Patellar Strapping: Understanding Techniques, Benefits, and Application

How to strap your patella?

Patellar strapping involves applying a brace or tape to the knee to provide support, reduce pain, and improve patellar tracking, commonly used for conditions like patellofemoral pain syndrome or jumper's knee.

Understanding Patellar Strapping: Why and What It Is

The patella, or kneecap, is a crucial component of the knee extensor mechanism. It glides within a groove on the femur (thigh bone) called the trochlear groove. Optimal patellar movement, known as patellar tracking, is essential for efficient knee function and pain-free movement. When the patella does not track correctly—often due to muscular imbalances, biomechanical issues, or overuse—it can lead to pain, inflammation, and conditions like Patellofemoral Pain Syndrome (PFPS) or Patellar Tendinopathy (Jumper's Knee).

Patellar strapping refers to the application of external support, usually via a specialized brace (often called an infrapatellar strap or patellar band) or athletic tape (including kinesiology tape), to influence the patella's position or reduce stress on the patellar tendon. The primary goals are to:

• Reduce pain: By offloading stress or improving tracking.
• Provide support: Stabilizing the patella during activity.
• Improve patellar alignment: Guiding the patella to track more centrally.
• Enhance proprioception: Increasing awareness of knee joint position.

Types of Patellar Strapping Techniques

Various methods exist, each with a slightly different mechanism of action and application:

• Patellar Tendon Strap (Infrapatellar Band): This is a narrow strap worn directly below the kneecap, applying pressure to the patellar tendon. It's often used for conditions like Jumper's Knee or Osgood-Schlatter disease. The theory is that it alters the angle of pull of the quadriceps muscle on the patella, reduces tension on the patellar tendon insertion, or diffuses forces over a larger area.
• Kinesiology Taping: Kinesiology tape is an elastic, adhesive tape that can be applied in various configurations to support the patella. It aims to lift the skin, decompress underlying tissues, facilitate lymphatic drainage, reduce pain, and provide subtle proprioceptive feedback for improved patellar tracking without significantly restricting movement.
• Rigid Athletic Taping (McConnell Taping Principles): While less common for everyday patellar strapping by individuals, this technique, often applied by physical therapists, uses rigid tape to physically pull the patella into a more favorable position (e.g., medially) to correct tracking issues. It's highly effective but can restrict movement more than kinesiology tape.

When to Consider Patellar Strapping

Patellar strapping is typically considered as an adjunct to a comprehensive rehabilitation program, not a standalone solution. It may be beneficial for:

• Patellofemoral Pain Syndrome (PFPS): Often characterized by pain around or behind the kneecap, especially with activities like climbing stairs, squatting, or prolonged sitting. Strapping can help improve patellar tracking and reduce pain.
• Patellar Tendinopathy (Jumper's Knee): Pain and tenderness at the bottom of the kneecap, often seen in athletes involved in jumping or explosive movements. An infrapatellar strap can help reduce tension on the patellar tendon.
• Osgood-Schlatter Disease: A common cause of knee pain in growing adolescents, involving inflammation of the patellar tendon where it attaches to the shinbone. An infrapatellar strap can help alleviate pain by reducing strain on the tendon.
• Temporarily managing symptoms: During activity or exercise, to allow participation while addressing underlying causes.

Important Note: Strapping should not be used to mask severe pain, acute injuries (e.g., fractures, dislocations), or undiagnosed knee pain. Always consult a healthcare professional for an accurate diagnosis.

Step-by-Step Guide: Applying a Patellar Tendon Strap

This method is for using a pre-fabricated infrapatellar band or strap.

1. Select the Right Size: Most straps come in different sizes; ensure it fits snugly but comfortably around your knee.
2. Positioning: Place the strap directly below your kneecap, over the patellar tendon. It should sit in the soft indentation just beneath the bottom of the patella, above the tibial tuberosity (the bony bump on your shinbone).
3. Fasten Securely: Wrap the strap around the back of your knee and secure it with the Velcro or buckle closure.
4. Adjust Tension: Tighten the strap until you feel firm, comfortable pressure. It should be tight enough to provide support and reduce pain but not so tight that it causes numbness, tingling, or restricts blood flow. You should be able to slide one finger underneath the strap comfortably.
5. Test Movement: Perform a few knee bends, squats, or the activity that usually causes pain. Adjust the strap as needed until you find the optimal tension that reduces symptoms without discomfort.

