NEUROMUSCULAR TAPING IN SPORT
NeuroMuscular Taping Institute, Rome
NeuroMuscular Taping is a non-invasive, non-pharmacological technique involving the application of elastic tape with special mechano-elastic properties. This tape, once applied, can bring about mechanical stimulation, creating space in the tissues; this promotes cellular metabolism while at the same time activating the body’s natural healing processes and triggering and/or controlling phenomena that facilitate neuromuscular proprioception. The action of NeuroMuscular Taping is, as mentioned, based on the body’s natural healing processes, which are stimulated by activation of the neuromuscular (mechanical principle) and neurosensory (reflexive principle) systems: it is thus a mechanical and/or reflexive treatment technique that facilitates blood circulation and lymphatic drainage in the treated area and interacts with the complex kinesithetic function, exploiting surface mechanoreceptor, connective tissue receptor and proprioceptor afferents.
NeuroMuscular Taping is a new approach to the treatment of the musculoskeletal system in post-traumatic conditions. Muscles are known to function as mechanical effectors not only in dynamic activities of the body but also, thanks to their visco-elastic properties, in the control of venous and lymphatic circulation and body temperature; consequently, malfunctioning muscles will have negative effects on other systems. By treating muscles with an elastic tape that allows recovery of muscle and joint movement, and therefore of normal homeostasis, normal physiological conditions are restored and the body’s ability to heal is increased (Fig. 1).
In rehabilitation, NeuroMuscular Taping is applied using protocols designed to diminish the congestion of body fluids, improve circulation of blood and lymph, reduce excess heat, and restore tissue homeostasis, reducing inflammation and hypersensitivity of pain receptors. NeuroMuscular Taping can also affect arthrokinematics, acting in a reflex manner on muscle tone and mechanically conditioning the fascia and its receptors, thereby altering muscle performance, and affecting the posture of the joint segments.
In the case of muscle fatigue
Muscle fatigue is extremely common in professional athletes: high levels of competitive activity and regular races or matches during the course of a week can severely test a person’s ability to maintain certain performance levels (Table 1).
Table 1 “Peripheral” processes affected by muscle fatigue
- Nerve fiber conduction
- Neuromuscular transmission
- Muscle excitability
- Electromechanical coupling
- Muscle relaxation
- Vascular and metabolic factors of muscle fibers
Continuous physiological stress, even when preventive measures are taken, does not facilitate recovery: the tiredness associated with muscle fatigue is caused by dehydration and overheating, reduction of the muscles’ energy reserves, depletion of carbohydrates, lowering of blood glucose levels, increase of lactic acid, muscle microtraumas and central fatigue (Table 2).
Table 2 Exercise-induced fatigue: main causes
- Dehydration and overheating
- Depletion of muscle energy stores
- Depletion of carbohydrates
- Lowering of blood glucose levels
- Accumulation of lactic acid
- Muscle microtraumas
- “Central” muscle fatigue
The aim of NeuroMuscular Taping in this case is to facilitate recovery by increasing the blood supply to and drainage of the muscles involved.
Water is an essential macronutrient in all bodily functions: it is particularly important during exercise because of the vital role it plays both in cardiovascular function and temperature regulation. During intense physical activity, muscles generate heat that is transported by the blood through capillaries lying near the surface of the skin. When the body loses water, the capacity of the blood to carry vital nutrients – glucose, fatty acids and oxygen – to the working muscles is reduced, as is the ability of the blood to eliminate the waste products of metabolism, such as carbon dioxide and lactic acid.
An athlete’s body temperature, normally around 37°C, can rise to as much as 40°C during intense physical activity. The circulatory system, through the blood, regulates body temperature. Blood also serves to meet the energy and metabolic needs of working muscles. If physical activity is excessive and prolonged it can place an excessive strain on the circulatory system, leading to inadequate dissipation of body heat and a corresponding increase in the athlete’s body temperature.
