CORE STANDARDS, OBJECTIVES, AND INDICATORSSTANDARD 3Students will apply injury prevention principles.

Objective 1: Describe the basic principles and specialized equipment used in the prevention of athletic injury.

a. Recognize types and functions of protective equipment.1. Helmet / face mask / ear guards2. Mouth guards3. Neck collars4. Padding5. Sports bras6. Athletic supporter / cup7. Shin guards8. Shoe9. Other sport specific protection devices

b. Discuss the legal ramifications of manufacturing, buying, and issuing equipment.1. NOCSAE warning2. Modification of equipment3. Proper fit and selection 4. Use of defective or worn out equipment

Objective 2: Demonstrate theory and principles of prophylactic taping.a. Analyze the basic principles of prophylactic taping.b. Identify the necessary supplies and their purpose for prophylactic taping.

1. Athletic tape (various size)2. Underwrap3. Heel and lace pad4. Adhesive spray5. Shark / Scissors

c. Analyze the basic principles of proper tape removal.d. Explain the terminology associated with prophylactic taping procedures.

1. Anchor2. Stirrup3. Horseshoe4. Spica5. Heel-Lock6. Checkrein / fan

e. Competently tape an ankle using the standard prophylactic taping method.f. Competently tape an arch using the standard prophylactic taping method.g. Competently tape a thumb using the standard prophylactic taping method.h. Competently tape a wrist using the standard prophylactic taping method.

Objective 3: Identify principles of protective bracing.a. Discuss the differences between functional and prophylactic bracing.b. Identify the function of joint sleeves (compression).

Unit 3 – INJURY PREVENTION Lecture Notes Prevention

Objective 1: Describe the basic principles and specialized equipment used in the prevention of athletic injury.

The best method of managing and caring for athletic injuries is to prevent them from occurring. 1. Many factors are important in the prevention of athletic injuries.

a. Proper fit and selection.b. Design

i. To prevent injury ii. To protect injured parts from further injury.

2. Practicality dictates that protective equipment should be: a. Simple to fit and maintain.b. Be durable and reliable.c. Not be extremely expensive. d. Minimal functional interference

3. Protective equipment can be abuseda. By players who use the equipment as a weapon against their opponent, b. By players who take dangerous risks and rely on the equipment to protect

them.4. Modifications and improvements in sports equipment are continually being made,

especially for sports in which injury is common. 5. Hazards demonstrated in each individual sport dictate the need for specific types of

protection.a. In collision contact sports, exposed and vulnerable areas must be protected

from impact with the surface or other players. b. Vital areas such as the head, neck, kidneys and genitalia must have priority

for protection. c. Padding must also protect primary contact points

i. Shouldersii. Elbowsiii. Forearmiv. Hipsv. Thighvi. Kneevii. Shin

d. High velocity hazards are seen in sports that use a type of projectile such as balls or pucks.

i. ExamplesA. BaseballB. Lacrosse C. HockeyD. Racquet sports

e. Dental protection such as mouth guards prevent dental injuries and may help to decrease impact causing concussions.

A. Recognize types and functions of protective equipment.1. Helmet / face mask / eye protection / ear guards2. Mouth guards3. Neck collars4. Padding5. Sports bras6. Athletic supporter / cup7. Shin guards8. Shoe9. Other sport specific protection devices

1. Helmets, Face Masks, Eye protection and Ear Guards – Effective protection for the head and face, including the ears and eyes, has improved significantly in recent years. A. Helmets –

1. Are mandated in sports such as football, ice hockey, lacrosse, boxing, baseball, cycling, and automobile and motorcycle racing, etc.

2. Spread high-velocity impacts over a large surface area through a firm exterior shell and decelerate forces that act on the head through an energy-absorbing liner.

