INTRODUCTION TO

THE PRINCIPLES OF WRAPPING & TAPING

INTRODUCTION

• Wrapping and taping are tools utilized by any individual dealing with athletic injuries.

• There are a variety of uses for both wrapping and taping including prevention, support and protection of injuries.

• Taping and wrapping are used for strains, sprains, contusions as well as a variety of other injuries and conditions.

WRAPPING PRINCIPLES

• PRINCIPLES OF WRAPPING

- Protection from a Painful Range of Motion.

- Support for a Mild to Moderate injury so the athlete can return to play.

- If athlete is unable to play – Part of the I.C.E.R. Principle (Compression and slight support).

WRAPPING PRINCIPLES

MATERIALS USED• Which materials are used depends on

whether the condition is Muscular (contractile) or Inert (ligament).

• Musculotendinous injuries require tensors (2”, 4”, or 6”) for support.

• Tensors can be used for a variety of injuries including Quadriceps and Hamstring Strains as well as “Groin” Injuries.

• Cloth Wraps are used for wrist and ankle injuries.

WRAPPING PRINCIPLES(APPLICATION)

• The following steps should always be used when applying a support technique using a tensor.

1. Assess the injury– Type of Injury (Contractile? Inert?

Contusion?)– Assess as any Muscle/Tendon Injury– Degree of Injury – If mild – Consider

Wrap & Return to play– If Moderate/Severe – Wrap as part of

ICER

TAPING PRINCIPLES

INTRODUCTION

• Taping is a skill which requires a great deal of practice and experience.

• Historically, taping has been a skill of the Athletic Therapist/Athletic Trainer but is effectively used by anyone who deals with athletes.

• The primary uses for athletic taping and wrapping are diverse

TAPING PRINCIPLES

THE THREE MAIN GOALS OF ATHLETIC TAPING THE THREE MAIN GOALS OF ATHLETIC TAPING INCLUDE;INCLUDE;

- Prevention (Prophylactic)- Prevention (Prophylactic)

- Protection (Rehabilitative)- Protection (Rehabilitative)

- Support (Functional)- Support (Functional)

• Taping or bracing should never replace the Taping or bracing should never replace the proper rehabilitation of an injured joint or muscle.proper rehabilitation of an injured joint or muscle.

TAPING PRINCIPLES

Contraindications/Precautions to Taping• Injuries requiring support more aggressive

than taping.• Taping over lacerations, blisters or

abrasions.• Allergic reaction to tape or adherent. • When taping excessively restricts range of

motion of a joint and thereby predisposes the athlete to further injury.

TAPING PRINCIPLES

PRE TAPING• PAST HISTORY OF TAPING (EFFECTIVENESS?)• ALLERGIES – TAPE? SPRAY? BANDAIDS?• QUICK STRUCTURAL TESTING AND ESTABLISH

ANATOMICAL BOUNDARIES.

POST TAPING• CHECK FOR WRINKLES, WINDOWS• CHECK FOR PERIPHERAL CIRCULATION• TEST FOR FUNCTION X 2.

“ IS TAPING PRACTICAL FOR THIS INJURY AND SITUATION, OR AM

I SETTING THEM UP FOR FURTHER INJURY OR RE-

INJURY?”

TAPING PRINCIPLES

TAPE SELECTION• Choosing the right tape depends on the type of

injury as well as the size of the area being taped.

• Tape comes in a assortment of types and sizes.• There are many different elastic tapes on the

market which can be used for musculotendonous injuries, as well as zinc oxide tape which can be used for joint injuries due to its non yielding properties.

TAPING PRINCIPLES

• ELASTIC TAPES (Elastoplast) are used to encircle muscle bulk and act as an anchor.

• You should always make the necessary allowances for contraction and expansion prior to using this tape.

TAPING PRINCIPLESTAPE SELECTION

• Zinc oxide tape should be used for ligamentous (inert) types of injuries which do not require ‘give.’

• Tearing the tape requires a surprisingly small amount of force. Simply tear the tape with your fingers by pinching the edge and ripping.

TAPING PRINCIPLES

STEPS IN TAPING• Once the pre-evaluation has been completed

and the tape has been selected, the following steps should be followed.

• SKIN PREPARATION - Wash, shave and dry the area to be taped - Check for cuts, blisters or skin irritations and protect these areas prior to taping.• PROTECT FRICTION AREAS WITH

LUBRICANT AND GAUZE.

TAPING PRINCIPLES

• SPRAY– Use ‘Skin Prep’ or ‘Skin Toughener’

to help adhere the tape and protect the skin. Be careful as some commercial preparations can cause skin irritation. Non-allergic options are available.

• UNDERWRAP– Apply Pro-wrap, underwrap or J-wrap

(if not shaved) to protect the skin, especially if the athlete is being taped for a prolonged period of time.

