The Role of Strapping and Taping in Sports and Physio

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The Role of Strapping and Taping

Strapping and taping techniques are some of the most important and most visible skills aphysiotherapist, sports therapist or athletic trainer working with sports men and women canhave.

Strapping and taping techniques can help prevent injury as well as protect the athlete fromre-injury whilst returning to sport.

The role of tape is to limit the movement in an injured joint to prevent excess or abnormal movement. In addition it should provide support to the muscles surroundingthe joint that may be under additional strain due to the ligament injury.

Another benefit of taping is thought to be the enhanced proprioception (or kinaestheticfeedback) that the tape provides during movement (or in other words it is thought to improveco-ordination). For example if a taped ankle starts to invert (turn over) during a jump then thetape will restrict this and inform the body that it needs to contract muscles to prevent thismovement in the ankle. Without this feedback the athlete may be unaware the ankle hasstarted to invert and land on it badly injuring it again.

Ankle and Achilles

Louisiana Wrap for the Ankle



Aim: to provide compression and prevent inversion sprains. This strapping can be removed &re-applied easily, which is useful during the early stages when cold/ice therapy is required.

What is required:

• 5cm Compression bandage - cohesive bandage that sticks to itself is ideal for thisstrapping.

Step 1

• Position the ankle with the athlete seated and the ball of the foot resting on the therapist’sknee.

• Place the foot with the toes slightly pointing upwards (dorsi flexed) and foot slightly rolledinwards (pronated).

• Starting at the front of the ankle, go outwards, around the back, to the front

Step 2

• From there, go across the front to the inside of the foot and then underneath.

Step 3

• Come up across the front, around the back and down again to the inside of the foot againin a figure of 8.



Step 4

•

This time when the bandage is passed under the foot it comes up the outside of the ankleand around the back.

• Slight tension can be applied pulling the outside of the foot up giving support where it isneeded to prevent inversion sprains

Step 5

• The bandage then goes around the back of the ankle and across the foot to the outsideof the foot and under.

Step 6

• Again, instead of going up and across the foot again the bandage goes up the inside of



the ankle and around the back.

• This pattern is repeated for 2 to 3 more times or as length of bandage allows.

Step 7• Finish off by wrapping a number of times around the ankle, working upwards.

• Be sure to allow enough bandage at the end to do this.

• Secure the end with a little non stretch tape or just tuck in the loose end.



Basketweave Taping

Aim: to provide support and compression to the acutely injured ankle. It leaves the top of thefoot uncovered allowing plantar and dorsi flexion (up and down movements) but preventing

lateral sideways movement that can inflame the already injured ligaments.

What is required:

• Foam underwrap (optional)

• Spray adhesive (optional)

• 2.5 cm non stretch zinc oxide tape.

• Tube grip or elastic cohesive bandage (optional).

Step 1

• Apply three strips of 2.5cm (1inch) tape anchors.

• Ensure they are not joined at the top but left open as the foot expands when placed onthe ground.

Step 2

• Apply three strips of tape from the inside of the upper anchor down the inside of the leg,

under the foot and pull up the outside of the leg to fix on the outside of the upper anchor.

Step 3

• Apply a horizontal horseshoe stirrup from the inside of the ankle to the outside of theankle.

http://www.return2fitness.co.uk/Strapping_And_Taping/Cohesive_Bandages




Turf Toe



Aim: To prevent excessive bending back (hyperextension) of the big toe.

What is required?

• 2.5cm (1 inch) non stretch white tape.

• 3.8cm (1.5 inch) non stretch white tape.

Step 1

• Apply a strip of 2.5cm tape around the big toe as ananchor. Use two strips if the big toe is long.

• Using 3.8cm tape apply two overlapping anchor stripsaround the middle of the foot.

• When applying the anchors to the middle of the foot,spread the toes apart to simulate load bearing on the foot.This will help prevent the tape being uncomfortable when the athlete stands up.

Step 2

• Apply a support strip of 2.5cm tape from the middle of the footdirectly up to the big toe. Ensure the toe is in the desired positionbefore fixing the tape.

• Some therapists prefer to tape from the toe downwards.

Step 3

• Apply a second support strip from the middle of the footupwards but slightly to the side and overlapping the first.

Step 4

• Then a third strip from the other side.

