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Low dye strapping vs foot orthotics

Discussion in 'Biomechanics, Sports and Foot orthoses' started by markleigh, Mar 8, 2011.

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  1. markleigh

    markleigh Active Member


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    Do you ever find patients with long standing (12 months plus) plantar calcanel heel pain get complete relief with just a 2-3 day application of a low-dye strapping? Had a lady in today for a review who has had no pain after suffering for a long time. My first thought was let's pursue orthoses but then I hesitated because she no longer had any pain (nor with palpation). I did say if it recurrs (& most likely it would) THEN orthoses would be the best option. Have I failed her in my treatment/thought processes?
     
  2. Admin2

    Admin2 Administrator Staff Member

  3. Lab Guy

    Lab Guy Well-Known Member

    I too always had great success using a LDS and also frequently incorporated a skived felt scaphoid pad as the taping loses its supportive taping as it stretches. Kineso Tape is becoming much more popular and although its more expensive, Podiatrists swear by it.

    I think the taping helps as it can get closer to the STJ axis to reduce the pronation moment. Taping also provides compression to the heel which helps to promote venous return of excess fluids/inflammation. It also helps to support the calcaneus in the event there are micro fractures from repetitive stress. It also provides very good support of the plantar fascia with the anchor strips to the sides of the foot.

    Steven
     
  4. 1st Mark no you have not failed your patient, if you think tissue stress you have done the right thing, given her advice. I do the same and usually have the patient continue with their soft tissue program. The patient leaves the office with - no news is good news if the pain comes back give me a call amd we will begin with the next step in treatment.

    Low dye taping is a funny one - I use a self modified approach and get very good results, there is one paper I know of which says it does not help with plantar fascia problems, does a great deal of good with me.
     
  5. JB1973

    JB1973 Active Member

    Hiya
    Almost universally I will strap a patient with PF at their first appointment as it almost always provides short term relief. Obviously it is allied with all the other usual treatments but I have a lot of success with it. And I don't think you have failed the patient. She was in pain and now she's not.
    Cheers
    JB
     
  6. markleigh

    markleigh Active Member

    Thanks for everyones replies. So Mike is that a fairly standard process for you ie. strapping, exercises, information then leave it in their hands to come back if pain persists? I am finding more & more patients are wanting alternatives to orthotic therapy as a first line option (most have read up via the internet).

    And what is your modified strapping approach? Do you attempt to plantar flex the first ray & if so, any tips? My standard strapping is straps from base 5th around heel to base of 1st met then horizontal straps under the foot from lateral to medial working back to the heel. If need be I try & plantar flex the first by applying a strap from medial to lateral starting over the 1st MPJ, applying a plantarflexory force then bring the tape under the met. heads & coming up on the lateral side of the 5th MPJ.
     
  7. Not all the time, but I seem to have more self satisfaction when I donĀ“t need to use an orthotic device and help patients, not really sure why that is. But it does depends on the Hx of the patients symptoms,level of stresses on the feet daily ie runner verse dog walker.


    Ok heres how I do it in the case of attempting to reduce pronation moments. (if tape works that way ??)

    Get the patient to dorsiflex the ankle to about 90 degrees and toes a little.

    2.5 cm tape and 5 cm tape required.

    * 5 cm tape planter 1 - 5 and up the sides -helps with getting tape to stick.

    * 3 times 2.5 cm beginning at 1st MTPJ (while plantarfexing the 1st MTP joint) around heel stick to the lateral forefoot at the 5th. These are pulled quite hard.

    * False plantarfascia tape applied now if required 2.5 cm.

    * 5 cm tape beginning at the 5th MTP joint ie lateral to medial work from the MTP joints towards hell 1-1.5 cm cross over with tape.

    * now take the 5 cm tape roll , stick it to area around plantar surface cuboid, pull tape lateral - medial, up around medial heel under the medial malleolar, up around Achilles tendon which then finished distal 1/3 of the anterior tibia repeat.


    These last 2 tape bits are a reverse heel lock used in lateral ankle taping techniques and has made a difference in results - positive.

    Hope that makes sense Mark.
     
  8. Glen

    Glen Member

    The Low Dye strapping is also useful for short term events such as sports training or game day. It provides compression and restriction of tissue movement. I use in shoe padding a lot more as I like to try things that will hopefully modify foot mechanics to produce a reduction of symptoms.
     
  9. efuller

    efuller MVP

    My theory on how low Dye strap works is that it reduces tension in the medial slip of the plantar fascia. It may effect STJ moments through the windless, but my sense is that its major effect is by reducing tension in the fascia and 1st ray intrinsics. Interesting theory on compression. Can you define support the calcaneus?

    Eric
     
  10. nikki.grant

    nikki.grant Welcome New Poster

    Hey there,

    I was wondering if it is reccommended to use strapping and orthoses in combination? Do you have to use them both separately?

    Nikki
     
  11. Hi Nikki :welcome: to the Arena.

    You can use the 2 in combination, but usually I would make adjustments to the orthotic once it has been issued.. But it all depends on what your are trying to achieve.
     
  12. Nikki:

    I am treating a professional skate boarder [has his own shoe for Nike] currently and this is exactly what I am doing for him. He wears foot orthoses all the time, when walking and when he skates. Then when he has a competition or photo shoot, he comes in to get a Low-Dye strapping on his injured foot which basically gives him the extra level of support necessary to do his routines comfortably.

    The foot orthosis works to cause an external forefoot plantarflexion moment by applying a compression force on the plantar aspect of the foot. However, the foot strapping works to cause an external forefoot plantarflexion moment by applying a tension force to the skin of the foot. Why not use both compression forces and tension forces to reduce the stress on the injured structural component of the foot and/or lower extremity?
     
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