2). The correlation between the baseline patellofemoral kinematics and the change in kinematics due to taping supports earlier work that identified the existence of subgroups within the patellofemoral pain population.33 The expected medial change in patellar displacement or tilt occurred in participants with lateral baseline values of these variables. Dip. Each knee underwent 2 testing conditions in the MRI (untaped and taped), which were randomly ordered. Low irritant Fixomull tape should be applied as an under-wrap to reduce the likelihood of skin irritation with rigid sports tape over the top of this. Bennell C Normally, this motion has almost no friction: the friction Boucher . It is often given the diagnosis of chondromalacia patellae, but this diagnosis is only appropriate if softening and fissuring of the un­dersurface of the patella has been vis­ualized either directly during surgery or arthroscopy or indirectly by means of an arthrogram (Devereaux and Lachmann 1984, Ficat and Hungerford 1977). Aditya Derasari, Timothy J. Brindle, Katharine E. Alter, Frances T. Sheehan, McConnell Taping Shifts the Patella Inferiorly in Patients With Patellofemoral Pain: A Dynamic Magnetic Resonance Imaging Study, Physical Therapy, Volume 90, Issue 3, 1 March 2010, Pages 411–419, https://doi.org/10.2522/ptj.20080365. The authors thank Elizabeth K. Rasch, PT, PhD, for support on the statistical analysis and Steven Stanhope, PhD, for guidance throughout the project. The patient will be counseled on which activities he or she can safely , Pasquinelli FM, Paladini P, et al. Crossley Chondromalacia patella often occurs when the undersurface of the kneecap comes in contact with the thigh bone causing swelling and pain. The chondromalacia on the patella was usually centrally located with extension equally onto the medial and lateral facets. These measures were used solely as inclusion and exclusion criteria and were not included in the kinematic data analysis arm of the study. For the participants in this study, patellar taping shifted the patella inferiorly with respect to the femur, which may account for some of the previously reported pain relief with taping, due to an increase in contact area. All Rights Reserved. GE Medical Systems, 4855 W Electric Ave, Milwaukee, WI 53219-1628. . McConnell test for chondromalacia patellae is a topic covered in the Taber's Medical Dictionary.. To view the entire topic, please sign in or purchase a subscription.. , Wooden C, Worrell T, et al. SR Cibulka The disorder results from knee injuries or sporting activities in which the knee is bend for long periods. 1, −1.6 mm, P=.04). Dr Sheehan provided fund procurement. 2, 4.6 mm). In addition, fastcard images (anatomic only) were acquired in 3 axial planes during the cyclic movement. . Chondromalacia patella, often called “runner’s knee” is a condition where the cartilage under the patella breaks down, causing increased knee pain. The lack of alteration in 5 of the 6 kinematic variables with taping may have been due to the fact that post-taping kinematic alterations are sensitive to the baseline kinematic values. To confirm or deny the presence of a J-sign, participants were seated at the end of the table and the examiner evaluated patellar motion as the participants raised their leg into full extension. Taping of the patella to pull it medially, followed by quadriceps exercises, has recently been recommended for the treatment of young people with anterior knee pain arising from the patellofemoral joint (chondromalacia patellae). Δdisp=changed in displacement. Data were interpolated to 1-degree knee angle increments, but symbols are provided at every 5 degrees for clarity. Chondromalacia patella - Chondromalacia patella - Treatment: The approach to the management of chondromalacia patella almost always begins with nonsurgical treatment. Man. The Process of Creating and Disseminating Exercise Programs by Physical Therapists for Older Adults With Chronic Back Pain, Cost-Effectiveness and Outcomes of Direct Access to Physical Therapy for Musculoskeletal Disorders Compared to Physician-First Access in the United States: Systematic Review and Meta-Analysis, Rehabilitation Therapy for Vocal Fold Paralysis Caused by Lung Cancer: A Case Report, Comparative Efficacy and Safety of Conservative Care for Pregnancy-Related Low Back Pain: A Systematic Review and Network Meta-analysis, PTJ: Physical Therapy & Rehabilitation Journal, International Classification of Functioning, Disability and Health (ICF), Receive exclusive offers and updates from Oxford Academic, Change with taping for participants with PFPS, Copyright © 2020 American Physical Therapy Association. Gigante Whittingham Originally, the McConnell taping technique was developed to correct altered patellofemoral kinematics and permit participation in normal daily activity.16 Today, there exist several variations of McConnell taping techniques, where attempts are made to alter patellar tilt, glide, or rotation.17 Clinical application of these techniques is based on a physical examination of patellar position, orientation, and mobility.18,19 The underlying concept is that most patients with PFPS would benefit from medialization of the patella, which theoretically would off-load the compressive forces at the lateral patellofemoral joint.16,20. On average, the only consistent influence McConnell taping provided on patellar kinematics was to shift the patella inferiorly. This should always be used in combination with hypoallergenic tape as an underlay, such as Fixomull. Thus, it is likely that the ineffectiveness of taping found in previous studies was due to the fact that some patients were not laterally tilted or displaced prior to taping. Find a physiotherapist in your local area who can help with Patella Taping. McConnell , Threlkeld-Watkins