TAPING PRINCIPLES

• TAPE REMOVAL –’SHARKS’ OR SCISSORS

TAPING PRINCIPLES

• RULES FOR TAPE APPLICATION

• If the part to be taped is a joint, place it in the position in which it is to be stabilized.

• If the part is muscle or tendon, make the necessary allowances for contraction and expansion (Warm up).

• Overlap the tape at least half the width of the tape below or it will separate, exposing the underlying skin.

• Keep the tape roll in hand whenever possible. This will ensure taping speed and accuracy.

• Avoid continuous taping (with a few exceptions – ie. The heel lock and figure eight pattern with ankle taping). Continuous taping will cause constriction.

TAPING PRINCIPLESRULES FOR TAPE APPLICATION

• Smooth and mould the tape to the body part as it is laid on the skin. This is done by stroking the tape with the fingers, palms or heels of the hand.

• Where maximum support is desired, tape directly over the skin surface. Shaving is required for this task to be accomplished successfully. In the case of sensitive skin, other mediums may be used (pre wrap) as tape bases.

• The athlete should not move during taping as this will loosen the tape. Fresh tape needs time to adhere.

TAPING TECHNIQUES

• Turf Toe – Turf toe is an injury involving a number of structures (ligament, tendon) at the metatarsal phallangeal joint MTP of the hallux (big toe).

• Turf toe may be a hyper extension or hyper flexion injury.

TAPING TECHNIQUES

• Taping Rationale: The most common mechanism of injury is

hyper-extension, hence the taping rationale is to limit the painful range of motion.

• Tape Used: Full strips and one quarter strips.

Brace

TAPING TECHNIQUES

• TURF TOE

• Taping Points – Following the placement of the anchors, three strips are placed close together, locked proximally, then followed by a ribbon strip which is then locked at the distal end.

TAPING TECHNIQUES

• PLANTAR FASCIITIS

- Plantar fasciitis is a term commonly

used to describe pain at the proximal

end of the heel.

TAPING TECHNIQUES

• Taping Rationale: To support the plantar fascia and the medial longtitudinal arch and to accentuate the fat pad.

TAPING TECHNIQUES

• Tape Used: Full strips and one quarter strips.

• Taping Points: All the strips in this tape job proceed from lateral to medial in order to support the Medial Longtitudinal arch.

• The final strips are full strips from the lateral anchor to the medial anchor.

TAPING TECHNIQUES

CLOSED GIBNEY TECHNIQUE• RATIONALE: The Closed Gibney tape job is used

primarily for three reasons; PROPHYLACTIC REHABILITATIVE SUPPORTIVE (FUNCTIONAL)• It is primarily Supportive rather than Compressive.• This technique can be used for both inversion and

eversion sprains and is composed of two parts; Part 1 - Basketweave Part 2 - Heel Locks and Figure Eights

TAPING TECHNIQUES

• TAPE USED: Full Strips• PART 1: The basket weave is formed by alternating

horseshoes

and stirrups closing the ankle in preparation for the

second and most important part of the technique.

TAPING TECHNIQUES

• PART 2: The Heel Locks & Figure Eights

• RATIONALE: This is the most important part of any ankle tape job. It is said that 80% of the effectiveness of ankle taping is from this part of the technique because it locks the subtalar joint (between the talus and the calcaneus). It is at this joint where inversion and eversion take place.

• The most common mechanism of ankle sprains

is the INVERSION SPRAIN.

TAPING TECHNIQUES

• LATERAL ANKLE LIGAMENTS

TAPING TECHNIQUES

HEEL LOCK & FIGURE EIGHTS• There are many different variations. All essentially do the

same thing which is to lock the subtalar joint.

LOUISIANNA ILLINOIS

TAPING TECHNIQUES

• “SHIN SPLINTS” - Shin splints are a “Wastebasket” term denoting pain in the lower third of the leg.

• The condition known as shin splints may include a variety of conditions including; tendonitis, periostitis, stress fracture of the tibia (or fibula), or compartment syndrome.

• Shin splints involves pain in the Anterior-Lateral part of the leg or the Posterior-Medial part of the lower leg.

POSTERIOR ANTERIOR

MEDIAL LATERAL

TAPING TECHNIQUES

• POSTERIOR-MEDIAL Shin splints usually involves the TIBIALIS POSTERIOR MUCLE which is found in the deep posterior compartment.

• This type of Shin splint is usually associated with a Pronated foot

TAPING TECHNIQUES

• ANTERIOR-LATERAL Shin splints usually involves the

TIBIALIS ANTERIOR MUSCLE which is found in the anterior compartment.

• This type of Shin splint is usually associated with a high arched or Supinated foot.

