Strapping for sports injuries A physiotherapists perspective Theo Kapakoulakis

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

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

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

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

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

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

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

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?

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.

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.

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.                                                                                            

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

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

Shoulder strapping AC joint instability

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

Muscle inhibition/’offloading’ taping Tennis elbow Patella tendon

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’

Taping to improve lymphatic function Kinesio tape