Mcconnell’s patellar taping does not alter knee and hip muscle activation differences during proprioceptive exercises: A randomized placebo-controlled trial in women with patellofemoral pain syndrome.

Tape Yourself copy

The purpose of this study was to assess the effect of patellar taping on muscle activation of the knee and hip muscles in women with Patellofemoral Pain Syndrome during five proprioceptive exercises. Forty sedentary women with syndrome were randomly allocated in two groups: Patellar Taping (based in McConnell) and Placebo (vertical taping on patella without any stretching of lateral structures of the knee). Volunteers performed five proprioceptive exercises randomly: Swing apparatus, Mini-trampoline, Bosu balance ball, Anteroposterior sway on a rectangular board and Mediolateral sway on a rectangular board. All exercises were performed in one-leg stance position with injured knee at flexion of 30° during 15s. Muscle activation was measured by surface electromyography across Vastus Medialis, Vastus Lateralis and Gluteus medius muscles. Maximal voluntary contraction was performed for both hip and knee muscles in order to normalize electromyography signal relative to maximum effort during the exercises. ANOVA results reported no significant interaction (P>0.05) and no significant differences (P>0.05) between groups and intervention effects in all exercise conditions.

Significant differences (P<0.01) were only reported between muscles, where hip presented higher activity than knee muscles. Patellar taping is not better than placebo for changes in the muscular activity of both hip and knee muscles during proprioceptive exercises.

Top 5 Fridays: 5 Non Traditional Core Exercises Every Gymnast Should Use

Every gymnast, gymnastics coach, strength coach, and medical provider knows that appropriate core development is essential for success and reduced injury in gymnastics. There are hundreds of gymnastics specific core strength exercises to pick from (presses/stalders, L holds, leg lifts, planks, arch/hollow rocks, etc), many of which need to be done on a regular basis. However, as I have progressed and learn more in the last 5 years I have found huge success in implementing many “non gymnastics” based core drills also. They have also become a staple in my advanced rehab and return to sport phases when working with patients. Here are 5 of my favorites that I feel the gymnastics community should learn more about, and properly implement with their athletes.

1. Basic Core Bracing and Breathing

Even though basic core control drills aren’t as glamorous as L hold rope climbs, it is absolutely essential that gymnasts master these basics and work them daily. A gymnast must know how to engage their core while maintaining proper breathing patterns (more diaphragm and less upper chest breathing) in a relatively neutral alignment. Many gymnasts default to over hollowed, over extended, or faulty core control/breathing strategies when attempting skills. Without revisiting and stressing these core basics, it makes it very challenging to properly work any higher level gymnastics specific core strength exercise. I highly recommend readers first teach their athletes, and then add them in daily. They are an essential part of our warm up that only takes 2 minutes.

2. Plank Kettlebell / Dumbell Drag Throughs 

I got last year this from some of my strength coach friends, and immediately started programming it once a week in our strength. The main reason that I love this exercise is because it takes a traditional (pretty boring) front plank and adds both a rotational and weight shifting component. I think it has great application to bar and floor twisting, as well as helping to build in an upper body pulling component for scapular strength.

3. Medball Slam and Throw Variations

I wrote about med ball slam variations a few months ago in this article, but still continue to see huge benefit to them. Standing medball slams are great for dynamic core control and tumbling/shape change application, and overhead medball throws are great for teaching a hip open setting technique. I will say I have been using much more 1/2 kneeling medball diagonal throws than diagonal slams, in an effort to help it transfer to an “up and over” type floor and vault twisting technique I learned from many great national team coaches. The key for these are building on the basics above, and using lighter weight with high power/intent to encourage rapid rate of force development.

4. Loaded Carry Variations

Loaded carries have become very popular in the strength and conditioning world through the last 5-10 years. After learning from friends of mine and understanding how to coach them, I think loaded carries have a ton of benefits for gymnastics. It can bias certain aspects of the core, teach proper breathing mechanics and control under loaded tension, and are a fantastic way to develop metabolic capacity when programmed during the right energy systems workout. There are many variations but farmer, suitcase, front rack, and overhead carries tend to be my 4 go to for our team. Overhead carries in particular develop great single arm loading that is essential for pirouetting and tumbling skills.

