditions but especially with ms could it be used to improve foot drop or if someone specifically has hamstring weakness so they can't bend their knee when they're walking like a very specific thing can it be used for that as well or is it more so for general awareness and general movement so the answer.
- [44:38]
C
Is yes it can be used for what you identified and i'll be more specific to foot drop and even wrist drop or wrist dexterity which we do have some evidence to support first and foremost you know shining that spotlight improving your blind spot giving the brain the information that it needs so it can make a better decision that first and foremost would be my my first set of instructions what is the area of the body that you're trying to influence and then apply a strip of tape over that area hamstring the front of your shin for drop foot the back of your wrist for drop wrist to improve dexterity of your fingers on the back side of your hand those are kind of simple instructions taking advantage of what we know about the brain and how it influences function so start with that and that allows someone again within a three to five day period how is your function changing some people experience changes within minutes some you know those are the ones that are like the miracle changes like my gosh this made all the difference and then others take days if not weeks of reconditioning with that added stimulus to be able to provide that outcome and some don't get a response and then at least you can remove that as one of the interventions that you may consider so all of those are available just by simply putting tape over the area but as i referenced earlier and we could talk about some of those specifics today but in february i want to show you some of the the troubleshooting nuanced approaches of putting on tape so i'm going to use my wrist as the example for both foot drop and wrist drop at least in that pattern is that we can apply the tape as i just said earlier applying the tape in a stretch position and putting a strip of tape over the area can provide you that stimulus that your brain will start to perceive but if i'm trying to change function a specific set of function and i'm having issues of keeping my wrist in extension to be able to do wrist grasping and movement with my hand i might want to take the area in a correct for what i'm using in the term for today is a corrected position so if the wrist is falling this way or my foot has the inability of dorsi flexing or flexing towards your shining i'm going to put that body part in a neutral if not even a shortened position with the tape applied to the body so when i lose that position that stimulus that stretchy tape is going to provide a different set of information to the brain to say hey you're starting to fall into flexion and you need to do something to make that correction so what we're finding is drop foot and drop wrist we're seeing improvements in motor function for those people when applied in a neutral if not shortened position caveat here going back to our safety profile i wouldn't start by taping someone in a shortened position if i didn't know their skin can tolerate it so that's one of the reasons why we have this less is more progression is that let's start it off in a stretch position apply the tape see if you get the response you're looking for if you didn't but your skin can tolerate that then i may put you in a neutral position and then apply the tape over that area that i'm trying to influence and then if that didn't do it then we could potentially put it in a shortened position each of those progressions leads to potentially a different conversation to the brain and a different outcome maybe improving your drop foot and then but the other thing is that it leads to more stress to the skin so you want to make sure that you're doing that sequentially to make sure that you're not leading to.
- [48:27]
A
Skin irritation i feel like you guys should release a journal that helps people keep track of what did i try today and what level of stretch was it and where was it i feel like that would be important information to.
- [48:40]
C
Keep track of it's so important and listen the journal i'm glad you brought that up and this is probably for another discussion and i said before we jumped on air that i just got back from a lecture in the middle east and one of one of the callings is probably the best way that i can reference it is like one of the things that i want to share with all communities from my professional manual and movement therapist to individuals is learning to better the term that is being better understood is interocept how do we better perceive sensations that we have within us and a lot of us because of either a disconnect or potentially a neurological factor like ms we end up just disregarding we disassociate from our body because it's considered a threat and when you brought up journaling the exercise of just paying attention to how you feel and it could be just how you feel with a strip of tape either in a stretch position or a shortened position that actually has an influence on the brain and it has an influence on how we feel and so you're absolutely right giving people instructions to be able to check in and we call it body scanning like scan your body and pay attention how you feel now how you're moving with this new information is actually part of the exercise part of the solution so i do have my patients journal after each treatment how did you feel on the table how did you feel in movement today how did you feel you know that evening at home doing your tasks that is part of the solution that i want more people to do yeah i.
- [50:33]
A
Really love that especially again i keep saying with ms but with everyone but especially with ms if you are focusing generally on well how did that feel the answer is probably going to be hard because you're focusing on your whole body but if you're focusing on where that tape was placed or even right now like what does the chair feel underneath you like focusing on a specific thing or specific area helps hone in on where we're trying to make a difference which i imagine affects the brain specifically for that area even more that's.
- [51:06]
C
Right and that is a part that i just don't see being used as much and through the exercise of just paying attention and more importantly paying attention like a third party observer not judging not layering any other influence to what your experience just noticing and that has been shown to be very effective affecting actually a specific region of the brain separate to the areas that are stimulated when you use touch even a strip of tape and these two areas of the brain interact with each other to actually help people move and feel better so we're really learning a lot about the nervous system this is very applicable to those experiencing any symptoms associated with ms at least feeling more autonomy that i have more tools to use to influence how i move my body how i interact with the environment and i think that's exciting this is an exciting time for us to share and you're doing that through this platform is to share with those people that there's more available so i'm excited to be part of that conversation even in a little.
- [52:19]
A
Bit yeah absolutely thank you so much this has been very insightful and i love personally understanding the why behind why things work especially with something like tape which at first glance might seem like well it's just stickiness you know so it's been really helpful and you did mention the blog that you have on ms i did read that super helpful and you actually link the the state the resources and studies articles etcetera at the end so we will be sure to put that in the show notes where else can we send people if they want to know more about you more about rock tape maybe they want to see your products and purchase some.
- [52:56]
C
I'M not the best when it comes to purchasing because i like to focus my attention on information and product development but rocktape dot com is a great starting point and we do have a youtube page that you know for those that are kind of new to this and saying well i don't feel confident of knowing how to apply it to a specific area we have a pretty large library of how to's video assets for those that do better looking at videos and just following along those instructions so rock tape on youtube would be the second one to follow me i have a handle it's the movement advocate and the movement advocate is exactly how it sounds is that i advocate if i could even say the word for movement because i truly believe movement is the medicine not all these tools even though i represent a brand that has all these tools so rocktape dot com comma rocktape on youtube and then the movement advocate would be the three sources that i would recommend people to to.
- [53:55]
A
Find me awesome we will put all of those in the show notes but thank you so much again for sharing your expertise and knowledge with us it's been really i think it'll provide a lot of hope and excitement for my audience so thank you very much blessing.
- [54:10]
C
Thank you very much.
- [54:17]
A
Thank you for listening to today's show i am so.
- [54:20]
B
Grateful to have you as a listener if you'd like extra resources such as a video of one of my seated exercise classes my favorite core exercises and the opportunity to ask me your questions head to missinglink dot com insider that link will be shared in the show notes along with links to my social media handles if you love this episode and think a friend or family member with ms would benefit from listening please go ahead and text or email this podcast to them right now sharing this podcast will help me educate and empower as many ms warriors as possible thanks again for joining and be sure to tune in next week for another episode of the missing link podcast.