How I tape my patella - by Pierluigi Vernetto

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.
	Dialogue to video: 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. One possible cause of a poorly tracking patella is having a tight lateral retinaculum and these soft tissues they become soft or less tight only with very prolonged stretching. You cannot stay with your hand for hours or hours - you will be uncomfortable to stretch your lateral retinaculum and having the tape stretch the tissues is a good way to make them a bit more loose.