Taping

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Taping
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Principles of Taping

• The application of tape is an art, and, in the
  hands of the inexperienced it may be very
  difficult. Practice is essential to good taping.
  Neatness is the trademark of a good taper. Be
  neat, and the respect of the athlete will be
  earned.The beginner should start slowly the
  application of tape should be very deliberate and
  neat. After much practice and speed, efficiency
  will be the result.
• - Stephen Rice, MD

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Selection considerations

• Diagnosis of injury
• Goals of taping
• Resource available
• Sport position
• Athletes acceptance
• Research findings
• Personal preference

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Diagnosis of injury

• Location
• Nature
• Severity

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Selection considerations

• Diagnosis of injury
• Goals of taping
• Resource available
• Sport position
• Athletes acceptance
• Research findings
• Personal preference

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Goals of taping

• Prophylactic
• Rehabilitative
• Functional

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Selection considerations

• Diagnosis of injury
• Goals of taping
• Resource available
• Sport position
• Athletes acceptance
• Research findings
• Personal preference

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Resource available

• Human resource
• Financial resource

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Selection considerations

• Diagnosis of injury
• Goals of taping
• Resource available
• Sport position
• Athletes acceptance
• Research findings
• Personal preference

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Sport and position

• A taping that is effective for an athlete in one
  sport may not be suitable for another athlete
• A taping that is effective for an athlete in one
  sport may not be suitable in another sport
• Requirements, Equipment, Environment Rules

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Selection considerations

• Diagnosis of injury
• Goals of taping
• Resource available
• Sport position
• Athletes acceptance
• Research findings
• Personal preference

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Athletes acceptance

• If the athlete feels that taping is uncomfortable
  or decreases performance the attempt to support
  will failed

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Selection considerations

• Diagnosis of injury
• Goals of taping
• Resource available
• Sport position
• Athletes acceptance
• Research findings
• Personal preference

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Research findings

• With respect to new techniques or products, it is
  probably best to keep an open mind but to be
  critical

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Selection considerations

• Diagnosis of injury
• Goals of taping
• Resource available
• Sport position
• Athletes acceptance
• Research findings
• Personal preference

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Personal preference

• After gaining clinical experience with various
  taping techniques, one usually begins to have
  with relying on experience when the athlete is
  looking for expert answers, as long as each case
  is viewed individually.

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TAPING MECHANISMS

• MECHANICAL
• PROPRIOCEPTIVE(DIRECT REFLEX STIMULATION
  LEARING PROCESS )

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Re-establishing Neuromuscular Control,
Proprioception, Kinesthesia and Joint Position
Sense

• Following injury, body forgets how to integrate
  information coming in from multiple biological
  sources
• Neuromuscular control is minds attempt to teach
  the body conscious control of a specific movement
• Re-establishing neuromuscular control requires
  repetition of same movement, step by step until
  it becomes automatic (progression from simple to
  difficult task
• Closed kinetic chain (CKC) exercises are
  essential for re-establishing control but can be
  difficult

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• Must regain established sensory pattern
• CNS constantly compares intent and production of
  specific movement w/ stored information,
  constantly modifying until discrepancy in
  movement is corrected
• Four key elements
• Proprioception and kinesthetic awareness
• Dynamic stability
• Preparatory and reactive muscle characteristics
• Conscious and unconscious functional and motor
  patterns
• Must relearn normal functional movement and
  timing after injury - may require several months
• Critical throughout rehab - most critical early
  in process to avoid reinjury

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• Reestablishing proprioception and kinesthesia
  should be of primary concern
• Proprioception is joint position sense (determine
  position of joint in space)
• Kinesthesia is the ability to detect movement
• Kinesthesia and proprioception are mediated by
  mechanoreceptors in muscle and joints, cutaneous,
  visual, and vestibular input
• Neuromuscular control relies on CNS to integrate
  all areas to produce coordinated movement

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• Joint Mechanoreceptors
• Found in ligaments, capsules, menisci, labra, and
  fat pads
• Ruffinis endings
• Pacinian corpuscles
• Free nerve endings
• Sensitive to changes in shape of structure and
  rate/direction of movement
• Most active at end of ranges of motion
• Muscle Mechanoreceptors
• Muscle spindles - sensitive to changes in length
  of muscle
• Golgi tendon organs - sensitive to changes in
  tissue tension

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Regaining Balance

• Involves complex integration of muscular forces,
  neurological sensory information from
  mechanoreceptors and biomechanical information
• Entails positioning center of gravity (CoG) w/in
  the base of support
• If CoG extends beyond this base, the limits of
  stability have been exceeded and a corrective
  step or stumble will be necessary to prevent
• Even when motionless body is constantly
  undergoing constant postural sway w/ reflexive
  muscle contractions which correct and maintain
  dynamic equilibrium in an upright posture

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• When balanced is challenged the response is
  reflexive and automatic
• The primary mechanism for controlling balance
  occurs in the joints of the lower extremity
• The ability to balance and maintain it is
  critical for athletes
• If an athlete lacks balance or postural stability
  following injury, they may also lack
  proprioceptive and kinesthetic information or
  muscular strength which may limit their ability
  to generate an adequate response to
  disequilibrium
• A rehabilitation plan must incorporate functional
  activities that incorporate balance and
  proprioceptive training

