1. Strapping for sports injuries
A physiotherapists perspective
Theo Kapakoulakis

2. Benefits of strapping /taping.
Prevent injury
Reduce the severity of injury
Provide support
Pain relief.
Limit specific movement at a joint
Allow desired movement at a joint
Improve posture
Facilitate desirable muscle function
Inhibit undesirable muscle function

3. Strapping / taping for sports injuries.
Is an adjunct treatment
Does not replace a strengthening / neuromuscular program as taping does not provide the same motion restriction as an uninjured ligament with intact muscle function.
Is a technical skill and requires expertise to apply correctly

4. Selection of tape .
Appropriate size for injured limb and size of athlete
Eg: 3.8cm for ankle/shoulder, 2.5cm for thumb, 1.25 cm for fingers.
Rigid vs Elastic
Rigid for joint support
Elastic for compression +/- joint support
Adhesive qualities
Maintain adherence despite perspiration
Not irritate skin
Removable without leaving excessive residue

5. Guidelines for tape application
Preparation of the area
Skin clean/dry, no lotions, oil or dirt.
Preferably shaved the day before
Apply padding to areas that require protection
Apply a tape adherent if required
Consider applying underwrap if athlete has tape sensitivity
Use plastic skin or hypoallergenic tape in sensitive areas that have frequent tape application

6. Guidelines for tape application
Taping
Select appropriate size
Place the joint in an appropriate position
If taping over muscle allow for contraction and expansion of area
Avoid continuous taping
Overlap the tape by at least half the width of the tape below
Tape from the roll where possible
Lay tape of the roll and only apply tension in the direction of movement restriction
Allow tape to follow contours of limb. No gaps or creases
Start with an anchor and finish with a locking piece

7. Guidelines for tape application
Post taping checks.
Check for impaired circulation
Capillary refill distal to tape application
Check for impaired sensation
Any pins and needles?
Normal feeling in area?
Is there any pain?
Does the tape feel too tight?
Check that tape is restricting the movement intended
Ask athlete to move the joint through the required functional movements

8. Guidelines for tape application.
Removing the tape
Use tape scissors with blunt nose
Pull the tape back on itself and place pressure on the skin as close as possible to the line of the attachment with the tape
Do not wrench the tape from the skin
If an injury has occurred , cut the tape at a site remote from the injury and avoid placing undue stress on the injured area

9. Ankle strapping. Popular application.
Mandated by many sports insurance and sporting bodies
Research available indicating validity but showing reduction of motion control over time
Role in proprioception?
Used in prophylaxis and rehab
+/- bracing?

10. A) Leukowrap: (underwrap) is applied in a Figure eight "overwrapping" style. (Shaving is preferred). B) Leukofoam: is cut to shape and stuck to skin to pad out the hollow below the ankle bone. Leuko Spray Adhesive: is normally used to help secure the Leukowrap.
Anchors: (Green Tape) are next applied to firmly attach the stirrups to. First Stirrup: (Red Tape) is firmly attached to the anchor. 3.8cm width Leuko Sportstape is the most popular for use throughout the technique. (Note: Coloured tape is only for demonstration purposes.).
Three Stirrups: (Blue Tape Stirrups Two and Three) are generally applied. Theses attach to the anchors starting from inside to outside in a U shape formation. They provide excellent support.
Two Figure Six's: (Red first, Blue second) are to further counteract the inversion movement that causes injury. Applied from the inside to the outside returning to the inside after crossing the front of the foot. Locking Strap: (Green Tape) is to hold the Stirrups and Figure Six's in place.
First Half Heel Lock: (Green Taper) is for support to the rear ankle region. Begin on front of lower leg and move under foot, to outside of heel. Finish on the inside of the lower leg where you started. Second Half Heel Lock: (not shown) is applied in the opposite direction.

11. Preventative Taping For The Finger
This taping method is to support a sprained finger joint. Tape is applied above and below the joint.  
                              
Use next finger as a splint: and position a strip of Leukofoam? Orthopaedic Support Foam to prevent rubbing between the fingers.
                             
Apply 2 simple spirals: (Blue Tape) of Leuko Sportstape 1.25cm around the fingers. Leave the joint area exposed: to allow some movement. Always finish off on top to prevent tape rolling in contact sports.

12. Preventative Taping For The Thumb
This taping is to support the proximal metacarpophalangeal joint of the thumb. Support is required following a thumb (abduction) sprain or to help stop reinjury of a weakened joint.  
                            
                              
                             

13. Patellofemoral taping.
For patellofemoral pain syndrome.
Used for pain relief and to facilitate VMO function
McConnell:PT

14. Postural strapping. Scapula repositioning for shoulder instability
syndromes
Lyn Watson: PT

15. Shoulder strapping
AC joint
instability

16. ‘Check straps’: Limit physiological ROM of injured joint.
Elbow:
Achilles:

17. Muscle inhibition/’offloading’ taping
Tennis elbow
Patella tendon

18. Taping to influence Biomechanics
Orthotics
Many options
Soft-hard
Customised or ‘off the shelf’
Expensive!
Consider supination assist
taping as alternative or ‘trial’.
Modified ‘Low-Dye’

19. Taping to improve lymphatic function
Kinesio tape