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Bandagem Funcional3, Notas de estudo de Medicina

Bandagem Funcional3

Tipologia: Notas de estudo

2016

Compartilhado em 12/07/2016

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Baixe Bandagem Funcional3 e outras Notas de estudo em PDF para Medicina, somente na Docsity! MOSBY'S Tala MOSBY'S SPORTS THERAPY TAPING GUIDE ROBERT KENNEDY Owner, Sports-Medics; President, Fitness Tech Products Inc., Ottawa, Ontario Canada St. Louis Baltimore Boston Carlsbad Chicago Naples New York Philadelphia Portland London Madrid Mexico City Singapore Sydney Tokyo Toronto Wiesbaden CHAPTER TWO CHAPTER FIVE Bunion ( Hallux Valgus) 36 Shoulder-AC Joint Protection 91 Turf Toe 39 Shoulder-Spica Wrap 94 Arch Taping-Plantar Fascitis 42 Shoulder-Prevent Anterior Dislocation 97 Moleskin Arch Taping 46 CHAPTER SIX Achilles Tendon Taping 48 Elbow-Hyperextension Support 101 " Shin Splints" Lateral Compartment 51 Wrist-Hyperextension Support 105 " Shin Splints" Medial Compartment 54 Thumb-Hyperextension Support 109 Thumb Hyperextension ( Checkrein) 114 CHAPTER THREE Finger ( Buddy Taping) 116 Knee-Medial Collateral Ligament 56 CHAPTER SEVEN Knee ( Hyperextension) 62 Glossary 119 Patella Tendon Taping 67 Patella Stabilizing Support 69 CHAPTER FOUR Quadriceps Support Quadriceps Support ( Option) Hamstring Support Hip Flexor-Groin Wrap 74 78 82 86 I I I I I I I I I I I THE PURPOSE OF TAPING Before applying tape orelastic wraps, it is important to establish the purpose of the support techique. Ifthe goal ofusing an elastic wrap is to decrease swelling, the wrap must startbelow ordistal to the injury and work upwards or proximal toward the heart to force the swelling back into the circulatory system. Using elastic tape to secure asterile dressing would mean that circulation would be compromised. Ifthe aim ofa support technique is to preventajoint from entering a painful range, one must perform simple movement tests before the application ofthe tape. When the tapejob is complete, one must re-evaluate the movement to determine if thejoint is moving in its painfree range. Too often inexperienced tapers simply read and follow the directions without any thought to what they are trying to accomplish. In addition, beginners forget to make sure that an athlete can function properly in his orher sportwith a support technique in place. For example, the use of "buddy taping" does not work in a baseball glove. When applyingtape and elastic wraps, always keep the purpose ofthe support technique in mind without losing sight ofthe athlete's sport and position. 2 PRINCIPLES OF ELASTIC WRAP 1- The purpose ofan elastic wrap ( tensor bandage) when used alone is for compression or mild support. ' 2- When used with padding, support and compression are increased significantly. 3- Always apply the bandage from distal to proximal. 4- Always center the injury in the middle of the wrap. 5- Never allow the athlete to wear the bandage overnight. 6- Always check circulation after application. 7- Educate your athlete in the proper application at home. 8- Fo: sports competitions, always secure the elastic wrap with elastic tape. ClIps are not sufficient. 9- Never end the bandage on the inside ( medial thigh, arm or ankle ). 10- Wash the bandages frequently and between athletes. MAIN FUNCTIONS OF TAPING & WRAPPING 1. To Provide Immediate First-Aid- Elastic wraps, compression pads and open tapejobswork well in acute injury situations by decreasing swellingand eventually pain. Elastic tapes and wraps are used to provide compression and to hold dressings in place. Tape is also very beneficial duringthe rehabilitation process in that it provides protection butdoes not completely immobilize thejoint. In combination with a proper rehabilitation program given byappropriate medical personnel, tape can facilitate the ultimate retum to play for an athlete. 2. Taping To Prevent An Injury- Preventative taping works well by decreasing the chanceor limitingthe extent ofan injury, especiallywhen combined with properstrength and balance programs. Prior to the use ofsuch programs, one must consult the appropriate medical personnel. Forcertain injuries some strength exercises can actually do more harm than good. Protective taping provides protection to the healing structures ofan athlete who has suffered an injury. Although some injuries can improve with time, ligaments may take many weeks or months to completely heal. Protective taping can assist this long healing process while allowing the athlete to participate earlier in his or her sport. Forathletes who havea history ofsignificant ligamentous injury producing joint laxity, preventative taping can be very useful. This is especially true for athletes competing in high risk sports ( football, hockey, basketball... etc ). Inall cases, whichever support technique has been applied, it is important that the athlete be able to function properly and adequately protect him! herself duringsportactivity. 