Athletes Treating Athletes

As you may recall from our intro post on kinesiology taping, we’re going to focus on each muscle group/joint and show you how to use kinesiology tape in three distinct ways:

1. Immediately after injury  (for swelling and pain)
2. During the healing process (correction techniques to restore normal position and allow for healing)
3. Techniques to help improve strength + function

In our last post we reviewed a taping application for a hamstring strain or sprain. In this post, we’ re going to be talking about a taping technique that is specific to the pes anserine. This is a commonly injured area in athletes and involves three separate muscles all sharing a common insertion point on the tibia. These muscles are the gracilis (an adductor/inner thigh muscles), the sartorious (a skinny little muscle that wraps around from the front of the hip to the inside of the knee), and the semitendinosus (an inner hamstring muscle). Due to the mount of force these muscles can generate, a bursa is located underneath the tendon itself. This means that injuries to this area can include tendonitis, muscle strain/sprain. or bursitis.

This type of application is called an inhibition technique. The key for using it is to use the anatomy! Remember, the tape is specifically made to pull on itself. That is what the weird spirals and shapes are when you look a the back of the tape. When trying to inhibit the muscle, you want the tape to move from the muscle insertion to origin so that when the tape pull on itself, it results in an eccentric pull (eccentric = lengthening of the muscle). This is ideal for trying to diminish the contraction which will allow for rest and more importantly recovery.

Muscle origin & insertion

The pes anserine involves three separate muscles that cross the inner knee joint to insert on the tibia (lower leg bone). They are the sartorious (blue line), gracilis (red line) and the semitendinosus (purple line and part of the inner hamstring muscles). Together these muscles act as an important stabilizer for the inner knee.

#1 Gracilis.

Of all the inner thigh muscles, the gracilis is the easiest to find. Unlike the other adductor muscles which work their way in towards the femur (long thigh bone), the gracilis remains on the outside and works it’s way straight down towards the knee and it’s insertion into the pes anserine. Click here to review the anatomy and for palpation tips to find the muscle.

Origin- Pubic tubercle (common insertion for the adductors)

Insertion- Pes anserine

# 2 Sartorious

This muscle is a s small rope like muscle that originates on the anterior illiac (hip) bone and wraps across the thigh to insert just below the inside of the knee. To find this muscle, bend your knee and flex your hip (bring the knee up towards the ceiling). Rotate your whole leg OUT (like you’re trying to prop your ankle up on your other knee). You will feel the Sartorious move under your hand. Click here to review the anatomy and for palpation tips to find the muscle.

Origin- ASIS (anterior superior iliac spine)

Insertion- Pes Anserine

#3 Semitendinosus

The semitendinosus is one of two medial (inner) hamstring muscles. It is a small, thin muscle that has a long tendon and wraps around the inside of the knee to insert into the front of the tibia. When bending/straightening your knee, you will feel two ropes moving behind the knee. The innermost rope is the semitendinosus and can be traced to its insertion on the pes anserine. Click here to review the anatomy and for palpation tips to find the muscle.

Origin- Ischial tuberosity (sit bone)

Insertion- Pes Anserine

What you will need:

1) Roll of kinesiology tape

2) Sharpest scissors in the house.

Prep work:

1) Clean skin. This means no oils or lotions of any kind. You want your skin to be clean and more importantly dry. Moisture of any kind = tape will fall off or fail to stick altogether.

2) Hair care. Ideally, the less hair the better. Guys, this means that for best results you will need to trim any long leg hair or shave the calf area.

3) If clean, dry, and hairless skin still = no sticking of tape. Time to get some adhesive spray like Tuf Skin.

4) The tape should last 3-5 days. You can get it wet and shower with it on. Just towel dry it after. No hair dryer! The tape is heat activated.

Taping Techniques

Here is a video demonstration of the taping application for the pes anserine.

Key Points:

• The tape must run from the muscle insertion to origin. In the case of the pes anserine, this means from the insertion on the tibia, up the thigh and following each of the three muscles towards their respective origins.
• Prep the skin first and then place the muscle on stretch. For the pes anserine there will be three different positions. The sartorious muscle acts as a hip flexor, abductor, and external rotator, so we will want to extend, adduct, and internally rotate the leg. The gracilis is an adductor muscle and will need to be abducted. The semitendinosus is a hamstring muscle and will need the hip to be brought up into hip flexion. See the video for full details on how to position the leg for all three strips.
• Apply primary strips WITHOUT tension. The tape works by pulling on itself. Lay the anchor down first (last 1-2″ of the tape), put the muscle on stretch, apply the tape, and then rub the tape to warm up and activate the adhesive. Return to the start position and repeat for until all three strips are in place.
• Due to the pes anserines roll in stabilizing the inside of the knee, it is common for symptoms to affect the knee cap itself. For this, a secondary correction strip can be applied at the knee to help reduce pressure on the patella. Cut the tape so that it is long enough to cover from the pes anserine across to the other side of the knee. Keep the first 1-2″ of tape as an anchor and then cut the strip in half creating two tails. Bend the knee to about 90 degrees and the place the anchor down. From here the two strips will be placed around the knee cap. This will help to reduce tension on the inside of the knee cap.
• See the video above for full details.

References

1) Capobianco, Dr. Steven and van den Dries, Greg. (2009). Power Taping, 2nd Edition, Rock Tape Inc, Los Gatos, CA.

2) Hammer, Warren. (2007). Functional Soft-Tissue Examination and Treatment by Manual Methods, 3rd edition. Jones and Bartlett Publishers, Inc, Sudbury, MA.

3) Kase, Kenzo, Wallis, Jim, and Kase, Tsuyoshi. (2003). Clinical Therapeutic Applications of the Kinesio Taping Method.

4) Muscolino, Joseph. (2009). The Muscle and Bone Palpation Manual. Mosby, Inc, St. Louis, MO.