Chapter 11 Bandaging and Taping Techniques 2007 Mc

Reasons to Bandage and Tape 1. Injury prevention 2. Provide compression to minimize swelling 3. Provide additional support to an injured structure 4. Decreases ROM © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Bandaging and Taping • • • Application requires skill and practice There is a specific technique – details matter Those with experience should do the taping Various techniques and modifications “Tapers” may tape differently, but all parts of the tape job must be done • Bandaging Materials – Gauze, cotton cloth, elastic wraps, tape © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Bandaging and Taping Should never be used as a substitute for rehabilitation – Rehab must be done to correct the problem and strengthen the area – Sanderson’s policy: • an athlete will not get taped if he or she is not doing rehab • athletes have to buy braces after a period of time, we will not tape all season (too expensive) © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Elastic Bandages • Reasons to use elastic bandage (Ace wrap) – Compression of acute injuries – limit swelling – Secure dressing/pad or ice pack – Provide support to injured soft tissue structure • Length and width of bandages vary • Lengths – Single (5 or 6 yds) and Double (10 yds) • Widths – 2”, 4”, 6” © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Elastic Bandage Application • Pressure and tension should be even • Body part should be flexed when wrapped – Keeps wrap from being too tight • Wrap distal to proximal (away from the torso to near the torso) • Overlap the bandage about ½ way each time to prevent separation – Separation causes pinching and skin irritation • Check circulation – signs: cold extremities, blue fingers/toes, and tingling © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Elastic Bandage Application • Create an anchor: “dog ear” the first corner should stick out 2 -3 inches and fold it down over the bandage and cover it with next wrap © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Spica: a bandage wrapped in a figure-eight pattern with one of the loops being larger than the other. • Ankle/foot spica • Hip spica • Shoulder spica © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Types of Wraps: • Ankle and foot spica • Lower leg spiral • Hip spica – Groin – Hip flexor • Shoulder spica • Elbow figure-eight • Hand wrist figure-eight © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Ankle/Foot Spica Uses: compression, hold pad or dressing, stabilization Size: 2 - or 3 -inch wrap (single) Position: sitting with foot extended over table edge Steps: 1. Anchor at metatarsal arch 2. Across instep (top of foot), around heel, back to start 3. Repeat several times & overlap bandage about ½ way moving up the foot and toward the calf © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Spiral Bandage or Compression Wrap Uses: to cover any large cylindrical area – acute injury, hold ice, decrease swelling, or muscle strain Size: any size – depends on body part Position: stand with weight on other leg Steps: 1. Anchor distally at smallest part 2. Wrap toward the body in a spiral 3. If wrap is long, wrap back down toward starting point 4. Hold end of wrap in place with tape Can put a piece of rolled tape between skin and bandage to hold in place © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Compression Wrap with X’s Uses: muscle strain Size: any size – depends on body part Position: stand with weight on other leg Steps: 1. Anchor distally at smallest part 2. Create X’s over the muscle strain by making the wrap go up and then down 3. Use tape to hold end of wrap in place Can put a piece of rolled tape between skin and bandage to hold in place © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Hip Spica – Hip Flexor Strain Uses: Supports hip flexor strain – helps lift the leg Size: 6 -inch wrap (double length) Position: stand with weight on other leg, injured leg relaxed and ext. rotated Steps: 1. Anchor: start at top of thigh and wrap laterally around thigh and back to start 2. Pull the wrap “up and out, ” go behind the back and around the abdomen staying below the belly button 3. Go across the anterior (front) of the thigh and repeat the same pattern 4. Secure the elastic wrap with tape Remember pull “up and out” because it helps pull the leg up. © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Hip Spica – Groin Strain Uses: Supports groin and adductor muscles – helps move the leg medially Size: 6 -inch wrap (double length) Position: stand with weight on other leg, injured leg relaxed and internally rotated Steps: 1. Anchor: start at top of thigh and wrap medially (toward middle) and around thigh and back to start 2. Pull wrap across the abdomen and over crest of ilium on opposite side 3. Go around the back and then down and “in” across the front of the thigh toward the groin. Repeat the pattern 4. Secure the elastic wrap with tape Go opposite direction of the picture Remember pull “in” because the groin moves the leg in to the middle © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Shoulder Spica Uses: Supports muscles and joint or to hold wound dressings in place Size: 6 -inch wrap (double length) Position: standing – “tea pot” position Steps: 1. Anchor: start by going around the back (posterior) side of the arm back to the start 2. Pull wrap across the back, under the unaffected arm, across the chest over the top of the shoulder 3. After crossing the shoulder, go around the back or posterior side of the arm to the starting point and repeat 4. Secure the elastic wrap with tape Posterior View / Back © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Shoulder Spica – to prevent external rotation Uses: Supports muscles and joint Size: 6 -inch wrap (double length) Position: standing in “tea pot” position Steps: Anterior 1. Anchor: wrap 1 time around the upper arm – View / roll is going in toward the chest Chest 2. Pull wrap across the chest, under the unaffected arm, & across the back to the shoulder 3. After crossing the top shoulder, go around the front or anterior side of the arm to the starting point and repeat 4. Secure the elastic wrap with tape Flex Bicep muscle and take deep breath so it won’t be too tight © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Elbow Figure ‘ 8’ Uses: hold dressing in place in the antecubital fossa, or restrict full extension Size: 3 - or 4 -inch wrap (single length) Position: elbow flexed 45 -90 degrees and biceps flexed Steps: 1. Anchor: wrap around the forearm 1 -2 times 2. Wrap obliquely upward across the antecubital fossa; wrap 1 ½ times around the upper arm 3. Wrap obliquely downward across the antecubital fossa and 1 ½ times around the forearm 4. Repeat; overlap the bandage each time moving more proximal each time © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Hand/Fingers Figure ‘ 8’ Uses: hold dressing in place or mild wrist/hand support Size: 2 - inch wrap (single length) Position: elbow flexed 45 degrees Steps: 1. Anchor: wrap around the palm 1 -2 times 2. Wrap obliquely across the hand around the wrist 3. Wrap obliquely across the hand back around the palm 4. Repeat as many times as needed © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Non-elastic White/Athletic. 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 • Comes in varied sizes (1”, 1 1/2” , 2”) © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Taping • Supplies are expensive and may not fit budget • Can be time consuming • Tape will stretch – maximally effect for about 20 minutes – Some studies question how much tape limits movement and provides supports – Some studies show braces may be equal or better © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