3 SPORTS THERAPIST TEAM KIT SPORTS THERAPIST (PERSONAL ITEMS) 8 *** QUANTITIES WILL BE DETERMINED BY NUMBER OF ATHLETES ON THE TEAM *** BELT HOLSTERBASIC CONTENTS TUF-SKIN SPRAY UNDERWRAP WIDTE ADHESIVE TAPE ELASTIC TAPE (ELASTOPLAST ) ALCOHOL PREP PADS TAPE REMOVER STERI-STRIPS SMALL COOLER ROLLER GAUZE ICE BAGS SECOND SKIN HEEL & LACE PADS MOLESKIN I-CLOTH BACITRACIN SKIN LUBRICANT, HAND LOTION PROVIODINE ( ANTISEPTIC SOLUTION) BANDAGE SCISSORS TONGUE DEPRESSORS MIRROR, NAIL CLIPPERS TOWELS, SCREWDRIVERS PEN LIGHT, LATEX GLOVES Q-TIPS ASSORTED STERILE GAUZE PADS KNIFE WITH RETRACTABLE BLADE EMERGENCY ACTION PLAN & INFO. PENS & PAPER ATHLETE MEDICAL INFO CARD TENSORS ( VARIOUS SIZES) TRIANGULAR BANDAGES BUTTERFLY BANDAGES OPTIONAL ITEMS BLISTEX DESENEX EPSOM SALTS LOZENGES BULK COTTON SALINE SPACE BLANKET EYE PATCHES MAXI PADS SUN SCREEN TWEEZERS ZINC OXIDE CREAM CONTACT LENS KIT SAFETY PINS FELT , I I I I I I I I I I I ) I I I FANNY PACK CONTENTS (EMERGENCY USE) LATEX GLOVES ( 4 PAIR) UNIVERSAL SCISSORS ( 1 PAIR) 4 X 4 STERILE GAUZE (6) UNIVERSAL SCREWDRIVER 3 X 3 STERILE GAUZE ( 6 ) RETRACTABLE CUTTING BLADE 2 X 2 STERILE GAUZE ( 6 ) BANDAGE SCISSORS TRIANGULAR BANDAGE ( 2) SPACE BLANKET ( 1 ) PEN LIGHT ( 1 ) 6" TENSOR ( 1 ) 4" TENSOR ( 1 ) KNUCKLE BANDAGES ( 10 ) ALCOHOL PREP PADS ( 10 ) 1/2" WHITE ADHESIVE TAPE ( 2 ROLL) C.P.R. MOUTH SHIELD ( 1 ), POCKET MASK Q-TIPS ( 10) 9 I I I I I • • • • • • • • I • • • • • ~ ~ ~ ~ ~ ~ • • CHAPTER ONE ANKLE TAPE-CLOSED GIBNEY BASKETWEAVE ANKLE TAPE-CLOSED GIBNEY (OPTION) COTTON-ANKLE WRAP (LOUISIANA) ANKLE TAPE-OPEN GIBNEY ACUTE ANKLE WRAP 12 ANKLE TAPE-CLOSED GIBNEY BASKETWEAVE ! SUPPORT TECHNIQUE- Using 11/2"whiteadhesivetape,applyonestinup starting on the inside upperanchorand fmishing on the outside upper anchor ( See Diagram B ). - Apply one" U " strip starting on the inside mid-arch anchor and fmishing on the outside mid-arch anchor ( See Diagram B). _Using 1 1/2" white adhesive tape, start the "figure 8" support strip on the inside ofthe ankle,just above the malleolus ( See Diagram D). Travel around the back, across the front, continuing down the inside ofthe ankle and under the foot ( SeeDiagram E). _Continueby pulling up on the outside, across the front and around the back to finish on the front ofthe ankle ( See Diagram F). Make sure to tear the tape after completing the "figure 8." 13 _Begin closure ofthe lower leg startingjust above the malleolus and working upwards. Overlap each strip by halfthe width ofthe tape and follow the leg contours ( See Diagram L ). _Apply afmishing forefoot closure to seal the ends of all the "U" strips. Spread the toes apart before securing this piece ( See Diagram L ). _The first heel lock starts on the inside ofthe anklejust above the malleolus ( See Diagram G ). _Continue behind the ankle, across the front, down the inside, under the foot and pull up on the outside ofthe heel ( See Diagram H). _The second heel lock continues from behind, travels across the front, down the outside, under the foot and pulls up on the inside ofthe heel ( See Diagrams 1& J). _Finish the second heel lock on the front ofthe ankle ( See Diagram K). _Repeat the above steps two more times. Alternate the stinups (movingforward) with the" U " strips (moving upward ), in each case overlapping by halfthe width ofthe tape ( See Diagram C). N.B. Foran eversion sprain apply four to five stirrups, using aneutral force ( ie., the pull is equal on each side ofthe ankle). Then apply double heel locks without the "figure 8 "strips. Once this is done, close the tapejob. CLOSURES HEEL LOCKS " FIGURE 8" - 1 1/2" white adhesive tape - heel & lace pads - Using 11/2" white adhesive tape, apply one anchor to the mid-arch, it should cover the base ofthe 5th metatarsal. Spread the toes apart with your fist before securing the strip. Do not apply too much tension. - Apply three overlapping anchors to the lower leg. These should start low and work upwards but they must notwrap around the muscle belly ofthe calf( See Diagram A ). PURPOSE: - To prevent inversion ankle sprains. ANCHORS IMPORTANT TEACHING POINTS: SKIN PREPARATION AND BODY POSITIONING - The athlete's foot should be maintained in full dorsiflexion ( toes pointing upwards at all times. Spray the front and back ofthe ankle with tuf-skin. - Place a lubricated heel & lace pad on the front and one on the back ofthe ankle (See Diagram A). - Apply underwrap to the skin abovethe lateral and medial malleolus, then apply underwrap to the mid-forefoot using a" figure 8 ." SU PPLI ES: - tuf-skin spray - undeiWrap - skin lubricant ANKLE TAPE-CLOSED GIBNEY (OPTION) " STIRRUPS CLOSURES 18 - Apply a 3" non tearing elastic tape strip starting on the inside ofthe ankle, level with the white adhesive tape anchors ( See Diagram B ). - Continue downwards, under the foot and then pull up laterally to secure the stirrup on the upper 3" elastic tape anchor ( See Diagrams B& C ). - Repeat two more stirrups using 1 1/2" white adhesive tape strips, each overlapping the other ( See Diagram D). - Close the stirrups with two 11/2"white adhesive tape strips placed on top ofthe elastic anchor ( See Diagram D). - Complete this option technique with a" figure 8 "and heel locks, then close the lower leg (Referto the closed gibney basketweave tapejob ). OUTSIDE VI EW OUTSIDE VIEW INSIDE VIEW OUTSIDE VIEW 19 COTTON-ANKLE WRAP (LOUISIANA) IMPORTANT TEACHING POINTS: SKIN PREPARATION AND BODY POSITIONING - Position the ankle with the toes pointed upward (dorsiflexion ). - Apply tuf-skin to the front and back of the ankle. - Cover the front and back of the ankle with baby powder to prevent friction. - Place an athletic sock on the ankle. - To establish the length of the ankle wrap, measure the distance from the floor to the palm above the athlete's head. Cut the wrap to this length. ( approx. 