Taping and Bandaging
PROTECTIVE EQUIPMENT
Terminology
• Protective Equipment
– Specialized sports equipment that is used to
protect athletes from injury.
• NOCSAE
– The National Operating Committee for Safety of
Athletic Equipment- a United States Federal
Government agency responsible for testing and
certifying the effectiveness of protective sports
equipment.
Athletic Trainers & Equipment
• Selection, fitting and maintenance of
protective equipment are critical in injury
prevention
• Athletic trainers must have knowledge of
protective equipment available for different
sports and proper fitting procedures
• Athletic trainers must also have knowledge of
how and when protective equipment should
be used to facilitate rehabilitation
Construction of Protective and
Supportive Devices
• An athletic trainer should be able to design
and construct protective devices
• Must have knowledge of theoretical basis of
padding construction
• Art form based on science
• A variety of materials are available
– Hard and soft materials
Legal Concerns
• Increasing amount of litigation regarding
equipment
– Must foresee all uses and misuses and warn user
against potential risks inherent in equipment misuse
• If equipment results in injury due to defect or
inadequacy for intended use manufacturer is
liable
• If equipment is modified --modifier becomes
liable
Helmets
• Direct collision sports require head protection
due to impacts, forces, velocities and implements
• Football Helmets
– NOCSAE develop standards for football helmet
certification
– Must be protective against concussive force
– While helmets must be certified, they may not always
be fail-safe
– Athletes and parents must be aware of inherent risks
Helmets
• Ice Hockey Helmets
– Undergone extensive testing in an effort to upgrade
and standardize
– Must withstand high velocity impacts (stick or puck)
and high mass low velocity impacts
– Helmet will disperse force over large area and
decelerate forces that would act on head (energy
absorption liner)
– Helmets must be approved by Canadian Standards
Association or the Hockey Equipment Certification
Council
Helmets
• Baseball Helmets
– Must withstand high velocity impacts
– Research has indicated that helmet does little to
dissipate energy of ball
– Possible solution would be to add additional
external padding
– Helmet must still carry NOCSAE stamp (similar to
football label)
Helmets
• Lacrosse Helmets
– Required for all male lacrosse players
– Women’s lacrosse only requires protective eye
guard
– Made of hard plastic with wire mesh face guard
– Designed to absorb repeated impact from hard,
high velocity projectiles
– Goalie helmet add throat protector
Helmet Fitting
• When fitting head/hair should be wet to simulate
sweat
• Follow manufacturer’s directions
• Must routinely check fit
– Snug fit (credit card test)
– With change in altitude bladder helmets must be
rechecked
– Chin straps (2, 4, or 6 strap systems)
– Jaw pads are essential (prevent lateral rocking)
• Certification is of no avail if helmet is not fit and
maintained
Football Helmet Fitting
Face Protection
• Categories
– Face Guard
– Throat Protection
– Mouth Guards
– Ear guards
– Eye Protection
Trunk/Thorax Protection
• Essential in many sports
• Must protect regions that are exposed to the
impact of forces
– External genitalia, bony protuberances, shoulders,
ribs, and spine
• While equipment may provide armor, it may also
be used as an implement
• Football Shoulder Pads
– Two types
• Cantilevered - bulkier and used by those engaged in blocking
and tackling
• Non-cantilevered - do not restrict motion (quarterback and
receivers)
Types of Braces
– Rehabilitative:
• Widely used following surgery
• Allows controlled progressive immobilization
• Adjustable
– Functional:
• Used during and following rehab to provide functional
support
• Ready-made and customized
– Neoprene (w/ medial and lateral support)
• Used by those that have sustained collateral ligament
injuries
• Some are also used to provide support in those that have
patellofemoral conditions
INTRO TO TAPING & BANDAGING
Terminology
• Athletic Tape
– Adhesive backed cloth tape that is applied to
athletes to prevent or support injuries by
preventing or restricting undesired joint motion.
(Non-elastic White Tape)
• Bandage Scissors
– Special scissors with blunt ends that are used to
cut tape and bandages from athletes after use
without cutting and injuring the athlete’s skin.
Terminology
• Elastikon
– A heavy-duty, tough elastic tape that cannot be easily torn
by hand, most often requiring bandage scissors to cut.
Most often used to restrict unwanted joint range of
motion or provide assist and support to injured muscles
and tendons.
• Heel and Lace Pads
– Foam or polystyrene pads that are usually coated with
Vaseline or skin lube and applied to the athlete’s heel and
lace areas when taping the ankle. Designed to reduce
friction in the heel and lace areas in order to prevent
blisters due to tape rub.
Terminology
• Pre-Wrap
– Non-adhesive foam under-wrap that is applied
prior to the application of athletic tape to protect
the athlete’s skin from tape irritation
• Skin Lube
– A petroleum based product similar to thick
Vaseline that is applied to heel and lace pads or
skin areas in order to reduce friction and prevent
blisters.