When buying consider the following: • Tape Grade – Graded according to number of fibers per inch – More expensive or heavier tape contains 85 horizontal and 65 vertical fibers per inch • Winding Tension – Very important – Needs even tension through the whole roll of tape – Poor quality – gets tight and hard to pull off at the end • Adhesive Properties – Should stick even with sweat – Contains few skin irritants – Easily removable without leaving adhesive residue and removing superficial skin © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Elastic Adhesive Tape or Stretch Tape • • Often used with non-elastic tape Good for small, angular parts due to elasticity. Comes in a variety of widths (1”, 2”, 3”, 4”) More expensive than non-elastic tape Storing Adhesive Tape • Store in a cool place • Stack so that the tape rests on its flat top or bottom to avoid distortion of the roll © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Preparation for Taping Clean: no dirt, sweat, oil, or lotion Heel and Lace pad to prevent blisters Shave hair if taping to skin Tape adherent (sticky spray) is an option 1 layer of pre-wrap Anchors: hold to skin and for tape to skick © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

• • Tape directly to skin for maximum support Pre-wrap helps protect skin Pre-wrap should only be applied one layer thick Tape should be anchored proximally and distally directly to the skin – Anchors pre-wrap to the skin – Provides a place for the rest of the tape to stick © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

• Proper taping technique – Tape width used depends on area – Angle

Tearing Tape • Should always hold the roll of tape • Do not bend, twist, or wrinkle the tape • Tearing should result in a straight edge with no loose strands • Some tapes may require cutting agents © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Rules for Tape Application • Tape in the position in which joint must be stabilized • Overlap the tape by half (prevent blisters) • Avoid continuous taping – Must tear the tape or it gets too tight • Keep tape roll in hand whenever possible • Smooth and mold tape as it is laid down on skin – Feel for wrinkles with your free hand • Allow tape to follow contours of the skin • If it’s a bad angle and starting to wrinkle, tear it off and start a new piece © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Rules for Tape Application (cont. ) • Anchor the tape job to the skin and finish with a piece that closes or “locks” all the loose tape ends • Tape on skin for maximum support • Do not tape if skin is hot or cold © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Removing Adhesive Tape • Manual Removal – Always pull tape in direct line with body (one hand holds the skin down and the other pulls the tape) • Use of scissors and cutters – Be sure not to aggravate injured area – Scissors with a blunt end – Tape cutters or Shark © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Removing Adhesive Tape • Using “Tape Remover” – Alcohol-based liquid useful for removing adherent or sticky residue – Works best when scrubbing with towel or cloth – Wash tape remover off with soap and water © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