3. Ear-flaps provide additional protection to the ears and lower portions of the skull.

4. Wearing an improperly fitted helmet increases the opportunity for head injuries.

5. Fit should be monitored often as it can be altered by:i. Temperatureii. Hair lengthiii. Deterioration of internal paddingiv. Loss of air (Air bladder helmet)

6. Nothing can eliminate the possibility of a head injury; however, helmets do significantly lessen their severity.

B. Face Masks – 1. Are used in a variety of sports to protect against flying or carried

objects during a collision with another player.2. In several sports, the addition of a face mask to a helmet is now more

widely used.3. A large variety of face masks styles are available, depending on the

position played and the protection needed.

C. Eye protection – 1. Is essential in those sports that are fast-moving and use projectiles or

implements. 2. Glasses pose considerable danger during competition. Glasses may:

i. Bend or breakii. Slip on sweatiii. Fog from perspirationiv. Detract from peripheral visionv. Be difficult to wear with protective headgear.

3. The following items can protect the eyes of an athlete:i. Glass guardsii. Case-hardened or plastic lenses

D. Ear guards – 1. Are essential in the following sport to help limit the amount of rubbing

and friction that causes injuryi. Boxingii. Wrestlingiii. Rugbyiv. Water polo

2. Irritation of the ears can occur to the point that permanent deformity can ensue. Some of these injuries may include:

i. Cauliflower-ear ii. Lacerationsiii. Ruptured eardrum

3. To avoid these problems, special ear guards should be routinely worn.

2. Mouth guards – 1. Correctly fitted intra-oral mouth guard prevents the majority of dental

trauma. 2. Fit should be:

i. Tight fitii. Be comfortableiii. Unrestricted breathingiv. Should not impede speech during competition.

3. Fit is best when retained on the upper jaw and projects backward only as far as the last molar.

4. Composed of a flexible, resilient material.5. In addition to protecting the teeth, the intra-oral mouth guard absorbs

shock and helps to prevent concussions.

3. Neck Collars – 1. Used by players in collision contact sports to reduce extreme backward

or lateral bending.

2. Also known as a:i. Neck rollii. Cowboy collariii. Butterfly restrictor

3. Made from a variety of different materials i. Foamii. Plastic

4. Generally fastened about the athletes shoulder pad around the rear and sides of a player's neck.

5. Serves as a stop-gap between the player's head and shoulders to prevent lateral bending as well as extension and may give some protection against axial compression.

4. Padding – A. Shoulder Pads –

1. Protect against forceful contact with opponents and other hard surfaces.

2. Impact force is spread over a large surface area of the exterior shell and then distributed into an energy-absorbing design composed of a plastic hull having resilient padding attached to the inside.

3. This Convex-shape and cantilever design offers protection to the wearer's shoulders and upper chest and back.

4. Offers no protection to the athlete’s ribs or sides between the arms and the waist.

B. Other types of pads – 1. Athletes who are exposed to repeated thoracic contusion or with prior

rib cage injury benefit from rib and back pads2. Pads are also used in other regions of the body

i. Hipsii. Tailbone (sacral/coccyx)iii. Thighsiv. Knees

3. These pads are often needed in collision and high-velocity sports.4. Padding must be varied in structure, weight, and application according

to the sport and size of the athlete for which it is used.

5. Sports Bras – 1. Designed to provide support to women's breasts and minimize

movement while exercising or playing sports.2. Motion is difficult to reduce without a sports bra because the ligaments

in the breasts do not contain strong structural support.3. Females, who play sports or exercise and do not wear a sports bra, put

themselves at risk of causing irreversible damage to ligaments in the breasts.

6. Athletic supporter / Cup – A. Athletic Supporter –

1. Consists of an elastic waistband and leg straps which connect to a pouch designed to support the male genitals as well as keep a protective cup in place.

2. It was believed that athletic supporters helped to protect from inguinal hernias

i. When a portion of the intestines descends through the canal that contains the spermatic cord.

ii. However athletic supporters have been shown to offer no protection against this relatively common injury.

3. Some athletes have moved away from the traditional athletic supporter into a more complete and supportive compression short or girdle.

i. These devises allow for more support to the entire groin and hip joint as well as provide pockets for protective cup and pads.

