1. Introduction to Taping, Wrapping and Tensoring
Injury Management I REC 1020
Obtained from: Sport Medicine Council of Alberta (SMCA)

2. Tape and Tensoring Done in SM 10
This Module:
Ankle (heel locks, figure 8, closed basketweave)
Wrist Hyperextension and Hyperflexion
Thumb Hyperextension and Hyperabduction/Contact Thumb
Finger Buddy Taping
Next Module:
Elbow Hyperextension
Peppard Thumb
Quad Tensoring
Open Basketweave
Finger Splint
Simple Wrist C Locks

3. When to Tape:
Acute Injury Management – may warrant the use of tape to support, stabilize and compress the injured limb or joint (Note: NOT for the purpose of allowing the athlete to return to play)
Injury Prevention – when the athlete participates in an activity in which there may be a higher risk for a particular injury, taping may reduce the chance of injury occurring or reduce the severity should one occur
Return to Activity – when the athlete is ready to return to partial (modified) or full participation, some form of support is usually required to prevent further injury or re-injury. Remember, the athlete requires medical clearance before returning to activity.

4. When NOT to Tape: Further Assessment Required
Taping/wrapping should not be done if you suspect that a professional assessment is conducted. Also, Not taping will reduce the discomfort when the tape is removed by paramedics or doctors later who have to assess the injury.
After an Acute Injury has occurred
Allowing an injury to participate immediately following an injury markedly increases the chance of further damage.
If there is a functional disability
If there are obvious limits to an athlete’s ROM, strength, stability, balance and/or coordination.

5. When NOT to Tape: Swelling present After cold application Pre-puberty
Even if there is swelling with light activity, the injury site is very “irritable” and not ready to be subject to excessive stress
After cold application
Due to the decreased blood flow from the ice and decreased sensitivity, the tape may be applied too tightly, causing a restriction of blood flow and pain
Pre-puberty
Ages 10-14, the use of any form of extra support and this stage of growth and development may cause serious injury. Taping or wrapping a pre-pubescent joint may adversely affect the epiphyseal (growth plate) development and lead to permanent disruptions in bone growth.

6. When NOT to Tape: At night For certain sports If you are unsure
Due to the decreased blood flow when asleep, the restrictive element of the tape can cause nerve damage. Should not be left on for more than 4 hours and only when athlete is awake.
For certain sports
Some sports (such as Jude, Karate, etc.) do not allow the use of any taping or wrapping. Other sports (ex: Rugby) allow taping and wrapping, however, the use of any hard padding is prohibited.
If you are unsure
If unfamiliar with the athlete’s condition or the required tape technique, it is better not to do any taping at all. Improper use can make an injury worse. When in doubt… DON’T!

7. Use of Taping and Wrapping Components:
Adhesive Athletic Tape (3.8cm)
Varies from brand by brand
Good tape: winds off roll easily, tears off easily with few threads, contains pores still visible to the light, roll feels tight, inside cardboard roll does not fall apart while taping
Heel and Lace Pads
Put anywhere that tape passes over superficial tendons (Achilles and extensor tendons on foot)
Bandage Scissors
Have a blunt end that will not cut the skin. Sometimes easier to use than a shark.
Shark Tape Cutter
Especially useful for quick removal of large tape jobs. Almost impossible to cut skin with it’s protected blades.

8. Use of Taping and Wrapping Components:
Razor
To remove the hair on areas where tape must adhere directly to skin. Increases the effectiveness of tape application (hair-free, clean, dry skin is best)
Tape Adherent
Spray form that provides a preparation bases that ensures tape and bandages will stick even in a sweating athlete. Be careful as some athletes may be allergic or sensitive to certain types.
Tensor Bandages
Hold compression pads, and apply even pressure to soft tissue injuries.
Underwrap (Pro-wrap)
Applied before the tape to prevent skin breakdown and tape adhesion to body hair (though taping directly to skin is best)

9. Considerations for Wrapping (Tensor Bandages)
It is much easier to wrap when a tensor has been firmly rolled up.
Roll off of the bottom of the tensor
Should be applied distally, progressing proximally towards the injury to force swelling back toward central circulation (the heart and lymphatic system) and away from the injury site.
Do not apply excessive tension as it will result in impaired circulation
Consistent, firm pressure is the goal.
When soaked in cold water and use in conjunction with an icepack, tensors help transfer the cold well
Test for circulation, comfort and ROM after wrapping.

