1. Chapter 8: Wrapping and Taping

2. Routinely used by athletic trainers
Used to minimize swelling, provide support to injured areas and prevent injury
While techniques are not difficult to master, trained professional should apply
Requires solid background in anatomy and biomechanics
Evidence Based Literature Reviews
Limited effectiveness of taping
Still widely used, not for all ailments
Braces are often more effective than taping
Countless variations

3. Wrapping Will contribute to recovery of injuries
When applied incorrectly may cause discomfort, wound contamination, hamper healing
Must be firmly applied while still allowing circulation
Used to cover open wound, secure compressive/protective pad, provide support

4. 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 wrap- extensible and very useful with sports; active wrap allowing for movement; can provide support and compression for wound healing
Cohesive elastic wrap- exerts constant even pressure; 2 layer wrap that is self adhering

5. Elastic Wraps 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 rolled when stored
Wrap selected should be free from wrinkles, seams and imperfections that could cause irritation

6. Elastic Wrap Application
Hold wrap 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
Usual application involves overlapping wrap
Start application at smallest circumference of limb

7. 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

8. Elastic wraps can be used to provide support for a variety scenarios:
Ankle and foot spica
Spiral wrap (spica)
Groin support
Shoulder spica
Elbow figure-eight
Gauze hand and wrist figure-eight
Cloth ankle wrap
Figure 8-1

9. Elastic Wrap Techniques
Figure 8-2
Figure 8-3

10. Elastic Wrap Techniques
Figure 8-4

11. Elastic Wraps Techniques
Figure 8-5
Figure 8-7
Figure 8-6

12. Elastic Wrap Techniques
Figure 8-8
Figure 8-9

13. Triangle 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

14. Cervical Arm Sling
Designed to support forearm, wrist and hand injuries
Bandage placed around neck and under bent arm to be supported
Figure 8-11

15. Shoulder Arm Sling
Forearm support when a shoulder girdle injury exists
Also used when cervical sling is irritating
A commercial arm sling can also be used to provide the same support
Figure 8-12

16. Sling and Swathe Combination utilized to stabilize arm
Used in instances of shoulder dislocations and fractures
Figure 8-13

17. Non-elastic and Elastic Adhesive Taping
Historically an important part of athletic training
Becoming decreasingly important due to questions surfacing concerning effectiveness
Utilized in areas of injury care and protection

18. 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 variety of sizes (1”, 1 1/2” , 2”)
When purchasing the following should be considered:

19. Tape Grade Adhesive Mass
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

20. Winding Tension Critically important
If applied for protection tension must be even
Figure 8-14

21. Elastic Adhesive Tape Used in combination with non-elastic tape
Good for small, angular parts due to elasticity as well as soft tissues that expand.
Comes in a variety of widths (1”, 2”, 3”, 4”)
Figure 8-15

22. Adhesive Tape: Preparation for Taping
Skin surface should be cleaned 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 and skin irritation

23. 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

24. Figure 8-16 A-E

25. 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

26. 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

27. Selecting Proper Tape Width
Tape width used dependent on area
Acute angles = narrower tape
Tearing tape
Various techniques can be used but should always allow athlete trainer 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

28. Figure 8-18
Figure 8-19
Figure 8-17

29. 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
Start superior to joint and move inferiorly
Also removable with chemical solvents

30. 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 wraps

31. Common Foot Taping Procedures

32. Arch Technique 1 (to support weak arches)
Figure 8-20

33. Arch Technique 2 (for longitudinal arch)
Figure 8-21

34. Arch Technique 3 (X teardrop arch and forefoot support)
Figure 8-22

35. Arch Technique 4 (fan arch support)
Figure 8-23

36. LowDye Technique (Management of fallen arch, pronation, arch strains and plantar fascitis) (
Figure 8-24

37. Sprained Toes
Figure 8-25

38. Hallux Valgus
Figure 8-26

39. Turf Toe (prevents excessive hyperextension of metatarsophalangeal joint)
Figure 8-27

40. Hammer or Clawed Toes (reduces pressure of bent toes against shoes)
Figure 8-28

41. Fractured Toes (splints injured to non-injured toe)
Figure 8-29

42. Common Ankle Taping Procedures

43. Most commonly used taping technique
Provides patient with comfort w/out restricting normal function
Evidence-based Literature Review
Questions effectiveness in reducing ankle sprains and providing mechanical restraint to excessive ankle motion
May lose initial level of resistance rapidly
Pre-wrap facilitate effectiveness, allowing for longer motion control
Ankle bracing is superior to taping
Still used widely by athletic trainers

44. Closed Basket Weave (Gibney) Technique
Used for newly sprained or chronically weak ankles
Figure 8-30

45. 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 wrap and cold application
U-shaped felt pad can be used to provide focal compression
Aids in controlling swelling

46. Open Basket Weave
Figure 8-31

47. Continuous-Stretch Tape Technique
Figure 8-32

48. Common Leg & Knee Taping Procedures

49. Achilles Tendon (prevent Achilles over-stretching)
Figure 8-33

50. Collateral Ligament
Figure 8-34

51. Rotary Taping for Knee Instability (provides stability following ACL & MCL injury)
Figure 8-35

52. Knee Hyperextension (Prevent knee hyperextension, provide support to injured hamstring or slackened cruciate ligament)
Figure 8-36

53. 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

54. Patellofemoral Taping (McConnell technique)

56. Common Upper Extremity Taping Procedures

57. Elbow Restriction (Prevents elbow hyperextension)
Figure 8-42 & 43

58. Wrist Technique 1 (Mild wrist sprains and strains)
Figure 8-44

59. Wrist Technique 2 (Protects and stabilizes badly injured wrist)
Figure 8-45

60. Bruised Hand
Figure 8-46

61. Sprained Thumb (Provides support to musculature and joint)
Figure 8-47

62. Finger and Thumb Checkreins
Figure 8-49
Figure 8-48

63. Kinesio Taping
Technique developed in Japan and widely used throughout Europe and Asia
Therapeutic in that its effect occurs through activation of neurological and circulatory systems with movement
Provides constant tension (shear) to the skin
Can be used immediately post and during rehab of injury
Used for edema reduction, pain management, and inhibition/facilitation of motor activity
Although popular, little evidence exists supporting its effectiveness

64. Mechanism by which Kinesio Tape works
Improves circulation and lymph flow by eliminating tissue fluid or bleeding beneath skin
Correcting muscle function by strengthening weakened muscles
Decreasing pain through neurological suppression
Repositioning subluxed joints by relieving abnormal muscle tension
Stimulates cutaneous mechanoreceptors through pressure and tension on skin, enhancing proprioception through cutaneous feedback

65. Basic Application Principles
Apply tape from origin to insertion without minimal tension for muscle support
Should be applied from insertion to origin during rehabilitation
Muscle is placed on gentle functional stretch with tape at ~10% of resting static length
Can be worn for 3-4 days
Latex free, cotton fabric
Heat activated adhesive
Comes in various sizes
Athletic trainers indicate…
It can provide support and stability
Requires specialized training

66. Kinesio Taping for Plantar Fasciitis
Figure 8-50

67. Kinesio Taping for Patellofemoral Pain
Figure 8-51

68. Kinesio Taping for Low Back Strain
Figure 8-52

69. Kinesio Taping for Shoulder Instability
Figure 8-53