B. Cup – 1. Sports involving high-velocity projectiles require that athletes wear a

proactive cup, usually made of a hard plastic with perforations for ventilation.

i. A more flexible, soft cup is also offered for low contact sports or female athletes.

7. Shin guards – 1. Hard-shelled device made of many differing synthetic materials,

including: fiberglass or polyurethane with a foam rubber under lining.2. Commercially marketed equipment worn in front of the shins (Lower

leg over the tibia bone) to protect against a large range of leg injuries.3. Commonly used in:

i. Soccerii. Rugbyiii. Baseball (Batters & Catchers)iv. Hockey v. Other sports where it is deemed necessary

8. Shoes – 1. The human foot was designed to function on uneven surfaces. Shoes

were created to protect against harmful surfaces, but they should never interfere with normal functioning.

2. Improperly fitted shoes can result in i. Mechanical disturbances that affect the body’s total postural

balance.ii. Problems with the joints and muscles.iii. Chronic abnormal pressures to the foot can often cause

permanent structural deformities.iv. Potential dangerous calluses and blisters.

3. Fitting sports footwear can be difficult

i. It is important to measure both feet. a. A person’s left foot generally varies in size and shape

from the right foot.b. Shoes should be selected for the longer of the two

measurementsc. The shoe should be long enough that all toes can be fully

extended without being cramped.i. The athlete should simulate the conditions under which they will

perform with the shoes on.a. It is ideal to fit the shoes at the end of the day to

accommodate the gradual increase in size that occurs during the course of the day.

4. Each sport places unique stresses and performance demands on the foot

i. Footwear can mean the difference between success, failure, or injury in competition.

ii. A shoe with cleats presents some additional problems in fitting.a. Cleats must be properly positioned under the two weight-

bearing joints and must not be felt through the soles of the shoes.

5. Additional Footweari. All athletic socks should be clean, dry and without holes to

avoid irritations.a. Poorly fitted socks can cause abnormal stresses on the

foot.ii. Orthotics may be helpful in treating a variety of foot problems,

as well as other lower extremity problems involving the hip and knee.

a. Commercial orthotics and insoles are intended for use by the general public and are not usually designed to withstand the rigors of sports activities. 1. Commercial orthotics, that are suited for sports, are

generally not durable enough for long and hard extended use.

b. Custom-made orthotics are fabricated from a variety of materials such as foam, felt, plaster, or aluminum.1. Custom-made orthotics are customized to the

individual’s natural curvature of each foot.

9. Other sport specific protection devices – 1. In addition to the various types and functions of the protective

equipment presented there are many specific devices designed to protect athletes. These may include:

i. Padded gloves, mitts, and boxing glovesa. Designed to protect the hand which is an often neglected

area of the body in sports and particular attention must

be paid to protecting the integrity of the hand when encountering high-speed projectiles.

ii. Limb Protectiona. Limbs, as with other areas of the body, can be exposed a

great deal to sports injuries and can require protection or, where there is a weakness, support.

b. Compression and mild soft-tissue support can be provided by neoprene sleeves, and hard bony areas of the body can be protected by commercial pads.

B. Discuss the legal ramifications of manufacturing, buying, and issuing equipment.

5. NOCSAE warning6. Modification of equipment7. Proper fit and selection 8. Use of defective or worn out equipment

As in other aspects of sports participation, there is increasing litigation related to legal ramifications of manufacturing, buying, and issuing equipment.1. Manufacturers and purchasers of sports equipment must foresee all possible uses

and misuses of the equipment and must warn the user of any potential risks inherent in the use or misuse of that equipment.

a. To decrease the possibilities of sports injuries and litigation stemming from the equipment:

i. Buy protective equipment from reputable manufacturers.ii. Buy the safest equipment resources permit.iii. Ensure that all equipment is assembled correctly – follow the

manufacturer’s instructions to the letter.iv. Maintain all equipment properly – follow the manufacturer’s guidelines.v. Use equipment only for the purpose for which it was designed.vi. Warn athletes who use the equipment about all possible risks that

using the equipment could entail.vii. Use great caution in the customizing of any piece of equipment.viii. Use no defective equipment.