8ft. ) PURPOSE: SUPPLIES: - To prevent inversion sprains using an economical, washable and re-usable cloth ankle wrap. - tuf-skin spray - baby powder - 2 "cloth wrap - 1" or 1 1/2" white adhesive tape ~ • • HEEL LOCKS • ~ ~ ~ • ~ ~ • ~ • • • • CLOSURES• •• • • • • • -The flfSt oftwo heel locks follows next and continues from the inside ofthe ankle; under the foot and pulls up on the outside ofthe heel ( See Diagram F). - Continue with one complete revolution around the ankle,just above the malleolus (See Diagram G). - Comingfrom behind once again, travel across the front, down the outside and under the foot ( See Diagram H). - For the second heel lock, travel on the inside ofthe heel and around the backcontinuingwith one complete revolution (See Diagrams 1& J) and finishing on the front ofthe ankle. - Secure the ankle wrap with asmall piece of I 1/2" white adhesive tape to hold the tension ( See Diagram K). - Repeat the entire procedure once with I 1/2" white adhesive tape. Before securing the tape, fold the edge overto create atab with which to remove the tape after the sport activity. - To preventthe wrap ends from fraying, coatthe two ends with nail polish or an oil base paint. po not put the cloth into a clothes dryer after washing. Hang to dry. SUPPORT TECHNIQUE STARTING POSITION - Make sure to use steady tension on the ankle wrap roll to avoid any wrinkles and open areas. - Apply the cloth wrap on the inside of the ankle just above the malleolus. Go around once to secure the wrap into position ( See Diagrams A & B ). "FIGURE 8" 20 - Coming from behind, start the" figure 8 "procedure by coming across the front, travelling on the inside of the ankle and under the foot ( See Diagram C). Continue by pulling up on the outside, across the front, around the back and across the front again (See Diagrams D& E). 21 COTTON-ANKLE WRAP (LOUISIANA) COTTON-ANKLE WRAP (LOUISIANA) FRONT VIEW FRO:'llT VIEW FRONT \'IEW OLTSIDE \'IE\\' HEEL LOCKS FRONT VIEWFRONT & OUTSIDE VIEW - FIGURE 8 FRONT VIEW • • • • • • m [[) t ([) CKll 22 I 23 ANKLE TAPE-OPEN GIBNEY ANKLE TAPE-OPEN GIBNEY I~SIDE & OUTSIDE VIEW OUTSIDE VIEW INSIDE & OUTSIDE VIEW INSIDE & OUTSIDE VIEW INSIDE & OUTSIDE VIEW OliTSIl>[ VI EW ~ • ~ • l m l OD CD ) 28 ) 29 ACUTE ANKLE WRAP PU RPOSE: - To limit range ofmotion and provide compression for acute ankle sprains. SUPPLIES: - undetwrap( optional) - 3" or4" tensor bandage - extended horseshoe made from 1/4" or 3/8" foam or felt - I 1/2" white adhesive tape IMPORTANT TEACHING POINTS: SKIN PREPARATION AND BODY POSITION ING - The foot is positioned so thatthe toes point upward. The ankle should be in as much dorsiflexion as tolerated. - Place the extended horseshoe on the lateral aspect of the ankle ( See Diagram A). For added compression, a second horseshoe may be placed on the medial aspect ofthe ankle. Hold the extended horseshoe(s) in place with undetwrap ( optional ). SUPPORT TECHNIQUE- The tensor bandage should start on the dorsum ofthe foot as close to the toe:> as possible. Spiral the bandage around the foot, two or three revolutions, overlapping each by half( See Diagrams B, C, D, E ). - Begin the ftrst "ftgure 8 " by travelling around the back ofthe heel, keeping as low as possible ( See Diagram F). - Repeat this motion, overlapping the previous "ftgure 8 "by half Continue this" herring bone" pattern up the leg. Finish approximately 6" above the maleoli (See Diagrams G, H, I, J). Secure the bandage with clips. 30 ,,,, • • • • • ) I NOTE _Additional" ftgure 8 "strips can be added with 1 1/2" white adhesive tape to help keep the foot in dorsiflexion. This position allows for the least amountofswelling in thejoint space. - The tensor bandage and horseshoe(s) should be removed prior to applying ice. - The bandage should not be worn while sleeping. - The athlete may need to stay offthe ankle until seen by a physician, crutches are suggested. 31 ACUTE ANKLE WRAP ACUTE ANKLE WRAP 32 OUTSIDE VIEW OUTSIDE VIEW OUTSIDE VIEW OUTSIDE VIEW OUTSIDE VIEW OUTSIDE VIEW OUTSIDE VIEW OUTSIDE VIEW 33 BUNION (HALLUX VALGUS) 39 - Applyone 1" white adhesive tape anchor around the big toe ( See Diagram A). Ifthe big toe is long, use two anchor strips. Not too tight! - Using 11/2"whiteadhesivetape,applytwoarch anchors to the mid-arch area ( See Diagrams A& B). Spread the toes apart by pushing upwards with your fmgers before securing these anchor strips. This will assimilate weight bearing on the foot. - Measure the distance from the arch anchors to the toe anchor. On the middle ofthe big toe, attach one 1" strip ofwhite adhesive tape with three 1" "X" strips on top ofit to create a checkrein. The ends ofthe checkrein must be narrow enough to fit on the big toe ( See Diagram C). The" X" must cross over the MP Joint line. Wiggle the toes to be sure. PURPOSE: - To preventexcessive hyperextension ofthe MTPjoint. TURF TOE SUPPLIES: - tuf-skinspray - I" white adhesive tape - I 1/2" white adhesive tape IMPORTANT TEACHING POINTS: SKIN PREPARATION AND BODY POSITIONING - The big toe should be in a neutral position. - Shave excess hair offofthe top ofthe forefoot and big toe. - Spray the forefoot and the big toe with tuf-skin. ANCHORS CHECK REIN FRONT VIEW FRONT VIEW FRONT VIEW BOTTOM VIEW 38 41 SIDE VIEW BOTTOM VIEW TURF TOE BOTTOM VI EW BOTTOM VIEW _This support technique can be done on the dorsum ofthe foot to prevent hyper-flexion. - Close the big toe with one I" white adhesive tape strip ( See Di~gram D). - Close the mid arch ofthe forefoot with two 1 1/2" white adhesive strips. Spread the toes apart prior to securing the closures ( See Diagram D). Ifthe big toe is very long, two or three closure strips may be necessary. 