Chapter 8 Wrapping and Taping

Chapter 8

Extended Lecture Outline

  • Introduction:
  • Bandaging and taping used to achieve the following objectives: Provides compression to minimize swelling in acute injury management, reduces the chance of injury by applying tape prophylactically, and provides additional support to an injured structure
  • Review of evidence-based support for using tape indicates that there is limited effectiveness of taping. In some instances braces have been shown to be more effective alternatives to taping.
  • Wrapping
  • Wraps:
  • Hold a dressing in place over an open wound
  • Secure a compressive or protective pad in place over an injured area
  • Provide support or limit range of motion for an injured body part
  • May consist of roller gauze, a cloth ankle wrap or triangular wrap, most commonly used is the elastic wraps
  • Elastic Wrap: active wraps, allow the athlete to move without restriction, act as controlled compression wrap to control hemorrhage or swelling and can also help support soft tissue
  • Elastic Wraps come in varying lengths and widths.
  • Cohesive Elastic Wraps: exerts constant, even pressure, coated with a substance that makes the material adhere to itself, often used in “speed taping”
  • Application of Elastic Wraps
  • Wrap body part in position of maximum muscle contraction to ensure unhampered movement or circulation
  • Better to use a large number of turns with moderate tension than a limited number of turn applied to tightly
  • Each turn should be overlapped by at least one half of the overlying wrap to prevent the separation of the material
  • When limbs are wrapped, fingers and toes should be checked often for signs of circulation impairment
  • Always check for deceased circulation and blueness of the extremity as well as for capillary refill
  • Elastic Wrap Techniques
  • Ankle and foot spica (spica = a figure eight wrap with one of the two loops larger than the other)
  • Spiral wrap (used for covering a large area of a cylindrical part)
  • Hip Spica: for groin strain or hip adductor strain (thigh internally rotated)
  • Hip Spica: for hip extensor support (thigh extended and externally rotated)
  • Shoulder spica: mainly used to hold protective pad in place or to limit shoulder flexion or abduction
  • Elbow figure-eight wrap: Used to secure a dressing in the antecubital fossa or to restrain full extension in hyperextension injuries
  • Hand and Wrist Figure-eight: Used for mild wrist and hand support and for holding dressings in place (fist clenched)
  • Cloth Ankle Wrap: Due to use of ankle braces, cloth ankle wraps are used infrequently
  • Triangular Wraps: Primarily used as first aid devices (arm slings)
  • Cervical arm sling: Designed to support the forearm, wrist and hand – placed around the neck and under the bent arm that is to be supported
  • Shoulder arm sling: Used for forearm support when there is an injury to the shoulder girdle or when the cervical arm sling is irritating
  • Sling and swathe: Used to stabilize the arm securely in cases of shoulder dislocation or fracture
  • Non-Elastic and Elastic Adhesive Taping
  • Non-Elastic Adhesive Tape
  • Tape Grade
  • Graded according to the number of longitudinal and vertical fibers per inch of backing material.
  • Heavier and more costly tape contains 85 or more longitudinal fibers and 65 vertical fibers per square inch
  • Adhesive Mass
  • Should adhere readily when applied and should maintain this adherence in presence of perspiration and activity
  • Must contain as few skin irritants as possible and must be able to removed easily
  • Winding Tension
  • Must be even and constant unwinding tension
  • Elastic Adhesive Tape
  • Often used in combination with non-elastic adhesive tape
  • Used for small angular body parts such as the feet, wrist, hands and fingers
  • Tape Storage
  • Store in a cool place
  • Stack so that the tape rests on its flat top or bottom to avoid distortion
  • Using Adhesive Tape in Sports
  • Preparation for Taping (Focus Box 8-1)
  • Skin surface should be cleaned to remove dirt and oil
  • Hair should be shaved to prevent further irritation when the tape is removed
  • Apply quick drying tape adherent to help tape stick to the skin
  • Apply heel and lace pads to prevent irritation or blister formation over bony prominences
  • Taping directly to the skin provides maximum support, however underwrap may be used to help protect the skin
  • Underwrap should only be one layer thick, and should be anchored proximally and distally
  • Selecting Proper Tape Width
  • The correct tape width depends on the area to be covered. The more acute the angles, the narrower the tape must be to fit
  • Supportive tape improperly applied can aggravate an existing injury or can disrupt the mechanics of a body part, causing an initial injury to occur
  • Tearing Tape
  • The tearing method used should permit the operator to keep the tape roll in the hand most of the time
  • Many tapes other than linen backed type cannot be torn manually and require the use of scissors
  • Rules for Tape Application
  • If part to be taped is a joint, place it in position in which it is to be stabilized
  • Overlap the tape at least half the width of the tape below
  • Avoid continuous taping
  • Keep the tape roll in the hand whenever possible
  • Smooth and mold the tape as it is laid on the skin