1. NOCSAE warning – a. A major influence on standardization of productive equipment in the United

States has been the National Operating Committee on Standards for Athletic Equipment (NOCSAE).

b. To be NOCSAE approved, protective equipment must be able to tolerate forces applied to many different areas of it.

c. Examplei. Football helmets must withstand repeated blows and high-mass-low-

velocity impacts. ii. All helmets must have a NOCSAE certification.

iii. Even though a helmet is certified does not mean that it is completely fail-safe.

iv. The following warning is placed on all football helmets:1. “Do not use this helmet to butt, ram or spear an opposing

player. This is a violation of football rules, and can result in severe head, brain, neck injury, paralysis, or death to you and possible injury to your opponent. There is a risk these injuries may also occur as a result of accidental contact without intention to butt, ram, or spear. No helmet can prevent all such injuries.”

2. Modification of equipment – a. Modifications and improvements in sports equipment are continually being

made by manufactures to insure the safety of the athlete.b. Alteration of sports equipment by an athlete or someone other than the

manufacture could result in the loss of the manufacturer's warranty of that product.

i. Any modification of equipment will void any legal liability the manufacturer would have as a result of failure of the product.

ii. Example:1. If one were to drill a hole in a piece of plastic material and the

material later failed, the manufacturer would have every right to suggest that the drilling altered the structure of the material and caused the failure.

iii. Liability resulting from the improper care or modification of manufactured products is separate from manufacturer's liability.

c. Only equipment that is unaltered and regularly inspected and reconditioned can be considered within the scope of the manufacturer's responsibility.

3. Proper fit and selection – a. Correctly fitting equipment is of the utmost importance for injury prevention

and protection.b. Standards of correct fit are set and should be adhered to.

i. To fit athletic equipment correctly, the following factors should be considered:

1. Size (of Athlete and Equipment)2. Sport and Position 3. Strength (of Athlete and Equipment)4. Age and Physical Development.

4. Use of defective or worn out equipment – a. Routine inspection of protective equipment and their parts is very important to

the safety of the athlete. b. Observe for:

i. Parts that can wear downii. Cracked or broken

iii. Missing parts or piecesiv. Frayed, torn or faded

c. Daily, weekly and seasonal inspections as well as repairs, refurbishing and replacement of protective equipment is important and could prevent an injury.

Unit 3 – INJURY PREVENTION Lecture Notes Taping

Objective 2: Demonstrate theory and principles of prophylactic taping.

A. Analyze the basic principles of prophylactic taping.Prophylactic taping is a preventive technique used for the protection, stabilization and care of athletic injuries.

General Guidelines1. Preparation

a. The athletic trainer and athlete should be in a comfortable position.i. The athlete should be high enough so the athletic trainer doesn’t have to

lean over.ii. Try to make the athlete comfortable but maintain the extremity in the

correct position while it is being taped.

b. Place taped body part away from mechanism of injury i. Ankle – place in 90° dorsiflexion plus slight eversion.

c. Be sure the area is dry, clean, and free of body hair.i. The area does not always have to be shaved when using underwrap (Pre-

wrap).ii. Underwrap helps to protect the skin but decreases the efficiency of the

tape.

d. Use some form of tape adherent (Spray) to ensure bonding of the tape to the skin.i. Cuts, blisters, and rashes should be covered with a clean non-stick pad

prior to the use of adherent or tape.ii. If underwrap is used, only one layer should be applied over the tape

adherent.

e. In areas with potential for friction blisters or burns, apply a lubricated pad. i. Heel-and-Lace pad with Skin Lube

2. Taping a. Select width of tape according to body part.

b. Begin with anchors on top and bottom to provide a base for other strips to attach to.