40 NOTE CLOSURES ARCH TAPING-PLANTAR FASCITIS PU RPOSE: - Used to support the plantar fascia (arch) and can also provide relieffrom "Shin Splints" by increasing shock absortion in the foot. SUPPLIES: -tuf-skinspray - heel & lace pads - skin lubricant - I "whiteadhesivetape - 11/2" whiteadhesivetape - 2"whiteadhesivetape 43 - Begin closure ofthe arch support strips by using I 1/2" white adhesive tape. _Begin the first closure stripjust in front ofthe heel by starting and finishing the strip on the top ofthe foot (See Diagram F). _Continue to apply theseclosure strips, working down towards the toes. In each case, the strips must starton the outside ofthe top ofthe foot and then pull up on the inside arch to finish on top ofthe foot. _Be sure to spread apart the toes before securing the tape strips. _All the toes should be free to move so do notcover them up. CLOSURES SUPPORT TECHNIQUE- These supportstrips require I" white adhesivetape. _ Start the first arch strip on the forefoot anchor beneath the fourth toe. Carrythis strip down and overthe heel pad to fmish at the base ofthe big toe ( See Diagram C). - Repeat the arch strip twice more by having the strip start on the forefoot anchor beneath the 3rdand 2nd toes respectively. These strips should finish near the base ofthe big toe (See Diagrams D& E). - Position the foot in dorsiflexion with the toes curled. This accentuates the arch (notshown in Diagram). - Apply one forefoot anchorat the base ofthe toes using I 1/2" white adhesive tape ( See Diagram A). Before securing this strip spread the athlete's toes apart with your fist. - Applyone I I12" peripheral anchor strip by startingon the outside forefoot anchor, continuingaround the heel and finishing on the inside ofthe forefoot anchor ( See Diagram B). ANCHORS IMPORTANT TEACHING POINTS: SKIN PREPARATION - Spray the top and bottom ofthe foot with tuf-skin. - Place halfofa lubricated heel & lace pad at the back ofthe heel and secure it in place with one 2" white adhesive tape strip ( See Diagram A ). 42 48 ACHILLES TENDON TAPING PU RPOSE: - To provide support for the achilles tendon by limitingextreme dorsiflexion ofthe ankle. 49 _Additional heel locks and stirrups followed by closures will decrease the risk ofankle sprains. _Close the forefoot with two I 1/2"whiteadhesivetape strips. Overlap these by halfthe width ofthetape ( See Diagram C ). _Close the lower leg with five or six 11/2" white adhesive tape strips. Donot apply the closures to the calfmuscle beIly as it could cramp or fatigue. Overlap the closures by halfthe width ofthe tape (See Diagram C). Have the athlete contract the calfby pointing the toes into your thigh. _Lay a second strip of 3" non tearing elastic tape on the plantar aspect ofthe forefoot. Secure this witha 11/2" white adhesive tape strip. _Measure this piece so that it is long enough to be split and secured to the calfanchor ( SeeDiagram B ). OPTION Fold the elastic tape over on each side ofthe base ofthe achilies tendon and then apply skin lubricanttothe achilles tendon to stop any friction. A heel lift may be used ( medium density foam) to give su~~rt to the achiIles. It is agood ideafor the athlete to wear one heel lift In each shoe to preventany biomechanical imbalances. OPTIONAL CLOSURE - Spiral a very thin piece of 3" elastic tape around the entire procedure from the forefoot upwards to secure the finished technique ( See Diagram 0 for closure ). N.B. CLOSURES - 1 1/2"whiteadhesivetajJe - medium density foam - 3" elastic tape (very thin) - Apply two 1 1/2" white adhesive tape forefoot anchors to the mid-arch and overlap them by half the width ofthe tape. Spread apart the toes before securing each strip ( See Diagram A ). - Apply three or four 1 1/2" white adhesive tape strips to the lower legjust below the belly ofthe calf Overlap these strips by halfthe width ofthe tape. Forathletes with long lower legs and high calfmuscles, do not position these anchors more than twelve inches above the heel ( See Diagram A). SU PPLI ES: - tuf-skin spray - 3" non tearing elastic tape - skin lubricant ANCHORS IMPORTANT TEACHING POINTS: SKI N PREPARATION AND BODY POSITIONING - Shave the lowerleg. - Apply tuf-skin spray to the lower leg. - Position the athlete lying on his/her stomach on a table or kneeling on a chair with toes slightly pointed ( plantar flexion ). Too much plantar flexion predisposes the athlete to inversion ankle sprains. SUPPORT TECHNIQUE- Laya 3" non tearing elastic tape strip on the bottom ofthe forefoot anchor. Secure this with a I 1/2" white adhesive tape strip ( See Diagram B). Pull up the non tearing elastic tape strip while applying tension and secure itto the calfanchors with all / 2" white adhesive tape strip (See Diagram B). ACHILLES TENDON TAPING "SHIN SPLINTS" LATERAL COMPARTMENT BACK VIEW BACK VIEW PU RPOSE: _To provide support to the outside ( lateral) muscles ofthe lower legdue to pain from overuse ofthe limb. 51 _Place one 11I 2" white adhesive tape anchor on the outside ofthe lower leg. This piece starts at the tip of the lateral malleolus and rises up the lower leg to just below the muscle belly ofthe calf( See Diagram A). _Place another I 1/2" white adhesive tape anchor on the inside ofthe lower leg. The boundaries for this strip lie between the tip ofthe medial malleolus andjustbelow the calfmuscle belly ( See Diagram A). ANCHORS SUPPORT TECHNIQU E- Begin the spiral support strips on the inside ofthe lower leg,justabove the medial malleolus ( See Diagram B). These strips start on the inside anchor, travel behind the achilles tendon, spiral up and overthe area oftendemess and finish on the inside anchor ( See Diagram B). IMPORTANT TEACHING POINTS: SKIN PREPARATION AND BODY pOSITIONING - Shavethelowerleg. _Spray the lower leg with tuf-skin. _Havethe athlete stand on atable. _Place a small pad 1" wide and 6" longoverthe areaoftendemess. The useof31 8" or 1/4" thick foam is ideal ( See Diagram A). SUPPLIES: - tuf-skinspray _ 1 1/2" white adhesive tape _3/8" or 1/4" thick foam pad OPTION BACK VIEWBACK VIEW 50 CLOSURES OPTION 52 - Overlap the spiral sUpJX>rt strips byhalfthe width ofthe tape. - Repeat the spiral technique about three to four times. The number ofstrips wi II depend on the length ofthe lower leg. - Start the I l/2" white adhesive tape closure stripsjustabove the lateral and medial . malleolus. All closure strips start on