5. Sled Push/Pull Variations 

Similar to above, sled pushing and pulling variations go hand in hand with loaded carries. They are great to  integrate leg strength or power development with core strength. Pushes can help bias anti extension core strength, pulls can help bias anti flexion core strength, and lateral sled drags can go a long way for anti – side bending and glute medius/minimus development. As with other exercises, there are a ton of great ways to make these harder or easier depending on the athlete you are working with.

Want To Learn More About Developing Core Strength and Power?

If you liked this post and want to learn a ton more about gymnastics core development, increasing shoulder/hip flexibility, preventing lower back pain, and training with cutting edge scientific methods, be sure to check out my brand new e-book, “The SHIFT Gymnastics Educational Series: Vol 1” that was just released. For this week only it is at a special discount of 25% off, so don’t miss out! You can click the link above to learn more, or the “Get Instant Access Now” to instantly get your hands on a copy.

The book has 230 pages, 7 Chapters, and 300+ full color photos that outlines all of the work I have done in gymnastics up to this point. Inside I go over hundreds of more exercises and training concepts for the gymnastics community to utilize, along with lots of current medical/strength research that fuels my ideas.


That’s all for now, and I hope this post was helpful!

– Dave Tilley DPT, SCS

Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

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Is there a relationship between impaired median nerve excursion and carpal tunnel syndrome? A systematic review.


It is accepted that the etiology of carpal tunnel syndrome (CTS) is multifactorial. One of the most commonly accepted etiologic factors for CTS is compromise of the kinematic behavior and excursion of the median nerve. The objective of this systematic review was to establish if there is a relationship between impaired median nerve excursion and CTS. A systematic review, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, was conducted. Studies were sought where in vivo median nerve excursion was compared between people with CTS to an appropriate control group. Quality appraisal for each study was conducted using the Newcastle-Ottawa Scale by 2 independent evaluators. Ten case-control studies using ultrasound imaging to quantify median nerve excursion were included. All studies were rated as of “moderate” methodologic quality having scored 6 or 7 (of 9 stars) for the Newcastle-Ottawa Scale. Seven of the 10 studies concluded that median nerve excursion was reduced in a CTS population when compared with controls.

The literature suggests that median nerve excursion is reduced in people with CTS when compared with healthy controls.

Kinesio taping or just taping in shoulder subacromial impingement syndrome? A randomized, double-blind, placebo-controlled trial.

Kinesiotaping. Physical therapist applying tape to patient. Pink: cervial trapezius supraspinatus blue: high dorsal paravertebral.

The objective of this study was to verify effects of kinesio taping (KT) in shoulder subacromial impingement syndrome (SIS) when compared to sham taping applied in the same way with KT. Patients were randomized as group 1 (n = 21) KT group and group 2 (n = 20) sham-taping group. Taping was applied every three days, three times during the study period. We assessed all the patients at baseline, at the end of the taping period (12th day), and at one-month post-intervention. We assessed pain on the 100 mm visual analog scale (VAS). Shoulder range of motion (ROM), Constant Scores, and Nottingham Health Profile (NHP) scores were evaluated. Of the 41 participants, 13 were males (32%) and 28 were females (68%). The mean age was 45 ± 15 years (range 20-65 years). We documented a significant decrease in VAS for nocturnal pain, and Constant Score in both groups. The KT group showed additional significant change in NHP pain and physical activity scores.

KT and sham taping generated similar results regarding pain and Constant Scores.

Cold Water Shock Therapy

Man swimming in the ice hole with emotional face

Everyone loves warm water but is it time to love the cold?

Hydrotherapy or Balneotherapy is a specialty area of physiotherapy and is used to help a wide demographic or person as well as a number of different musculoskeletal complaints as well as chronic pain. It usually involves very warm water, which is therapeutic in itself, and bridges the gap for those who find land based exercise difficult or near impossible to do. It takes the edge off of the pain and relieves anxiety which often creates a cycle of uncontrollable pain.