Terminology
• Ace Bandage
– An elastic woven cloth material available in a
variety of lengths and widths that is used to wrap
an athlete’s injured joint or muscle in order to
provide compression, support, or somewhat
restrict undesired range of motion.
• Conform or Lightplast
– A stretchable elastic tape that can be torn by
hand. Most often used to hold bandages in place
or secure protective padding.
Terminology
• Taping Base
– Sometimes referred to as “Tuff-skin” or “QDA”, a
sticky adhesive spray or liquid that is applied to
the athlete’s skin prior to the application of
athletic tape, bandages, or pre-wrap. It helps to
keep the tape or bandage in place by preventing
slippage while also offering some skin protection.
Taping Info
• Used to minimize swelling, provide support to
injured areas and prevent injury
• Evidence Based Literature Reviews
– Limited effectiveness of taping
– Still widely used, not for all ailments
– Braces are often more effective than taping
• Countless variations
Tape Application Prep
• Skin surface should be cleaned of oil, perspiration and
dirt
• Hair should be removed to prevent skin irritation with
tape removal
• Tape adherent is optional
• Foam and skin lubricant should be used to minimize
blisters and skin irritation
• Tape directly to skin
• Prewrap should only be applied one layer thick when
taping and should be anchored proximally and distally
Tape Application
•
•
•
•
•
•
•
Tape in the position in which joint must be stabilized
Overlap the tape by half
Avoid continuous taping
Keep tape roll in hand whenever possible
Smooth and mold tape as it is laid down on skin
Allow tape to follow contours of the skin
Start taping with an anchor piece and finish by applying
a locking strip
• Where maximum support is desired, tape directly to
the skin
TAPING BASICS
Anchor
• A strip of tape, usually
applied first in a taping
procedure that provides
a base for other strips
of tape to attach to
High C
• Describes the tape strip
as having an increased
angle as it’s applied;
used where the body
part has high degree of
taper (i.e. more
proximal on the lower
leg)
Middle C
• Describes the tape strip
as having a moderate
angle as it’s applied;
used where the body
part has a moderate
degree of taper (i.e.
middle 1/3 of lower leg)
Low C
• Describes the tape strip
as having a low angle as
it’s applied; used where
the body part has a low
degree of taper (i.e.
more distal on the
lower leg)
SHIN & LOWER LEG TAPING
Terminology
• Overlapping Strips
– Tape that is applied so that it overlaps the
previous strip by ½ the width of the tape
• Shin Splints
– A non-medical, catch-all term that refers to pain in
the anterior portion of the lower leg; sometimes
referred to as medial tibial stress syndrome
Shin Splint Tape Applications
Other Treatments/Applications
Shin Splint Taping
Kinesio Tape
• Technique developed in Japan and widely
used throughout Europe and Asia
• Provides constant tension (shear) to the skin
• Therapeutic in that its effect occurs through
activation of neurological and circulatory
systems with movement
• KT Tape is an elastic sports and fitness taped
designed for muscle, ligament, and tendon
pain relief and support.
KT Tape
 KT TAPE is applied along muscles, ligaments, and
tendons (soft tissue) to provide a lightweight,
external support that helps you remain active
while recovering from injuries. KT Tape creates
neuromuscular feedback (called proprioception)
that inhibits (relaxes) or facilitates stronger firing
of muscles and tendons. This feedback creates
support elements without the bulk and
restriction commonly associated with wraps and
heavy bracing. KT Tape gives you confidence to
perform your best
KT Tape Application
THIGH WRAP
Posterior Injuries
• Hamstring Strain
– an injury to the muscle on the posterior thigh
involving stretched or torn fibers; also known as a
“pulled muscle”
Anterior Injuries
• Quadriceps Strain
– an injury to the muscle on the anterior thigh
involving stretched or torn fibers; also known as a
“pulled muscle”
• Quadriceps Contusion
– an injury to the muscle on the anterior thigh
involving crushed muscle fibers and internal
bleeding; also known as a bruise or a “charlie
horse”
Thigh Wrap Video
Thigh Wrap Instructions
• Use a 6 inch double Ace Wrap (elastic
bandage)
• Athlete Position:
– WB on non-injured leg with knee in extension
– Slight pressure on injured leg with heel off the
ground with 15-30 degrees of flexion in the knee
• Optional: Spray area with taping adherent
Thigh Wrap Instructions
• Start wrapping distally on the leg about 2-3
inches superior to the knee in a medial
direction
– Wrap around once and fold over a flap of the
previous layer to lock in place
• Continue wrapping around angling upward
and downward to create a crisscross “x”
pattern with the wrap
Thigh Wrap Instructions
• Applying about 50% tension to the wrap as
you go
• Overlapping the previous strip by almost ½
• Wrap should end up in the proximal (upper)
1/3 region of the thigh
• Wrap is secured with tape
– Either white athletic tape using “C” strips on the
end or elastic tape covering the entire wrap
Thigh Wrap
• Is used for:
–
–
–
–
Reduce swelling
Compression
Athlete to feel better
To stay warm
HIP & GROIN SPICA
Injuries
• Groin Strain
– An injury to the hip adductor muscles located on
the medial side of the upper thigh; also known as
a “pulled” groin
• Hip Flexor Strain
– An injury to the muscles that produce hip flexion
located on the anterior hip and thigh; also
referred to as a “pulled” hip flexor
Wrapping Technique
• Hip Spica
– The ace bandage wrapping procedure for groin
and hip flexor injuries
• Below is Groin Strain method
Groin Wrap Video
Hip Spica General Instructions
• Use a 6 inch double elastic wrap
• Athlete Position:
– Stand WB on non-injured leg with knee extension
– Injured leg needs to be Internally Rotated (IR) with
slight pressure on the toes, heel off the ground,
and 15-30 degrees flexion in the knee
• Optional: spray area with tape adherent
• Approximately ½ of the stretch is pulled out of
the wrap as it is applied (50% tension)
Hip Spica: Groin Strain Wrap
• Start distal on the leg about mid thigh, wrapping
in a medial direction
• The wrap angles up and around the upper thigh
and then up and around the hip, circling the
athlete’s gluteus maximus and crossing back
down in front of the hip in a figure eight pattern.
