The short answer: some of these kids, some of the time.
The long answer: To use K-tape effectively, you need to understand the mechanics of tape on the skin and underlying tissues, how connective tissue disorders disrupt skin healing, how to minimize skin shear and inflammation, and that only using one type of tape may not be enough.
I love to use taping for kids with hypermobility, but kids with connective tissue disorders such as Ehlers-Danlos syndrome aren’t always able to tolerate taping without some significant adaptations. Children that were preemies often have similar issues that make taping more challenging. Fragile skin, immune system reactions, fragile blood vessels, etc. will require adaptations and alterations to standard taping procedures and protocols. Read more about CTDs in Could Your Pediatric Therapy Patient Have a Heritable Disorder of Connective Tissue?. But it doesn’t mean an automatic “no”!
Here are my clinical suggestions to make K-taping more successful for kids with connective tissue distorders:
- Very few children with connective tissue disorders are able to communicate discomfort clearly. Their hypermobility creates limitations in proprioceptive and kinesthetic awareness. Children of all ages with poor proprioceptive discrimination have a sensory deficit that directly reduces their feedback for taping. Therapists have to be very skilled at observation and clinical judgement. A good therapist will carefully listen to a parent’s descriptions of movement, skin conditions and complaints to hear clues that should guide your taping.
- Assume significant skin sensitivity and fragility. If a child sails through your test tape period, don’t assume that you can use regular taping procedures and protocols. Always use a test tape, and consider doing multiple test tapes in different locations and with different levels of tension. Paper-off tension is highly recommended in treatment, and so is caution with taping protocols that add significant skin shear. Those include placing the tissue on stretch as you apply the tape, and protocols in which rotary force is exerted (such as spiral patterns around limbs). Because skin recovery may be impaired, skin tolerance can deteriorate after repeated taping. Use the most conservative treatment plan, even if you are getting good results. Slow and steady is better for everyone.
- Expect to take taping breaks and shorten the amount of time tape stays on the skin. These kids should receive longer periods without tape. This allows any micro-damage to be repaired. Once the tape has lost the majority of it’s elastic properties, it is less beneficial and becomes more of a risk for skin integrity. Instruct parents to trim the tape or remove it completely when the edges start to catch on clothing. The effect is constant shear on the skin next to the loose edge. This is irritating for all kids, but it can create significant inflammation for kids with CTD’s. Try taping another location and returning to taping after a substantial break. Children with connective tissue disorders usually have more than one area of instability that could benefit from taping.
- Use pediatric tape and pediatric protocols well into childhood and perhaps beyond. I use the Milk of Magnesia barrier technique with all children under 3, and with all children with diagnosed or suspected connective tissue disorders. I am also a big fan of PerformTex’ pediatric tape. Their adhesive seems to be to be less intense than ROC Rx tape, and significantly less adhesive than regular tape. The cute monkeys and flowers don’t hurt! I have been using Kineseotex’ Plus tape, which has an ultra-gentle adhesive with good results. I also like SpiderTech’s gentle tape. I don’t always need to do the barrier technique and get good skin tolerance. The biggest drawback to the Plus tape, other than cost, is that it is easily peeled off, so using excellent skin preparation and management, such as careful bathing and limiting clothing shear, is essential. Once I started using pediatric tape, I haven’t looked back. No parent wants to see their child’s skin inflamed, and no therapist wants to strain their client’s trust by appearing to be unconcerned about skin integrity and pain.
- Become skilled at taping typical kids before you tape kids with CTDs. Really know your stuff, know the different taping protocols and select carefully. This is not beginning taping. Find a mentor if you can. It will save you a lot of aggravation and show your clients that you are making every effort to deliver the best care you can.
- Expect that some children truly cannot tolerate taping, and move on. Good therapists have many different ways to make a difference in a child’s life, and taping may be tolerated better as a child grows up. While this can happen, don’t get hung up on one treatment technique as a saving grace. We can never predict the clinical course of a connective tissue disorder with certainty, so don’t give up, but don’t become rigid in your treatment planning either.
Looking for more information on treating hypermobility and hypermobility syndromes?
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Are you the parent or the therapist of a child with EDS that has questions about taping or other therapy treatment? Contact me through my website and book a consultation on my website tranquil babies. I will review your goals and your therapies, and help you identify how things can change to make greater progress today!
My e-book on potty training, The Practical Guide To Toilet Training Your Child With Low Muscle Tone, is a great reference for therapists and a helpful resource for families of young children with low muscle tone. Many of our hypermobile preschoolers are still in pull-ups because no one knows how to make it easier. My book has readiness checklists and equipment assessment guides that can help kids move forward with training immediately! Visit my website to purchase my book at tranquil babies, or go to Amazon , or visit Your Therapy Source, a wonderful site for therapy materials.