Monday, September 25, 2017

A Dynamic Approach to ACL Rehabilitation and Prevention: Part IV - A Guest Blog

Last week, we discussed how dynamic tape could be used to control internal rotation and some specific case examples of.  This week, we will start to discuss use of taping to assist in mid-foot control and postural taping.

If you have never seen, used, or heard of Dynamic Tape I bet you have never seen a taping that looks like this?  I always loved using rigid tape to support the plantar fascia or to control over pronation. Worked pretty good but often I would get issues up the kinetic chain if I used it too long. Why? Because if I STOP motion with rigid tape or a hard orthotic, kinetic energy still needs to travel somewhere. With pronation, you utilize the mid foot to disperse forces away from the body. This taping:  
  • Slows down the navicular through rotation control 
  • Supports the plantar fascia longitudinally by creating an artificial Windlass mechanism off the great toe 
  • Squeeze up the fat pad to artificially increase the height of the arch

Watch this video on pronation control taping, click here to learn more: 

Does this mean Dynamic Tape can replace all orthotics?
No, but it may be a good start instead of using a rigid orthotic with an over pronating foot. If through reducing workload foot mechanics are re-established, then within the first couple weeks of use improvements should be noted. If not, it is likely orthotic time.

This taping is good for anyone with plantar fascia issues?
Many but not all. If a patient has a hypermobile first ray, this taping irritated the foot as it drives down the great toe in open chain. Those with a “high” arch have poor mobility so the bungee effects of Dynamic Tape are rendered minimal if the body part can’t move.

So, for an ACL rehabbing patient with over pronation, is this something I should use with everyone?
You should use this type of taping with anyone that mechanically is breaking down at the foot. Being in a brace, minimal WB, and altered gait patterns have likely weakened the foot musculature. If foot kinematics are contributing to excessive front plane motions (varus/valgus) and excessive IR at the hip because the foot cannot manage load, this is something to seriously consider for short term use.

I attend conferences and I will be honest, sometimes I tape my feet because they get exhausted from standing all day. When it comes to pronation control taping relating to the ACL, the purpose still centers around restoring normal lower quarter movement patterns. This taping, while generally not the “main driver” such as the quad or hip, needs to be considered as a viable option as the entire leg, not just the knee, has taken a beating with this surgery.

Lumbopelvic stability is pretty much essential to everything in rehab. Probably why clinicians spend so much time talking about “the core” or “the body’s center” during treatment. With Dynamic Tape, the concept of posterior kinetic chain takes on a whole new meaning with a Biomechanical Tape.

Every good ACL rehab program will have some sort of dynamic jump training involved to restore eccentric control. In the previous blogs we have examined this via the hip, quad, and foot but have you ever thought about it through the thoracic? It is not a surprise that many ACL injuries are in younger athletes, at the high school or collegiate levels. And during these years (and it seems for the rest of our lives) we can pretty much determine that handheld devices are destroying everyone’s posture.

This standing, posteriorly pelvic tilt is not the most “athletic” position. While I am making no claims that this position is constant on the field, reality is the muscles in the back are lengthened and weakened regardless. So, with Dynamic Tape, here is an opportunity to get after that problem without constantly saying “STAND UP STRAIGHT!!”

To go after apparent weakness and poor pelvic position we are going to attack this issue from the thoracic. Using the Dynamic Tape X Posutre Pal (note: this can be created with regular Dynamic Tape as well) the thoracic spine is functionally supported. If an over kyphotic position is present, so will be a deficient lordic position. Functional weakness in the thoracic is a very common issue, particulalry with somone laying around resting a knee playing video games. Thoracic strengthening exercises, using prone dumbell flexion and resistance bands in standing are essential in conjunction with correcting posture with biomehcanical tape.

Postural dysfunction in athletes, or everyone for that matter, affect everything from the mid back down. Whether it is:
·       Landing on the heels due to a posteriorly tilted pelvis
·       Difficulty maintain pelvic stability with lateral movements
·       Fatigue causing excessive rotation through the spine resulting in IR/ADD at the hips

having a practical treatment solution for the thoracic spine is a must for any clinician. With Dynamic Tape and Posture Pals that solution is only a simple step away.

Want to learn more about Dynamic Tape or the Posture Pals pre-cut system? Please contact Keith J. Cronin, DPT, OCS, CSCS at or visit the website at

Dr. Nessler is a practicing physical therapist with over 20 years sports medicine clinical experience and a nationally recognized expert in the area of athletic movement assessment.  He is the developer of an athletic biomechanical analysis, is an author of a college textbook on this subject  and has performed >5000 athletic movement assessments.  He serves as the National Director of Sports Medicine Innovation for Select Medical, is Chairman of Medical Services for the International Obstacle Racing Federation and associate editor of the International Journal of Athletic Therapy and Training.   He is also a competitive athlete in Jiu Jitsu. 

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