c. Overlap each strip of tape to the previous strip of tape by half.

d. Avoid spaces or gaps between tape segmentsi. These spaces may result in blistering or cutting of skin.

e. Neatness over speed.i. Smooth and mold the tape to the natural contour of the area being taped.ii. Never force the tape to go where you want it to go.iii. Learn the contours of the different extremities.iv. Use even pressure as you apply tape to avoid decreasing circulationv. Wrinkles can also cause cuts and blisters.vi. If a fold or wrinkle appears, tear off that strip and readjust your angle.

f. When taping over a muscle belly, allow for contraction.i. Don’t tape too tight! ii. Use an elastic or stretch tape whenever possible.

g. To tear tapei. Hold firmly on each side of the proposed tear line. ii. Pull the free end away at an angle so that the force crosses the lines of

the fabric at a sharp angle. iii. When tape is properly torn, the edges should be straight with no loose

threads.

3. After Taping a. Check for comfort as well as signs of impaired circulation.

i. Numbnessii. Tinglingiii. Discolorationiv. Loss of pulsev. Loss of function

4. Precautions a. Never apply tape immediately after icing. Wait until the body part is warmed

up.

b. The effectiveness of taping for prevention and treatment of injury has been a matter of controversy for many years.

c. Ankle taping to prevent injury should only be used in conjunction with proper exercise. i. Athletes with normal or near normal ankles should rely more on

strengthening exercises than taping or bracing.

d. An improperly applied wrap or tape can compound an injury and may even create postural imbalances that can adversely affect other parts of the body.

e. Reactions to tape adherent and skin irritations commonly develop with prolonged use of taping over a sport season.i. Usually these irritations are minor.ii. Proper daily cleansing of the area that has been taped can sometimes

prevent irritation

5. Arguments against taping a. Include the following

i. Tape usually becomes loose with wear.ii. Because the skin is mobile, taping cannot be effective.iii. Taping the ankle weakens the leg muscles.iv. Moisture develops between the skin and tape, thus affecting the

adherence of the tape.v. Tape tears under stress.

b. Despite these arguments, most studies agree that taping does contribute to a lower incidence of injury and re-injury.

c. Studies have also shown that prophylactic ankle taping is superior to lace-on braces for the first 20 minutes. i. After 20 minutes, taping is equal to bracing in its ability to support the

ankle.

B. Identify the necessary supplies and their purpose for prophylactic taping. 1. Athletic tape (various size) 2. Underwrap3. Heel and lace pad4. Adhesive spray5. Shark / Scissors

1. Athletic tape (various size) – 2. Athletic tape is available in a variety of

a. Manufacturesb. Widths (Sizes) 1”, 1.5”, 2”c. Colorsd. Strength Styles

i. Static cloth-linenii. Elasticity or stretch

A. Stretch or elastic tape is used for the smaller, more angular body parts such as the feet, hands, wrist and fingers.

3. Tape should adhere readily when applied and should maintain this adherence despite profuse perspiration and activity.

4. Tape should be stored and stacked in a cool place.

2. Underwrap – 5. Underwrap or Pre-wrap is available in a variety of manufactures and colors.6. Underwrap helps to protect the skin but decreases the efficiency of the tape.

a. It is to be used over areas that have not been shaved or are not free of body hair.

b. It may also be used over areas of irritation due to adhesive tape.c. Only one layer should be applied.d. Improper application techniques can result in blisters or small skin

lacerations.

3. Heel and lace pad – 1. Should be used in areas with potential for friction to prevent blisters and cuts.2. Made from a friction-proofing material (foam) and a lubricant (skin lube).3. Placed over the lacing area (Dorsal aspect) and to the back of the heel.

4. Adhesive spray – 7. A form of tape adherent to ensure bonding of the tape to the skin.8. May be found in a wipe on form but more commonly used as an aerosol.9. There are various names and manufactures although most serve the same purpose.

a. QDA (Quick Drying Adherent) - Cramerb. Tuf Skin - Cramerc. Pre-Tape - Muellerd. Stickum - Mueller

10.Skin irritations and reactions to tape adherent may develop with prolonged use of taping over a sport season.

