Chapter 8: Bandaging and Taping Jennifer L. Doherty, MS, LAT, ATC Academic Program Director, Entry-Level ATEP Florida International University Acute Care and Injury Prevention

Bandaging Contributes to recovery of injuries Must be firmly applied while still allowing circulation When applied incorrectly may cause Discomfort Wound contamination Prolonged healing

Bandaging Materials Gauze Cotton cloth Elastic bandages Sterile pads for wounds Roller bandages to hold dressings in place Padding to prevent blisters Cotton cloth Ankle wraps Triangular bandages Elastic bandages Extensible and very useful with sports Active bandages allowing for movement Provide support and compression for wound healing Cohesive elastic bandage Two-layer, self adhering bandage Exerts constant and even pressure

Elastic Bandages Gauze, cotton cloth, or elastic wrapping Length and width vary and are used according to body part and size Length: 6 or 10 yards Widths: 2, 3, 4, or 6 inches Should be stored rolled Should be free from wrinkles, seams, and imperfections that could cause irritation

Elastic Bandage Application Hold bandage in preferred hand Loose end should extend from bottom of roll Back surface of loose end should lay directly on skin surface Pressure and tension should be standardized Anchors are created by overlapping wrap Start anchor at smallest circumference of limb

Elastic Bandage Application Body part should be wrapped in position of maximum contraction Each turn should overlap by half to prevent separation More turns with moderate tension Fewer turns with maximum tension Circulation should be monitored

Elastic bandages may 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

Triangle Bandages First aid device Application is easy and fast Primarily used for slings Cervical arm sling Shoulder arm sling Sling and swathe

Cervical Arm Sling Provides support for forearm, wrist, and hand injuries Bandage placed around neck and under bent arm to be supported

Shoulder Arm Sling Utilized following injury to the shoulder girdle Provides support for the forearm May be used if the cervical arm sling is causing irritation

Sling and Swathe Combination of cervical and shoulder arm slings Provides support for the upper extremity Used in instances of Shoulder dislocations Upper extremity fractures

Taping Historically an important part of athletic training profession Becoming less important due to questions regarding its effectiveness Utilized in areas of… Injury care Injury protection

Taping: Injury Care Retention of wound dressing Stabilization of compression bandages utilized to control internal and external bleeding Support for recent injuries in an effort to prevent additional trauma Provide stabilization during rehabilitation

Taping: Injury Protection Used to prevent acute injuries Limits motion Secures special device Brace Splint Soft Cast Padding

Non-Elastic White Tape Great adaptability due to: Adhesive mass Adhering qualities Lightness Relative strength Available in varied sizes: 1”, 1.5”, 2” Utilized to… Hold dressings in place Provide support to a joint Protect injured areas

When purchasing non-elastic white tape, consider the following: Tape Grade Longitudinal and vertical fibers per inch  cost =  fibers Adhesive Mass Should adhere evenly Should maintain adhesion with perspiration Should contain few skin irritants Should be easily removed without leaving residue and without removing superficial skin

When purchasing non-elastic white tape, consider the following: Winding Tension Critically important for even application If applied for protection, tension must be even

Elastic Tape Used in combination with non-elastic tape Good for small, angular body parts Available in varied sizes: 1”, 2”, 3”, 4”

Preparation for Taping Skin surface should be clean No oil, perspiration, or dirt Hair should be removed Prevents skin irritation upon tape removal Tape adherent is optional Foam and skin lubricant should be used to minimize blisters and skin irritation Heel and lace pads

Proper Taping Technique Tape directly to skin Prewrap may be used Helps protect skin in cases where tape is used daily Only one layer of prewrap should be applied Too much prewrap causes irritation and loosens the tape job Prewrap must be anchored proximally and distally

Proper Taping Technique Select tape width based on area to be taped Acute angles require narrower tape Tearing tape Should always hold on to roll of tape Do not bend, twist, or wrinkle tape Tear a straight edge with no loose strands Some tapes may require cutting agents

Proper Taping Technique Tape joint in proper position Position for stabilization Overlap the tape by half Avoid continuous taping Keep tape roll in hand whenever possible Allow tape to follow contours of the skin Smooth and mold tape as it is laid down on skin

Proper Taping Technique Always start taping with anchors Always finish taping with locking strips Where maximum support is desired, tape directly to the skin Do not apply tape if skin is hot or cold from treatments Altered sensation Altered circulation

Tape Removal Tape may be removed by hand Always pull tape in direct line with body One hand pulls tape while other hand presses skin in opposite direction Tape scissors/cutters may be required Be sure not to aggravate injured area with cutting device Tape may also be removed with chemical solvents

Common Foot Taping Procedures

Arch Technique 1 Function: to support weak arches

Arch Technique 2 Function: to support the longitudinal arch

Arch Technique 3 X teardrop method Function: to support longitudinal arch and forefoot

Arch Technique 4 Fan method Function: to support the longitudinal arch

LowDye Taping Technique ( Function: to support longitudinal arch and forefoot Used to support: Fallen arches Forefoot pronation Arch strains Plantar facitis

Taping for Sprained Toes Function: to support metatarsophalangeal joint

Bunion Taping

Turf Toe Taping Function: to prevent excessive hyperextension of metatarsophalangeal joint

Taping Hammer or Clawed Toes Function: to reduce pressure of bent toes against shoes

Taping for Fractured Toes Function: to splint injured toe to non-injured toe

Common Ankle Taping Procedures

Routine Prophylactic Taping

Closed Basket Weave Function: to minimize ankle motion Dorsiflexion and Plantarflexion Inversion and Eversion Used to support newly sprained or chronically weak ankles U-shaped felt pad can be used to provide focal compression Aids in controlling swelling

Closed Basket Weave Technique

Open Basket Weave Function: to minimize ankle motion Allows more dorsiflexion and plantarflexion Minimizes inversion and eversion Used to support newly sprained ankles allowing room for swelling Used with elastic bandage and cold application U-shaped felt pad can be used to provide focal compression Aids in controlling swelling

Open Basket Weave Technique

Continuous Stretch-Tape Technique

Common Leg & Knee Taping Procedures

Achilles Tendon Taping Function: to prevent over-stretching of achilles

Collateral Ligament Taping Function: to provide joint stability following injury to the MCL or LCL ligaments

Rotary Taping for Knee Joint Instability Function: to provide joint stability following injury to the ACL and MCL

Knee Hyperextension Taping Functions: To prevent knee hyperextension To provide support for hamstrings and cruciate ligaments following injury

Patellofemoral Taping McConnell Technique Function: 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

Common Upper Extremity Taping Procedures

Elbow Taping Function: to prevent elbow hyperextension

Wrist Technique 1 Function: to provide support to the wrist following mild wrist sprains and strains

Wrist Technique 2 Function: to protect and stabilize a badly injured wrist

Bruised Hand Taping Function: to protect the hand following injury

Thumb Taping Function: to provides support for the thumb joint following a sprain injury

Finger and Thumb Checkreins