J. Sutlive The top row contains displacements (medial, superior, and anterior are the positive directions, respectively), and the bottom row contains the rotations (flexion, medial tilt, and varus rotation are the positive directions, respectively). Therefore, taping shifts the patella medially in patients with lateral baseline values of patellofemoral displacement (relative to an asymptomatic average), and it shifts the patella in the opposite direction in patients with medial baseline values of patellofemoral displacement. , Andreasen E, Urfer A, et al. Post All authors provided data collection. Yet, in previous studies, participants often applied their own tape,21,44 and no previous study measured the force applied with taping.17,21,24,29,30,44,45 Lastly, pain was not measured after tape application. The kneecap, or patella, is the bone that covers your knee. Statistical significance was set at P≤.05, (SPSS, version 14.0).‡ An a priori sample size calculation determined that adequate power (α=.05, β≥.80) could be achieved with the inclusion of 15 knees, assuming that taping would result in a 2-mm medial patellar shift30 and that the standard deviation associated with this change would be 2.5 mm.34. 3 and Fig. Lesher For full access to this pdf, sign in to an existing account, or purchase an annual subscription. You should discuss the suitability of this taping technique with your physiotherapist prior to using it. In general, for most patients with PFPS with lateral baseline values of patellofemoral LM displacement, the inferior shift and taping may lead to further patellar engagement with the femoral sulcus. B A 10-degree knee flexion angle was used because not all participants were able to achieve full knee extension (0° flexion angle). N . This study was approved by the National Institute of Child Health and Development. This is the first study to evaluate 3-dimensional changes in patellar kinematics with McConnell taping during voluntary active motion. It’s the number one cause in the United States with an incidence as high as one in four people. Bockrath Similarly, taping is effective in medially tilting the patella in patients with PFPS and lateral baseline tilt, but it has the opposite effect for patients with medial baseline tilt. For more information see Become a Member. They also thank Bonnie Damaska, Jamie Fraunhaffer, Jere McLucas, Dr Ken Fine, and the Diagnostic Radiology Department at the National Institutes of Health for their support and research time. This measure was not included in the study design, as previous studies21–26 have clearly shown the effectiveness of taping for pain reduction. Due to individual variations in range of motion within the magnetic resonance scanner, not all participants were represented at the extreme ranges of knee flexion and extension. Patellofemoral pain syndrome (PFPS) is one of the most common causes of orthopedic-related physician visits each year, especially among women.1,2 Patellofemoral pain syndrome can be caused by direct trauma to the knee, or the cause can be insidious in nature. Isometric quadriceps muscle activity has been incorporated into a few of these studies.21,28 In these studies, no differences in lateral patellar translation or tilt were found with taping, with or without muscle contraction. Dr Brindle provided consultation (including review of manuscript before submission). Gilleard , Besier TF, Santos JM, et al. Thus, considering the participants in this study as a single population masked the true changes with taping seen on a person-by-person basis. It is typically used in conjunction with a physical therapy regimen1… The following patella taping technique may be used to provide support for the patella and knee and to reduce abnormal patella positioning or tracking (lateral patella tracking). Thus, medialization of the patella with taping was dependent upon the patellofemoral kinematic alterations present in each participant. Patellar taping is widely used clinically to treat patients with patellofemoral pain syndrome (PFPS). , Trone DW, Leone DM, et al. Participants were excluded if they had any contraindications to having an MRI scan. , Muhle C, Schroder C, et al. , Krebs B. Sathe /* 336x280, large square txt created 11/24/08 */ Participants were instructed to generate knee extension without hip movement, and a loose strap was placed over the thighs as a reminder, but minor femoral motion was allowed to enable a natural movement. by Jenny McConnell, Ronald P. Grelsamer The experts show clinicians the newest and most effective solutions to patellar malalignment and pain. In addition, patellar taping should have the greatest effect when the patella is in terminal extension and is most free from the constraints of the femoral groove.5,35,42, Statistical differences between the taped and untaped conditions were investigated using a paired 2-tailed Student t test. This participant had the highest baseline values of superior displacement (39.0 mm, asymptomatic average [±SD]=21.7±6.3 mm). . NA It is a knee disorder in which the cartilage behind the patella is damaged. M Although patellar taping has been demonstrated to reduce patellofemoral pain in patients with PFPS,21–26 the kinematic source of this pain reduction has not been identified. The movements were isolated to the knee, neglecting the influence of proximal or distal joints on patellofemoral kinematics. In these instances though, taping during high-risk activity (such as sport) is usually still recommended. Karst Seisler examined each knee for evidence of altered patellofemoral kinematics: (1) Q-angle of ≥15 degrees,18,31,32 (2) a positive apprehension test, (3) patellar lateral hypermobility of ≥10 mm,18 or (4) a positive J-sign.18,32,33 Any knee that did not exhibit 1 or more of these 4 signs was excluded.