5. Shark / Scissors – 1. Special cutters are made for tape removal. 2. Avoid cutting over bony prominences. 3. Be careful to look for blisters or other skin irritation as the tape is removed

C. Analyze the basic principles of proper tape removal. 11.Tape should be removed immediately after use to decrease the chances of skin

irritation. 12.Use either a Shark or special tape scissors.13.Avoid cutting over bony prominences. 14.To use tape cutters

a. Gently insert the blunt end under the tapeb. Pull up as you side down the tape while cutting. c. Pull skin from the tape not vice versa. d. Be careful to look for blisters or other skin irritation as the tape is removed

Common Taping ProceduresNOTE: The following taping procedures follow a variety of prophylactic

taping methods. It is important to become familiar with many different procedures in order to properly treat effectively.

Visit: http://www.muellersportsmed.com/taping/taping.html for video.

D. Explain the terminology associated with prophylactic taping procedures.1. Anchor2. Stirrup3. Horseshoe4. Spica5. Heel-Lock6. Checkrein / fan

1. Anchor – 15.Provides a firm base to attach other tape ends. 16.Anchors can be taped directly to skin so as to ensure better adherence.17.With an Ankle

a. Adhere 1-2 anchor strips at about one third of the way up the lower leg & also at approximately the midpoint of the foot.

2. Stirrup – 18.A vertical "U" piece of tape to support either side of the ankle. 19.With an Ankle

a. Adhere a strip of tape to the inside (Medial) upper (Proximal) anchor, flowing down (Distal) the inside ankle, under the foot & up & over the outer (Lateral) edge of the ankle.

3. Horseshoe – 1. This term may be used in reference to two types of treatment procedures.

a. Foam or Felt Horseshoe Padi. Used around the malleous after an injury to fill in hollows, compress

swelling and pad-sensitive areas.ii. Usually kept in place with an elastic bandage or compression sock.

b. A particular application of athletic tape associated with prophylactic taping procedures

i. Also referred to as a “C-Strip” or “Spur”ii. With an Ankle

A. Adhere a strip of tape from the inside (Medial) of the mid-foot anchor, back across the Achilles tendon, & finishing up on the outer (Lateral) anchor.

iii. The combination of alternating stirrup & horseshoe techniques is known as the basket-weave.

A. 2-3 strips each, and with each change in position, the tape overlaps by half of the width.

4. Spica – 1. A strip of tape or bandage applied in overlapping opposite spirals, in the shape of a

figure eight, to immobilize a digit or limb.2. Used to bind extremities to their trunk or root.3. Namely used in the thumb, hip and shoulder 5. Heel-Lock – 1. Tape makes a "U" pattern around the side to lock in one side of the heel.2. Lateral

a. A Lateral (outer) Heel Lock is applied to support the back of the ankle. b. Start at the mid frontal area of the ankle & flow to the outer edge of the foot, in

a downwards direction, towards the back of the arch. Go under the foot & cup the heel as shown, moving in an upward direction across the Achilles tendon, over the outer edge of the side of the ankle & back on to where you started.

3. Mediala. A Medial (inner) heel lock is applied in the opposite direction of the Lateral

Heel lock.b. Start at the mid frontal area of the ankle & flow to the inner edge of the foot, in

a downwards direction, towards the back of the arch. Go under the foot & cup the heel as shown, moving in an upward direction across the Achilles tendon, over the inner edge of the side of the ankle & back on to where you started.

6. Checkrein / fan – 1. A crossed fan or X-taping used to for immobilization of a joint and to protect against

hyperextension.2. Used to protect the elbow, wrist and knee joints

E. Competently tape an ankle using the standard prophylactic taping method. a. Routine Non-Injury Ankle Taping

1. The athlete should sit on a table with the leg extended, the lower third of the calf extended past the edge of the table and the foot held at a 90 degree angle in dorsiflexion. The taper faces the plantar aspect of the athlete’s foot.

