After a long day in the clinic I’m covering a rugby match and slowly getting through the long pre match injury list. Ankles sprains, knee laxity, thumb and wrist sprains, ‘dead legs’ from the previous weeks battle. The list goes on.
Me: “Ok who’s next lads?”
Player X: “I need my ankle, shoulder, knee and wrist strapped please?”
Me (concerned): “Really? OK. So what happened? When did you injure all this?”
Player X: “Oh I’m not injured. It’s just to make sure I don’t get an injury”
Me: (Sigh – as I look at my once full medical bag of tape dwindle to a measly couple of remaining rolls).
There is a culture of taping in sports, none more so than rugby where as the impact at collisions increases so too does the risk and severity of injury. But is taping an anatomical structure a means of preventing injury? Actually maybe it is. Ankle taping is the most common. I remember as a child watching in awe as a medic came on at Centre Court, Wimbledon with a limited time frame to assess and strap up a players ankle. Nine years later working with team sport I now see that she actually could have done this in half the time with her eyes closed (still impressive).
The sportspeople we watch can have a massive influence on how we prepare for our sport. The coaching methodology incorporated by a successful team management will be adopted by every other team the following season. If this means double daily training sessions every team the following season will be doing it. If the national champions made line dancing part of their weekly routine no doubt others would replicate it too. The point is there may be no sound evidence for doing it but due its association with success it will be copied. The same can be seen with how we manage injuries (skeptical hats at the ready!). Ice baths, cryotherapy, recovery pants, Kinesio tape, copper bracelets, special footwear… often there is little evidence to support their use but because a high profile sport star endorses a product (usually paid to be seen wearing or using it) the rest of us get drawn in by it as the must have to facilitate return to full fitness. The different variety of tapes available is as diverse as the sports people that make use of them; different colours, different patterns, tapes to facilitate movement, tapes to limit movement, tape to stop socks falling down and keep their sleeves rolled up (you soon see how a full medical back gets cleaned out), rigid tape, stretchy tape etc etc. But just what is the aim of taping? Is there an over reliance and dependence on it? Is it necessary? Or in some cases is it nothing more than a fashion statement?
So what does taping actually do? Taping aims to protect or prevent injury to a joint. It can help to facilitate contraction in weak structures or inhibit overactive tight structures. Other uses can be to unload tissues that may be causing pain thereby improving function especially around the shoulder and shoulder blade. Studies have shown decreased incidence of ankle sprains with taping (Garrick & Requa 1973, Moiler et al 2006) and improvement in shoulder range of movement through joint positioning and muscle deactivation, although there’s plenty of conflicting evidence on this (Selkowitz et al 2007, Smith et al 2009). Despite some of the restriction that the tape creates reducing with the commencement of exercise due to movement and perspiration some restriction will remain to avoid excessive motion. But does this loss of movement come at a price? There have been reports of a reduction in functional performance which may make taping the ankle for example not suitable for every sport especially those requiring large ranges of motion like ballet or gymnastics (Ozer et al 2009).
But surely taping up a joint will mean an increased reliance on that tape? Having something do the work instead of the connective and soft tissue would make them lazy right? For recurring or chronic ankle instability no significant benefit was found for increasing balance, i.e. while the tape is on it will restrict ankle motion, provide stability and may prevent further injury but there is no carry over once the tape is removed (Gross et al 1997). However with more acute sprains it may actually help with improving balance by giving feedback to joint position as to how the ankle should be responding.
My take on taping for sport is straight forward. I’m not a huge fan due to the over reliance that is often seen like the example of the rugby player above. But of course if it is the one thing that will get a player through a game for those first weeks back following injury consider it done. Ideally a comprehensive rehabilitation programme should be carried out as well as appropriate injury prevention warm up strategies and maintenance work. A 6 week programme working on landing mechanics has long term benefits for prevention of injury that last way beyond the 6 weeks (Di Stefano et al 2016). These are the more important long term solutions for reducing the likelihood of future injury.
Ok. That’s a wrap! (Sorry). I’m off to place another bulk order of tape from my supplier to hopefully cover the rest of the season and try to convince some weaning off tape.
For more information on any of the issues addressed throughout this article please contact Rob via email at firstname.lastname@example.org, Twitter @mccabephysio, Facebook at McCabe Physiotherapy or visit http://www.mccabephysiotherapy.com
Rob McCabe MISCP
MSc (pre reg) Physiotherapy, BSc Sport Science and Health, MSc Sports Physiotherapy, PG Dip Orthopaedic Medicine
Orchard House, Moorefield Rd, Newbridge, Co. Kildare