Depletion of muscle fuels
During brief but very intense bouts of exercise, depletion of glycogen stores in the muscles can result in tiredness. At the start of physical activity, most of the energy supplied by carbohydrates comes from the glycogen stores in the muscles. During continuous exercise, however, these stores are reduced, making glycogen a less and less significant source of energy. As the contribution of muscle glycogen decreases, that of circulating glucose (blood sugar) increases, to counterbalance it.
Lactic acid is a byproduct of anaerobic metabolism that diffuses into the bloodstream which carries it to the heart, liver and inactive muscles, where it is turned back into glucose. When the intensity of the exercise is increased, more and more lactic acid accumulates in the muscles, and the blood has to remove it. Therefore, the level of lactic acid in the blood increases with increasing exercise intensity and if the high-intensity effort continues, the athlete will reach his lactate threshold, i.e. the point at which the level of lactic acid in his blood is greater than the level his body is able to metabolize.
Microtraumas can occur at the level of the muscle fibers as a result of the larger amounts of amino acids used by muscle cells during prolonged exercise, build-up of lactic acid build and the reaching of the anaerobic threshold, constant contractures and stretching, exercise-induced spasms (when the muscle fibers remain contracted even after the end of the movement), reduced blood circulation and reduced lymphatic drainage.
Objectives and rehabilitation program
The aims in the recovery phase after intense physical activity that has produced delayed onset muscle soreness (doms) are influenced by the physiological recovery times (24-72 hours) and are summarized in Table 3.
Table 3 Delayed onset muscle soreness: aims of rehabilitation
- Relieve pain and contracture
- Limit pain and control bleeding (if present) and edema
- Reflexive massotherapy on the surrounding areas
- Lymphatic drainage
- Promote healing and reduce the formation of fibrous scar tissue
- Recover strength and muscle elasticity
- Recover a complete ROM
- Recover full loading
NeuroMuscularTaping in a cyclist
Decompressive taping was applied to the quadriceps muscle of a cyclist: the cyclist’s muscle and tendon disorders involved, primarily, the quadriceps muscle and patellar tendon, which are the main structures used when applying force to the pedal.
This particular athlete uses a mountain bike; after three hours of training he suffers quadriceps muscle contractures and often nocturnal cramps as well. Figure 1 illustrates the application of decompressive NeuroMuscular Taping to the quadriceps musculature of the right leg (no tape was applied to the left leg, figure 2).
The athlete, after training, is asked to passively flex his right leg: a, it is easy to note the poor flexion of the quadriceps muscle (due to contraction of the muscle fibers); b, after 5 minutes’ rest and application of tape, using the NeuroMuscular Taping technique, unloading of the quadriceps muscle is obtained.
The athlete is asked to passively flex his left leg, to which the NeuroMuscular Taping technique has not been applied: the poor flexion of the quadriceps muscle (a) persists even after 5 minutes’ rest (b).
The advantage of this taping technique is that, unlike others, it does not compress the muscles and other body parts and therefore does not restrict body movement or venous and lymphatic flow. The use of NeuroMuscular Taping is a new approach to treatment of the nervous system, muscles and organs. The tape and its particular method of application allow the individual to obtain therapeutic benefits that last all day. Moreover, once applied, it can be left in place for several days.
Although this type of taping looks very similar to traditional taping, it is actually fundamentally different, in that it allows decompression of neurophysiological structures.
Figure 2 clearly shows the increase in flexion, from 30 to 65%, obtained in the leg treated with the decompressive technique: on the other hand, the left leg, which was not submitted to NeuroMuscular Taping, showed no real increase in flexion after 5 minutes’ rest (figure 2).
An increase in flexion indicates that the muscle tension has relaxed, increasing the blood supply and drainage of metabolic waste products. After intense physical activity, it is possible to facilitate recovery by applying NeuroMuscular Taping tape from the end of the activity until the following day. The tape will goes on working, 24 hours a day, or until the athlete resumes training or competitive activity the following day (figure 3).
Example of application to the quadriceps musculature (striated) of the right thigh (a); the decompressive effect (marked wrinkling of the tape and the skin) is clear to see in the photograph (b).