the inside, travel down on an angle to pass around the achilles and then rise back up on an angle. Tear offthe strips oftape at this point. Repeatthis "angle down" and "angle up "procedure until the sUpJX>rt technique is closed in. This will create a "herring bone" pattern ( See Diagram C). - Do not tape over the muscle belly ofthe calfas the muscle could cramp or fatigue. - For extra sUpJX>rt and shock absorption, use the arch taping procedure in combination with the shin splint tapejob. "SHIN SPLINTS" LATERAL COMPARTMENT FRONT VIEW FRONT VIEW FRONT VIEW 53 58 CLOSURES - Close the lower leg using 3" elastic tape strips. Startat the calfanchor and then work upwards to below the knee cap. Do not spiral continuously. Cut the tape after each tum around the leg and overlap the pieces by halfthe width. Continue the closure above the knee and then fmish on the upper th igh ( See Diagram G ). - Be sure never to end your tape on the inside ofthe thigh, this will result in the tape rolling offdu~ to friction ofthe other thigh. - Use one 6" tensor bandage orone double length 6" tensor bandage to secure the 3" elastic tape closures. Make sure the tensor bandage starts at the calfand works up to the top ofthe thigh. The tensor bandage should cover the entire leg. Secure the tensor bandage at the upper thigh with one or two 3" elastic tape strips. KNEE-MEDIAL COLLATERAL LIGAMENT 59 60 KNEE-MEDIAL COLLATERAL LIGAMENT EJ KNEE-MEDIAL COLLATERAL LIGAMENT FRONT VIEW 61 KNEE (HYPEREXTENSION) PURPOSE: - To prevent hyperextension ofthe knee in order to provide support for a sprained posterior capsule, a lax anterior cruciate ligament or strained lower hamstring tendons. SUPPLIES: - 3" elastic tape - 11/2"whiteadhesivetape - skin lubricant - undeIWrap - tuf-skin spray - heel & lace pad - 6" tensor bandages (2 ), or one double length 63 - To add more support to the knee-hyperextension technique, add the de-rotation strip as found in the knee-medial collateral ligament taping procedure ( See de-rotation strips section). This de-rotation strip is applied immediately after the anchors. Then complete the knee-hyperextension technique as shown. - Position the pre-formed checkrein on the back ofthe leg ( See Diagram D). Secure the lower leg first with three 3" elastic tape strips ( See Diagram E). Be sure to maintain at least 15 degrees offlexion. - Now secure the checkrein on the thigh by using four 3" elastic tape closures. Overlap these strips by half the width ofthe tape ( See Diagram E). - Check the function ofthe tapejob. Ifthe checkrein is too loose, fold the center ofthe fan onto itselfand then re-secure it with two strips of ~" elastic tape. Do not end these on the inside ofthe thigh. - Usetwo 6" tensor bandages or one double length 6" tensor bandage to secure the 3" elastic tape closures. Make sure the tensor bandage(s) start atthe calfand work up to the top ofthe thigh. The tensor bandage(s) should cover the entire leg. Secure the tensor bandage at the upper thigh with one or two 3" elastic tape strips. -Measure the distance from one anchor to another by using the white adhesive tape ( See Diagram C). Lay this strip on a table and add four more to itto create a fan shaped checkrein. Secure a 1 1/2" white adhesive tape piece around the centre ofthe checkrein ( See Diagram D ). OPTION CLOSURE CLOSURES CHECKREIN FORMATION - Apply two or three 3" elastic tape anchors to the upper thigh and overlap each one byhalfthe width ofthe tape. Be sure to have the athlete contract the thigh muscles ( See Diagram B ). - Apply two orthree 3 "elastic tape anchors around the lower leg ( See Diagram B ). - Position the first strip below the belly ofthe calfand the second one mid-belly. - These strips should overlap each other byhalfthe width ofthe tape. Have the athlete contract the calfmuscles before securing these strips. ANCHORS IMPORTANT TEACHING POINTS: SKIN PREPARATION AND BODY POSITIONING - Shave the thigh and lower leg. - Spray the entire calf& thigh with tuf-skin. - Apply a lubricated heel & lace pad to the back ofthe knee to prevent irritation ( See Diagram B ). - Secure the heel & lace pad with uriderwrap startingjust above the calfand finishing mid-thigh. - Position the limb by placing a roll of1 1/2" white adhesive tape under the athlete's heel (See Diagram A). - Have the athlete internally rotate his or her lower leg so that the toes face inward. 62 PATELLA TENDON TAPING 69 SUPPORT TECHNIQUE- Create apatella stabilizing strip from 3" non tearing elastic tape by cutting one end ofthe tape into two equal sections. The cut should be about 6 "deep ( See Diagram A). Place the 6" split ends on the inside ofthe knee so that they surround the inside of the knee cap ( See Diagram B ). • PATELLA STABILIZING SUPPORT IMPORTANT TEACHING POINTS: SKIN PREPARATION AND BODY POSITIONING - Shave the hair fromjust above and belowthe kneecap. - Spray the front and back ofthe knee with tuf-skin. - Position the athlete in a supported sitting position so that the quadriceps muscles are relaxed. Now place a small roll beneath the middle ofthe thigh ( See Diagram A). This will allow you to access the back ofthe knee to complete the taping procedure. _Place two lubricated heel and lace pads on the back of the knee for protection ( See Diagram A). - Place the horse shoe on the outside ofthe patella( See Diagram B). PURPOSE: - To preventthe patella from trackinglaterally,subluxing or dislocating. SUPPLIES: - 3"nontearingelastictape - tuf-skin spray, skin lubricant - heel & lace pads - 1 1/2" or 2" elastic tape - 11/2" white adhesive tape - 3/8" or 1/4" thick orthopedic felt or medium density foam ( Horse Shoe Shape ) FRONT VIEW SIDE VIEW -- SIDE VIEW 68 71 FRONT & SIDE VIEW PATELLA STABILIZING