But what if we make the water cold?

In response to acute tissue damage/injury, feelings of fear are heightened as part of a normal consequence of pain. The individual will rest and protect the painful area as an adaptive behaviour to allow tissue healing to occur. As the acute phase and initial tissue healing resolves, it has been suggested that some individuals can confront their fearful emotions and are able to resume normal activities, which ultimately extinguish their fears as they experience positive increase in mobility/movement not associated with further increase in pain. For others, they may be unable to overcome the fearful emotion and the resulting avoidance behaviour persists. A cycle of continued activity avoidance and fearful emotions may ensue, the longstanding effect of which in patients with chronic pain may have an adverse effect on the musculoskeletal and cardiovascular system (disuse syndrome), which fundamentally increases disability. Several models have been proposed to explain the persistence of ‘fear-avoidance’ and its impact on pain and behaviour.

Cold water therapy, although it may not sound pleasant, may well be a new approach to managing this sort of catastrophizing pain behavior and aid in breaking the downward spiral and facilitate recovery with exercise. It is said to work by increasing your body’s ability to cope with stress and pain but making your coping system more robust. The theory makes sense and evidence shows it may well work. 

In brief it is hypothesized to work by activating the sympathetic nervous system and increase the blood level of beta-endorphin and noradrenaline and to increase synaptic release of noradrenaline in the brain as well. Additionally, due to the high density of cold receptors in the skin, a cold shower is expected to send an overwhelming amount of electrical impulses from peripheral nerve endings to the brain, which could result in an anti-depressive effect.

Untold Physio Stories S3:E3 – Doctors as a Referral Source with Aaron LeBauer

Download file | Play in new window | Duration: 10:13 | Size: 23.38M

Starting out a business is tough! If you have some family as a potential referral source, that would make it easier, right? Right? Find out what happened to Cash Based PT guru Aaron LeBauer of

Untold Physio Stories is sponsored by the EDGE Mobility System, featuring the EDGE Mobility Tool for IASTM, EDGE Mobility Bands, webinars, ebooks, Pain Science Education products and more! Check it out at .  Be sure to also connect with Dr. Erson Religioso at Modern Manual Therapy and Jason Shane at Shane Physiotherapy.
Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

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Effects of therapeutic ultrasound on pain, physical functions and safety outcomes in patients with knee osteoarthritis: a systematic review and meta-analysis.

Abdominal ultrasound

The aim of this study was to explore the effects of therapeutic ultrasound with sham or no intervention on pain, physical function and safety outcomes in patients with knee osteoarthritis. This systematic review was searched on CENTRAL, EMBASE, MEDLINE, CINAHL, Physiotherapy Evidence Database, Open Gray on 4 September 2015. Trials included randomized controlled trials that compared therapeutic ultrasound with a sham or no intervention in patients with osteoarthritis of the knee. Eligible trials and extracted data were identified by two independent investigators. Standardized mean differences (SMDs) and 95% confidence interval (CI) were calculated for pain and physical function outcomes. Heterogeneity was assessed by the I2 test and inverse-variance random-effects analysis was applied to all trials. Ten randomized controlled trials (645 patients) met the inclusion criteria. Therapeutic ultrasound showed a positive effect on pain (SMD = -0.93, 95%, CI = -1.22 to -0.64, p < 0.01, p for heterogeneity = 0.12, I2 = 42%). For physical function, therapeutic ultrasound was advantageous for reducingWestern Ontario and McMaster Universities physical function score (SMD = -0.37, 95% CI = -0.73 to -0.01, p = 0.04, p for heterogeneity = 0.94, I2 = 0%). In terms of safety, no occurrence of adverse events caused by therapeutic ultrasound was reported in any trial.

The authors suggested that therapeutic ultrasound is beneficial for reducing knee pain and improving physical functions in patients with knee osteoarthritis and could be a safe treatment.