Chapter 3 General Guidelines for Taping
The choice of taping technique requires specific knowledge and observation skills. The following points are essential to ensure an effective, efficient taping application:
• a thorough knowledge of the anatomy of the area to be taped
• evaluation skills to assess:
• appropriate tape and choice of technique
• consideration of sport-specific needs (if applicable)
• be prepared to adapt your technique to suit individual needs
• adequate preparation of the area to be taped
Deciding when to tape an injury, what techniques to apply for maximum effectiveness and how to test a completed job may seem a daunting task to the novice. To simplify and facilitate the process, three major stages of taping application with useful checklists follow. These will help the taper to quickly assess all the important factors critical to each stage. These stages are:
Using the following outline as a guide, specific checklists for a particular sport or event may be devised with the assistance of someone who is familiar with the unique requirements of the sport/event and athletes involved therein.
| PREAPPLICATION CHECKLIST [✓] | page 27 |
 Practical? |
page 27 |
| Logical? |
page 27 |
| Materials? |
page 27 |
| Assessment |
page 27 |
|
Joint range and muscle flexibility |
page 28 |
|
Problem areas |
page 28 |
|
Sport-specific items |
page 28 |
| Starting position |
page 28 |
| APPLICATION CHECKLIST [✓] | page 29 |
| Skin preparation |
page 29 |
| Choice of tape |
page 29 |
| Tape application |
page 29 |
| Taping techniques |
page 29 |
| Quality control |
page 30 |
| POSTAPPLICATION CHECKLIST [✓] | page 31 |
| Monitoring of results |
page 31 |
| Functional testing |
page 31 |
| Removal of tape |
page 32 |
PREAPPLICATION CHECKLIST
PRACTICAL: IS TAPING GOING TO WORK FOR THIS INJURY?
• Will tape adhere effectively to the body part?
• Does the area need to be prepared, e.g. cleaned and shaved?
• Is the athlete’s skin damp or excessively oily?
• Are environmental factors likely to make taping impractical (weather or sport factors, i.e. rain, cold temperatures, high humidity; diving or swimming injury)?
• An athlete should not leave the treatment room with a taping job that does not stick; their false sense of security could lead to further injury.
LOGICAL: IS TAPING THE CORRECT PROCEDURE?
• Has the injury been adequately assessed and properly diagnosed? If you do not have the appropriate assessment skills, ensure that someone who does evaluates the athlete: which structures are injured, degree of injury, stage of healing?
• Is it possible that the athlete has an unhealed fracture, an unreduced dislocation or subluxation, etc. which would require medical attention? If so, taping would not be the appropriate intervention.
• In cases of concussion, profuse bleeding, abrasion, laceration, etc. IMMEDIATE FIRST AID and a trip to the emergency room are the treatments of choice – not taping.
NOTE:Should an athlete continue to participate in their sport with an incorrectly diagnosed injury, serious tissue damage could be the result and lead to a more complicated recovery process.
TIP:
TIP:• MATERIALS: WHAT IS NEEDED?
A quick review of the type and quantity of taping materials needed for the specific injury will facilitate a swift, organized taping job. Having the materials ready and within reach will maximize efficiency.
ASSESSMENT: WHAT IS INJURED OR AT RISK?
The ability to assess which body structures are injured (or at risk, either directly or indirectly), and to what degree, is essential in selecting the right taping application. A thorough knowledge of anatomy coupled with an understanding of the demands and requirements of specific sports are also essential elements in determining the appropriate taping technique. If tape is to be used as part of a rehabilitation regime, tapers will also need knowledge of the repair mechanism and stages of repair as they apply to the injured tissues, to enable them to select appropriate taping techniques. Application of this knowledge will become second nature through experience.
The following general points should be considered before taping an injury.
JOINT RANGE AND MUSCLE FLEXIBILITY: WHAT IS THE ATHLETE’S NORM?
Although this range differs from athlete to athlete, testing and examination of the corresponding uninjured joint and muscle area should be helpful in delineating these factors. This procedure will also ensure that the taping will not excessively limit the range of motion of the injured area.
PROBLEM AREAS: SUPERFICIAL SKIN DAMAGE IN CREASES OR BONY AREAS
Soft skin (in elbow or knee creases) and areas where tape pulls around bony points (the back of the heel in ankle taping) are often the sites of superficial skin damage.
Constant pressure from a poor tape job can cause painful pressure points (such as the styloid process at the base of the fifth metatarsal bone when an ankle is taped too tightly).
Arteries, veins, nerves or bones that are anatomically superficial (close to the skin surface) require extra care to avoid skin damage.
Trouble spots for each injury area should be reviewed before taping is attempted.
SPORT-SPECIFIC ITEMS: MEETING MOVEMENT DEMANDS OF THE ATHLETE
What is the range of motion required for the injured athlete’s sport? For example, for a lateral ankle sprain, when taping a basketball player, the taping need is near-maximum plantarflexion (for jumping); in taping an ice hockey player, the requirement shifts to near-maximum dorsiflexion. In both cases the taping purpose is to prevent abnormal lateral mobility, yet the taping procedures must be different in order to accommodate the demands of a sport-specific range of motion. Even within a sport, there may be differences; for example, in rugby the needs of a forward player may be different from that of a back player. Don’t be afraid to ask the athlete what they want or usually have done when taping. Very often, they will know what works for them and what they are comfortable with. Remember, whatever you do, it must be effective.
