Chapter 1: Tapes, Wraps, Braces, and Pads

INTRODUCTION

Taping, wrapping, bracing, and padding techniques have been used for many years by health care professionals in the prevention, treatment, and rehabilitation of injuries. Athletic trainers, the health care professionals who typically apply the techniques, are skilled in technique application as a result of instruction and practice. For example, in a day, a typical athletic trainer (AT) may tape 20 ankles, wrap two hand contusions, apply three knee braces, and construct two protective pads. With appropriate didactic instruction in anatomy, biomechanics, injury evaluation, treatment, and rehabilitation, students can become proficient in the application of these techniques. In fact, practice may be the only hurdle to becoming proficient.

The application of taping, wrapping, bracing, and padding techniques should be implemented within the paradigm of evidence-based medicine (EBM). Evidence-based medicine is the integration of the best available research evidence with individual clinical expertise and patient goals, values, and preferences to make clinical decisions.¹ The evidence comes from patient-centered, clinically relevant research² on taping, wrapping, bracing, and padding interventions published in the scientific literature. Evidence is evaluated to determine its quality and value to day-to-day clinical practice. The evidence can support or refute previously accepted techniques or reveal new techniques that produce improved patient outcomes. Clinical expertise within EBM is the knowledge and proficiency in anatomy, biomechanics, injury evaluation, treatment, and rehabilitation, and taping, wrapping, bracing, and padding techniques. Clinical judgment is developed from clinical training, experience, and practice. Patient goals, values, and preferences are different among patients based on sport, occupation, lifestyle, and activity level. These must be identified and implemented into the practice of EBM.

The implementation of EBM into practice, or evidence-based practice (EBP), achieves several goals. EBP improves patient care, promotes critical thinking among clinicians, and advances the profession of athletic training.² EBP is a process of five progressive steps: (1) developing clinically relevant questions, (2) searching for the best evidence, (3) evaluating and appraising the evidence, (4) implementing the evidence into clinical practice with patients, and (5) evaluating the effects of interventions on patient outcomes.^1–3 Many of these steps require research training, knowledge, and skills; large amounts of time; and financial and personnel resources to successfully complete. For a more detailed discussion of EBM and EBP, see the Further Reading section at the end of this chapter.

Clinical decision making and the prevention, treatment, and rehabilitation of injuries and conditions should be based on the available evidence, clinical ...