SUPPORT SIDE LEG VIEW - HORSESHOE & TAPE STRIP , , / ,, - Roll the tape around the back ofthe knee, over the heel & lace pads and up to the lateral side ofthe knee cap ( See Diagram B ). - Advancetheelastictape 6" beyond the outside edge ofthe knee cap and horse shoe then cut the tape ( See Diagram B). - Divide the end into two equal sections then cut them back to one inch beyond the outside < edge ofthe horse shoe ( See Diagram B). - Move the lower strip upwards to be applied to the top ofthe knee cap. Move the upper strip downwards and secure below the knee cap ( See Diagram C ). - This final step prevents the possibil ity ofrips occuring along the seams. - Apply a continuous strip of I 1/2" elastic tape that will cover the skin above the knee cap. This same strip mustcontinue from the inside and outside ofthe thigh to cross down behind the knee ( See Diagram D). This strip will eventually overlap on the patella tendon ( See Diagram E). - Add a I 1/2" white adhesive tape strip horizontally belowthe knee cap to secure the continuous elastic "X "strip ( See Diagram E). CLOSURES 70 PATELLA STABILIZING SUPPORT CHAPTER FOUR ' FRO~T & SJ[)E VIEW QUADRICEPS SUPPORT QUADRICEPS SUPPORT (OPTION) HAMSTRING SUPPORT HIP FLEXOR-GROIN WRAP FROI\T VI EWBACK VIEW 72 QUADRICEPS SUPPORT (OPTION)" PURPOSE: - To provide support to the quadriceps muscles. This technique may be used as an option. SU PPLI ES: - tuf-skin spray - undetwrap - 1 1/2"whiteadhesivetape - 3" elastic tape - 6" tensor bandage - protective foam pad (medium density) IMPORTANT TEACHING POINTS: SKIN PREPARATION AND BODY POSITIONING - Shave the front ofthe thigh. - Apply the tuf-skin to the front and back ofthe thigh. - The athlete should be positioned so that the knee is bent at approximately a 30 degree angle. Position the athlete by placing a 11/2" roll ofwhite adhesive tape under the heel ( See Diagram A). SUPPORT TECHNIQUE- Applyfour I 112" white adhesive tape strips ( rolled sticky side out) over the area to be protected ( See Diagram B). These strips will help to preventthe foam pad and tensor bandage from sliding down the leg during activity. - Apply a pad over the area to be protected ( 3/8" thick, medium density foam as a minimum requirement- See Diagram C). 78 CLOSURES _Close the entire tapejob with a 6" tensor bandage. _ Start applying the tensor below the area to be supported, then work upwards with a "TUG" on a 45 degree angle. Now spiral around the thigh and work the tensor downwards with a "TUG" on a45 degree angle. Repeat this up and down configuration to create a herring bone pattern ( See Diagram D). Secure the wrap on the upper thigh with two clips. Do not finish the clips on the inside ofthe thigh as they could cut the opposite thigh orjust pop off. _Secure the wrap with one3" elastic tape strip whilethe athlete contracts his/her thigh muscles (See Diagram D). 79 81 • FRONT VIEW l QUADRICEPS SUPPORT (OPTION) • . ) ~ QUADRICEPS SUPPORT (OPTION) 80 82 HAMSTRING SUPPORT PU RPOSE: - To provide compression to astrain ora contusion in the acute stage. _Close the entire tapejob with a 6" tensor bandage. - Have the ath lete contract the muscle. - Start to apply the tensor below the injury and then work upwards with a "TUG" on a 45 degree angle. Now spiral around the thigh and work the tensor downwards with a "TUG" on a 45 degree angle as well. - Repeat this up and down configuration to create a herring bone pattern ( See Diagram E). _ Secure the wrap with three clips. Do not finish the clips on the inside ofthe leg as they could rub and cut the opposite leg orjust pop off. Secure the wrap with one 3" elastic tape strip ( See Diagram E). 83 CLOSURES - Secure one 2" white adhesive tape strip on the outside ofthe injured area and one 2" white adhesive tape strip on the inside ofthe injured area ( See Diagram A). ANCHORS SU PPLI ES: - tuf-skin spray - undetwrap - pressure pad - 1 1I2"and2"whiteadhesivetape - 6" tensor bandage - 3" elastic tape SUPPORT TECHNIQUE- Start the first compression stripjust below the area ofinjury on the inner back ofthe thigh, travelling upwards on a45 degree angle ( See Diagram B). The next support strip starts on the outside anchor ofthe back ofthe thigh. From here the strip travels upwards to the inside ofthe thigh on a 45 degree angle. - Repeatthe above strips while overlapping by half the width ofthe tape unti Ithe area is fully covered (See Diagram C). The tape strips do not go completely around the thigh (See Diagram D). Cover the support with underwrap. This decreases the possibilty ofthe wrap moving or sliding during activity. IMPORTANT TEACHING POINTS: SKIN PREPARATION AND BODY POSITIONING - The athlete should be standing. - Shave the hair from the back ofthe thigh. - Spray the thigh with tuf-skin. - Apply a pressure pad over the area ofinjury. 89 8 • • • HIP FLEXOR-GROIN WRAP . ) / I / I / I I I I / / I I I I I HIP FLEXOR-GROIN WRAP 88 SHOULDER-AC JOINT PROTECTION PURPOSE: - To provide support and protection to an acromio clavicular ( AC )joint. _ Apply a3" elastic tape anchor from the nipple, passing upwards overthe clavicle and then down to the shoulder blade ( See Diagram A). _ Apply a 3" elastic tape anchor over the biceps muscle ( mid-biceps). Have the athlete tighten the muscle before securing the tape. _ Apply a 3" elastic tape anchor around the chest. Be sure to have the athlete inhale before securing the tape ( See Diagram A). 