Wrapping and Taping Techniques

*DISCLAIMER* It is recommended that all coaches/students acquire first aid certification. The following information should be used only to accompany information provided in a certifiable first aid course. This is not a certification course for first aid or athletic taping techniques.

Introduction to Athletic Injuries: Classification of Injuries: Acute Injuries = Have a known mechanism and are of sudden onset; signs and symptoms usually surface immediately or shortly after the injury. Chronic Injuries = Have a gradual onset and long duration. Often the person does not recall a specific mechanism of injury, and injury results from an accumulation or repetitive stress over time.

Common Athletic Injuries: CONTACT SPORTS: Football Hockey Rugby Lacrosse

Common Athletic Injuries: NON-CONTACT SPORTS: Team Sports Soccer Basketball Volleyball Field Hockey Swimming Baseball Cheerleading Racquet Sports Tennis Badminton Squash Individual Sports Track and Field Cross Country Wrestling Golf Figure Skating Skiing / Snowboarding Weight Lifting

The Purpose of Athletic Injury Support Techniques: To prevent an injury from occurring (prophylactic). To protect an injury which has occurred (rehabilitative). To protect an injury which is healing and assist an athlete with potentially faster return to sport (functional).

Indications for Athletic Taping: Tape may be applied for the following reasons: Support and stability Immediate first aid To secure a pad or brace To prevent injury To restrict the angle of pull Psychological assistance

Principles of Taping: When applying tape follow the contours of the individual. Smooth and mould the tape, as it is lad on the skin. This will take some practice. Provide a constant tension on the roll of tape to help eliminate wrinkles. Make sure that the structure to be taped is in a functional position, but also in a position that will not stress the injured or rehabilitated structure. When taping over a muscle or tendon make sure the athlete contracts.

Principles of Taping: When applying tape, overlap the strips by at least one half the width of the tape to eliminate pinching or blisters. Be very careful not to cut off circulation with tape strips. Communicate with the athlete during the tape procedure and loosen strips as necessary. This can be vary depending on the individual. Tape should never be applied continuously. Make one turn at a time, and make sure that each encirclement be torn to overlap the starting end by approximately one inch. Always retest your athlete, especially in the movement that will stress the injured or protected structure. Then test the athlete in a functional position.

Precautions to Taping: Do Not Apply Tape If: Injuries that require more support that tape can provide. When taping excessively restricts the ROM of a joint predisposing the athlete to further injury. Inflammation. Taping over a laceration, abrasions, blisters. Allergic reactions to tape or adherents and band aids.

Skin Preparation: Skin should be shaved, washed and dried. Minor cuts and blisters should be cleaned and covered. Areas that are sensitive (like Achilles, nipples, etc) should be covered with a gauze or heel and lace pad). Spray the area with Tufskin (adhesive spray). Make sure the athlete is not allergic to Tufskin. Be careful when constantly applying tape, such as at a training camp or two a days. You may have to use under wrap to prevent skin irritation but you will also lose some support.

AC Joint RTS Taping:

AC Joint RTS Taping: Use of this technique: Supplies Needed: This taping technique will give the AC joint a little more stability. This is used on chronic conditions, or after the AC joint has healed from a sprain (return to sport). Supplies Needed: Hypafix, leukotape, foam padding Common Mechanisms of Injury: Fall on outstretched arm, contact sports – blow to top of shoulder (shoulder depression)

Wrist Taping: Use of this technique: Supplies Needed: To support and limit movement at the radiocarpal and midcarpal joints. This is more of a return to sport taping. Supplies Needed: Zinc oxide, tufskin Common Mechanisms of Injury: Fall on outstretched hand, contusions, chronic overuse injuries (carpal tunnel, etc).