2. Apply a coating of tape adherent to protect the skin and offer an adhering base.

3. Make sure that the ankle surface is cleaned of dirt and oil and apply an underwrap material (or tape directly to the skin).

4. Apply a foam pad over the instep and to the back of the heel.5. Using 1 ½ inch tape, a single anchor is placed around the ankle

approximately 5-6 inches above the malleolus.6. An anchor can also be placed at the distal third of the longitudinal arch.

Make sure that the base of the fifth metatarsal is not constricted.

7. Two to three stirrups are applied in consecutive order beginning on the medial part of the calf and pulling up on the lateral aspect of the leg with moderate tension. This direction of application results in slight eversion of the foot, thus counteracting the common inversion sprain.

8. Circular strips are applied from the point of the proximal anchor, moving downward until the malleolus is completely covered.

9. Next, arch strips are applied down to the distal anchor.10. The final support is given by a heel lock. A simple method is to start

high on the instep, bring the tape along the ankle at a slight angle, hooking the heel, leading under the arch, then coming up on the opposite side, and finishing at the starting point. At this point the tape is torn to complete half of the heel lock. To complete the remaining half, execute the same procedure on the opposite side of the ankle.

11. You may then choose to cover the ankle again with a second layer of tape. This will hold the other components in place. Begin at the bottom of the stirrups and encase the entire area upward to the proximal anchor.

F. Competently tape an arch using the standard prophylactic taping method. a. Routine Arch Taping (Low-Dye, Plantar Fasciitis)

1. The athlete should sit on a table with the leg extended, the lower third of the calf extended past the edge of the table and the foot held at a 90 degree angle in dorsiflexion. The taper faces the plantar aspect of the athlete’s foot.

2. Apply a coating of tape adherent to protect the skin and offer an adhering base.

3. Using 1 ½ inch athletic tape, apply a base layer (anchor) of tape around the foot. This layer of tape should extend around the ball of the foot (around the base of the metatarsal heads).

4. Continue with the anchor tape layer by placing a strip of tape around the base of the foot. This piece (C-Strip) should extend along the base of the foot, around the back of the heel, and connect on the opposite side to the tape already placed around the ball of your foot (medial & lateral borders of the foot).

5. Now split 1 ½ inch tape into half, or use 1 inch tape. Using smaller tape for the remainder of the arch taping will make it easier to maneuver across the bottom of the foot.

6. Begin taping the bottom of the foot at the joint underneath the small toe (5th metatarsal head). Wrap the tape in a loop around the heel to hold it in place. Finish this loop at the same place you began and tear the tape.

7. Repeat this same loop around the heel technique with another piece of tape. This time beginning at the joint underneath the big toe (hallux, 1st metatarsal head).

8. Alternate taping these two loops over again overlapping each by half until you have done each one three times and worked into the middle

of the foot. This will result in a strong taping criss-crossing the arch of your foot.

9. Finish taping the foot by using your 1 ½ inch tape. Place a piece of tape horizontally across the bottom of the foot. Begin at the base (distally) on the anchor tape at the edge of your foot (lateral side) go across the foot and end on the anchor tape at the other end of the foot (medial side). This creates a splint effect in combination with the looped tape.

10. Continue placing pieces of tape across the foot this way, overlapping by half, down to the heel, until the entire bottom of the foot is covered in tape.

11. Close by repeating step 3; apply a base layer (anchor) of tape around the foot. This layer of tape should extend around the ball of the foot (around the base of the metatarsal heads).

G. Competently tape a thumb using the standard prophylactic taping method. a. Prophylactic Thumb Taping

This taping technique is designed to protect the joints of the thumb as well as the surrounding muscles.

1. The athlete should fully extend and adduct the fingers while keeping the thumb in a relaxed, neutral position (as if holding a can). The taper should stand in front of the athlete’s thumb.