Step-by-Step Guide: Kinesiology Taping for Patellar Tendon Support

This technique provides support for the patellar tendon, similar to an infrapatellar strap, but with the flexibility of tape.

Materials:

• Kinesiology tape (approximately 10-15 inches long, 2 inches wide)
• Scissors
• Clean, dry skin

Application:

1. Prepare the Skin: Ensure the skin around your knee is clean, dry, and free of oils or lotions. Shaving excess hair may improve adhesion.
2. Measure and Cut: Measure a piece of tape that will extend from just above the kneecap to just below the tibial tuberosity. Round the corners of the tape to prevent peeling.
3. Anchor Point (Above Patella):
   • Bend your knee slightly (about 10-20 degrees of flexion).
   • Tear the backing off about 1-2 inches from one end of the tape.
   • Apply this anchor directly above the top of your kneecap, on the quadriceps tendon, with no stretch. Rub to activate the adhesive.
4. Apply with Stretch (Over Patella and Tendon):
   • With your knee still slightly bent, gently stretch the tape to about 25-50% tension.
   • Smoothly apply the tape downwards, over the patella, and continuing down over the patellar tendon.
   • Ensure the tape covers the entire patella and extends down to just below the tibial tuberosity.
5. Anchor Point (Below Tibial Tuberosity):
   • Once you've reached the desired length, remove the rest of the backing.
   • Apply the final 1-2 inches of tape onto the shinbone below the tibial tuberosity with no stretch.
   • Rub the entire length of the tape vigorously to activate the adhesive and ensure proper adherence.

Alternative for Patellar Tracking (Medial Glide):

1. Prepare Skin: As above.
2. Measure and Cut: Cut a piece of tape long enough to go from the outside of your thigh, across the patella, and to the inside of your shin. Round corners.
3. Anchor (Lateral Thigh):
   • Bend your knee slightly.
   • Apply the first 1-2 inches of tape to the outside of your thigh, about 2-3 inches above the patella, with no stretch.
4. Apply with Stretch (Across Patella):
   • Gently pull the patella medially (towards the inside of your leg) with your hand.
   • With the patella held medially, apply the tape with 25-50% stretch, pulling it across the center of the patella towards the inner side of your leg.
5. Anchor (Medial Shin):
   • Apply the final 1-2 inches of tape to the inside of your shin, below the kneecap, with no stretch.
   • Rub the entire length of the tape.

Important Considerations and Best Practices

• Consult a Professional: Always seek guidance from a physical therapist, sports medicine doctor, or certified athletic trainer before starting any strapping regimen. They can accurately diagnose your condition and recommend the most appropriate strapping technique.
• Skin Integrity: Ensure your skin is healthy. Avoid applying tape or straps over cuts, blisters, rashes, or irritated skin. Remove tape immediately if irritation occurs.
• Proper Fit and Tension: Too tight can restrict circulation or cause skin damage; too loose provides no benefit. Adjust until comfortable and effective.
• Not a Permanent Solution: Strapping is a temporary aid. It should be used in conjunction with a comprehensive rehabilitation program focusing on strengthening (especially glutes, quadriceps, and core), flexibility, and biomechanical correction.
• Duration of Use: Do not wear strapping continuously for extended periods. Remove tape regularly (e.g., every 3-5 days for kinesiology tape) to allow the skin to breathe. Patellar straps are often worn only during activity.
• Listen to Your Body: If pain worsens or new symptoms develop, remove the strapping and consult your healthcare provider.

Potential Risks and Limitations

While generally safe, patellar strapping carries some potential risks:

• Skin Irritation: Adhesives can cause itching, redness, or blisters, especially with prolonged use or sensitive skin.
• Circulation Issues: Over-tight strapping can impede blood flow, leading to numbness, tingling, or swelling.
• Over-reliance: Relying solely on strapping without addressing underlying causes can hinder long-term recovery and lead to muscle weakness.
• Masking Serious Injury: Strapping can temporarily alleviate pain, potentially delaying diagnosis and treatment of more serious conditions.

Conclusion

Patellar strapping, whether through an infrapatellar band or kinesiology tape, can be an effective tool for managing patellar-related pain and improving knee function during activity. However, it is crucial to understand that it serves as a supportive measure, not a cure. For lasting relief and optimal knee health, integrating strapping with a targeted exercise program, addressing biomechanical deficits, and seeking professional guidance are paramount. Always prioritize a thorough assessment by a qualified healthcare professional to ensure safe and effective use.