Wrist Taping

Ankle Taping: Use of this technique: Supplies Needed: To support and stabilize the ankle joint for INVERSION sprains. Supplies Needed: Heel and lace pads, pre-wrap, zinc oxide Common Mechanisms of Injury: Inversion sprains (rolled ankle)

Ankle Taping: Taping Instructions: Before you begin taping, apply heel and lace pads at high friction areas – one at the distal aspect of the Achilles tendon, the other at the dorsal aspect of the ankle joint. Additionally, apply pre-wrap to secure the two heel and lace pads in place and reduce skin irritation. It is critical that the foot remain at a 90 degree angle for this procedure. With the zinc oxide tape, apply an anchor strip around the lower leg at approximately the musculotendon junction of the gastrocnemius. Since the leg at this site is not cylindrically shaped the tape must be angled slightly to conform to the leg.

Ankle Taping: Apply an additional anchor at the instep. Remember that excessive tension on the 5th metatarsal could cause pain on weight bearing. Apply the first of three stirrup strips. Beginning on the medial aspect of the upper anchor, this stirrup continues down the inside of the leg, over the medial maleolus, across the plantar aspect of the foot, over the lateral maleolus, up the lateral aspect of the leg, and ends at the lateral aspect of the upper anchor. Proper tension must be applied to cause some eversion of the foot, thus helping to reduce inversion.

Ankle Taping: Apply the first of three horseshoe strips. The first horizontal strip is started on the medial aspect of the foot, continues toward the heel and below the medial malleolus, crosses the achilles tendon below the lateral malleolus, and ends on the lateral aspect of the foot. Repeat steps #4 and #5 twice, overlapping the tape one-half its width. These interlocking strips should provide additional support for this technique. The completed portion of this closed basket weave has sets of interlocking stirrups and horseshoe strips. Apply a proximal anchor for support. For proper adherence, apply compression to the tape so that the tape conforms to the body part.

Ankle Taping: Apply the first heel lock strip. Begin on the anterior portion of the upper anchor. This lateral heel lock will continue down the outside of the leg, crossing the achilles tendon, around the medial aspect of the heel, angling underneath the foot, and moving up the lateral aspect of the leg. Proper tension must be applied to insure stabilization of the calcaneus. Apply the second heel lock strip. Begin on the anterior portion of the upper anchor. This medial heel lock will continue down the inside of the leg, crossing the achilles tendon, around the lateral aspect of the heel, angling underneath the foot, and moving up the medial aspect of the leg.

Ankle Taping: A figure of eight is applied next. Starting on the dorsal aspect of the foot, move medially down the inside of the foot, across the plantar portion, up the outside of the foot to the starting point. Continuation of the tape will proceed medially around the lower leg crossing the achilles tendon, and finishing at the origin of this figure of eight technique. By encircling the foot and lower leg, this technique will assist in dorsal flexion and eversion. Final closure strips are then applied. Begin proximally and work distally. From the upper anchor, apply individual circular strips around the extremity to cover tape ends. Make sure you overlap the tape approximately one-half its width on each strip.

Ankle Taping:

Turf Toe Taping: Use of this technique: Supplies Needed: This taping supports the ligaments of the MTP joints and protects the articular surfaces. Supplies Needed: Zinc oxide, tufskin Common Mechanisms of Injury: Sudden stop The foot slides forward in the shoe Resulting in compression of the MTP joint and severe dosiflexion of the great toe. Most common in the following sports: Most prevalent with athletes competing on artificial turf.

Turf Toe Taping: Taping Instructions: Patient Position: The athlete is long sitting on the bed with the MTP joint in slight flexion. Begin with an anchor strip around the transverse arch of the foot. Another anchor should be placed around the great toe just below the level of the nail. Be very careful not to put too much tension on this anchor thus causing a tourniquet effect. Place a longitudinal strip from distal anchor to proximal anchor crossing the medial aspect of the MTP joint. Place two diagonal trips across the joint on the plantar surface and two diagonal strips on the dorsal surface ensuring that the X these strips make lies on top of the MTP joint. Finish with an anchor around the great toe and another around the transverse arch overlapping by half a tape width.

Turf Toe Taping:

Achilles Tendon Taping: Use of this technique: To limit range of dorsiflexion and decrease tension on the achilles tendon. Used for chronic conditions, or return to sport post-injury. Supplies Needed: Elastic tape, tufskin, zinc oxide, heel and lace pads Common Mechanisms of Injury: Acute = Sprinting, jumping (eccentric contraction). Chronic = Tendonitis, chronic strains.

