1. Therapeutic Taping for the Elbow, Wrist and Hand
Dr. Dyanna Haley-Rezac, PT, DPT, OCS, CSCS, CKTP
Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS

2. Carpal Tunnel Syndrome Modified Technique
Single strip with moderate stretch
Diamond cut-outs over 2nd & 3rd
Apply in wrist extension
Extend up medial forearm
Space Correction
On dorsum to open volar surface
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

3. Brachioradialis Kinesio® Technique
Facilitate elbow flexion and forearm supination
Kinesio® Technique
Supinate forearm and flex elbow to about 45 degrees
Apply with a mod to max stretch to the brachioradialism
Modified Technique Practical Application
Tape over brachioradialis moderate stretch with wrist in flexion and elbow extension, pronation
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

4. Supinator Kinesio® Technique
Inhibit or Facilitate Supination
Modified Kinesio® Technique
Apply a single strip to the lateral epicondyle with the forearm in full pronation and slight elbow flexion
Apply the tape with appropriate stretch for functional outcome
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

5. Pronator Teres Kinesio® Technique
Faciliate or inhibit pronation
Modified Kinesio® Technique
With the forearm in supination and slight flexion, apply a single strip to the medial humeral epicondyle
Apply the tape with appropriate stretch towards the lateral forearm to the proximal third of the
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

6. Extensor Digiti Minimi Kinesio® Technique
Facilitate finger extension and assist with wrist extension
Apply a ½ single strip with a split placing the tails on the 4th & 5th dorsal digits
With the hand and fingers in flexion, apply tape with a mod to max stretch towards the lateral epicondyle of the humerus
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

7. Tenosynovitis Kinesio® Technique
Decrease inflammation and inhibit overuse
Apply an extensor pollicis longus taping with minimal stretch (for protection phase, during strengthening change to facilitation)
Space correction anatomical snuff box
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

8. Valgus Laxity of Elbow (Mechanical Correction) Athletic Training
Reinforced for extreme laxity or throwing sports
Two single strips maximal stretch medial elbow
Two single strips in X over medial elbow
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

9. Elbow Hyperextension Athletic Training
Two single strips maximal stretch anterior elbow
Two single strips in X over anterior elbow
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

10. Olecranon Bursitis Space Correction Technique
Space Correction strips over olecranon bursa
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

11. Lateral Epiconylitis (Tennis Elbow) Athletic, Mulligan & Kinesio®
Place 2nd & 3rd digits through the diamonds and apply end of strip to palmar aspect of hand
Apply single strip towards lateral epicondyle with appropriate stretch
Protection, minimal
Strengthening, mod to max
Can also unload
Mulligan lateral glide
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

12. Taping for chronic Lateral Epicondylalgia Improvement in Grip & Pain
Vicenzio B et al. Links Initial effects of elbow taping on pain-free grip strength and pressure pain threshold. J Orthop Sports Phys Ther Jul;33(7):400-7.
The taping technique significantly improved pain-free grip strength by 24% from baseline (P = .028). The treatment effect was greater than that for placebo and control conditions. Changes in pressure pain threshold (19%), although positive, were not statistically significant.
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

13. Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand
Kinesio® Taping for Lateral Epicondylalgia US Images Indicate Improved Motion
Liu YH et al. Links Motion tracking on elbow tissue from ultrasonic image sequence for patients with lateral epicondylitis. Conf Proc IEEE Eng Med Biol Soc; 2007:95-8.
The experimental results show that Kinesio® Taping makes the motion of muscle on the ultrasonic images enlarge. It means that the performance of muscle motion improves.
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

14. Medial Epicondylitis (Golfer’s Elbow) Kinesio® & Mulligan
Same as lateral epicondyle with diamond cut-out, but over flexor group
Mulligan medial glide
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

15. Trigger Finger Athletic Training
Facilitate extension
Apply a ½ single strip with split tails around the involved distal phalanx
With the wrist and fingers in flexion, apply tape with a mod to max stretch
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

16. Mallet Finger Athletic Training
Apply a ½ single strip to distal palmar aspect of involved digit and wrap around to the dorsal finger with no tension
While holding the distal phalanx in extension, apply maximum tension to approximately 1” distal to MCP
Continue lying tape down with minimal tension with the finger flexed
Anchor tip of finger
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

17. Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand
Taping Fingers
1” or ½ single strip tape can be utilized for mallet/trigger /swan-neck/ boutonnière, tendonosis, immobilization.
Tape according to what you want to accomplish:
Extension of DIP – maximal stretch dorsal joint
Normal motion of PIP – no stretch
Flexion of DIP – maximal stretch volar joint
Collateral ligament protection / Unload one joint with space corrections on either side of joint, anchor the ends
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

18. Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand
Taping Fingers
Tape according to what you want to accomplish:
Decrease strain on flexor tendon – tape with moderate stretch on volar surface of digit along muscle
Immobilize a digit – “Buddy Tape” two fingers together with two 1” strips
Space correction over entrapment site
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

19. Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand
Ulnar Collateral Ligament Sprain (Gamekeeper’s / Skier’s Thumb) Athletic Training & Kinesio® Technique
Ligament correction to the ulnar side of the 1st MCP with 1” or ½ straight strip with maximal stretch
Second 1” strip in a figure 8 around the thumb and wrist to provide adduction pressure
Edema strips can be used in the acute phase for swelling
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

20. Clinical Evidence-Based
Select pre/post test based on your purpose of taping:
Pain
rating scales (VAS)
% perceived improvement
at rest / re-test aggravating activities
Strength testing
grip / pinch dynamometer
Number of reps against a fixed resistance (endurance)
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

21. Clinical Evidence-Based
AROM – increased range, improved pain
Dexterity Tests (standardized)
Functional Activities
Grip, lift, slice, chop, cut with scissors, typing, writing
ADL and occupational
Outcome Measures
Volumetric Measures
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

22. Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand
Upper Quarter Summary
Evidence-Based Practice
Research is limited to lower tiers of pyramid
Small Subject Size, Case Studies
Significant portion based on “normal” subjects
Lacking Large Subject, RCT, published in peer-reviewed journals
Very few articles comparing similar techniques
Utilize Objective Measures (* Sign) to document efficacy and validate use
Tape for function, then pain (pain generally follows function)
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand

23. Questions, Comments, Discussion
Scott & Dyanna Rezac - Taping Elbow, Wrist & Hand