1. Chapter 11: Bandaging and Taping Techniques

2. Reasons to Bandage and Tape
Injury prevention
Provide compression to minimize swelling
Provide additional support to an injured structure
Decreases ROM

3. 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

4. Should never be used as a substitute for rehabilitation
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)

5. 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”

6. 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

7. Elastic Bandage Application
Create an anchor: “dog ear” the first corner - corner should stick out 2-3 inches and fold it down over the bandage and cover it with next wrap

8. 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

9. Types of Wraps: Ankle and foot spica Lower leg spiral Hip spica
Groin
Hip flexor
Shoulder spica
Elbow figure-eight
Hand and wrist figure-eight

10. 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:
Anchor at metatarsal arch
Across instep (top of foot), around heel, back to start
Repeat several times & overlap bandage about ½ way moving up the foot and toward the calf

11. 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:
Anchor distally at smallest part
Wrap toward the body in a spiral
If wrap is long, wrap back down toward starting point
Hold end of wrap in place with tape
Can put a piece of rolled tape between skin and bandage to hold in place

12. Compression Wrap with X’s
Uses: muscle strain
Size: any size – depends on body part
Position: stand with weight on other leg
Steps:
Anchor distally at smallest part
Create X’s over the muscle strain by making the wrap go up and then down
Use tape to hold end of wrap in place
Can put a piece of rolled tape between skin and bandage to hold in place

13. 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:
Anchor: start at top of thigh and wrap laterally around thigh and back to start
Pull the wrap “up and out,” go behind the back and around the abdomen staying below the belly button
Go across the anterior (front) of the thigh and repeat the same pattern
Secure the elastic wrap with tape
Remember
pull “up and out” because
it helps pull the leg up.

14. 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:
Anchor: start at top of thigh and wrap medially (toward middle) and around thigh and back to start
Pull wrap across the abdomen and over crest of ilium on opposite side
Go around the back and then down and “in” across the front of the thigh toward the groin. Repeat the pattern
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

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

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

17. 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 degrees and biceps flexed
Steps:
Anchor: wrap around the forearm 1-2 times
Wrap obliquely upward across the antecubital fossa; wrap 1 ½ times around the upper arm
Wrap obliquely downward across the antecubital fossa and 1 ½ times around the forearm
Repeat; overlap the bandage each time moving more proximal each time

18. 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:
Anchor: wrap around the palm 1-2 times
Wrap obliquely across the hand and around the wrist
Wrap obliquely across the hand and back around the palm
Repeat as many times as needed

19. Non-elastic White/AthleticTape
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”)

20. 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

21. 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

22. 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

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

24. 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

25. Proper taping technique
Tape width used depends on area
Angle the tape with the shape of the body

26. 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

27. 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

28. 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

29. 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

30. 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

31. 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

32. 1. For maximum support Tape over prewrap Tape directly to the skin
Tape distal to proximal
Shave the area
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33. 2. Pre-wrap … Makes tape stronger Provides cushion Decreases swelling
Decreases the chance of blisters
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34. 3. Tape stretches out after how long?
10 minutes
20 minutes
1 hour
Does not stretch
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35. 4. Which of the following are rules to tape application?
Overlap tape, no wrinkles, no continuous taping
Must use sticky spray, no wrinkles, no rehab is needed
Keep tape in hand, continuous tape,
the tighter the better, overlap tape, 1 layer of prewrap
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36. Common Taping Techniques

37. Buddy Taping (fingers)
Uses: support an injured finger using the finger beside it
Size: thin piece of tape
Position: elbow flexed, fingers together
Steps:
Wrap above and below the injured joint
Should be able to bend finger
Can put gauze or thin piece of foam between fingers for comfort
Check circulation

38. Toes

39. Finger and Thumb Checkreins

40. 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 layer of pre-wrap
(only tape 3-4 finger width above wrist)
Tape must cover wrist joint
Apply 2 layers of 4 support strips
-1st layer go distal to proximal
-2nd layer go proximal to distal

41. 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

42. 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:
Anchor: around metatarsal arch
Tear drop strips; pull around lateral side of heal to medial side
Finish at same place tape started
1st metatarsal is on medial side (big toe) and 5th metatarsal is on lateral side (little toe)
Start and finish on metatarsals
3-3, 4-4, 2-2, 5-5, 1-1 (fan shape)
Closure strips from lateral side across the plantar side of foot toward the medial side

43. Thumb (Provide support to musculature and joint)
Anchor around wrist
Use split tape to make 3 figure 8’s
Close at wrist

44. Great Toe Taping

45. 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

46. 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

47. 2 Heel locks 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

48. 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

49. Heel locks are close to the heel and compact
Figure 8 goes just above and below the heel lock

50. Achilles Tendon (prevent Achilles over-stretching)

51. Elbow (Prevents elbow hyperextension)