How I tape my patella

Pierluigi vernetto

 

 

Today I am going to show you how I tape my patella. This operation is called patellar taping or McConnell taping (McConnell is a physiotherapist and she perfected this method).

Actually I haven’t done any courses on my own, so mine is ‘poor man’s patellar taping’ – it is not specialist patellar taping. But I have been doing it for more than one year and it has helped me a lot.

 

 

 

 

 

First of all If you have patellofemoral pain, most likely the reason is that your kneecap is lateralized - it doesn’t track properly. Most of the time [with malalignment] it is in the outward position, it is lateral - this is medial, this way, and this is lateral. Most of the time the kneecaps are misaligned laterally, 95% of the cases. So basically if your kneecap is lateral, we want to keep medial, so that it will track properly in the femoral condyles.

 

 

Taping is NOT a solution - it’s OK temporarily, as a workaround - but I would definitely suggest not to rely on it as a permanent solution to your problem. Most likely if your kneecap is not tracking properly you have some muscular imbalance, probably a weak vastus medialis... and if the vastus medialis is weak, or if the vastus lateralis is too strong, the kneecap tends to pull on the side of the strongest muscle - or of the most tense muscle.

 

Most of the time the problem is a weak vastus medialis. The vastus medialis is a TERRIBLE muscle, it is the first one to become atrophic whenever you have knee pain, and it is the most difficult to recover. You can detect an atrophic vastus medialis, by straightening your leg and seeing whether you have a sort of pouch here, a valley here, in my case it’s not too bad, it is still a bit atrophic but not too bad - it used to be a lot worse. So if you see like a saddle, a shadow here, it means that your vastus medialis is gone, and you’d better work on it, and the patellar taping is only a workaround, but this is really the main focus, where you should really work hard.

 

So another reason for having misalignment in your kneecap is a tight iliotibial band, or a tight vastus lateralis, or high kneecap (if the kneecap is high it doesn’t track properly). Another predisposing factor is having tibia vara. You see that my tibia is definitely going... it’s not straight, it goes whoop!... and having tibia vara - I will show you with a pen - so here you have the patellar tendon and the patellar ligament, and if you have tibia vara, the resulting forces (rraaa!) tend to bring your kneecap outwards.

 

The TEMPORARY workaround is to tape the patella so that it stays in an inner position, to contrast these forces which are pulling the kneecap laterally. And to do that you should use an antiallergic tape - like this. This is a 3M Micropore antiallergic tape. It’s a sort of paper tape, and every pharmacy should have this kind of tape. It is not very strong, so you you should use on top of it a second normal tape - they are more or less 4 or 5 cm. So you position the tape like this - with one hand you push the patella medially, the skin should do some folds here, you help with your hand and there you are. So that’s it! And after you apply the second tape. Be very careful that the second tape doesn’t touch directly the skin, because it will produce after a couple of hours HORRIBLE ulcers, which can be EXTREMELY painful.

 

A collateral GOOD effect of taping is the stretching of the lateral retinaculum. So one possible cause of a poorly tracking patella is having a tight lateral retinaculum. And these soft tissues become soft or less tight only with a very prolonged stretching. So you cannot stay with your hands for hours and hours - it’s very uncomfortable to stretch your lateral retinaculum - and having the tape stretching the tissues is a good way to make them a bit more loose.

How to tell whether the taping was successful? Only pain can tell you whether it is done correctly. If you can walk with less pain – fine. If the pain increases then immediately remove the taping because pain is always a bad sign.

You can even sleep with your tape on, but it is not really very advisable – it is up to you. I mean you can check whether in the morning you wake up with a stiff knee or not.

Normally they suggest to wear the tape for two days in a row, then remove it for one day, then two days with the tape on, but I wouldn’t think there is a hard-and-fast rule and whatever suits you is OK. Obviously with the tape on you cannot bend your knee too much - if you do then pop! – the tape will come away, but it is OK.

It’s not so great for biking, but probably you can even bike up to some point if you don’t tape too tightly. Sometimes honestly, when my kneecap was a lot worse than now, it was the only way that I could bike without having my kneecap dislocate. At least the taping was keeping the kneecap inside the condyles - otherwise it would go out all the time.

One last word of advice if you have knee pain and a kneecap which is not tracking properly – act quickly! And act with determination!

Don’t deal with pain for a long time - for months and months – because if you have pain in your kneecap it most likely means your cartilage is going away and once it is gone it will never come back. If your cartilage is deteriorating too much, later on in your life you may end up with arthritis which is very debilitating. Don’t say “I don’t have time, I have to work” – just postpone everything, get good medical advice and a good physiotherapist and focus on your knees.

Quote - “Every time I see an adult on a bicycle, I no longer despair for the future of the human race.”

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