THE STARTING POSITION OF THE INJURED PART IN PREPARATION FOR TAPING
The best position is one in which the injured structure is unstressed (or neutral) and well supported (not stretched). Check that the athlete is sufficiently comfortable to maintain the required position throughout the taping procedure. The taper should also be able to work from an efficient, comfortable, biomechanically sound position.
APPLICATION CHECKLIST
PREPARATION OF THE INJURED AREA: SKIN CONDITION
• DIRTY: clean gently with a liquid antiseptic soap or antiseptic-soaked gauze. Pat dry. If skin is lacerated or abraded, apply a light layer of antibiotic ointment locally and cover with protective gauze. Always wear protective gloves when dealing with lacerations and abrasions.
• WET: dry gently with gauze. Use adhesive spray.
• OILY: wipe with rubbing alcohol-soaked gauze. Apply adhesive spray to ensure tape adhesion.
• HAIRY: shave area to be taped. Apply antiseptic lotion. Swab dry with gauze. Use a skin toughener if skin is not irritated.
• IRRITATED: apply a small amount of antibiotic ointment. Apply lubricant sparingly and use protective padding over the area.
TIP:CHOOSING THE CORRECT TAPE FOR A SPECIFIC TAPING JOB
As stated in Chapter Two, choosing the right type of tape depends on the actual structure(s) involved and whether the taping job involves padding, support, restraint or compression.
In general, ELASTIC tape is used for contractile tissue injuries (i.e. muscles, tendons). Elastic tape is preferable in these instances because it gives stretch with support and a graduated resistance, yet limits full stretch of the muscle or tendon.
Because muscles must be allowed a certain amount of normal expansion during activity, elastic tape should be used as anchors when encircling muscle bulk is required. It should also be used for specific compression taping requiring localized pressure.
NON-ELASTIC tape is used to support injuries of non-contractile structures (i.e. ligaments). Non-elastic tape reinforces the joints in the same way the ligaments would, thereby increasing joint stability.
TAPE APPLICATION
The person applying tape to an injury must modify the application to suit the circumstances specific to each situation, and the needs of each patient. Education and experience will enable the taper to develop variations on the basic techniques offered in this guide. Several ankle taping variations are illustrated in Chapter Six.
As long as the tape application is fulfilling the goal of supporting or protecting the targeted area without putting other structures at risk, a procedural variation can be used.
TAPING TECHNIQUES
The two main techniques used in applying tape are commonly referred to as strip taping and smooth roll.
Strip taping employs one short strip of tape at a time, in very specific directions and with highly controlled tension. This technique is often used in basic preventive taping as demonstrated in Chapter Six.
Smooth roll refers to use of a single, continuous, uninterrupted winding of a piece of tape.
| Advantages | Disadvantages | |
|---|---|---|
| Strip | ||
| Smooth roll |
NOTE:POSTAPPLICATION CHECKLIST
MONITORING THE RESULTS: IS THE TAPING EFFECTIVE?
Follow these steps only when the tape job has been completed.
• Gently manually stress the joint movement to check for adequate limitation at the extremes of range of motion and in the direction of the injury.
• Check for stability of the joint and taping strips. The athlete should experience no pain during these tests.
• Further testing of the finished taping procedure involves functional tests in sport-specific movements as well as action and/or ranges of motion.
• Don’t forget to ask the athlete ‘Is it comfortable? Can you function adequately?’.
FUNCTIONAL TESTING: CAN THE ATHLETE SAFELY ENGAGE IN SPORT?
Before the athlete can return to training or competition, it is necessary to thoroughly evaluate the taping relative to performance of sport-specific skills and movements. These tests, performed in order of increasing difficulty and stress to the joints, should also be assessed by the medical support personnel.
The last activity will test the athlete’s ability to perform full-impact weight bearing on the ankle from a height – a position which places the ankle at its highest risk of reinjury.
If at any juncture in these tests the athlete experiences pain or loss of agility, the evaluation should be STOPPED before they suffer further injury or reinjury.
NOTE:At this point in testing, any ineffective taping should either be adjusted, to correct the problem that is causing the pain or loss of agility, or completely reapplied. The injury should be reassessed for the appropriateness of taping.
The key factors in determining whether or not the athlete can return to training and competition with the aid of tape are:
TAPE REMOVAL
When the tape is no longer required, removal must be undertaken with the utmost care. The ‘rip it off quick’ approach should be avoided as it has the very real possibility of damaging the skin, creating a new injury and jeopardizing recovery.
Only appropriate bandage scissors or tape cutters (tape shark) should be used to avoid damage to the skin or other sensitive structures in the area.
The preferred method is to first select an area of soft tissue away from bone or bony prominences as these can be quite painful to cut across. Cut the tape using the blunt tip of the scissors and ease the skin away from the tape, forming a tunnel to facilitate cutting. After cutting the tape, carefully peel off slowly and gently, while pressing down on the exposed skin and pulling the tape back along itself, parallel (not perpendicular!) to the surface of the skin – keep it low and slow.
The safe removal of tape is demonstrated in the accompanying DVD.
TIP: