PRINCIPLES OF SPORTS TAPING CONTENTS Definition of Taping Uses of Taping Principles of application Effectiveness and evaluation Practical application Definition of Taping Application of adhesive tape (elastic or non-elastic) to: provide support & protection to soft tissues and joints, and to minimize swelling and pain after injury Can be used: immediately following injury during rehabilitation e.g. chondromalacia patellae prophylactic measure e.g. training and competition Taping Principles Sound knowledge of anatomy, joint & tissue mechanics thorough assessment & diagnosis Injury mechanics specific to the sport Is an adjunct to the total injury care Not a substitution for treatment & rehabilitation Effects of Taping Mechanical limits & controls joint movement limits stretching of soft tissues compression to oedematous area maintains desirable alignment Physiological proprioception prevents & limits swelling relax protective muscle spasm ‘physiological rest’ rate of tissue repair Therapeutic pain muscle spasm maintains optional functional ability risk of further injury/ irritation risk of permanent deformity Psychological Types of Tapes Occlusive vs. Porus - Rubber-based tapes - Acrylate tapes Elastic vs. Non-elastic - Elastic tape - for compression and generally ineffective as a support material - Non-elastic tape - for stability & protection from further mechanical damage Non-elastic tape support structures like ligament, joint capsule limit joint movement protect vs. re-injury not for compression Elastic tape compress & support soft tissues like muscles provide compression ineffective as a support material Not for first aid use (compression too severe) Elastic tape Hamstring Strain Lateral Ligament Sprain Non-elastic tape A-C joint sprain Turf Toes Principles of Application Consider: Area to be supported movement to be limited functional status modification needed? assess & analyse RULE OF THUMB tape in the direction that will shorten injured structures Application procedures wash the part remove hair (prewrap) check skin condition (blisters, skin irritation, minor wounds) orthopaedic felt (bony prominence) do not use limb as anchor to pull tape off even overall pressure Basic Taping Applications Anchor Tape Stirrup / U tape Spur / Lateral U / Gibney Locking tape Heel lock overlap 1/2 - 2/3 of previous turn not over inflammatory or infectious skin conditions remove strapping: snubbed nose scissors never pull at right angles to the skin or rip off violently! Problems in Sports Taping Wrong application? Not enough support Contraindications? (Open skin, infection, tape allergy) Signs: circulatory signs, discomfort, skin laceration, blisters, allergic skin reaction Other problems: hinder application of other treatment or performance, psychological dependence, tapes are expensive! Evaluation of the effectiveness of taping Is it effective in reducing the injury incidence? Is it effective after a long period of exercise? Does it influence performance? Does it lead to reduction in symptoms? Is taping superior to bracing or cast immobilisation? Is it effective in reducing the injury incidence? Two review studies Verhagen et al. (2000) Quinn et al. (2000) – Cochrane Review Critical review Verhagen et al. (2000) 8 studies included Taping incidence of sprains and results in less severe sprains Brace seems to be more effective in athletes with previous ankle sprains Meta-analysis Quinn et al (2000) Meta-analysis on the use of external ankle support towards prevention of ankle injuries Meta-analysis “Beneficial effect of external ankle supports in the form of semirigid or aircast braces to prevent lateral ligament injury in high risk sporting activities.” Subjects with previous history of ankle sprain may have risk reduced by wearing such supports Meta-analysis The effect should be taken in the light of: baseline risk of the injury in the activity, previous injury status any possible or perceived loss of performance supply and cost of the supportive device Is it effective after a long period of exercise? Greene & Hillman (1990) Compare athletic taping vs. semirigid orthosis inv./ev. restriction before, during & after 3 hour volleyball practice n = 14 Results: • Maximum reduction in joint restriction due to taping (both inv. & ev.) occurred 20’ after exercise • orthosis - only eversion was compromised (? More effective) Does it influence performance? Burks et al (1991) analysis of athletic performance with prophylactic ankle devices performance when ankles are taped ankle taping performance in vertical jump, shuttle run & sprint performance in brace is minor Does it lead to reduction in symptoms? Cushnaghan et al (1994) Medial taping of the patella provides short term pain relief in patients with PFJ OA Kowall et al (1996) Efficacy of taping PFJ pain no beneficial effect in the addition of taping to standard PT treatment Is taping superior to bracing or cast immobilisation? Braakman et al (1998) 5th MTP fracture functional taping vs. cast immobilisation Functional recovery: mobility, power grip, pulling strengths and torque strengths functional taping showed earlier functional recovery (1 & 4 wks)