TAPING TECHNIQUES• RATIONALE: TIBIALIS POSTERIOR – The rationale for this

taping technique involves both a direct and an indirect component. The direct component is for compression and to approximate the tendon back onto the bone. The indirect component is to give arch support to the pronated/arch foot and indirectly take the stress off of the affected tendon.

• TAPE USED: Full strips of tape (Part 1), & one quarter strips. • TAPING POINTS: The strips around the lower part of the leg

go from the lateral to the medial aspect of the leg (ie. Back toward the midline of the leg.

• The second part of the tape job is the same arch support technique as plantar fasciitis.

TAPING TECHNIQUES

• TIBIALIS POSTERIOR TENDINITIS (Direct)

• Indirect

TAPING TECHNIQUES

• RATIONALE: TIBIALIS ANTERIOR – The rationale for this taping technique also involves a direct and indirect component. The direct component is for compression and to approximate the tendon back onto the bone, the indirect component is to support the extensor retinaculum and thereby take the pressure off of the tibialis anterior muscle.

• TAPE USED: Full strips• TAPING POINTS: The strips around the lower leg go in

the opposite direction of the tibialis posterior technique (from medial to lateral), and the second strip(s) are placed around the retinaculum (tear drop design).

TAPING TECHNIQUES

• TIBIALIS ANTERIOR

TAPING TECHNIQUES

• PATELLAR TENDONITIS – Is commonly referred to as jumper’s or kicker’s knee is a common condition which places extreme tension of the knee extensor muscle complex, resulting in the repetitive injury of tendonitis.

• RATIONALE: The rationale for this taping technique is to act as a counter-force strap to dissipate stress away from the painful area on the lower third of the patellar tendon.

• TAPE USED: Full Strips of Tape.• TAPING POINTS: The strips cross in the front of the

knee and the twisting of the tape adds strength.

TAPING TECHNIQUES

• PATELLAR TENDINITIS

QUADRICEPS/HAMSTRING WRAPS

• The wrapping techniques for the upper thigh (Quadriceps/Hamstring) muscles can be used for a muscle strain or contusion.

• A Muscular strain is tested via:– Extensibility– Contractibility– Palpation– Circumference

• This will give the examiner an idea of the degree of injury and the purpose for the wrap.

UPPER LEG WRAPPING

TAPING TECHNIQUES(Finger Injuries)

• Finger injuries are very common in sports like basketball and volleyball.

• An injured finger can be taped against an adjacent finger for support (buddy system), or a functional technique known as a ‘finger spica’ can be used.

TAPING TECHNIQUES

FINGER/THUMB TAPING (SPICA TECHNIQUE)

• RATIONALE: The finger (and thumb) spica tape job is an alternative to the “Buddy” tape job when the athlete needs functional use of their hand. It will still allow for support but will help limit painful range of motion.

• TAPE USED: One quarter strips.• TAPING POINTS: Anchors should first be placed above

and below the knuckles of the involved fingers. The hand is then placed in a functional position (ie. A position that the athlete will use their hands in) and then transverse strips are placed between the anchors. A final strips ‘pinches’ the strips together.

TAPING TECHNIQUES

• FINGER TAPING

Buddy Technique

TAPING TECHNIQUES

• Thumb/Finger Spica

TAPING TECHNIQUES

WRIST TAPING (PREVENTION OF HYPEREXT/FLEX)

• Wrist injuries usually involve a hyper-flexion or hyper-extension mechanism. This can damage a variety of structures in and around the wrist area.

• RATIONALE: The rationale for this type of taping is to prevent painful movement in either flexion or extension. This technique is very similar to the turf toe tape job.

• TAPE USED: Full Strips• TAPING POINTS: There should be equal distance

between the top and the bottom anchor with the mid point being at the carpal region of the wrist.

TAPING TECHNIQUES

• WRIST TAPING

TAPING TECHNIQUES

• THUMB TAPING – Thumb injuries such as Gamekeeper’s thumb are common amongst athletes, especially to skiers and athletes involved in contact sports. The mechanism of injury is usually a forceful abduction (and extension) of the proximal phalanx.

• RATIONALE: The Rationale for this technique is to limit painful range of motion.

• TAPE USED: Full strips (Anchors) and one quarter strips.• TAPING POINTS: Once the anchor is in place on the

crease of the wrist, the smaller strips are started on the dorsum of the hand and finished on the palmer part of the anchor.

TAPING TECHNIQUES

• THUMB TAPING

TAPING TECHNIQUES

• ELBOW HYPER-EXTENSION injuries are very common in contact sports such as wrestling and football as well as non-contact sports such as gymnastics.

• RATIONALE: The Rationale for this tape job in to limit painful range at full extension or hyper-extension.

• TAPE USED: Full Strips.• TAPING POINTS: This is the same technique

as the wrist.

TAPING TECHNIQUES

• ELBOW HYPER-EXTENSION