1. Taping and Bandaging

2. PROTECTIVE EQUIPMENT

3. Terminology Protective Equipment – Specialized sports equipment that is used to protect athletes from injury. NOCSAE – The National Operating Committee for Safety of Athletic Equipment- a United States Federal Government agency responsible for testing and certifying the effectiveness of protective sports equipment.

5. Athletic Trainers & Equipment Selection, fitting and maintenance of protective equipment are critical in injury prevention Athletic trainers must have knowledge of protective equipment available for different sports and proper fitting procedures Athletic trainers must also have knowledge of how and when protective equipment should be used to facilitate rehabilitation

6. Construction of Protective and Supportive Devices An athletic trainer should be able to design and construct protective devices Must have knowledge of theoretical basis of padding construction Art form based on science A variety of materials are available – Hard and soft materials

7. Legal Concerns Increasing amount of litigation regarding equipment – Must foresee all uses and misuses and warn user against potential risks inherent in equipment misuse If equipment results in injury due to defect or inadequacy for intended use manufacturer is liable If equipment is modified --modifier becomes liable

8. Helmets Direct collision sports require head protection due to impacts, forces, velocities and implements Football Helmets – NOCSAE develop standards for football helmet certification – Must be protective against concussive force – While helmets must be certified, they may not always be fail-safe – Athletes and parents must be aware of inherent risks

9. Helmets Ice Hockey Helmets –Undergone extensive testing in an effort to upgrade and standardize –Must withstand high velocity impacts (stick or puck) and high mass low velocity impacts –Helmet will disperse force over large area and decelerate forces that would act on head (energy absorption liner) –Helmets must be approved by Canadian Standards Association or the Hockey Equipment Certification Council

10. Helmets Baseball Helmets – Must withstand high velocity impacts – Research has indicated that helmet does little to dissipate energy of ball – Possible solution would be to add additional external padding – Helmet must still carry NOCSAE stamp (similar to football label)

11. Helmets Lacrosse Helmets – Required for all male lacrosse players – Women’s lacrosse only requires protective eye guard – Made of hard plastic with wire mesh face guard – Designed to absorb repeated impact from hard, high velocity projectiles – Goalie helmet add throat protector

12. Helmet Fitting When fitting head/hair should be wet to simulate sweat Follow manufacturer’s directions Must routinely check fit – Snug fit (credit card test) – With change in altitude bladder helmets must be rechecked – Chin straps (2, 4, or 6 strap systems) – Jaw pads are essential (prevent lateral rocking) Certification is of no avail if helmet is not fit and maintained

14. Football Helmet Fitting

15. Face Protection Categories – Face Guard – Throat Protection – Mouth Guards – Ear guards – Eye Protection

16. Trunk/Thorax Protection Essential in many sports Must protect regions that are exposed to the impact of forces – External genitalia, bony protuberances, shoulders, ribs, and spine While equipment may provide armor, it may also be used as an implement Football Shoulder Pads – Two types Cantilevered - bulkier and used by those engaged in blocking and tackling Non-cantilevered - do not restrict motion (quarterback and receivers)

17. Types of Braces – Rehabilitative: Widely used following surgery Allows controlled progressive immobilization Adjustable – Functional: Used during and following rehab to provide functional support Ready-made and customized – Neoprene (w/ medial and lateral support) Used by those that have sustained collateral ligament injuries Some are also used to provide support in those that have patellofemoral conditions

18. INTRO TO TAPING & BANDAGING

19. Terminology Athletic Tape – Adhesive backed cloth tape that is applied to athletes to prevent or support injuries by preventing or restricting undesired joint motion. (Non-elastic White Tape) Bandage Scissors – Special scissors with blunt ends that are used to cut tape and bandages from athletes after use without cutting and injuring the athlete’s skin.

20. Terminology Elastikon – A heavy-duty, tough elastic tape that cannot be easily torn by hand, most often requiring bandage scissors to cut. Most often used to restrict unwanted joint range of motion or provide assist and support to injured muscles and tendons. Heel and Lace Pads – Foam or polystyrene pads that are usually coated with Vaseline or skin lube and applied to the athlete’s heel and lace areas when taping the ankle. Designed to reduce friction in the heel and lace areas in order to prevent blisters due to tape rub.

21. Terminology Pre-Wrap – Non-adhesive foam under-wrap that is applied prior to the application of athletic tape to protect the athlete’s skin from tape irritation Skin Lube – A petroleum based product similar to thick Vaseline that is applied to heel and lace pads or skin areas in order to reduce friction and prevent blisters.