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Principle of taping

• Tape selection
• Skin care
• Application

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Tape selection

• Size
• Type
• Quality

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Principle of taping

• Tape selection
• Skin care
• Application

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Skin care

• Skin surface should be clean of oil, perspiration
  and dirt
• Hair should be removed to prevent skin irritation
  with tape removal
• Tape adherent is optional
• Foam and skin lubricant should be used to
  minimize blisters

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Principle of taping

• Tape selection
• Skin care
• Application

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Rules for Tape Application

• Tape in the position in which joint must be
  stabilized
• Overlap the tape by half
• Avoid continuous taping
• Keep tape roll in hand whenever possible
• Smooth and mold tape as it is laid down on skin
• Allow tape to follow contours of the skin

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Rules for Tape Application (cont.)

• Start taping with an anchor piece and finish by
  applying a locking strip
• Where maximum support is desired, tape directly
  to the skin
• Do not apply tape if skin is hot or cold from
  treatments

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Type of tape

• Elastic
• Non- Elastic

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Uses of elastic taping

• To compress support soft tissue
• To provide anchors around muscle thus allowing
  for expansion
• To hold protective pads in place

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Uses of non-elastic taping

• To support inert structures
• To limit joint movement
• To protect against re-injury
• To secure ends of elastic tape
• To reinforce elastic tape
• To enhance proprioception

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Materials

• Bandaging materials
• Padding
• Underlying bandages
• Fixation bandages
• Elastic bandages
• Adhesive bandages
• Additional materials

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Classification

• According to time of application
• According to type of bandage
• According to bandaging technique
• According to bandage materials

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Time of application

• First bandage
• Second bandage
• Later bandage
• Prophylactic bandage

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Type of bandage

• Open wound
• Compression bandage
• Immobilizing bandage
• Supportive bandage

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Bandaging technique

• Circular bandage (dolabra asc. or desc.)
• Testudo rev. or inv.
• Spica asc. or desc.
• Head bandage (mitra rev. or inv.)

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Bandaging material

• Elastic bandage
• Adhesive bandage
• cloth tape
• Self-sticking bandage

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Materials

• Gauze- sterile pads for wounds, hold dressings in
  place (roller bandage) or padding for prevention
  of blisters
• Cotton cloth- ankle wraps, triangular and cravat
  bandages
• Elastic bandages- extensible and very useful with
  sports active bandages allowing for movement
  can provide support and compression for wound
  healing
• Cohesive elastic bandage- exerts constant even
  pressure 2 layer bandage that is self adhering

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Elastic Bandages

• Gauze, cotton cloth, elastic wrapping
• Length and width vary and are used according to
  body part and size
• Sizes ranges 2, 3, 4, 6 inch width and 6 or 10
  yard lengths
• Should be stored rolled
• Bandage selected should be free from wrinkles,
  seams and imperfections that could cause
  irritation

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Elastic Bandage Application

• Hold bandage in preferred hand with loose end
  extending from bottom of roll
• Back surface of loose end should lay on skin
  surface
• Pressure and tension should be standardized
• Anchor are created by overlapping wrap
• Start anchor at smallest circumference of limb

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• Body part should be wrapped in position of
  maximum contraction
• More turns with moderate tension vs. fewer turns
  with maximum tension
• Each turn should overlap by half to prevent
  separation
• Circulation should be monitored when limbs are
  wrapped

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Elastic bandages can be used to provide support
for a variety scenarios

• Ankle and foot spica
• Spiral bandage (spica)
• Groin support
• Shoulder spica
• Elbow figure-eight
• Gauze hand and wrist figure-eight
• Cloth ankle wrap

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Triangle and Cravat Bandages

• Cotton cloth that can be substituted if roller
  bandages not available
• First aid device, due to ease and speed of
  application
• Primarily used for arm slings
• Cervical arm sling
• Shoulder arm sling
• Sling and swathe

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Cervical Arm Sling

• Designed to support forearm, wrist and hand
  injuries
• Bandage placed around neck and under bent arm to
  be supported

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Shoulder Arm Sling

• Forearm support when a shoulder girdle injury
  exists
• Also used when cervical sling is irritating

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Sling and Swathe

• Combination utilized to stabilize arm
• Used in instances of shoulder dislocations and
  fractures

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Non-elastic White Tape

• Great adaptability due to
• Uniform adhesive mass
• Adhering qualities
• Lightness
• Relative strength
• Help to hold dressings and provide support and
  protection to injured areas
• Come in varied sizes (1, 1 1/2 , 2)
• When purchasing the following should be
  considered

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• Tape Grade
• Graded according to longitudinal and vertical
  fibers per inch
• More costly (heavier) contains 85 horizontal and
  65 vertical fibers
• Adhesive Mass
• Should adhere regularly and maintain adhesion
  with perspiration
• Contain few skin irritants
• Be easily removable without leaving adhesive
  residue and removing superficial skin

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• Winding Tension
• Critically important
• If applied for protection tension must be even

