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May, 2011

The Therapeutic Taping Method: Genuine Value-Added Therapy

By Tracy Barnes, DC, DICCP, CKTI

Elastic therapeutic taping was developed by Kenzo Kase, DC, in Japan for use with his own patients. From the very beginning, elastic therapeutic tape was designed to work in concert with chiropractic care. Chiropractic improves the efficiency of the body to heal itself through the use of manipulations to release restricted nerve pathways that inhibit normal function. It is non-invasive and succeeds without the use of pharmaceuticals. Elastic therapeutic taping succeeds in a similar manner.

Dr. Kase developed his technique to work with the body's innate healing systems to achieve and maintain a healthy balance. Applying tape is an extension of the treating practitioner's hands-on treatment, lasting three to five days, assisting in muscle facilitation for post-injury rehab, decreased selling for injuries and/or decreased muscle spasm for overuse sprains. In practice, tape allows the body the proprioceptive input to maintain subluxation correction by its influence on muscle function. If we can appropriately facilitate and inhibit muscle function both anteriorly and posteriorly, we can further allow the body to attain and maintain homeostasis.

Well-Tailored to the Chiropractic Model

In the United States, elastic therapeutic taping is generally a billable insurance modality. Dr. Kase originally introduced the technique in Japan and elsewhere through the chiropractic and sports medicine community. In the US, though, an interesting thing happened. Once physical and occupational therapists got wind of the elastic therapeutic taping option, they caught on quickly to its benefits and insisted it be a billing option in their treatment programs. Since PTs and OTs are part of a treatment team supervised by MDs, this allowed elastic therapeutic taping to be codified as a medical option for insurance and regulatory purposes. As a result, states, insurance companies, associations and agencies have been quick and cooperative in paying elastic therapeutic taping reimbursements.

Ron Frers, a licensed massage therapist and certified kinesio taping practitioner (CKTP) who works in a chiropractic setting, notes, "To my knowledge, sending a copy of the attending CKTP's certification along with the billing has assisted our company in never being denied payment, nor having a payment adjusted or reduced." He adds, "For a DC practice it is a billable modality, the patients like it and they show improvement almost immediately.  Especially with acute patients, pain is reduced and a sense of security comes to the taped area. Elastic therapeutic taping fits easily into a chiropractic practice. It can be applied post-massage or at any time during the treatment protocol."

The original intent of the therapeutic taping experience was for the manual adjustment to stay in place between office visits: for the doctor's touch to remain with the patient for a more extended time period of two to five days. Physiological effects include decreasing pain, muscle hypertonicity and swelling, increasing range of motion and circulation, improving function and providing support, to name just a few. I've found that since it can be worn for up to five days, it prolongs the work we can do in one office session. As Dr. Kase says, "The tape ... It's like you keep your hands on the patient."

Like a Phone Call to Your Brain

The tape is like an elastic band. Imagine if you were to attach (say, by stapling) an elastic band to one end of the muscle, stretch it and then staple it the other end of the muscle. It would create a mechanical recoil and a neurological stimulation / recoil, just as therapists do during rehab when they tape the skin / muscle to promote facilitation. For instance, in treating edema, since 90 percent of swelling occurs just below the skin and above the last layer of muscle, the convolutions created during a lymphatic application create a lymphatic pump that is effective for 24 hours a day for three to five days. For some DCs, this is the best-selling modality in the office.

I tell patients that the tape is like a phone call to your brain. Even when we forget the tape is there, as we move, it continues to call the nervous system and give it messages to restore function in an area. With staff, we would go over the same thing we communicate to our patients: information about how the tape works, who uses it and why, cautions for taking it off as needed and that it has no latex or medication in it.

Major distributors sell to the practitioners, who provide the service and product to the patient. Although many chiropractic offices do have displays, posters and literature about elastic therapeutic taping available, they primarily provide a service, rather than selling tape.

In most cases the service itself has proved lucrative for practitioners. Taping instructor and practitioner Scott Hainz, DC, CKTI, provides some context: "On the average I get $35 per visit for tape. This is cash or insurance. If you only tape an average of 45 patients a week for 48 weeks, it comes to $75,000 increase in revenue."

"A True Win-Win!"

Ron Frers is affiliated with Comprehensive Physician Services of Tampa, Fla., where every massage therapist and DC has completed some elastic therapeutic training and many are CKTP certified. In their seven office locations, they estimate that elastic therapeutic taping has been a profitable modality for them, returning close to $100 per application. They've found elastic therapeutic taping to be cost-effective, as it takes about 5 to 8 minutes to apply, with an average material cost of $2-$3 or less per application. He notes that the key is to use the tape when medically necessary and not to overuse it.

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