• You should have an 'X' of tape with the cross passing over the joint of the big toe.

Step 5

• Secure the support strips with two strips over the top at the big toe and the middle of thefoot with 2.5cm and 3.8cm tape respectively - like the original anchor strips.

• Assess the taping to ensure the big toe cannot be bent back and the tape is secure.

Bunions (Hallux Valgus)



Aim: To reduce the stress on the big toe by pulling the toe outwards

What is required?

• 2.5cm (1 inch) non stretch white tape.


Step 1

• Using the 1.5 inch non stretch white tape, apply 2 anchorsto the middle of the foot.

• Spread the toes when securing the anchor to simulateweight bearing so the foot is not constricted when the athletestands up.

• Using the 1 inch tape, apply two anchors, one overlappingthe other to the big toe.

• Ensure these are not too tight!

Step 2

• Pull the big toe outwards (towards us in the image).

• Apply a strip of 1 inch tape from the toe, down the inside of the foot and secure.

Step 3

• Repeat this twice more, overlapping each strip.

•

Step 4

• Finish off by applying two overlapping one inch strips over the big toe to secure theends of the supporting strips.

• If there is not enough support from the supporting strips at this point then they can bedetached and re-attached a little tighter.

• Finally secure the taping by applying two overlapping 1.5 inch strips over the middle of the foot.



Taping for Plantar Fasciitis

Aim: To support the arch of the foot and take the pressure off the plantar fascia.

What is required?

• One roll of non stretch zinc oxide tape about 1 inch or 2.5cm wide.

•

Step 1

• Starting on the inside of the foot apply a strip of zinc oxide tapeas shown below.

• The tape should be about 2 cm in width. Note you should finishup at the same point you started from.

• Try not to get any wrinkles in the tape as this could causeblisters.

Step 2

• Next do the same starting on the outside of the foot and finishingon the outside of the foot.

• You should have a crossed pattern as shown on the left.

• Then repeat these first two steps overlapping with tape until youhave applied two pieces of tape each side.

Step 3

• Finally cover what you have just done with a number of shorts strips of tape that go across the underneath of the foot.

• Again be careful not to wrinkle the tape or do it too tight.

Step 4

• You might like to finish it off with a small piece of tape across thetop of the foot connecting each side to secure it.

• This is what is should like like when finished.

http://www.return2fitness.co.uk/Strapping_And_Taping/Zinc_Oxide_Tape

http://www.return2fitness.co.uk/Strapping_And_Taping/Zinc_Oxide_Tape



Bruised heel / Fat pad contusion Taping

Aim: To compress the soft tissue under the heel to increase natural cushioning and protect

the heel from impact.

What is required?

• One roll of non stretch zinc oxide tape about 1 inch or 2.5cm wide.

Step 1

• Place an anchor strip horizontally around the back of theheel.

Step 2

Then place a support strip under the heel.

Step 3

• Then repeat the first anchor strip over the top.

Step 4

• Continue alternating support strips and anchor strips until most of the heel is covered.

•



Shin and Lower Leg

Shin Splints

Aim: To provide support and relieve from shin pain originating at the lower third of inside(medial side) of the shin bone or tibia.

What is Required?

• 2.5cm (1inch) Non stretch zinc oxide tape.

• Underwrap and skin adhesive (optional).

The tape will be more effective if applied directly to the skin. However the skin will need to befree of hair (shaved) to allow the tape to stick effectively and

prevent pain when removing. The tape can be applied ontounderwrap which is secured with a skin adhesive, however it isunlikely to be as effective or last as long as tape applied directly tothe skin.

Step 1

• Starting with the bony bit on the inside of the ankle apply astrip of tape across the front of the ankle, around the back of theachilles tendon (not too tight here) and then diagonally across and up the front.

• Make sure it is not too tight around the back of the achilles tendon but you might like to

try a little pressure as the tape comes up the front. You may need to experiment a fewtimes

Step 2

• Repeat this two more times slightly overlapping the firstone as shown opposite. Make sure the tape covers thepainful area on the inside of the shin.

• If done correctly this is a very good taping that will take the pressure off the lower shin.Remember that you can rid yourself of shin splints but must also use all other methods of treatment possible.

