By Lauren J. Stephenson, MA, ATC
As clinicians, we know that understanding the whole picture is imperative in devising a comprehensive and effective rehabilitation plan when working with patients who have musculoskeletal injuries. We assess not only the injury site, but also deviations, deficiencies and malalignments throughout the kinetic chain in order to best address the source of the problem and return our patients to full activity as safely and efficiently as possible.
This concept is similar when applying tape to an athlete who has sustained an injury to the lower extremity. The clinician must take into consideration the properties of each type of tape, the nature of the equipment for the sport, the position the athlete plays, and the patient's personal preferences in addition to the injury. By incorporating these principles, taping procedures applied to the lower extremity will be functional, which will facilitate healing while allowing the athlete to continue participating in his sport.
In order for any taping procedure to be functional, the patient has to be willing to keep it on while participating in sport. There are several factors that go into whether or not athletes will be compliant with wearing a supportive external device. Primarily, the taping procedure must be comfortable for them. While part of the equation depends on the actual application of the tape, the other is choosing a tape that will serve its purpose in providing support, allowing the joint to move through a pain-free range of motion while maintaining neurovascular integrity. Part of ensuring comfort and function is having an understanding of how taping procedures can be integrated into protective equipment.
The primary purpose of taping a joint is to support and protect injured joint structures. In many sports, other protective devices such as guards or padding are required to maintain safe play. The clinician must consider how a taping procedure fits underneath or outside of protective equipment. For example, a football player wears a cleat that's more of a high-top, with a wide heel counter, midsole and toe box. The structure of this type of cleat allows the clinician to add a significant amount of tape to the foot and ankle without causing too much crowding in the shoe.
Conversely, a soccer player traditionally wears a cleat that is a half- to a full-size smaller than his shoe size in order to allow for better ball handling. The soccer cleat design usually has a low top, narrow heel counter, midsole and toe box. Using a similar taping procedure to that used on the football player would not only compress the foot in the shoe, but would limit the ability of the soccer player to feel the ball, therefore limiting effective play. While the soccer player may have the same injury as the football player, the clinician can't apply the same taping procedure and maintain compliance.