Tuesday, September 18, 2012

Classic AT: Taping an Ankle

Students: You asked for it, here it is.

So many times, I hear AT's and students upset that public perception is that we tape ankles and get ice. Not sure why, but it's never really  bothered me.  Yes, we do much more than that, but I'd be more concerned if we had NO public perception.  At least we are being noticed.

Anyway, a co-worker of mine is adamant about applying a clean, neat and functional taping technique.  He describes taping as an "ATC's signature".  I love that!  Take pride in it; make sure it works and don't try to rush it.  

When teaching traditional taping techniques to university students, I seem to find that while there are hundreds of variations and personal preferences on taping.  That said, the instructor HAS to teach one method for the student to capture the basics and learn the skill.  I frequently hear from clinical instructors questioning the technique involved when students displays their skills at a clinical site.  While I do teach one method; it is just that; one method.  I fully expect each student's taping to evolve as they progress clinically, and even encourage it.  However, there are several taping basics which can easily be lost or discarded over time. We should be sure that the evolution is one of sound clinical reasoning and not just clinician preference.  This can potentially decrease the effectiveness of the tape itself, delaying rehabilitation or even exacerbating the injury.
Some general rules on taping:
The first assumption here is that I am discussing taping an injured ankle, not simply taping a healthy one. 
1.  Avoid continuous tape.  This means don't wrap with one or two long strips of tape completely circling the joint.  Use smaller, shorter strips for greater tensile strength.  An added danger with continuous tape is that it may only provide compression, not support.

2.  Know what you are taping for.  In this video, we are taping to help lock the talus into the ankle mortise. I am applying a basic variation of the closed basket weave taping technique.
3.  Overlap the tape by half all the time, and you will have both a neat AND functional taping.
4.  I've heard colleagues say for years that taping with white tape is going out the door.  This, coupled with the proliferation of over the counter braces and advances such as  Kinesio tape (among others) certainly would lend credence to that argument.  However, I think that sometimes nothing beats regular tape.  In addition, much like anything in health care, I think it's more damaging to completely discard something when a) it still works for some athletes and some injuries, and b)it's the athlete's preference.  At the end of the day, I think that's what drives the discussion for me.
5.  Make sure it's latex free.  Most, but not all tape is nowadays.  Be sure to ask and double check before applying directly to your athlete!

Lastly, I'm not against other styles of taping, nor am I against bracing.  As an educator I believe that all are beneficial when used correctly, and it's up to the ATC, athlete and injury to determine which is the best specific tool for that specific scenario.

Random Question: When did we start calling these "Ankle Tape Jobs"?  Does "Nice ankle taping." not suffice?  Does anyone know the origin of the phrase "tape jobs"?  It is so awkward sounding; both to type and speak.  

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