22. Terminology Ace Bandage – An elastic woven cloth material available in a variety of lengths and widths that is used to wrap an athlete’s injured joint or muscle in order to provide compression, support, or somewhat restrict undesired range of motion. Conform or Lightplast – A stretchable elastic tape that can be torn by hand. Most often used to hold bandages in place or secure protective padding.

23. Terminology Taping Base – Sometimes referred to as “Tuff-skin” or “QDA”, a sticky adhesive spray or liquid that is applied to the athlete’s skin prior to the application of athletic tape, bandages, or pre-wrap. It helps to keep the tape or bandage in place by preventing slippage while also offering some skin protection.

24. Taping Info Used to minimize swelling, provide support to injured areas and prevent injury Evidence Based Literature Reviews – Limited effectiveness of taping – Still widely used, not for all ailments – Braces are often more effective than taping Countless variations

25. Tape Application Prep 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 Tape directly to skin Prewrap should only be applied one layer thick when taping and should be anchored proximally and distally

26. 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 Start taping with an anchor piece and finish by applying a locking strip Where maximum support is desired, tape directly to the skin

27. TAPING BASICS

28. Anchor A strip of tape, usually applied first in a taping procedure that provides a base for other strips of tape to attach to

29. High C Describes the tape strip as having an increased angle as it’s applied; used where the body part has high degree of taper (i.e. more proximal on the lower leg)

30. Middle C Describes the tape strip as having a moderate angle as it’s applied; used where the body part has a moderate degree of taper (i.e. middle 1/3 of lower leg)

31. Low C Describes the tape strip as having a low angle as it’s applied; used where the body part has a low degree of taper (i.e. more distal on the lower leg)

32. SHIN & LOWER LEG TAPING

33. Terminology Overlapping Strips – Tape that is applied so that it overlaps the previous strip by ½ the width of the tape Shin Splints – A non-medical, catch-all term that refers to pain in the anterior portion of the lower leg; sometimes referred to as medial tibial stress syndrome

34. Shin Splint Tape Applications

35. Other Treatments/Applications

36. Shin Splint Taping

37. Kinesio Tape Technique developed in Japan and widely used throughout Europe and Asia Provides constant tension (shear) to the skin Therapeutic in that its effect occurs through activation of neurological and circulatory systems with movement KT Tape is an elastic sports and fitness taped designed for muscle, ligament, and tendon pain relief and support.

38. KT Tape KT TAPE is applied along muscles, ligaments, and tendons (soft tissue) to provide a lightweight, external support that helps you remain active while recovering from injuries. KT Tape creates neuromuscular feedback (called proprioception) that inhibits (relaxes) or facilitates stronger firing of muscles and tendons. This feedback creates support elements without the bulk and restriction commonly associated with wraps and heavy bracing. KT Tape gives you confidence to perform your best

39. KT Tape Application

40. THIGH WRAP

41. Posterior Injuries Hamstring Strain – an injury to the muscle on the posterior thigh involving stretched or torn fibers; also known as a “pulled muscle”

43. Anterior Injuries Quadriceps Strain – an injury to the muscle on the anterior thigh involving stretched or torn fibers; also known as a “pulled muscle” Quadriceps Contusion – an injury to the muscle on the anterior thigh involving crushed muscle fibers and internal bleeding; also known as a bruise or a “charlie horse”

45. Thigh Wrap Video

46. Thigh Wrap Instructions Use a 6 inch double Ace Wrap (elastic bandage) Athlete Position: – WB on non-injured leg with knee in extension – Slight pressure on injured leg with heel off the ground with 15-30 degrees of flexion in the knee Optional: Spray area with taping adherent

47. Thigh Wrap Instructions Start wrapping distally on the leg about 2-3 inches superior to the knee in a medial direction – Wrap around once and fold over a flap of the previous layer to lock in place Continue wrapping around angling upward and downward to create a crisscross “x” pattern with the wrap

48. Thigh Wrap Instructions Applying about 50% tension to the wrap as you go Overlapping the previous strip by almost ½ Wrap should end up in the proximal (upper) 1/3 region of the thigh Wrap is secured with tape – Either white athletic tape using “C” strips on the end or elastic tape covering the entire wrap