Warning - be aware:

• If you are allergic to tape or the latex in some zinc oxide tape then use tape that willnot cause a reaction or do not tape at all.

• Do not apply the tape to tightly, particularly around the back of the achilles

tendon. This may cause unnessessary pain.



Anterior Compartment Syndrome



What is required:

• 3.5cm zinc oxide tape

• Underwrap and adhesive spray (optional)

Step 1

• Apply the underwrap if desired. Then starting with the bony bit on the outside of theankle apply a strip of tape across the front of the ankle, around the back of the achillestendon (not too tight here) and then diagonally across and up the front.

Step 2

• Repeat step 1 with another strip of tape slightly overlapping the first.

Step 3

•

Repeat this once more working from the bottom upwards. Make sure the tapecovers the painful area on the inside of the shin. When done correctly this can helpsupport the muscles on the outside of the shin during healing and rehabilitation

Knee

Patella Tendon Taping



Aim: to provide support to the patella tendon or patella ligament and take some of the stressof the patella tendon insertion into the shin bone (tibia).

What is required:

• 3.8 cm (1.5 inch) non stretch white tape or 5 cm (2 inch) elastic tape. Some athletesmay prefer one, some the other depending on amount of support required.

•

Step 1

• Sit the athlete on the floor or coach with the knee bent to 90 degrees.

• A small amount of underwrap may be applied around the knee for comfort and to stopthe tape pinching. Or if the leg is particularly hairy then it may be best to shave the leg aswell where the tape will be applied.

•

Step 2

• Starting on the outside of the leg pass the tape justunder the lower pole (bottom) of the patella and around theback of the knee.

Step 3

• As the tape passes around the front of the knee it is twistedto give extra support. Continue wrapping the tape around theknee a couple of times.

Step 4

• Apply one third and final wrap around the knee withouttwisting the tape as it passes under the patella.

Patellofemoral Pain Taping



Aim: To correct the abnormal position of the patella (kneecap).

This should prevent it from tracking in the wrong place, rubbing on the femur bone and

causing pain.

If the athlete has pain on normal daily activities then taping should be applied all day andgradually reduced as the knee improves. If there is pain only on specific activies then onlytape for those activities or rehabilitation exercises.

It is done by finding the sore spot where the underneath of the patella rubs on the tibia boneunderneath. It is often trial and error to tape the kneecap away from this position. Thekneecap may need to be glided sideways away from the sore spot. It may also need to betilted or rotated. It is up to the therapist to look and assess the patella. If the first attempt is notsuccessful then try a tilt or rotation.

Always assess the effectiveness of taping by performing a painful activity such as a squatbefore applying the tape, then repeat the activity after the tape is applied. If the taping hasbeen effective then the activity should be virtually pain free.

What is required:

• Fixomul / Hypafix type tape.

• 2.5cm (1 inch) non stretch white zinc oxide tape.

• It is often possible to buy a specific patella taping kit.

Step 1

• Assess the knee cap to determine which way the tape should be applied.

• By moving and pressing the knee cap it may be possible to establish where the sorespot is and which way the patella should be pulled.

• This is usually towards the middle of the knee (medially).

Step 2

• Apply strips of the Fixomul / Hypafix tape covering the patella (kneecap) area.

• Do not apply any tension to the stips at this point.

• Re-assess the position of the kneecap again.

Step 3

- If the patella needs tilting



• Apply a strip of 2.5cm non stretch tape from the middle of the kneecap towards theinside of the knee.

• Pull on the tape gently before fixing to assist in gliding the patella towards the inside of the knee.

• This can be increased further by pushing the skin on the inside of knee towards thekneecap before fixing the tape

Step 3

- if the patella needs gliding medially

• Apply a strip of 2.5cm non stretch tape from the outside of the knee to the inside applying tension before fixing the

tape.

Step 3

- if the patella needs rotating

• Apply a strip of 2.5cm non stretch tape from bottom of the kneecap inwards and upwards diagonally to rotate thepatella.

• To rotate the other way, apply tape from the top.

Step 4

• Assess the position of the patella. If additional strips are required then apply as in steps3 and 4.

• Finally the athlete performs a previously painful activity. If successful there shouldbe at least a 50% reduction in pain if not a complete reduction of pain.

Posterior Cruciate Ligament



Aim: to prevent hyperextension (over straightening) of the knee. It will provide support for astrained posterior cruciate ligament.

What is required:

• 7.5 cm (3 inch) elastic bandage.

• Underwrap.


• Adhesive spray.

• 6 inch crepe bandage (optional)

Step 1

• Position the athlete standing on a roll of tape to bend the knee slightly.

• Either shave the leg or apply spray adhesive and underwrap starting just above thecalf and going up the leg finishing above the middle of the thigh.

Step 2

• Using two or three 7.5 cm strips of elastic bandageapply anchors to the mid / upper thigh of the athlete.Tape should overlap by half the width of the tape.

• Ensure the athlete contacts both the calf and thighmuscles while the anchors are applied so blood flow isnot restricted later on.

• Repeat the above applying two 7.5cm elastic anchorsto the middle of the calf muscle.

• Again ensure muscles are contracted when this isdone.

• Padding can be added to the back of the knee toprevent friction and provide comfort.

Step 3

• Create a fan of strips of tape which will form acheckrein. The length of the pieces of tape should bemeasured against the back of the knee.

Step 4

• Position the checkrein at the back of the leg.

http://www.return2fitness.co.uk/Strapping_And_Taping/Elastic_Bandages




Medial ligament sprain



Aim: To provide support to the medial collateral ligament. This may be important if theathlete has an unstable knee or laxity in the joint. Tape will provide support. It may also beuseful to protect the area when gradually returning to full fitness. Do not tape if unsure of theinjury or why the taping is being used.

What is required?

• 5cm (2 inch) elastic tape.

• 7.5 cm (3 inch) elastic tape.

• Underwrap.


• Adhesive spray.

Step 1

• Prepare the leg by shaving or applying the spray adhesive followed by underwrap.

• Place a roll of tape or similar under the heel of the athlete to achieve the correctposition for taping.

• The calf, knee and thigh need to be covered. This will help the tape stick properly andprotect the leg from pain hair removal when removing the tape.

• Once the leg is bent, ensure the toes face inwards slightly so the lower leg is partially

rotated inwards (not shown).

Step 2

• Using two or three 7.5 cm strips of elastic tapeapply anchors to the mid / upper thigh of the athlete.

• Ensure the athlete contracts both the calf and thigh

muscles while the anchors are applied so blood flow isnot restricted later on.

• Repeat the above applying two 7.5cm elasticanchors to the middle of the calf muscle.

• Again ensure muscles are contracted when this isdone.

• The taping will have more support if these anchorscan attach to the skin - the leg will need to be shavedfor this.

Step 3



• Using 5cm elastic tape, apply a strip of tape from the outside of the lower leg,upwards and inwards crossing the joint line of the knee (but staying below the knee).

• Pull firmly upwards when applying this strip to stretch it before applying it to the upper anchor.

Step 4

• Using 5cm elastic tape apply a second strip of tape starting on the inside of the calf anchor.

• The tape passes up across the knee joint line and above the kneecap.

• Again stretch the tape firmly before fixing on the upper anchor.

Step 5

• Repeat both of the above taping strips with non stretch 3.8 cm zinc oxide tape.

Step 6

• Complete the taping by applying strips of 7.5 cm elastic tape over the original anchorsto close the taping off.

• Avoid finishing a tape strip on the inside of the thigh as may peel off due to friction of the legs.

Anterior Cruciate Ligament Injury



Aim: to provide support to the knee following injury to the anterior cruciate ligament injury.This may be important if the athlete has an unstable knee or laxity in the joint. Tape willprovide support. It may also be useful to protect the area when gradually returning to full

fitness. Do not tape if unsure of the injury or why the taping is being used.

What is Required?

• Underwrap (optional)

• 5 or 7.5 Elastic Adhesive Bandage

• 5cm zinc oxide tape

Step 1

• Apply underwrap to the knee if required.

•

It is better to tape directly to the skin in which case the skin should be prepared first byshaving.

Step 2

• Apply Anchors above and below the knee with 5cm or 7.5cm elastic adhesivebandage (EAB).

• These provide a secure base to attach the support straps.

Step 3

• Apply a cross of EAB to the inside of the knee.

Step 4

• Apply a cross of EAB to the outside of the knee.