2. Apply underwrap to the forearm, wrist and thumb.3. Using 1 inch tape, place an anchor strip around the wrist and another

around the distal end of the thumb.4. From the anchor at the tip of the thumb to the anchor around the wrist,

apply four strips in a series on the dorsal side of the thumb.5. Hold these strips in place by applying one locking strip around the wrist

and one encircling the tip of the thumb.6. Next add a series of three “spica” strips. The first spica is started on

the radial side at the base of the thumb and carried under the thumb, completely encircling it, and then crossing to the starting point. The strip should continue around the wrist and finish at the starting point. Each of the following spica strips should overlap the preceding strip by at least 2/3 inch and move downward on the thumb.

7. Place a final locking strip around the wrist.

H. Competently tape a wrist using the standard prophylactic taping method. a. Prophylactic Wrist Taping (Circular)

This tape job limits some range of motion and adds mild support to the wrist.  It works well for mild sprains or just when you need some extra support.

1. First apply pre-wrap below the wrist joint, around the wrist, and the heel of the hand.

2. Make sure that you keep the fingers spread and hand flat while applying the tape.

3. Place the first strip of tape just below the wrist joint, pulling the tape in a circle around the wrist, from the outside toward the inside of the arm. 

4. Apply 3 – 4 additional strips moving up the wrist toward the hand.  Each strip should overlap about half of the strip before it.

5. For additional support, continue back down the wrist in the same pattern.

b. Prophylactic Wrist Taping (Figure 8 – Through the hand)This tape job can provide slightly more support than the basic circular, and also provides more of a limit on the wrists range of motion.  It works well for mild sprains and provides extra support.

1. First, apply pre-wrap from just below the wrist joint, over the wrist, and continue around the back of the hand, across the palm, and between the thumb and pointer finger.

2. Keep the hand flat, and the fingers spread while applying the tape. 3. Place the first strip just below the wrist joint, pulling the tape in a circle

around the wrist, from the outside toward the inside of the arm.  4. The next strip should start on the first strip, and cross over the back of

the hand, then continue through the space between the thumb and finger, the across the palm.  It may help to fold the tape when it crosses the thumb web to make it more comfortable. 

5. Continue pulling the same strip of tape back across the back of the hand and back to the point of the wrist where the strip started. 

6. Repeat this pattern 3 or 4 times, making the next strip of tape overlaps half of the previous strip. 

7. The tape should allow the thumb and fingers to move freely, and only restrict movement of the wrist. 

Objective 3: Identify principles of protective bracing.

c. Discuss the differences between functional and prophylactic bracing. 1. The effectiveness of prophylactic (to prevent or avoid) braces is controversial.

a. To date, studies are divided, with some indicating a decrease in knee injuries and others reporting no difference or an increase in injuries.

2. The braces are used by players who are at a greatest risk of being injured due to:a. Position or sport being playedb. Previous injury

3. There are a number of different braces and manufactures on the market. a. Knee braces are designed to provide protection against lateral and medial,

but not rotary forces. 4. The braces vary depending on the manufacturer, but commonly consist of a

single-sided strut made of metal or heavy plastic, having a dual axis with a dual hinge.

5. Following serious joint injury that produces chronic instability or necessitates surgery, a functional, customized orthopedic brace may be prescribed for the athlete.

a. These functional braces are designed to prevent re-injury in athletes with prior injury.

b. The effectiveness of these braces has been better documented than that for prophylactic braces.

B. Identify the function of joint sleeves (compression). 1. Joint sleeve or compression sleeves provide mild soft-tissue support, and to

some extent, retain body heat and help to reduce edema caused by tissue compression.

2. Pads or guards may be added that protect the athlete from falls or a direct blow to a joint.

3. Joint sleeves may help to dissipate an anterior striking force but fails to protect the joint against lateral, medial, hyperextension or twisting forces.

4. Sleeves are generally composed of elastic or neoprene material.