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© 2011 McGraw-Hill Higher Education. All rights reserved. Chapter 8: Bandaging and Taping.

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1 © 2011 McGraw-Hill Higher Education. All rights reserved. Chapter 8: Bandaging and Taping

2 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

3 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

4 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

5 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 rolled when stored Bandage selected should be free from wrinkles, seams and imperfections that could cause irritation © 2011 McGraw-Hill Higher Education. All rights reserved.

6 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 Usual application involves overlapping wrap –Start application at smallest circumference of limb © 2011 McGraw-Hill Higher Education. All rights reserved.

7 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

8 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

9 Elastic Bandage Techniques Figure 8-2 Figure 8-3 © 2011 McGraw-Hill Higher Education. All rights reserved.

10 Elastic Bandage Techniques Figure 8-4 © 2011 McGraw-Hill Higher Education. All rights reserved.

11 Elastic Bandage Techniques Figure 8-5 Figure 8-6 Figure 8-7 © 2011 McGraw-Hill Higher Education. All rights reserved.

12 Elastic Bandage Techniques Figure 8-9 Figure 8-8 © 2011 McGraw-Hill Higher Education. All rights reserved.

13 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

14 Cervical Arm Sling Designed to support forearm, wrist and hand injuries Bandage placed around neck and under bent arm to be supported © 2011 McGraw-Hill Higher Education. All rights reserved. Figure 8-11

15 Shoulder Arm Sling 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 © 2011 McGraw-Hill Higher Education. All rights reserved. Figure 8-12

16 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

17 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

18 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: © 2011 McGraw-Hill Higher Education. All rights reserved.

19 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

20 Winding Tension –Critically important –If applied for protection tension must be even Figure 8-14 © 2011 McGraw-Hill Higher Education. All rights reserved.

21 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

22 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

23 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

24 Figure 8-16 A-E © 2011 McGraw-Hill Higher Education. All rights reserved.

25 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

26 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

27 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

28 Figure 8-17 © 2011 McGraw-Hill Higher Education. All rights reserved. Figure 8-18 Figure 8-19

29 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 Start superior to joint and move inferiorly –Also removable with chemical solvents © 2011 McGraw-Hill Higher Education. All rights reserved.

30 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

31 Common Foot Taping Procedures © 2011 McGraw-Hill Higher Education. All rights reserved.

32 Arch Technique 1 (to support weak arches) Figure 8-20 © 2011 McGraw-Hill Higher Education. All rights reserved.

33 Arch Technique 2 (for longitudinal arch) Figure 8-21 © 2011 McGraw-Hill Higher Education. All rights reserved.

34 Arch Technique 3 (X teardrop arch and forefoot support) Figure 8-22 © 2011 McGraw-Hill Higher Education. All rights reserved.

35 Arch Technique 4 (fan arch support) Figure 8-23 © 2011 McGraw-Hill Higher Education. All rights reserved.

36 LowDye Technique (Management of fallen arch, pronation, arch strains and plantar fascitis) ( Figure 8-24 © 2011 McGraw-Hill Higher Education. All rights reserved.

37 Sprained Toes Figure 8-25 © 2011 McGraw-Hill Higher Education. All rights reserved.

38 Hallux Valgus Figure 8-26 © 2011 McGraw-Hill Higher Education. All rights reserved.

39 Turf Toe (prevents excessive hyperextension of metatarsophalangeal joint) Figure 8-27 © 2011 McGraw-Hill Higher Education. All rights reserved.

40 Hammer or Clawed Toes (reduces pressure of bent toes against shoes) Figure 8-28 © 2011 McGraw-Hill Higher Education. All rights reserved.

41 Fractured Toes (splints injured to non-injured toe) Figure 8-29 © 2011 McGraw-Hill Higher Education. All rights reserved.

42 Common Ankle Taping Procedures © 2011 McGraw-Hill Higher Education. All rights reserved.

43 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

44 Closed Basket Weave (Gibney) Technique –Used for newly sprained or chronically weak ankles © 2011 McGraw-Hill Higher Education. All rights reserved. Figure 8-30

45 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

46 Open Basket Weave Figure 8-31 © 2011 McGraw-Hill Higher Education. All rights reserved.

47 Continuous-Stretch Tape Technique Figure 8-32 © 2011 McGraw-Hill Higher Education. All rights reserved.

48 Common Leg & Knee Taping Procedures © 2011 McGraw-Hill Higher Education. All rights reserved.

49 Achilles Tendon (prevent Achilles over-stretching) Figure 8-33 © 2011 McGraw-Hill Higher Education. All rights reserved.

50 Collateral Ligament Figure 8-34 © 2011 McGraw-Hill Higher Education. All rights reserved.

51 Rotary Taping for Knee Instability (provides stability following ACL & MCL injury) Figure 8-35 © 2011 McGraw-Hill Higher Education. All rights reserved.

52 Knee Hyperextension (Prevent knee hyperextension, provide support to injured hamstring or slackened cruciate ligament) Figure 8-36 © 2011 McGraw-Hill Higher Education. All rights reserved.

53 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

54 Patellofemoral Taping (McConnell technique) © 2011 McGraw-Hill Higher Education. All rights reserved.

55

56 Common Upper Extremity Taping Procedures © 2011 McGraw-Hill Higher Education. All rights reserved.

57 Elbow Restriction (Prevents elbow hyperextension) Figure 8-42 & 43 © 2011 McGraw-Hill Higher Education. All rights reserved.

58 Wrist Technique 1 (Mild wrist sprains and strains) Figure 8-44 © 2011 McGraw-Hill Higher Education. All rights reserved.

59 Wrist Technique 2 (Protects and stabilizes badly injured wrist) Figure 8-45 © 2011 McGraw-Hill Higher Education. All rights reserved.

60 Bruised Hand Figure 8-46 © 2011 McGraw-Hill Higher Education. All rights reserved.

61 Sprained Thumb (Provides support to musculature and joint) Figure 8-47 © 2011 McGraw-Hill Higher Education. All rights reserved.

62 Finger and Thumb Checkreins Figure 8-49 Figure 8-48 © 2011 McGraw-Hill Higher Education. All rights reserved.

63 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

64 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

65 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 © 2011 McGraw-Hill Higher Education. All rights reserved.

66 Kinesio Taping for Plantar Fasciitis Figure 8-50 © 2011 McGraw-Hill Higher Education. All rights reserved.

67 Kinesio Taping for Patellofemoral Pain Figure 8-51 © 2011 McGraw-Hill Higher Education. All rights reserved.

68 Kinesio Taping for Low Back Strain Figure 8-52 © 2011 McGraw-Hill Higher Education. All rights reserved.

69 Kinesio Taping for Shoulder Instability Figure 8-53 © 2011 McGraw-Hill Higher Education. All rights reserved.


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