Step 5

• Reinforce the medial and lateral anchors with strips of 5cm non stretch zinc oxidetape.





Step 6

• Apply a derotation strip of 5cm EAB to support the anterior cruciate ligament and helpprevent rotation of the knee.

Step 7

• Repeat initial anchors from step 2 to finish the taping.

Thigh

Groin Strain

What is required:

• A 7cm or 10cm elastic or elastic cohesive bandage.• 2.5cm non stretch zinc oxide tape

Step 1

• Starting on the inside of the thigh to be supported wrap once around

the thigh applying tension across the front and upwards of the groin.

Step 2

•

Pass the bandage around the back of the waist and around to the front.• Then pass the bandage around the back of the thigh and around the groin once more





applying tension to the front and upwards on the groin.

• Again, pass around the back and repeat this as required or until the bandage runsout.

Step 3

• Follow the same pattern with a roll of 2.5cm zinc oxide tape.

• Start on the inside of the groin, pass around the thigh applying tension as the tapecomes around the groin and up the front of the thigh.

• Pass the tape around the back of the waist, across the front and then back around thethigh to the start.

Hamstring Taping

Aim: to provide compression to a strain or contusion in the acute stage

What is required:

• Adhesive spray

• Under wrap



• 1.5 inch non stretch oxide tape

• 6 inch non adhesive elastic bandage

•

Step 1

• The athlete should be standing. Ideally the hair should be shaved from the back of thethigh.

• Apply adhesive spray and under wrap starting at the bottom and work up.

Step 2

• Apply a pressure pad over the site of the injury.

• Using 2 inch non stretch zinc oxide tape apply one anchor stripon the outside of the injury and another on the inside.

Step 3

• Using 2 inch non stretch tape again apply the firstcompression strip from just below the site of injury on the insideanchor upwards and across at 45 degrees.

• The next supporting strip goes from the outside anchor justbelow the site of injury and crosses the first strip as it passes

upwards to the inside of the thigh again at 45 degrees.

Step 4

• Repeat the above overlapping each strip by half workingupwards until the entire area is covered.

• Note the strips do NOT go completely around the thigh as thiswould stop circulation of blood.

• The taping is covered with under wrap to help prevent it frommoving.

Step 5

• Close the entire taping with 6 inch crepe type compression bandage.

• Starting at the bottom wrap the tape around working upwards at 45 degrees applyinga tug on the bandage at the 45 degree angle. Then as it comes around the thigh and backdown at 45 degrees apply another tug.

• Work upwards crossing at 45 degrees all the way.

• Ensure the athlete tenses muscles in the thigh when this is being done to allow for



muscle expansion after the job is finished.

Thigh Taping

Aim: To provide compression and support to the quadriceps muscles in the acute stagefollowing muscular injury.

What is required:

• Foam underwrap (optional).

• Spray adhesive (optional).

• 2 inch elastic tape.

• 1.5 inch non stretch white tape.

•

2 inch non stretch white tape (use 1.5 if you do not have 2 inch)• 6 inch elastic bandage.

• Pressure pad cut to size.

Step 1

• The athlete is positioned by placing a 1.5 inch roll of tape under the heal to bend theknee.

• Ideally the thigh should be shaved but if this is not an option then apply sprayadhesive and underwrap. Wrap from the bottom upwards.

Step 2

• Apply a strip of 2 inch non stretch white tape either side of the area to be supported.

• Place a foam pressure pad over the site of injury.



Step 3

• Using 1.5 inch non stretch white tape start the first support strip on the anchor, just

below the area of injury on the inside of the leg and apply it across and up at 45 degrees.• Repeat this from the other side.

Step 4

• Repeat these strips up the thigh, overlapping by half the width of the tape until the area is fully covered.

•

Note, the support strips do not go completely aroundthe thigh.

• The support can be covered again with underwrap tohelp prevent it moving around (optional).

Step 5

• Close the entire taping with 6 inch elastic crepebandage (non-adhesive). Wrap from the bottomupwards.

• The athlete should contract the thigh whilst this isbeing done to avoid the bandage being applied tootightly.



Upper Back and Neck

Upper Back Taping

Aim: To encourage correct posture of the upper back and neck and so will aid in therehabilitation of neck pain. Use this taping technique in the early stages of rehabilitation toencourage good posture and take some stress off the back. Do not rely on it long term asthis will lead to muscle weakness.