10. Proper Skin Preparation for Taping and Wrapping
Hair should be shaved off
Skin must be washed and dried. Oily, greasy substances interfere with tape adherence.
Check the skin for cuts, blisters or skin irritations and cover with a bandage prior to the application of tape or adherent.
Spray the area evenly with tape adherent prior. Apply a thin, even layer of spray, avoiding fingers and toes so that they do not stick together.
Apply underwrap only in certain circumstances such as marked skin breakdown or tape allergies. Should be applied after the tape spray has been put on.
Note: do not apply anchor strips to the underwrap. They should be put directly on skin to prevent anchors from sliding under support strips.

11. Considerations for Taping - Checklist
Before you begin, make sure that each is checked √
□I am familiar with the athlete’s condition
□ I am familiar with the severity of the injury
□ I am familiar with the stage of healing of the injury
□ I understand the physical requirements of the sport/activity
□ Taping is appropriate for this injury
□ I know which structures must be supported by tape
□ I know the position that will best support the underlying structures
□ I know the normal movement pattern and the motion of the involved muscle fibres
□ I have protected other areas that are likely to be irritated by the tape
□ I have the appropriate materials for the taping technique
□ I know how to perform the taping technique very well.

12. Positioning of Injured Person and Athletic Trainer
Position of Athlete:
To be most effective, the structure to be supported with tape should be positioned so that it is under the least amount of tension.
Ensure that the athlete is relaxed and fully supported at a height which is comfortable to yourself as the trainer as well. The athlete must maintain this position during entire taping so make sure that they are comfortable because some tape jobs can take several minutes.
Position of Trainer:
The person taping should be in a position of comfort and one in which taping is unimpeded. In many cases however you find yourself hunched over on a playing surface or getting down to the athlete’s level. When taping a number of athlete’s it is important that you work in a position that will not place excessive pressure on your body, especially your back.
Have all necessary materials within reach.

13. Mistakes when Taping or Wrapping
Shadows
Areas in which there is only one layer of tape next to the skin as compared to the surrounding skin which has two or more layers of tape. Shadows are more often due to improper overlapping of the tape when closing off.
2) Windows
Areas in which the skin is exposed completely between other strips of tape. Often due to improper layer of tape.
3) Wrinkles
Occur when tape is carelessly placed on the skin or on other layers of tape. Wrinkles frequently occur on stirrups and heel locks. Also often occur when wrapping tape around a limb or joint and the angle does not follow natural body contours.

14. How to Inspect a Completed Tape Job
Check for shadows, wrinkles, windows (go back and fix if necessary)
Check for circulation (squeeze fingers or toes and watch for return of blood flow – compare to uninjured side)
Ask athlete to describe comfort level (should be stiff and firm, but not painful) Remind them that the tape will loosen after just a few moments of activity especially if underwrap is below.
Assess ROM and functional movement

15. How to Remove a Completed Tape Job
For safety and ease of tape removal, use only bandage scissors or tape cutter (Shark).
Take care not to damage skin, blood vessels, nerves, tendons etc. below tape
Apply a small amount of skin lubricant to tip of scissors to help it slide below tape if necessary.
Tape removal of ankle can be eased by asking athlete to cut the tape from the top on the medial side of the leg around the medial malleolus, and then to angle forward to the side of the big toe.
Avoid trying to rip off big segments of tape in one piece as it will bunch up and create further difficulty.

16. Functional Tape Strips
Check-reins
Prevent a segment or joint from moving into a painful ROM. An injured segment is taped to an adjacent uninjured structure to stabilize the injury yet allow for some degree of movement (often used with fingers and toes)
Figure 8’s
Describe the figure 8 motion of tape on a limb (usually ankle) to restrict movement of joint
Locks
Used in conjunction with figure 8’s to support (‘lock’) joints in a neutral position (heel locks support to subtalar joint of the ankle)
Spicas
Continuous strips of tape or tensors that encircle a limb and more stable body part forming a figure 8 (Groin)

17. Functional Tape Strips
Spirals
Continuous strips of tape or wraps that wrap around the limbs between upper and lower anchors like stripes on a candy cane
Anchors
The top and bottom base of a tape job
Stirrups
Continuous strips of tape that run down from anchors, loop under the heel, and come back up on opposite side *ankle)
Close off Strips
Overlapped by at least a half, to cover all anchors and other functional strip ends, and to avoid shadows and windows

18. Locating Landmarks of Ankle
The ankle joint consists of three bones and landmarks
Medial malleolus (distal end of tibia)
Lateral malleolus (distal end of fibula)
Talus (Tarsal Bone)
The ankle gets stability from bones, ligaments and tendons surrounding the joint

19. Locating Landmarks of Wrist
The bones of the wrist and hand are:
Distal ends of the radius and ulna
8 carpals
5 metacarpals
14 phalanges
Ligaments hold these bones together, while tendons and muscles allow for an extraordinary amount of fine finger and hand movements