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The Use of Sports

Taping in
Musculoskeletal
Physiotherapy

Andrew Leipus
B.Appl.Sc.(Exercise&Sports Science)
B.Appl.Sc.(Physiotherapy)
M.Appl.Sc.(Musculoskeletal&SportsPhysio)
Physiotherapist Indian Cricket Team 1999-2005
Acknowledgement of
Resources

 Dr Mary Magarey  Mr Nigel Rowe


– UNISA Postgrad lecturer – Podiatrist, SportsMed
SA
– APA Sports Physiotherapist
 Mr
 Mr Jim Mack
Patrick Custance
APA Sports

– APA Sports Physiotherapist Physiotherapist
– AFL Physiotherapist – AFL Physiotherapist
A Definition?
 “Asports physiotherapist is a recognised professional
who demonstrates advanced competencies in the
promotion of safe physical activity participation,
provision of advice, and adaptation of rehabilitation
and training interventions, for the purposes of
preventing injury, restoring optimal function, and
contributing to the enhancement of sports
performance, in athletes of all ages and abilities,
while ensuring a high standard of professional and
ethical practice” (IFSP)
A Description of our
profession?

 “Atthe heart of sports physiotherapists’


thinking and behaviour lies understanding of
and sensitivity towards the implications of
injury for the athlete and the impact on others
around them. They maintain independence in
their decision-making, ensuring their duty
of care to the athlete in a context of many
potential conflicts of interest.”(IFSP)
Considerations
 What are the sports Physio’s tricks and secrets? How do we
get injuries back so quickly?
 What are the essential skills we require?
– Sports knowledge…demands, regulations, structure?
– Biomechanical considerations…kinetic chains, ROM?
– Physiological considerations…energy systems, dynamics?
– Pathological considerations…degree of trauma?
Applications?
 Istaping just for the sports physio though?
 Can we apply techniques to non-sportspeople?
 Absolutely….
 But we still require an excellent knowledge of
human movement.
 Physiotherapists are the most skilled health
professionals to do this!
Important!!

 Taping is simply a tool that we can use to


achieve a certain outcome
 Application requires clinical reasoning
 Remember to always put it into the
context of the patient’s
injury/circumstance
What Do We Hope to Achieve?
 Mechanical restriction range of movement
(pathological or physiological)
 Support for joint/ligamentous instability/hypermobility
 Facilitation of muscle function or normal movement
 Inhibition of overactivity
 Proprioception and/or awareness of posture
 Confidence/mental effects of taping
 Protection/support of tissues
What do we actually achieve?

 There is little evidence that any particular


type of tape is more effective than any
other!!!
 Rigid tape loses its ability to control
movement within approx 20 minutes of
application during vigorous activity
What do we actually achieve?

 Its likely that the primary effect of


all tape is proprioceptive
 Strong placebo effect likely
 Tape muscles/joints attracts a
certain amount of attention from
Drs/PTs/Other players…sympathy,
excuses…?
What do we actually achieve?
 Some evidence to suggest that one piece of tape
applied across the body at no tension has equal
effectiveness as ‘skillfully’ applied tape (outcomes
being patient satisfaction & effect on control of
body part)
 My taping skills? – Undergrad/post-grad
education, sports courses, interaction with other
physios, working in different sports, texts, and
most importantly trial and error
Basic Principals
Your Equipment…

 Many varieties of tape are available;


– Rigid tapes are strong and generally do
not stretch
– Elastic tapes allow stretch either in length
or width but still have a rigid end-point
– Other elastic tapes stretch in all directions
(Kinesiotape)
– Different levels of adhesiveness and
allergy properties (zinc-oxide)
Basic Principals
Your Equipment…

– Underwrap foam is non-adhesive


– Co-Ban® only adheres to itself
and can be re-used
Basic Principals
Application
 Patient SAFETY is the number one priority
– Allergy
– Friction areas
– Hygiene
– Hair
– Skin thickness
– Skin mobility
– Instructions and advice to the patient
Basic Principals
Application

 Use an ‘under-tape’ under rigid tape to


protect skin
 Use vaseline and/or gauze pad over
sensitive, bony or flexor aspects
 Use RIGID tape to restrict movement
(muscular, capsular, ligamentous, joint,
functional)
Basic Principals
Application
 Use ELASTIC tape for compression or proprioceptive
stimulation (muscular, motor patterning)
 Taping ACROSS muscle fibres generally INHIBITIVE
 Taping ALONG muscle fibres generally FACILITATIVE
 Adapt the principals to the situation
 The direction of pull of the tape matters…it can determine
whether your taping is effective or not
Basic Principals
Application

 Effectiveness
is your second priority -
assess and reassess until the desired
effect/outcome is achieved;
– Use a functional or physiological
reassessment sign following tape application
 Experienced sports physios will have an
individual style
Basic Principals
Application

 No ‘right or wrong’…but only if you can


provide adequate reasoning for every
piece of tape applied to the patient
 The tape MUST serve a purpose
 Think!
Basic Principals
Application

 Often the tape will need to ‘set’ – a


combination of the adhesive activating to the
body heat as well as the natural elasticity of
the tape to ‘settle’
 Tape sticks better following this process
 Can facilitate this process by vigorous rubbing
 Care with applying clothing/socks over tape –
tends to ‘roll’ at the edges
Basic Principals
Tape Removal
 Always remove tape carefully and slowly
 DO NOT RIP!
 Apply a tension to the skin in the opposite
direction to the pull of the tape
 Pull/peel the tape back on itself, avoiding
any torsion
 Facilitate adhesive degradation with
eucalyptus oil, commercial tape remover,
white spirit or even soak in bath
Assessment for Taping
 Why do I want to tape?
 Does an appropriate taping technique exist
for the situation?
 Do I have the appropriate taping materials?
 Identify/assess for any safety issues with
taping and the patient
 Efficiency and neatness (minimal creases,
finished off, professional)
Assessment for Taping
 Time considerations? During a match?
 Patient comfort for effective taping and therapist control over patient
 Practicality of the taping technique for the sporting situation
 Ability to modify the tape if it isn’t effective?