What you will need:

• One roll of 1.5 inch (3-4cm) or similar zinc oxide tape which is non elastic.

• If you have a very hairy back you may need to shave to prevent discomfort when

removing the tape -also to provide a better surface for the tape to stick to.

Step 1

• Stand or sit in an upright position with shoulders back.

• Place one strip of tape from the bottom of the neck, downthe back, pulling gently downwards when applying the tape.

Step 2•Place another strip of tape the other side of the neck in the sameway.

Step 3

• Repeat this process on the first side coming from the frontof the shoulder down the back.

Step 4

•Repeat step 3 on the other side of the back to complete theprocess.

This taping technique will aid in posture correction and help temporarily take the strain off the

upper back and neck. Use in the short term for pain relief and to assist in educating about

maintaining the correct posture. Avoid using it for more than a few days as the athlete may



get to rely on it and muscles may start to weaken.

AC joint injury - Taping technique

Aim: To support the AC joint by applying pressure down onto the clavicle. Always ensurewhen taping that you apply the tape smoothly so there are as few creases and lines in thetape as possible.

What is Required?

• 2.5cm zinc oxide tape

• 5cm Elastic Adhesive bandage

•

Step 1• First apply two or three strips of 2.5cm (or 2 strips of 3.8cm) zinc oxide tape over the top of the shoulder, makingsure they are covering the AC joint.

• This will provide an anchor for the support strip toattach to.

Step 2

• Next pass a support strip of tape from the front of the shoulder, down the side of the arm.

• Apply tension to the tape as you do so. Pass itunder the elbow and back up to the top of the shoulder.

• This support strip will help pull the AC joint down.

Step 3

• Secure the support strip with a piece elastic adhesivebandage (EAB) .Get the patient to tense the bicep muscleas you apply the tape to allow for muscle expansion.

• Cut away the excess tape from below the EAB strip.



Finger and Thumb

Taping for a sprained finger

Aim: To prevent movement of the injured finger during the healing stage of rehabilitation.Fingers 1 and 2 are usually 'paired' for taping and 3 and 4 are usually best taped together

What is Required?

• 2.5 cm (1 inch) non stretch white tape.

• If neccessary for small fingers a narrower tape can be used or the tape can be tornalong it's length to make thinner strips.

• A thin strip of padding foam to place between the fingers for comfort and protection.

Step 1

•

Apply two strips of 1.25 cm (half inch) white non stretchtape - one above the injured joint and one below.

• These will provide an anchor from which to attach thesupporting strips.

Step 2

Place the strip of padded foam between the fingers to betaped.

Step 3

• Apply two supporting strips from the two anchorsabove and below the joint around the 'buddy' finger.



• This taping should allow the fingers to bend together but sideways movement shouldbe limited.

Thumb Sprain

This taping technique is useful:

• To prevent the thumb from being bent backwards (hyperextension).

• To provide support during the healing process and when returning to sport.

What is required:

• 3.5cm (1.5 inch) white non stretch tape

Step 1

• Start at the front of the wrist.

• Go around the back of the hand and over theweb of the thumb.

Step 2

• Go across the palm of the hand,

• Around the back of the wrist,

• Then cut the tape to finish the anchor.

Step 3

• Next come the supporting strips.

• Start on the anchor at the back of the hand,

• Go around the base of the thumb and secure on the anchor at the palm of the hand.



Step 4

• Repeat this up the thumb as far asrequired - 2 or 3 strips are usually all that isrequired.

• The higher the tape, the more support butthe more the motion is restricted.

• Less support and more mobility may berequired when returning to some sports,particularly ball games.

Step 5

• Finish off the taping by securing a strip as in stage 1:

• Go around the back of the hand and over the web of the thumb.• Go across the palm of the hand,

• Around the back of the wrist,

• Then cut the tape to finish the anchor.

Step 6

• Assess the taping to ensure that the thumb cannot be moved into the painful area -pull in the direction of the arrow.

• If it can then the taping may need to be redone or adjusted to prevent this happening.

• There is little point taping the thumb if it can be moved into the painful range of

movement.

The Role of Strapping and Taping in Sports and Physio

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