1. Taping

2. 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

3. Selection considerations
Diagnosis of injury
Goals of taping
Resource available
Sport & position
Athletes acceptance
Research findings
Personal preference

4. Diagnosis of injury
Location
Nature
Severity

5. Selection considerations
Diagnosis of injury
Goals of taping
Resource available
Sport & position
Athletes acceptance
Research findings
Personal preference

6. Goals of taping
Prophylactic
Rehabilitative
Functional

7. Selection considerations
Diagnosis of injury
Goals of taping
Resource available
Sport & position
Athletes acceptance
Research findings
Personal preference

8. Resource available
Human resource
Financial resource

9. Selection considerations
Diagnosis of injury
Goals of taping
Resource available
Sport & position
Athletes acceptance
Research findings
Personal preference

10. 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

11. Selection considerations
Diagnosis of injury
Goals of taping
Resource available
Sport & position
Athletes acceptance
Research findings
Personal preference

12. Athlete’s acceptance
If the athlete feels that taping is uncomfortable or decreases performance the attempt to support will failed

13. Selection considerations
Diagnosis of injury
Goals of taping
Resource available
Sport & position
Athletes acceptance
Research findings
Personal preference

14. Research findings
With respect to new techniques or products, it is probably best to keep an open mind but to be critical

15. Selection considerations
Diagnosis of injury
Goals of taping
Resource available
Sport & position
Athletes acceptance
Research findings
Personal preference

16. 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.

17. TAPING MECHANISMS: MECHANICAL
PROPRIOCEPTIVE (DIRECT REFLEX STIMULATION– LEARING PROCESS )

18. 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 mind’s 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

19. 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

20. 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

21. Joint Mechanoreceptors
Found in ligaments, capsules, menisci, labra, and fat pads
Ruffini’s 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

22. 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

23. 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

24. Principle of taping
Tape selection
Skin care
Application

25. Tape selection
Size
Type
Quality

26. Principle of taping
Tape selection
Skin care
Application

27. 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

28. Principle of taping
Tape selection
Skin care
Application

29. 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

30. 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

31. Type of tape
Elastic
Non- Elastic

32. Uses of elastic taping To compress & support soft tissue
To provide anchors around muscle thus allowing for expansion
To hold protective pads in place

33. 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

34. Materials Bandaging materials Padding Underlying bandages
Fixation bandages
Elastic bandages
Adhesive bandages
Additional materials

35. Classification According to time of application
According to type of bandage
According to bandaging technique
According to bandage materials

36. Time of application First bandage Second bandage Later bandage
Prophylactic bandage

37. Type of bandage Open wound Compression bandage Immobilizing bandage
Supportive bandage

38. Bandaging technique Circular bandage (dolabra asc. or desc.)
Testudo rev. or inv.
Spica asc. or desc.
Head bandage (mitra rev. or inv.)

39. Bandaging material Elastic bandage Adhesive bandage cloth tape
Self-sticking bandage

40. 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;

41. 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

42. 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

43. 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

44. 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

45. 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

46. Cervical Arm Sling
Designed to support forearm, wrist and hand injuries
Bandage placed around neck and under bent arm to be supported

47. Shoulder Arm Sling
Forearm support when a shoulder girdle injury exists
Also used when cervical sling is irritating

48. Sling and Swathe Combination utilized to stabilize arm
Used in instances of shoulder dislocations and fractures

49. 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:

50. 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

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

52. 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”)

53. 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

54. 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

55. 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

57. 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

58. 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

59. 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

60. Taping, Bandaging and Splinting Techniques
Wrist / Hand / Finger
Wrist hyperextension / flexion taping
Fan or spica
Finger buddy taping
Thumb hyperextension / abduction taping
Elbow
Hyperextension taping

61. 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

62. 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

63. 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

64. Common Foot Taping Procedures

65. Arch Technique 1 (to strengthen weakened arches)

66. Arch Technique 2 (for longitudinal arch)

67. Arch Technique 3 (X teardrop arch and forefoot support)

68. Arch Technique 4 (fan arch support)

69. LowDye Technique (Management of fallen arch, pronation, arch strains and plantar fascitis) (

70. Sprained Toes

71. Bunions

72. Turf Toe (prevents excessive hyperextension of metatarsophalangeal joint)

73. Hammer or Clawed Toes

74. Fractured Toes

75. Common Ankle Taping Procedures

76. Routine Non-Injury Taping

77. 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

78. Closed Basket weave (Gibney) Technique

79. Open Basket Weave

80. Continuous-Stretch Tape Technique

81. Common Leg & Knee Taping Procedures

82. Achilles Tendon (prevent Achilles over-stretching)

83. Collateral Ligament

84. Rotary Taping for Knee Instability

85. Knee Hyperextension (Prevent knee hyperextension, provide support to injured hamstring or slackened cruciate ligament)

86. 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

87. Patellofemoral Taping (McConnell technique)

88. Patellofemoral Taping (McConnell technique)

89. Patellofemoral Taping (McConnell technique)

90. Patellofemoral Taping (McConnell technique)

91. Patellofemoral Taping (McConnell technique)

92. Common Upper Extremity Taping Procedures

93. Elbow Restriction (Prevents elbow hyperextension)

94. Wrist Technique 1 (Mild wrist sprains and strains)

95. Wrist Technique 2 (Protects and stabilizes badly injured wrist)

96. Bruised Hand

97. Sprained Thumb (Provide support to musculature and joint)

98. Finger and Thumb Checkreins