Transcript Chapter 8: Bandaging and Taping

Chapter 11: Bandaging and
Taping Techniques
© 2007 McGraw-Hill Higher Education. All rights reserved.
Reasons to Bandage and Tape
1. Injury prevention
2. Provide compression to minimize swelling
3. Provide additional support to an injured
structure
4. Decreases ROM
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Bandaging and Taping
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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
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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)
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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”
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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
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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
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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
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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
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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:
1. Anchor at metatarsal arch
2. Across instep (top of foot),
around heel, back to start
3. Repeat several times & overlap
bandage about ½ way moving
up the foot and toward the calf
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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:
1. Anchor distally at smallest part
2. Wrap toward the body in a spiral
3. If wrap is long, wrap back down
toward starting point
4. Hold end of wrap in place with tape
Can put a piece of rolled tape between
skin and bandage to hold in place
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Compression Wrap with X’s
Uses: muscle strain
Size: any size – depends on body part
Position: stand with weight on other leg
Steps:
1. Anchor distally at smallest part
2. Create X’s over the muscle strain by
making the wrap go up and then
down
3. Use tape to hold end of wrap in
place
Can put a piece of rolled tape between
skin and bandage to hold in place
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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:
1. Anchor: start at top of thigh and wrap
laterally around thigh and back to start
2. Pull the wrap “up and out,” go behind
the back and around the abdomen
staying below the belly button
3. Go across the anterior (front) of the
thigh and repeat the same pattern
4. Secure the elastic wrap with tape
Remember
pull “up and out” because
it helps pull the leg up.
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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:
1. Anchor: start at top of thigh and wrap
medially (toward middle) and around
thigh and back to start
2. Pull wrap across the abdomen and over
crest of ilium on opposite side
3. Go around the back and then down and
“in” across the front of the thigh toward
the groin. Repeat the pattern
4. 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
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Shoulder Spica
Uses: Supports muscles and joint or to hold
wound dressings in place
Size: 6-inch wrap (double length)
Position: standing – “tea pot” position
Steps:
1. Anchor: start by going around the back
(posterior) side of the arm back to the start
2. Pull wrap across the back, under the
unaffected arm, across the chest over the top
of the shoulder
3. After crossing the shoulder, go around the
back or posterior side of the arm to the
starting point and repeat
4. Secure the elastic wrap with tape
Posterior
View /
Back
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Shoulder Spica –
to prevent external rotation
Uses: Supports muscles and joint
Size: 6-inch wrap (double length)
Position: standing in “tea pot” position
Steps:
Anterior
1. Anchor: wrap 1 time around the upper arm –
View /
roll is going in toward the chest
Chest
2. Pull wrap across the chest, under the unaffected
arm, & across the back to the shoulder
3. After crossing the top shoulder, go around the
front or anterior side of the arm to the starting
point and repeat
4. Secure the elastic wrap with tape
Flex Bicep muscle and take deep breath so it won’t
be too tight
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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 45-90 degrees and biceps flexed
Steps:
1. Anchor: wrap around the forearm 1-2 times
2. Wrap obliquely upward across the antecubital fossa; wrap 1 ½ times
around the upper arm
3. Wrap obliquely downward across the antecubital fossa and 1 ½ times
around the forearm
4. Repeat; overlap the bandage each time moving more proximal each time
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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:
1. Anchor: wrap around the palm 1-2 times
2. Wrap obliquely across the hand and around the wrist
3. Wrap obliquely across the hand and back around the palm
4. Repeat as many times as needed
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Non-elastic White/AthleticTape
• Great adaptability due to:
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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”)
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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
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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
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Elastic Adhesive Tape or Stretch Tape
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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
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Preparation for Taping
Clean: no dirt,
sweat, oil, or lotion
Heel and Lace pad
to prevent blisters
Shave hair if
taping to skin
Tape adherent (sticky
spray) is an option
1 layer of pre-wrap
Anchors: hold to skin
and for tape to skick
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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
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• Proper taping technique
– Tape width used depends on area
– Angle the tape with the shape of the body
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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
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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
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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
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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
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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
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• 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
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1. For maximum support
A. Tape over prewrap
B. Tape directly to the
skin
C. Tape distal to
proximal
D. Shave the area
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2. Pre-wrap …
A. Makes tape stronger
B. Provides cushion
C. Decreases swelling
D. Decreases the
chance of blisters
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3. Tape stretches out after how
long?
A. 10 minutes
B. 20 minutes
C. 1 hour
D. Does not stretch
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4. Which of the following are rules to
tape application?
A. Overlap tape, no wrinkles,
no continuous taping
B. Must use sticky spray, no
wrinkles, no rehab is needed
C. Keep tape in hand,
continuous tape,
D. the tighter the better, overlap
tape, 1 layer of prewrap
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Common Taping Techniques
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Buddy Taping (fingers)
Uses: support an injured finger using the finger beside it
Size: thin piece of tape
Position: elbow flexed, fingers together
Steps:
1. Wrap above and below the injured joint
2. Should be able to bend finger
3. Can put gauze or thin piece of foam between fingers for
comfort
4. Check circulation
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Toes
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Finger and Thumb Checkreins
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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. 1 layer of pre-wrap
(only tape 3-4 finger width above wrist)
Tape must cover wrist joint
2. Apply 2 layers of 4 support strips
-1st layer go distal to proximal
-2nd layer go proximal to distal
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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
© 2007 McGraw-Hill Higher Education. All rights reserved.
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:
1. Anchor: around metatarsal arch
2. Tear drop strips; pull around
lateral side of heal to medial side
3. Finish at same place tape started
4. 1st metatarsal is on medial side
(big toe) and 5th metatarsal is on
lateral side (little toe)
5. Start and finish on metatarsals
3-3, 4-4, 2-2, 5-5, 1-1 (fan shape)
6. Closure strips from lateral side
across the plantar side of foot
toward the medial side
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Thumb
(Provide support to
musculature and
joint)
1. Anchor around
wrist
2. Use split tape to
make 3 figure 8’s
3. Close at wrist
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Great Toe Taping
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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
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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
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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
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• 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
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• Heel locks are close to
the heel and compact
• Figure 8 goes just
above and below the
heel lock
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Achilles Tendon
(prevent Achilles over-stretching)
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Elbow
(Prevents elbow
hyperextension)
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