  • Allow tape to fit the natural contour of the skin
  • Start taping with an anchor piece and finish by applying a lock strip
  • Where maximum support is desired, tape directly on the skin
  • Do not apply tape if skin is hot or cold from a therapeutic treatment
  • Removing Adhesive Tape
  • Manual removal: Remove the skin from the tape, and pull in direct line with the body
  • Use of Tape Scissors or Cutters: Avoid cutting the tape near the site of the injury
  • Use of Chemical Solvent
  • Common Taping Procedures
  • The Arch
  • Arch technique no. 1: with pad support: Used to support weakened arches
  • Metatarsals must have room to spread out when weight bearing
  • Arch technique no. 2: The X for the longitudinal arch: use the figure 8 method of taping the longitudinal arch
  • Arch technique no. 3: The X teardrop arch and forefoot support: supports the longitudinal arch and stabilizes the forefoot into good alignment
  • Arch technique no. 4: Fan arch support: Supports the entire plantar aspect of the foot
  • LowDye technique: Excellent for managing fallen medial longitudinal arch, foot pronation, arch strains and plantar fasciitis
  • The Toes
  • Sprained great toe
  • Hallux Valgus
  • Turf Toe: Designed to prevent excessive hyperextension of the MTP joint
  • Hammer or Clawed Toes: Designed to reduce pressure of the bent toes against the shoe
  • Fractured Toes: Used to splint the fractured toe with a non-fractured toe
  • The Ankle Joint
  • Routine Prophylactic Prevention Taping
  • A few studies have indicated that ankle taping rapidly loses its initial level of resistance to motion during exercise, but a majority of studies have demonstrated that the restraining effect on extreme ankle motion is not eliminated by prolonged activity
  • Using pre-wrap under adhesive tape has been shown to extend the effectiveness of tape application in controlling motion longer than if the tape is applied directly to the skin
  • A variety of ankle braces are used as alternatives to ankle taping, and a majority of studies have concluded that ankle bracing is superior to taping, based on less increase in ankle motion following exercise.
  • Closed Basket Weave (Gibney) Technique: Offers strong support, primarily used for newly sprained or chronically weak ankles
  • Open Basket Weave (Gibney) Technique:
  • Gives freedom of movement in dorsiflexion and plantarflexion while providing lateral and medial support
  • Allows room for swelling after acute injuries
  • Continuous Elastic Tape Technique: Provides fast alternative to other taping methods for the ankle
  • The Lower Leg
  • Achilles Tendon: Prevents the Achilles tendon from overstretching
  • The Knee
  • Medial Collateral Ligament
  • Never use tape in place of proper rehabilitation
  • Tape must not restrict the patella
  • Rotary Taping for Instability of an Injured Knee
  • Provides the knee with support when it is unstable from injury to the medial collateral and anterior cruciate ligaments
  • Hyperextension
  • Prevents knee from hyperextending
  • May also be used for a strained hamstring muscle or for slackened cruciate ligaments
  • Patellofemoral Taping (McConnell Technique)
  • Patellofemoral orientation may be corrected to some degree by using tape
  • Evaluates four components of patellar orientation: Glide, tilt, rotation, and anteroposterior (AP) orientation
  • Tape provides prolonged gentle stretch to soft-tissue structures affecting patellar movement
  • Utilizes special tape: Cover roll and Leuko sport tape
  • The Elbow
  • Elbow Restriction: Tape to prevent hyperextension
  • The Wrist and Hand
  • Wrist Technique no. 1: Designed for mild wrist strains/sprains
  • Affected hand should be flexed towards the injured direction and the fingers should be moderately spread to increase the breadth of the wrist for protection of nerves and blood vessels
  • Wrist Technique no. 2: Stabilizes and protects badly injured wrists
  • Affected hand should be flexed towards the injured direction and the fingers should be moderately spread to increase the breadth of the wrist for protection of nerves and blood vessels
  • Bruised Hand: Utilizes padding to cover the bruise under the taping technique
  • Sprained Thumb: Designed to give protection to the muscle and the joint utilizing thumb spica technique
  • Finger and Thumb Checkreins: Protects the injured thumb or finger via a checkrein to an uninjured finger
  • Kinesio Taping
  • Technique developed in Japan and widely used in Europe and Asia
  • Kinesio tape is elastic and can be stretched to 140 % of its original length before being applied to the skin thus providing constant tension to the skin over which it is applied
  • Kinesio tape is said to be therapeutic, activating neurological and circulatory systems with movement
  • Used immediately after injury to reduce edema, to control pain and inhibition and facilitate motor activity
  • Application of Kinesio Tape
  • Apply the tape from one end of a muscle to the other with very little to no stretch on the tape from origin to insertion for muscle support and from insertion to origin during rehabilitation
  • Can be worn continuously for three to four days
  • Requires specialized training
  • Kinesio Taping Techniques
  • Plantar Fasciitis
  • Patellofemoral Pain
  • Low back Strain
  • Shoulder Instability

Prentice, Principles of Athletic Training , 15e LO-8 | 1