49. Thigh Wrap Is used for: – Reduce swelling – Compression – Athlete to feel better – To stay warm

50. HIP & GROIN SPICA

51. Injuries Groin Strain – An injury to the hip adductor muscles located on the medial side of the upper thigh; also known as a “pulled” groin Hip Flexor Strain – An injury to the muscles that produce hip flexion located on the anterior hip and thigh; also referred to as a “pulled” hip flexor

52. Wrapping Technique Hip Spica – The ace bandage wrapping procedure for groin and hip flexor injuries Below is Groin Strain method

53. Groin Wrap Video

54. Hip Spica General Instructions Use a 6 inch double elastic wrap Athlete Position: – Stand WB on non-injured leg with knee extension – Injured leg needs to be Internally Rotated (IR) with slight pressure on the toes, heel off the ground, and 15-30 degrees flexion in the knee Optional: spray area with tape adherent Approximately ½ of the stretch is pulled out of the wrap as it is applied (50% tension)

55. Hip Spica: Groin Strain Wrap Start distal on the leg about mid thigh, wrapping in a medial direction The wrap angles up and around the upper thigh and then up and around the hip, circling the athlete’s gluteus maximus and crossing back down in front of the hip in a figure eight pattern. The wrap continues the same pattern until it reaches the end, with the end of the wrap finishing on the upper thigh.

56. Hip Spica: Groin Strain Wrap The wrap is secured with athletic tape applied over the end of the wrap with the tape following the same pattern as the wrap. The athlete’s leg is checked for any signs of circulatory impairment and comfort

57. Hip Spica – Hip Flexor Injury

58. Hip Flexor Wrap Video

59. SHOULDER SLING & SPICA

60. Shoulder Spica A figure-8 pattern completed with an Ace/elastic bandage to minimize movement of the shoulder (ball-and-socket joint) – used to hold padding or an ice bag in place

61. Shoulder Spica

62. Shoulder Spica Instructions Position athlete like a teapot: arm on injured side is flexed with hand near waist; opposite arm abducted OPTIONAL: Spray upper arm and chest with adherent Use 6 inch double elastic wrap, anchor it to upper arm in a down and inward motion Bring wrap up and across proximal humerus then medial towards center of chest, around chest under opposite arm and back up to athlete’s injured arm Wrap is looped around the upper arm and back down around the chest in a figure-8 pattern End wrap on injured upper arm and secure with tape

63. Shoulder Slings A method of restricting range of motion and/or to immobilize an injury to the upper extremity Cervical –Designed to support forearm, wrist and hand injuries –Bandage placed around neck and under bent arm to be supported Shoulder Arm –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

64. Slings Triangle Bandage SlingCommercial Arm Sling

65. Sling and Swathe Combination utilized to stabilize arm Used in instances of shoulder dislocations and fractures © 2011 McGraw-Hill Higher Education. All rights reserved. Figure 8-13

66. Ace Wrap Sling

67. Ace Wrap/Elastic Bandage Sling Have athlete stabilize arm close to trunk Check for circulation in fingers Anchor 6 inch double-length elastic wrap to athlete’s injured wrist, pulling wrap in outward and upward direction When anchor is secure to wrist, pull wrap up and over uninjured shoulder Continue wrap down back at angle to catch the injured elbow and bind elbow to trunk Continue circulars around trunk to secure elbow and arm End sling by tucking end into the circulars that hold arm to trunk Fingers of injured arm should remain exposed for circulation check

68. ELASTIC WRAPS FOR ACUTE INJURIES

69. Reasons to Use an Ace Wrap: Provide injury compression Reduce injury swelling Stabilize to prevent further injury Makes the victim feel better

70. 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 – More turns with moderate tension vs. fewer turns with maximum tension Usual application involves overlapping wrap Start application at smallest circumference of limb Each turn should overlap by half to prevent separation Body part should be wrapped in position of maximum contraction Circulation should be monitored when limbs are wrapped

71. Quiz Rubric: Victim Preparation/Placement Anchors Pull/Technique and Wrap Effectiveness Overall Neatness of Job 3 Effective Technique; excellent 3 No wrinkles or circulation issues; very neat 2 Body part positioned properly 2 Placed at proper spot and secure 2 Adequate technique with adequate pull and/or angles 2 Some wrinkles and and/or circulation problems 1 Body part not completely positioned correctly 1 Not placed properly but secure; or properly placed but not secure 1 Poor technique with poor pull and/or angles 1 Lots of wrinkles and/or loose wrap 0 Wrong body position0 Not in proper place and not secure 0 Not effective or completed wrong technique