• Waterproof tape – Swimmer, diver, or waterpolo player might require application of adhesive tape – If waterproof tape is not available, duct tape can be used as an effective substitute © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

1. For maximum support A. Tape over prewrap B. Tape directly to the skin

2. Pre-wrap … A. Makes tape stronger B. Provides cushion C. Decreases swelling D.

3. Tape stretches out after how long? A. 10 minutes B. 20 minutes C.

4. Which of the following are rules to tape application? A. Overlap tape, no wrinkles, no continuous taping B. Must use sticky spray, no wrinkles, no rehab is needed C. Keep tape in hand, continuous tape, D. the tighter the better, overlap tape, 1 layer of prewrap © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Common Taping Techniques © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Buddy Taping (fingers) Uses: support an injured finger using the finger beside it Size: thin piece of tape Position: elbow flexed, fingers together Steps: 1. Wrap above and below the injured joint 2. Should be able to bend finger 3. Can put gauze or thin piece of foam between fingers for comfort 4. Check circulation © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Toes © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Finger and Thumb Checkreins © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Wrist Uses: support wrist, limit extension Position: fingers abducted (spread out) and forearm flexed or making a fist with forearm flexed; athlete must hold arm still Steps: 1. 1 layer of pre-wrap (only tape 3 -4 finger width above wrist) Tape must cover wrist joint 2. Apply 2 layers of 4 support strips -1 st layer go distal to proximal -2 nd layer go proximal to distal © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Wrist with Fan Protects and stabilizes badly injured wrist • Anchor at palm and wrist • Use 3 -5 strips to make fan; attach from palm to wrist • Fan will prevent flexion or extension depending on the side that is taped • Secure fan at both ends © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Arch Taping Uses: Supports plantar aspect of foot and longitudinal arch Position: sitting with foot off table and foot in neutral position (90 deg) Steps: 1. Anchor: around metatarsal arch 2. Tear drop strips; pull around lateral side of heal to medial side 3. Finish at same place tape started 4. 1 st metatarsal is on medial side (big toe) and 5 th metatarsal is on lateral side (little toe) 5. Start and finish on metatarsals 3 -3, 4 -4, 2 -2, 5 -5, 1 -1 (fan shape) 6. Closure strips from lateral side across the plantar side of foot toward the medial side © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Thumb (Provide support to musculature and joint) 1. Anchor around wrist 2. Use split

Great Toe Taping © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Closed Basket Weave Ankle Taping • Purpose: acute injuries for maximum support • Anchor just below calf • Stirup – pull medial to lateral (tape goes under heel) • Horseshoe – goes behind heel • Alternate or weave (stirups and horse shoes) • Close the entire tape job with C strips • Finish with heel locks – Prevents side to side movement © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

Open Basket Weave Ankle Taping • Purpose: allows for movement and room for swelling • Not typically used during activity • Open space is left down the front of the tape job • The horseshoes and C strips do not touch or close on the front • Finish with an ace wrap to control swelling © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

• • • Clean ankle, neutral position (90 degrees) Heel and lace pads – and 1 layer of prewrap Anchor at the top just below the calf Optional anchor at the distal end proximal to metatarsal arch – Don’t make this too tight – it will squeeze the metatarsals and be uncomfortable “C” strips – overlap the anchor and close in the tibia 3 stir-ups – Start on the medial (inside) & pull under the heel up to the lateral side of anchor – Pull toward the side that is injured – Stir-ups keep the heel pushed up into the other bones (talus and tibia) 2 Heel locks – Keeps the heel from moving side to side – Start in valley, behind, under, back to the start = ½ heel lock 2 Figure 8’s – Around the arch and above the ankle – Prevents plantarflexion (toes going down) Close with “C” strips & put a piece on the distal end across top of the foot © 2007 Mc. Graw-Hill Higher Education. All rights reserved.

• Heel & Lace pad, pre-wrap, anchors • 3 Stirrups • Pull inside to outside • “C” strips- close to ankle • 2 Heel locks • “start in valley, behind, under, back to the start” = ½ • 2 Figure 8’s • Crosses on top © 2007 Mc. Graw-Hill Higher Education. All rights reserved.