Strapping for sports injuries

1. Strapping for sports injuries A physiotherapists perspective Theo Kapakoulakis

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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? Ankle strapping.

11. Preventative Taping For The Finger This taping method is to support a sprained finger joint. Tape is applied above and below the joint.

12. 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.

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

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

15. AC joint instability Shoulder strapping

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

17. Tennis elbow Patella tendon Muscle inhibition/’offloading’ taping

18. 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’

19. Taping to improve lymphatic function • Kinesio tape