All tapes that have been used to address the UH have in common that they compress and cover the umbilicus. We suggest that activating skin around the hernia and not covering the hernia at all might be a cost effective and safe alternative. Please check out this Clinical note on the subject. We are looking forward to hearing your questions and comments. Esther and Martyna
Hi Esther, еxcuse me, I just could not exactly figure out your non-compressive taping technique. Nevertheless it's correct - mobilizing the skin around the navel to squeeze the herniated skin down with a sticker is the most appropriate method. I have been using it for a long time, putting additionally a small cotton ball at the center of the umbilical hernia to press it down.
dear Ognyan, thank you... the point is, that with this technique NO pushing of umbilicus is undertaken. I now see that the Clinical Note I wrote on this subject was not included in the question. I am sorry for this;. Please look at what I have wrote on this. Raw Data Clinical Notes 14: Umbilical Hernia
The blue tape on the third casus is the tape we use. No covering of the umbilicus. I would very much appreciate your reaction after you have seen what I mean... we do not put any force on the umbilicus, we merely activate the rectus abominis in this manner.
As I understood, the idea of this tape is to bring both recti together in the midline and this will fasten spontaneous closure of the umbilical hernia. Correct?
Yes, the interesting thing is that using only 10% stretch on the tape, and applying the tape to the stretched skin is enough to activate underlying muscles. We 'fasten' nothing... we just 'activate the rectus muscles', they 'come together' and this without any pressure exerted. Of course this does need to be done for a number of weeks to allow the muscle to become active and strong enough to 'close the gap'. It is such an interesting idea that we need NO force... just some activation of the muscle to have good results. We have had the same type of results using tape in the Diastasis Recti Abdominis. I have presented this at a Conference in Poland. I thought it was important that physicians know of about this possibility The slightest of skin stretch activates underlying muscles and even muscles in the periphery. USimaging has shown us this. I have a little video of this phenomenen and will add this here. You see a picture of my hand and later a small blue tape... Tape imitates skin stretch given manually. You see that the muscles react even thought patient is sitting still in the last part of the video. The slighter the stretch stimulus, the better the effect.. The brain can process this stimulus and do what it needs to do. I have come to regard the skin with great admiration. It is our outer brain. We are just not trained to look at it in this fashion. When you do, many new things become possible like this little tape application. kind regards Esther .
The majority of umbilical herniae will spontaneously resolve in the first few years of life. This, with the rarity of complications make you wonder whether any intervention is necessary.
dear Roy, Thank you so much for taking the time to comment. Yes, the mayority of these herniae will resolve in most cases but in some they do not and some of your colleagues actually apply pressure and bandaging. Parents are seen by us after such an treatment and ask for assistance when this treatment option is not effective. Parents go online looking for assistance and often buy these specific abdominal binders themselves, As paediatric physios, we do not see that many UH's, we see more DRA's. As herniae are often combined with a DRA it is something we have started to address more these days. Why?.. because we have been seeing an increase in children with low tone and weak trunk muscles and DRA's causing dysfunction. What I have seen a lot is that these children fall more often. Since I have started adding DRA tapes, total therapy session time has halved. I am planning a Clinical Note about the DRA's in children at this moment. I thought this tape would be interesting for phycicians as you/they are the ones that often start with the pressure tapes on the UH's. The idea that putting no pressure on the hernia at all, but activating the underlying rectus abdominis is what is exciting. Good rectus strength is needed for all other trunk muscles to function properly. It is their 'mobile' punctum fixum and if this muscle is weak, the others cannot function as well.
Dear Esther,
thank you for that. Like umbilical hernias, the vast majority of diastasis recti also spontaneously get better, and never need surgery in the otherwise normal child. It would be useful to see some hard evidence that these devices assist these children, and are not just causing an inconvenience for both the parents and children.
Dear Roy, we are not speaking of devices, we are speaking of using a small piece of elastic tape applied to the skin, no more. It is not inconvienent at all, it is very cost effective and parents learn how to apply themselves. In most cases tape is needed for only 2 -4 weeks and it complements the therapy already being given. Difficult to prove and virtually impossible to research as obtaining permission is not easy especially when treating yojng children. As a clinician not using every possibility to help a child, and doing no harm in the process, is my first priority. So that leaves us in a stale mate position. Am I not suppossed to use a treatment tool until it has been proven effective? Or could I say as a clinician... hey... this works. It will be up to researchers to look into it further. That is why I have posted this here in the first place. Hope to find someone interested enough to do a pilot.
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