Thursday, February 4, 2010

It Isn't Just Me

Matthew had physio yesterday. I could barely contain myself. I was so anxious to see if Steve saw what I thought I was seeing.

It took about a minute for Steve to look at me and say "His foot feels really good"

I had been hoping the tape would help. I had thought his foot felt looser then a week ago. Every day I stretched it, I thought it was looser. But I was scared to place so much hope on a few strips of carefully placed tape. Until now.

And his talus is back into place. I had to look hard to even find it.

All fantastic news.

But (isn't there always a but?) he is still supinated while walking, even with the tape on, worse with the tape off. That supination will only lead to the talus wanting to protrude, and eventually decreased dorsiflexion.

And the other problem. After a week of taping, his skin is starting to get very sensitive. Tape removal yesterday was painful and his skin looked almost like it was covered in hives afterwards.

We discussed actual kinesio tape which is easier on the skin, but Steve feels it won't hold his foot. The elasto tape he is using is stronger. He doubled up the under tape hoping for a bit of relief for the skin, but I have a feeling this is our next hurdle. Steve said I might be able to find a de adhesive spray. I have used it before to remove heart monitor leads from the kids after surgery (and NICU stays) but not sure if I can find some at a drug store. Will have to call around.

And now I am conflicted. This may be the answer to stopping the casting this time. But I am worried about the supination and the MA (metatarsal adduction) we are seeing

Casting fixes both those problems.

Maybe we started the taping too late? Maybe if he is casted, we can start taping earlier to prevent problems? As long as we can find a way past the skin problem?

So many questions. So few answers.


Donna said...

I am glad to hear that the tape is working.

Sue said...

Oh, man ... nothing's ever easy, is it?! :)

First off, though, I'm SO glad to hear of the improvement. That's a great start -- something else to add your repertoire of things that actually work! :)

I remember our PTs giving us tips about the skin issues but ... for the life of me I can't remember what they said. I do remember having those concerns -- Grace has such terribly dry skin in the winter, plus eczema, so I was afraid of some kind of reaction. With the Kinesio tape, I think I recall them saying you can't leave it on for more than a certain amount of days because of that, and then you have to re-tape. How long was Matthew's tape on?

We used olive oil to take the tape off and that worked pretty well. We just kind of soaked the tape and her lower leg and it slipped off nicely, with limited friction on the skin. And she smelled like a pizza too! :)

I don't know what to say about the casting, or the timing of it all ... Interesting, you said that casting "fixes" the MA. But is that really true? Or is it a temporary fix? This is my dilemma right now -- the casting had worked for a while but, like Matthew, we saw the curve come back after several months. Does casting just hold it for a while? Ugh ... like I said, never easy.

I'm curious about Steve's view that the Kinesio product won't "hold" the foot. I don't know -- like I said earlier, when I saw Grace's foot actually move outward with the tape on, nothing was going to turn that foot back in. But then again, Matthew's got a few other things going on too that obviously complicate things. Not sure what to think ...

Hang in there! And invest in olive oil! :)

Anonymous said...

Jo-Ann: Spoke with my husband who is a therapist also and has more experience in this area than I do. He said that the type of tape Steve is using is a more rigid tape (not the kinesiotape brand, because true kinesiotape isn't strong enough to hold the talus in. Kinesiotape is more for muscle re-education/support and the tape Steve is using is more for joint support. There is a possiblity that people can be allergic to the adhesive (even though let's say that they can wear baindaids normally with no allergy). When my husband has used the more rigid tape like Steve is using he usually only has them wear for about 24 hours, they remove it at home, and come back later in the week for the appt. Kinesiotape you can leave on for 2-3 days. So, if the talus and other issues like MA and dorsiflexion are happening quickly after the tape is removed (which my guess is maybe they are) then unfortunately I think you may need to cast again. And perhaps do some sort of taping post cast to help maintain correction? Putting that strong tape right back on is just too much stress for the skin perhaps. Anyhow, that's all I can give in terms of advice! Run it by Steve and Dobbs, both of them sound like they are really there to truly help you and are very trustworthy people! They will know best! :) Jamie

Michelle said...

I'm glad to hear that the tape seems to be helping - wonderful news! Is there anyway that they could use the more gentle tape on the skin and then tape over that with the stiffer tape? Just an idea.