• The wrap continues the same pattern until it
reaches the end, with the end of the wrap
finishing on the upper thigh.
Hip Spica: Groin Strain Wrap
• The wrap is secured with athletic tape applied
over the end of the wrap with the tape
following the same pattern as the wrap.
• The athlete’s leg is checked for any signs of
circulatory impairment and comfort
Hip Spica – Hip Flexor Injury
Hip Flexor Wrap Video
SHOULDER SLING & SPICA
Shoulder Spica
• A figure-8 pattern completed with an
Ace/elastic bandage to minimize movement of
the shoulder (ball-and-socket joint)
– used to hold padding or an ice bag in place
Shoulder Spica
Shoulder Spica Instructions
• Position athlete like a teapot: arm on injured side is
flexed with hand near waist; opposite arm abducted
• OPTIONAL: Spray upper arm and chest with adherent
• Use 6 inch double elastic wrap, anchor it to upper arm
in a down and inward motion
• Bring wrap up and across proximal humerus then
medial towards center of chest, around chest under
opposite arm and back up to athlete’s injured arm
• Wrap is looped around the upper arm and back down
around the chest in a figure-8 pattern
• End wrap on injured upper arm and secure with tape
Shoulder Slings
• A method of restricting range of motion and/or
to immobilize an injury to the upper extremity
• Cervical
– Designed to support forearm, wrist and hand injuries
– Bandage placed around neck and under bent arm to be
supported
• Shoulder Arm
– Forearm support when a shoulder girdle injury exists
– Also used when cervical sling is irritating
– A commercial arm sling can also be used to provide the same
support
Slings
Triangle Bandage Sling
Commercial Arm Sling
Sling and Swathe
• Combination
utilized to
stabilize arm
• Used in
instances of
shoulder
dislocations
and fractures
Figure 8-13
© 2011 McGraw-Hill Higher Education. All
rights reserved.
Ace Wrap Sling
Ace Wrap/Elastic Bandage Sling
• Have athlete stabilize arm close to trunk
• Check for circulation in fingers
• Anchor 6 inch double-length elastic wrap to athlete’s
injured wrist, pulling wrap in outward and upward direction
• When anchor is secure to wrist, pull wrap up and over
uninjured shoulder
• Continue wrap down back at angle to catch the injured
elbow and bind elbow to trunk
• Continue circulars around trunk to secure elbow and arm
• End sling by tucking end into the circulars that hold arm to
trunk
• Fingers of injured arm should remain exposed for
circulation check
ELASTIC WRAPS FOR ACUTE
INJURIES
Reasons to Use an Ace Wrap:
•
•
•
•
Provide injury compression
Reduce injury swelling
Stabilize to prevent further injury
Makes the victim feel better
Elastic Bandage Application
• Hold bandage in preferred hand with loose end
extending from bottom of roll
• Back surface of loose end should lay on skin surface
• Pressure and tension should be standardized
–More turns with moderate tension vs. fewer turns with
maximum tension
• Usual application involves overlapping wrap
• Start application at smallest circumference of limb
• Each turn should overlap by half to prevent separation
• Body part should be wrapped in position of maximum
contraction
• Circulation should be monitored when limbs are
wrapped
Quiz Rubric:
Victim
Preparation/Placement
Anchors
Pull/Technique and
Wrap Effectiveness
Overall Neatness of Job
3 Effective Technique;
excellent
3 No wrinkles or
circulation issues; very
neat
2 Body part positioned
properly
2 Placed at proper spot
and secure
2 Adequate technique
with adequate pull
and/or angles
2 Some wrinkles and
and/or circulation
problems
1 Body part not
completely positioned
correctly
1 Not placed properly
but secure; or properly
placed but not secure
1 Poor technique with
poor pull and/or angles
1 Lots of wrinkles and/or
loose wrap
0 Wrong body position
0 Not in proper place and 0 Not effective or
not secure
completed wrong
technique