Taping for Collateral and Taping for Collateral and Rotary Insufficiencies of Rotary Insufficiencies of the Knee the Knee Chuck Whedon, MS, ATC, CSCS Chuck Whedon, MS, ATC, CSCS Coordinator of Athletic Training and Sports Medical Services Coordinator of Athletic Training and Sports Medical Services Rowan University, Glassboro, NJ Rowan University, Glassboro, NJ
Introduction Introduction For the past fifteen years I have studied the needs and management of the nt of the For the past fifteen years I have studied the needs and manageme � � unstable knee. unstable knee. Not until I sustained a grade two medial collateral ligament sprain while rain while Not until I sustained a grade two medial collateral ligament sp � � wrestling competitively did I actively pursue an effective strapping ping wrestling competitively did I actively pursue an effective strap technique. technique. Available techniques reviewed and tested and have been found either too Available techniques reviewed and tested and have been found eit her too � � restrictive or offering insufficient support. restrictive or offering insufficient support. I have talked with a number of professionals, some of which profess that ess that I have talked with a number of professionals, some of which prof � � taping of the knee is ineffective. taping of the knee is ineffective. For ACL injuries, this may be the case, but with most others, the author e author For ACL injuries, this may be the case, but with most others, th � � must disagree. must disagree. While some injuries may need to be augmented by bracing (another While some injuries may need to be augmented by bracing (another � � controversial area) knee taping has a viable place in sport medicine. controversial area) knee taping has a viable place in sport medi cine. During these years I tested, modified and settled on a knee strapping During these years I tested, modified and settled on a knee stra pping � � technique which has proven to provide an effective balance between en technique which has proven to provide an effective balance betwe restriction and support. restriction and support.
Rationale Rationale � The rotary support technique is based on the fact that The rotary support technique is based on the fact that � virtually all knee injuries have some rotary virtually all knee injuries have some rotary component to their mechanism. component to their mechanism. � The taping position and strapping technique take into The taping position and strapping technique take into � account these mechanisms related to injury and re- - account these mechanisms related to injury and re injury. injury. � Attention must be paid to both positioning and Attention must be paid to both positioning and � tension at specific points to maximize effectiveness tension at specific points to maximize effectiveness and comfort, as well as the acceptable state of healing and comfort, as well as the acceptable state of healing for the technique to be successful. for the technique to be successful.
Supplies needed Supplies needed � Spray adherent Spray adherent � � Heel and lace pads Heel and lace pads � � 2" white tape 2" white tape � � Heel prop Heel prop � � 3" high 3" high- -tensile elastic tensile elastic � tape tape � Skill and practice Skill and practice �
Application technique Application technique Place the knee in a position Place the knee in a position opposite to the causative opposite to the causative mechanism: mechanism: For medial collateral For medial collateral � � ligament sprains and ligament sprains and suspected medial meniscus suspected medial meniscus pathology, the tibia should pathology, the tibia should be held in a internally be held in a internally rotated position with the rotated position with the ankle slightly inverted. ankle slightly inverted. This produces a varus varus load, load, This produces a � � slacking the MCL. slacking the MCL.
Skin preparation/Anchors Skin preparation/Anchors Spray adhesive is applied in the Spray adhesive is applied in the � � traditional fashion, as are two heel and traditional fashion, as are two heel and lace pads in the popliteal popliteal fossa fossa. . lace pads in the Padding may be used to additionally Padding may be used to additionally � � reduce friction. reduce friction. Pre- -taping wrap may be used, but is not taping wrap may be used, but is not Pre � � recommended, especially on the thigh, recommended, especially on the thigh, as this will promote slippage, and as this will promote slippage, and compromise the effectiveness of the compromise the effectiveness of the taping application. taping application. Four to six adhesive straps are placed as Four to six adhesive straps are placed as � � anchors using standard 1 1/2" or 2" anchors using standard 1 1/2" or 2" white tape from one inch above the white tape from one inch above the superior patellar pole to mid- -thigh. thigh. superior patellar pole to mid Three to five adhesive straps are placed Three to five adhesive straps are placed � � as anchors using standard 1 1/2" or 2" as anchors using standard 1 1/2" or 2" white tape from one inch inferior to the white tape from one inch inferior to the tibial tuberosity tuberosity to mid to mid- -calf. calf. tibial Elastic tape can serve as anchors if Elastic tape can serve as anchors if � � constriction is a concern. constriction is a concern.
Hyperextension straps Hyperextension straps � Optional Optional – – used when used when � terminal extension is terminal extension is pathogenic. pathogenic. � Two to three straps of Two to three straps of � white tape are crossed white tape are crossed over the popliteal popliteal fossa fossa, , over the superior to inferior to superior to inferior to prevent hyperextension. prevent hyperextension.
Elastic strap # 1 Elastic strap # 1 � Beginning on the unaffected side Beginning on the unaffected side � (lateral) above the patella, apply (lateral) above the patella, apply a 2 to 3" strap of high- -tensile tensile a 2 to 3" strap of high strength elastic tape ( one likely strength elastic tape ( one likely not to rip, especially with the not to rip, especially with the heavy flexion demands of heavy flexion demands of wrestlers). wrestlers). � This is angled inferiorly along This is angled inferiorly along � the lateral patellar border and the lateral patellar border and across the lateral joint line across the lateral joint line (drawn tautly), around the (drawn tautly), around the posterior calf (drawn loosely- - posterior calf (drawn loosely complete slack). complete slack).
Elastic strap # 1 Elastic strap # 1 � The strap is then drawn The strap is then drawn � tightly up across the tightly up across the tibial tubercle over the tubercle over the tibial medial joint line and medial joint line and along the medial along the medial patellar border of the patellar border of the affected side. affected side.
Elastic strap #2 Elastic strap #2 � The second elastic support The second elastic support � strap begins superior to the strap begins superior to the patella, following the patellar patella, following the patellar border across the affected border across the affected joint line (drawn tautly). joint line (drawn tautly). � Again loosely (complete Again loosely (complete � slack) around behind the calf, slack) around behind the calf, and then across the tibial tibial and then across the tubercle, along the finish of tubercle, along the finish of the first elastic strap on the the first elastic strap on the affected side, overlapping it affected side, overlapping it by 1/2 the width, (drawn as by 1/2 the width, (drawn as tautly as possible). tautly as possible).
Elastic Strap # 3/closure Elastic Strap # 3/closure � The third elastic strap The third elastic strap � serves both as the final serves both as the final collateral support and a collateral support and a spiral closure. spiral closure. � Trace the origin as strap # Trace the origin as strap # � 2 and overlap by 1/2 the 2 and overlap by 1/2 the tape width. tape width. � Draw tautly across the Draw tautly across the � joint line, loosely across joint line, loosely across the posterior calf, and the posterior calf, and spiraled upward. spiraled upward.
Closure Closure � The tape should be The tape should be � overlapped by 1/2 overlapped by 1/2 width to assure width to assure complete coverage. complete coverage. � The closure should The closure should � be secured with be secured with white tape at mid white tape at mid thigh thigh
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