91 ANCHORS IMPORTANT TEACHING POINTS: SKIN PREPARATION AND BODY POSITIONING - Shave the area around the chest and ann prior to taping. _Spray the ann and chestwith tuf-skin. _Cover the nipples with heel and lace pads or with a band-aid and some skin lubricant. _The arm should be supported on atable. _Apply adonut pad over the ACjoint( See diagram A). Ahard shell placed over the donut will provide good protection. SU PPlI ES: - tuf-skin spray _ felt or adhesive foam ( 1/2" thick) (SanSplint is optional ) - 3" elastic tape - heel & lace pads - 2" elastic tape - I 1/2"whiteadhesivetape - band-aids ( 2 knuckle) - skin lubricant CHAPTER FIVE SHOULDER-SPICA WRAP SHOULDER-AC JOINT PROTECTION SHOULDER-PREVENT ANTERIOR DISLOCATION CLOSURES 93 FRONT VIEW FRONT VIEW FRONT VIEW SHOULDER-AC JOINT PROTECTION . FRONT VIEW - Close the biceps with two 2" elastic tape strips. Be sure to have the athlete flex the arm before closing the strips. - Close the area above the nipple by using 2" elastic tape strips passing upwards from the nipple and finishing on the shoulder blade anchor. Repeat three or four times and overlap each strip by halfthe width ofthe tape ( See Diagram C). - Apply three I 1/2"whiteadhesivetapestripclosures wh ich startatthe nipple and go horizontally around the chest to finish at the shoulder blade. Overlap each strip by halfthe width ofthe tape ( See Diagram C). - Finish the closure by using 3" elastic tape around the chest. Have the ath lete inhale before securing the tape closure ( See Diagram D). - Secure the end ofthe tape with three I II 2" white adhesive tape strips (See Diagram D). - Atight-fitting sh irt should be worn by the ath lete to keep this support technique in place. SUPPORT TECHNIQUE- Use I 1/2" white adhesive tape to create the following support strips. The first support strip should begin on the outer part ofthe back ofthe arm then work upwards to end on the front of the chest. - The next strip should begin on the front ofthe arm whi Ie crossing over the first support strip to end on the shoulder blade. This will create an" X" pattern ; over the ACjoint. - Repeatthe above" X "pattern until the ACjoint is covered ( See Diagram B). - Usually three to four strips in each direction is adequate. 92 99 FRONT VIEW FRONT VIEW SHOULDER-PREVENT ANT. DISLOCATION . FRONT VIEW - Close the support technique with 3" elastic tape starting on the outside ofthe am1 (See Diagram C). Nowtravel horizontally across the chest, behind the back and around the affected arm again. Finish this 3" elastic tape strip just near the side ofthe chest wall ( See Diagram C). - Pinch the elastic tape together again between the arm and chest. Wrap several I 1/2" white adhesive-tape strips around the checkrein that has been established between the am1 and the chest ( See Diagram C ). CLOSURES 98 ELBOW-HYPEREXTENSION SUPPORT PU RPOSE: - To prevent the elbow from hyperextention. 101 - Apply two 2" elastic tape anchors around the mid- forearm. Overlap each strip by halfthe width ofthe tape. Make sure the athlete makes a fist and contracts foreann musculature (See Diagram A). - Apply two 3" elastic tape anchors around the biceps muscle. The first anchor is placed around the mid- biceps and the second anchor is placed above the belly ofthe biceps. Overlap each piece by halfthe width of the tape. Have the athlete contract the biceps before securing the anchors ( See Diagram A). This can be done by resisting flexion at the elbowwith the opposite hand. - Shave the upper and lowerarm. - Spray the upperand lowerarm with tuf-skin. - Position the elbow in a slightly bent position. ANCHORS IMPORTANT TEACHING POINTS: SKIN PREPARATION AND BODY POSITIONING SUPPLIES: - tuf-skinspray - 1 1/2" white adhesive tape - 2" and 3" elastic tape - skin lubricant / // (~~ .-\. ~ CHAPTER SIX FINGER (BUDDY TAPING) WRIST-HYPEREXTENSION SUPPORT ELBOW-HYPEREXTENSION SUPPORT THUMB-HYPEREXTENSION SUPPORT THUMB HYPEREXTENSION (CHECKREIN) CHECKREIN FORMATION CLOSURES OPTION 102 - Once the painfree angle ofthe elbow has been established, measure the distance from the top ofone anchor to the bottom ofthe other by using the white adhesive tape. Lay this strip on a table and add four to six more to it to create a fan shaped checkrein. The amountofadded strips wi II depend on the size ofthe ann. Securea I 1/2"·white adhesive tape piece around the center ofthe checkrein ( See Diagram B). - Position the pre-formed checkrein (See Diagram C), then secure the forearm first with two 2" elastic tape strips ( See Diagram D). - Overlap each piece by halfthe width ofthe tape. - Now secure the checkrein on the biceps, again with two 2" elastic tape strips, each overlapped by halfthe width ofthe tape. - Apply one 3" elastic tape piece over the mid-biceps. Close the area beyond the biceps muscle with one 2" adhesive tape strip. Have the athlete contract the biceps before applying both closures (See Diagram D). - An additional checkrein cqn be made and appl ied to the medial aspect ofthe arm to protect the medial collateral ligaments. ELBOW-HYPEREXTENSION SUPPORT ~I 103 - Using I 1/2" white adhesive tape, the first anchor should start on the front ofthe wrist( See Diagram B), wrap around the back ofthe hand and over the web of thethumb( See Diagram C). As the tape passes over the web ofthe thumb, pinch the edges to preventthe tape from cutting the skin. - Continue the anchor down the palm and around the back ofthe wrist to finish on the front ofthe wrist ( See Diagram C ). - This strip can be repeated for more stability and support ( optional ). ANCHORS 109 THUMB-HYPEREXTENSION SUPPORT HOOD FORMATION & SUPPORT TECHNIQUE- Using I 1/2" white adhesive tape strips, start the hood on the back ofthe anchorat the base ofthethumb, wrap around and attach onto the front ofthe anchor ( See Diagram D). - Repeat these strips by continuing up the thumb and overlapping by halfthe width ofthe tape each time ( See Diagram E). IMPORTANT TEACHING POINTS: SKIN PREPARATION AND BODY POSITIONING - The hand is supported on the therapist's