Athletic Taping, Padding, and Bracing

1. Athletic Taping, Padding, and Bracing Core Concepts in Athletic Training and Therapy Susan Kay Hillman

2. Objectives • Identify the types of tape commonly used in athletic taping. • Explain the “check reign” used in athletic taping and identify different styles or shapes. • Describe the five different taping techniques (spiral, figure 8, teardrop, herringbone, and horseshoe) and give an application of each. • Identify the points to consider when developing preventive and protective pads. • Identify six basic products used in the construction of pads and braces for injury protection or prevention. • Explain why a fiberglass cast on a football lineman’s wrist should be padded for practice and games, regardless of rules. • Identify the three categories of knee braces and when each might be used.

3. Introduction • Athletic Taping and Bandaging is one of the more psychomotor skills of the A.T. • Prevent injury • Facilitate injured persons return to physical activity • Support ligaments and capsule of unstable joints • limit excessive or abnormal motion • Enhance proprioceptive feedback from the injured limb or joint • Requires a great deal of practice

4. Anatomy and Injury Mechanism as the Foundation for Taping and Bracing • Necessary to have understanding of anatomy and mechanism of injuries • Important to understand link between anatomical structure, mechanism of injury, and purpose for which the tape is being applied • Human anatomy is the foundation for everything you learn about athletic training

5. Materials for Taping and Wrapping • Elastic tape, non elastic tape, elastic wraps, commercially manufactured braces • Non elastic • Standard white tape: porous, different sizes • Optimal support to joints and strategically restrict abnormal/excessive motion • Elastic tapes/wraps • Support for body parts that require more ROM • Apply compression to acute injury to minimize swelling • Braces • Prevent injury • Support unstable joints • Reduce cost of athletic tape

6. Prerequisites to Taping and Bracing • Thorough injury evaluation • Nature and mechanism of injury • Associated with appropriate rehabilitation program • Criteria of full return to activity has been met • Optimal ROM, strength, progression of functional activity, psychological readiness • Safety of athlete is #1 concern

7. Preparing for Taping • Ergonomic taping area • Proper illumination, ventilation and free from excessive heat and humidity • Area should be coeducational • Patient should be willing participant • Area to be taped should be clean and shaven for optimal support • Prewrapmay be applied • Tape adherent and friction pads over bony prominences or muscle tendons

8. Applying Tape • Creativity with taping techniques and supplies is valuable skill for A.T. • Various Application Techniques • Spiral: Used when padding, compression or general support of joints or soft tissue is the objective • Overlapping circles, usually by 1/d tape/wrap width • Distal to Proximal • Promote venous return and function • Commonly used for thigh (hamstring, quad), groin, hip, wrist and lower leg

9. Spiral Taping/wrapping

10. Applying Tape Check Reigns: Using strips of tape that cross a joint to limit normal or excessive movement • Anchor strips applied proximally and distally are anchor points for various check reigns • Stacks • Strips of tape placed directly on top of each other to add strength to application Proximal and distal anchors with stack technique to limit dorsiflexion

11. Applying tape: Check Reign Techniques • Fan • Similar to stacking method, but one end is wider than the other • Allows for taping over a joint where proximal aspect is larger than distal or vice versa • Greater contact area=greater control of motion and support • The “X” • Crisscross method to provide more control/support in one area and more movement in another

13. Applying tape: Check Reign Techniques • The “Y” • Type of stack check reign that is cut at 1 end and split to facilitate attachment to anchor • Split end can be cut long enough to be placed in circular fashion • The “Double Y” • Like “Y” but split at both ends • Different from X because center is ore elongated and covers larger area • Often used for elbow hyperextension and Achilles pathologies

14. THE DOUBLE “Y”

15. Applying Tape • Figure 8 • Foundational technique applied in numerous situations to benefit multiple joints • Limit motion or provide support to joint • Circular and angular patterns crossing over itself while forming an “8” proximally and distally • Tape tension, joint placement, and type of tape are key factors

17. Applying Tape • Teardrop • Strip of tape originates and ends in same spot to form an oval or “teardrop”

18. Applying Tape • Herringbone • Overlapping strips that cross over each other in alternating and opposite directions • Sequential support from overlapping strips • Compression and support due to directional pull applied

19. Applying Tape • Horseshoe (Stirrup) • Used during taping of ankle, heel and shoulder • Used when circumferential tape application is not possible • Direction of pull, amount of tension, % of overlap, and type of tape all affect the benefit of this technique

21. Padding • Valuable in preventing or lessening severity of injuries from sporting competition • Many different types of pads and protective equipment have been developed • Different material • Moldable plastic • Foam • Felt • Commercially manufactured padding

22. Pad Fabrication Considerations • a. Density • Weight of product compared to its size • Higher density offer greater protection and more resistant to deformation • b. Strength • Maximal external stress or load material can withstand • Compression sleeve vs. ankle brace. • c. Rigidity • Amount of bending or compression that occurs in response to amount of applied stress • Fiberglass splint more stiff and has less elasticity • Aluminum splint less stiff and lower elasticity • d. Conformability • Ease in which material forms to the body

23. Pad Fabrication Considerations • e. Self-Adherence • Strength in which material bonds to itself • Integrity and durability of the splint • f. Durability • Ability to withstand repeated stress • More durable=last longer • g. Ease of Fabrication • Time, equipment and skill needed to shape material for support and comfort • h. Availability and Cost

24. Type of density Custom vs. prefabricated Boil and bite designed for custom fit High modulus of elasticity vs. low modulus

25. Pad Construction Materials • Open Cell Foam • Lower density • Slowly regains shape after deformation • Better protection for low levels of impact • More comfortable • Can have adhesive backing for ease of application • Closed Cell Foam • Higher density • Regains original shape quickly after deformation • Provides better protection fro higher levels o impact • Stiffer foam, less comfortable • Can have adhesive backing for ease of application

26. Pad Construction Materials • Thermomoldable foam • Closed or open cell that can be heated and molded to body part • Improves conformability • Great padding for cast and braces • Felt • Varying thickness • Used in conjunction with foam or other padding • Can have adhesive backing

27. Pad Construction material • Gel • Made entirely or partially with silicone or sorbothane • Effective in dispersing different levels of impact • Comfortable and increased ability to conform to body part • Can create adherence problems, must secure well

28. Pad Construction Material • Heat and Moldable Plastics • Activated by heat or water • Hard covering for foam or felt • Increased absorption of high level of impact • Elevated strength levels • Can also be used for immobilization or ROM restriction • A.T. may vary how padding is used • Doughnut or bubble techniques

29. Role of Bracing • Prevent injury or support unstable joints • Ankle Braces • Knee Braces • Preventative, rehabilitative, and functional braces • Shoulder Braces • Support unstable glenohumeral joints • Elbow Braces • Wrist Braces