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Elastic Adhesive Tape

• Used in combination with non-elastic tape
• Good for small, angular parts due to elasticity.
• Comes in a variety of
• widths (1, 2, 3, 4)

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Preparation for Taping

• Skin surface should be clean of oil, perspiration
  and dirt
• Hair should be removed to prevent skin irritation
  with tape removal
• Tape adherent is optional
• Foam and skin lubricant should be used to
  minimize blisters

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• Tape directly to skin
• Prewrap (roll of thin foam) can be used to
  protect skin in cases where tape is used daily
• Prewrap should only be applied one layer thick
  when taping and should be anchored proximally and
  distally

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• Proper taping technique
• Tape width used dependent on area
• Acute angles narrower tape
• Tearing tape
• Various techniques can be used but should always
  allow athlete to hold on to roll of tape
• Do not bend, twist or wrinkle tape
• Tearing should result in straight edge with no
  loose strands
• Some tapes may require cutting agents

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Taping Guidelines

• Place joint in position to be stabilized
• Overlap tape ½ width
• Avoid continuous taping
• Keep roll in hands at all times
• Smooth and mold time with free hand
• Do not force tape
• Start with an anchor and end with a lock strip
• Do not tape after a cold / hot modality treatment

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Rules for Tape Application

• Tape in the position in which joint must be
  stabilized
• Overlap the tape by half
• Avoid continuous taping
• Keep tape roll in hand whenever possible
• Smooth and mold tape as it is laid down on skin
• Allow tape to follow contours of the skin

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Rules for Tape Application (cont.)

• Start taping with an anchor piece and finish by
  applying a locking strip
• Where maximum support is desired, tape directly
  to the skin
• Do not apply tape if skin is hot or cold from
  treatments

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Taping, Bandaging and Splinting Techniques

• Wrist / Hand / Finger
• Wrist hyperextension / flexion taping
• Fan or spica
• Finger buddy taping
• Thumb hyperextension / abduction taping
• Fan or spica
• Elbow
• Hyperextension taping
• Fan or spica

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Taping, Bandaging and Splinting Techniques

• Lower Leg
• Achilles
• Fan or spica
• Ankle
• Closed gibney basketweave
• Open gibney basketweave
• Foot / Toes
• Arch
• X
• Teardrop
• Spread / Fan
• Turf toe
• Fan

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Additional Taping Information

• Removing adhesive tape
• Removable by hand
• Always pull tape in direct line with body (one
  hand pulls tape while other hand presses skin in
  opposite direction
• Aid of tape scissors and cutters may be required
• Be sure not to aggravate injured area with
  cutting device
• Also removable with chemical solvents

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Taping Supplies

• Razor (hair removal)
• Soap (skin cleaning)
• Alcohol (oil removal)
• Adhesive spray
• Prewrap material
• Heel and lace pads
• White non-elastic tape

• Elastic adhesive tape
• Felt and foam padding material
• Tape scissors
• Tape cutters
• Elastic bandages

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Common Foot Taping Procedures
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Arch Technique 1(to strengthen weakened arches)
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Arch Technique 2(for longitudinal arch)
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Arch Technique 3(X teardrop arch and forefoot
support)
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Arch Technique 4(fan arch support)
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LowDye Technique(Management of fallen arch,
pronation, arch strains and plantar fascitis)(
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Sprained Toes
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Bunions
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Turf Toe(prevents excessive hyperextension of
metatarsophalangeal joint)
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Hammer or Clawed Toes
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Fractured Toes
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Common Ankle Taping Procedures
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Routine Non-Injury Taping
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• Routine Non-injury taping
• Closed Basket Weave
• Used for newly sprained or chronically weak
  ankles
• Open Basket Weave
• Allows more dorsiflexion and plantar flexion,
  provides medial and lateral stability and room
  for swelling
• Used in acute sprain situations in conjunction
  with elastic bandage and cold application

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Closed Basket weave (Gibney) Technique
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Open Basket Weave
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Continuous-Stretch Tape Technique
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Common Leg Knee Taping Procedures
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Achilles Tendon(prevent Achilles over-stretching)
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Collateral Ligament
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Rotary Taping for Knee Instability
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Knee Hyperextension(Prevent knee hyperextension,
provide support to injured hamstring or slackened
cruciate ligament)
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Patellofemoral Taping (McConnell technique)

• Helps to manage glide, tilt, rotation and
  anteroposterior orientation of patella
• Accomplished by passively taping patella into
  biomechanically correct position
• Also provides prolonged stretch to soft-tissue
  structures associated with dysfunction

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Patellofemoral Taping (McConnell technique)
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Patellofemoral Taping (McConnell technique)
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Patellofemoral Taping (McConnell technique)
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Patellofemoral Taping (McConnell technique)
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Patellofemoral Taping (McConnell technique)
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Common Upper Extremity Taping Procedures
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Elbow Restriction(Prevents elbow hyperextension)
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Wrist Technique 1(Mild wrist sprains and strains)
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Wrist Technique 2(Protects and stabilizes badly
injured wrist)
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Bruised Hand
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Sprained Thumb(Provide support to musculature
and joint)
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Finger and Thumb Checkreins