Chapter 8: Bandaging and Taping

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

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 8-7 Figure 8-6 © 2011 McGraw-Hill Higher Education. All rights reserved.

12. Elastic Bandage Techniques Figure 8-8 Figure 8-9 © 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 Figure 8-11 © 2011 McGraw-Hill Higher Education. All rights reserved.

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 Figure 8-12 © 2011 McGraw-Hill Higher Education. All rights reserved.

16. Sling and Swathe Combination utilized to stabilize arm Used in instances of shoulder dislocations and fractures Figure 8-13 © 2011 McGraw-Hill Higher Education. All rights reserved.

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

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. 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 Taping Supplies © 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 Figure 8-30 © 2011 McGraw-Hill Higher Education. All rights reserved.

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.