chest or stomach. - The thumb should be placed in afimctional position and in its pain free range ( See Diagram A ). - Spray the entire hand & thumbwith tuf-skin. PURPOSE: - To prevent hyperextension ofthe thumb. SU PPLI ES: - tuf-skin spray - 11/2"whiteadhesivetape - BACK VIEW C2 C3 C4 PALM VIEW WRIST-HYPEREXTENSION SUPPORT 108 OPTION HYPERABDUCTION SUPPORT I I I \ THUMB-HYPEREXTENSION SUPPORT - The number of hoods required will depend on the length of the thumb. - Make sure the proximal joint is covered. - Pinch the edges of the last hood piece together in order to help prevent hyperextension. The last hood piece should not interfere with the bending of the tip of the thumb. - The degree of hyperextension restriction will depend upon the positioning of the thumb. - To close, re-apply the original hand anchor to secure the hood pieces (See Diagram F). - To prevent the thumb from opening up into abduction, apply two" figure 8"strips travelling in the same direction ( See Diagrams G& H). The two strips should begin on the back of the hand, loop around the base of the thumb and end in the palm. The" XIS" should cross over the MTP joint. These strips should be applied before the closures. - Do not apply the tape too tight as it is easy to cut off circulation. CLOSURES "FIGURE 8" 110 113 zo...... t- - p.,o z o...... t- - p.,o THUMB-HYPEREXTENSION SUPPORT EJ EJ VJ Q o o ::r: THUMB-HYPEREXTENSION SUPPORT 112 CHAPTER SEVEN GLOSSARY Abduction: Acute: Adduction: Anterior: Articulation: Avulsion: Axilla: Bursa: Checkrein: Chronic Injury: Dislocation: Distal: Dorsal: GLOSSARY The lateral movement of a limb away from the median plane of the body. Immediate injury onset associated with inflammation. The movement of a body segment toward the median anatomical line of a nearby segment. The front of the body or a body part. Ajoint between bones. A forcible tearing away of a part or structure ( i.e., a ligament from a bone ). Arm pit. Afluid-filled sac or sac-like cavity that allows a muscle or tendon to slide over bone thereby reducing friction. Several strips of tape that run between upper and lower anchors. It is often shaped like an hour glass. an injury showing little change or slow improvement. The opposite of acute. The displacement of one or more bones, a joint, or any organ from it's original position. Farthest from a center, from the midline, or from the trunk. Farthest from a point of reference ( opposite of proximal ). Upper surface ( i.e., top of hand/ foot) 119 120 Dorsum: The back of a body part. Hyper: Prefix meaning too much (i.e., hyperextension). 121 A suffix, an inflammation of something ( i.e., tendonitis) Muscle attachment to a bone that moves. Moving the feet so that the soles face each other. Away from the midline of the body. Pertains to the side ( in relationship of position from the midline of the body). Partial displacement of the articular surfaces between two or more bones. ( articular capsule or synovial capsule) A saclike, fibrous membrane that surrounds ajoint, often including or interwoven with ligaments. A band of flexible, tough, dense white fibrous connective tissue connecting the articular ends of the bones and sometimes enveloping them in a capsule. A rounded bony protuberance on each side of the ankle joint. Toward the midline of the body. Hyperflexion: In excess of normal flexion. Hypo-: Prefix signifying a lack of or deficiency; also a position below, under or beneath. Inferior: Towards the bottom of the body or body part. Hyper- Extension: Beyond the normal extension. Inversion: Insertion: itis: Ligament: lateral: Malleolus: Joint Capsule: Medial: Medium Density Foam: Similarto that found in hockey helmets Joint Su bl uxation: Moving the soles of the feet so that they are facing away from each other. A growth plate. Fibrous membrane that covers, supports, and separates muscles. Moving a body segment toward a straight line position. Inflammation of fascia. Moving a body segment away from a straight line position. The area of the foot before the toes ( arch area ). A bruise, consisting of a collection of blood that is usually clotted. A 3" X 3" closed cell foam pad, 2 - 3 mm thick, designed to protect the skin.. Edema: Swelling as a result of the collection of fluid in the connective tissue. Eversion: Fascia: Epiphysis: Effusion: Escape of the fluid into a cavity ( such as within a joint capsule ). Extension: Dorsiflexion: Moving the toe or foot, finger or wrist, toward the dorsal aspect of a nearby body segment. Fascitis: Flexion: Forefoot: Heel & lace Pads: Hematoma: Hemorrhage: Escaping of blood through ruptured walls of blood vessels. 122 Continuous strips of tape or a tensor that wrap around a joint forming a " figure 8 ". An overstress of a joint, producing a stretching or tearing of the ligaments and capsule. Excessive stretching or overuse of a part, such as a tendon or a muscle. Towards the top of the body or body part. To spread apart or move outward. Lying on the back. facing upwards, opposed to prone. A band of dense fibrous tissue forming the termination of a muscle and attaching the latter to a bone. A sticky skin adherent spray. A toe injury resulting from the big toe being forced against the tip of the shoe. This results in excessive hyper extension of the MP joint. A thin, tearable wrap used as a protective barrier against the skin. It comes by the roll and is also know as under wrap or pre-wrap. Position of a body part that is bent outward away from the midline of the body. Position of a body part that is bent inward toward the midline of the body. Bottom surface ( opposite of dorsal ); near, on, or toward the belly; in human, anterior. 123
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