Achilles Tendon Taping Taping Instructions: Position = Ankle placed in plantar flexion and knee in slight flexion. Apply two anchors using 3” elastic tape. The proximal anchor should be applied on the proximal aspect of the gastrocnemius. The distal anchor should be applied around the heads of the metatarsals (ball of the foot). It is preferred that this circular strip begins on the dorsal aspect, goes laterally, continues across the plantar aspect, to medial side of the foot, and crossing the tape ends. Using 3” elastic tape, measure on the posterior aspect the distance between the proximal and distal anchors. This will be the length required for your support strips. The first support strip of elastic tape is applied, going from the proximal to the distal anchor. Upon application, full tension should be applied to the tape ends. You will note that the slight knee flexion and plantar flexion is maintained so that there is a small degree of tension across the first support strip.

Achilles Tendon Taping: Additional strips of support are applied in an angular fashion to cover the posterior aspect of the lower leg and the plantar aspect of the foot. For proper adherence, apply compression to the tape so that the tape conforms to the body parts. (Using 3” elastic tape, close up the procedure by overlapping the tape by one-half its width on each revolution.) Secure the elastic tape ends with anchors of zinc oxide tape.

Achilles Taping:

Anterior / Posterior Compartment Shin Splints: Use of this technique: To decrease pain and tension on anterior/posterior shin muscles. Used on chronic conditions. Supplies Needed: Tufskin, ultralite, zinc oxide, foam padding strip Common Mechanisms of Injury: Overuse (prolonged running, biking, skating, etc) Biomechanics Training techniques

Anterior / Posterior Compartment Shin Splints: Taping Instructions: Place a strip of thin foam padding over affected area. Apply an adhesive tape strip. Begin the tape one to two inches below the distal end of the felt pad, proceed laterally, cross the achilles tendon an pull the tape and felt back against the tibia. Tear the tape. Apply four to six additional overlapping adhesive tape strips as applied in step #2. NOTE = Instructions are for pain on the medial aspect of the tibia. For pain on the lateral side of the tibia, pull the tape in the opposite direction.

Anterior / Posterior Compartment Shin Splints:

Finger Taping: Use of this technique: Supplies Needed: To provide support and prevent re-injury of MCP and IP joints. Supplies Needed: Zinc oxide (1/2” strip) Common Mechanisms of Injury: Jammed finger, sprains, return to sport post-fracture.

Finger Taping: Taping Instructions: Apply ½” adhesive tape around the proximal and distal aspects of the affected and adjacent phalanges. This technique is known as buddy taping.

Finger Taping:

Patellar Strap: Use of this technique: Supplies Needed: To decrease the tension on the sub-patellar tendon. Used to prevent pain caused by a tight quadriceps muscle, pain caused by osgoode-schlaters, and/or growth pains. Supplies Needed: Pre-wrap

Patellar Strap: Wrapping Instructions: Have the athlete standing with the injured leg forward. The leg should be slightly bent at the knee, and should be bearing weight to create tone in the muscle. Position the prewrap so that the top edge is on the patellar tendon (below the patella). Roll the prewrap around the leg, approximately eight times. Tear the prewrap, and roll the bottom edge up towards the knee, creating a ‘band’. NOTE: Tape is not required because the prewrap will stick to itself and hold once it has been rolled. Adjust the band (if necessary) so that it is positioned in the middle of the tendon.

Patellar Strap:

References: University of Toronto, Bachelor of Physical and Health Education, Lecture notes 1997-2001 Sheridan College, Bachelor of Applied Health Science in Athletic Therapy, Lecture Notes 2003 – 2007. Wright, KE, Whitehill, WR, The Comprehensive Manual of Taping and Wrapping Techniques, Cramer Products Inc., USA, 1996. Cartwright, LA, Pitney, WA, Athletic Training for Student Assistants, Human Kinetics, USA, 1999.