© 2009 mcgraw-hill higher education. all rights reserved. chapter 8: bandaging and taping

© 2009 McGraw-Hill Higher Education. All rights reserved.

Chapter 8: Bandaging and Taping

© 2009 McGraw-Hill Higher Education. All rights reserved.

• 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

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Bandaging

• 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

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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

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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

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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

• Anchors are created by overlapping wrap– Start anchor at smallest circumference of limb

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• 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

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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

Figure 8-1

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Elastic Bandage Techniques

Figure 8-2

Figure 8-3

Figure 8-4

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Elastic Bandage Techniques

Figure 8-5

Figure 8-6

Figure 8-7

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Elastic Bandage Techniques

Figure 8-9

Figure 8-8

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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

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Cervical Arm Sling

• Designed to support forearm, wrist and hand injuries

• Bandage placed around neck and under bent arm to be supported

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Shoulder Arm Sling

• Forearm support when a shoulder girdle injury exists

• Also used when cervical sling is irritating

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Sling and Swathe

• Combination utilized to stabilize arm

• Used in instances of shoulder dislocations and fractures

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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

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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:

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• Tape Grade– 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

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• Winding Tension– Critically important– If applied for protection tension must be even

Figure 8-14

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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

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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

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• 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

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Figure 8-16 A-E

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• 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

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Figure 8-17

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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

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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

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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

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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

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Common Foot Taping Procedures

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Arch Technique 1

(to support weak arches)

Figure 8-20

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Arch Technique 2

(for longitudinal arch)

Figure 8-21

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Arch Technique 3(X teardrop arch

and forefoot support)

Figure 8-22

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Arch Technique 4(fan arch support)

Figure 8-23

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LowDye Technique(Management of fallen arch, pronation, arch

strains and plantar fascitis)(

Figure 8-24

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Sprained Toes

Figure 8-25

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Hallux Valgus

Figure 8-26

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Turf Toe(prevents excessive hyperextension of

metatarsophalangeal joint)

Figure 8-27

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Hammer or Clawed Toes(reduces pressure of bent toes against shoes)

Figure 8-28

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Fractured Toes

(splints injured to non-injured toe)

Figure 8-29

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Common Ankle Taping Procedures

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• Most commonly used taping technique

• Provides patient with comfort w/out restricting normal function

• Evidence-based Literature Review– Effective 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

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• Closed Basket Weave– Used for newly sprained or chronically weak

ankles

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Closed Basket weave (Gibney) Technique

Figure 8-30

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• 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

– U-shaped felt pad can be used to provide focal compression

• Aids in controlling swelling

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Open Basket Weave

Figure 8-31

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Continuous-Stretch Tape Technique

Figure 8-32

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Common Leg & Knee Taping Procedures

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Achilles Tendon(prevent Achilles over-stretching)

Figure 8-33

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Collateral Ligament

Figure 8-34

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Rotary Taping for Knee Instability

(provides stability following ACL & MCL injury)

Figure 8-35

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Knee Hyperextension

(Prevent knee hyperextension,

provide support to injured hamstring or slackened cruciate

ligament)

Figure 8-36

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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

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Patellofemoral Taping

(McConnell technique)

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Common Upper Extremity Taping Procedures

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Elbow Restriction(Prevents elbow hyperextension)

Figure 8-42 Figure 8-43

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Wrist Technique 1(Mild wrist sprains and strains)

Figure 8-44

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Wrist Technique 2(Protects and stabilizes badly injured wrist)

Figure 8-45

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Bruised Hand

Figure 8-46

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Sprained Thumb(Provides support to

musculature and joint)

Figure 8-47

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Finger and Thumb Checkreins

Figure 8-49 Figure 8-48

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Kinesio Taping• Technique developed in Japan and widely used

throughout Europe and Asia• Can be stretched to 140% of original length• Provides constant tension (shear) to the skin• Therapeutic in that its effect occurs through activation of

neurological and circulatory systems with movement• Can be used immediately post and during rehab of injury• Used for edema reduction, pain management, and

inhibition/facilitation of motor activity

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• Mechanism by which Kinesio Tape works– Improving circulation and lymph 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

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• 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

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Kinesio Taping for

Plantar Fasciitis

Figure 8-50

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Kinesio Taping for

Patellofemoral Pain

Figure 8-51

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Kinesio Taping for Low Back

Strain

Figure 8-52

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Kinesio Taping for Shoulder Instability

Figure 8-53