Cath Lab Digest

Sever’s disease/heel taping. This tape job helps to reinforce the calcaneus fat pad and support the calcaneal apophysis. First, I apply a low dye strapping and then fill in the heel with anchor strips, which I apply behind and below the heel. Using a basket weave technique, one can apply strips alternately until the heel is covered, using firm pressure with each strip. Apply anchors to lock the tape job.
Modified ankle taping for ankle sprains. This consists of a series of stirrups and J straps to restrict inversion or eversion, depending on the injury. Advanced taping would incorporate a heel lock, which is technically much more difficult to master. Place pads with petroleum jelly over the front of the ankle and the heel where the Achilles tendon attaches to provide protection from irritation. One may need to shave the area or apply underwrap to the area. Hold the ankle at 90 degrees. Utilizing 1 and 1/2-inch tape works well for this technique.
The modified ankle taping uses an anchor around the lower leg, about a hand width above the malleoli, and an anchor around the midfoot. Then one should apply a series of three stirrups with tension medial to lateral (eversion). Apply a series of two to three J straps. These should run medially down the ankle, under the foot and finish up across the dorsal medial part of the foot, overlapping each J strap by one half. One would apply heel locks at this time. Proceed to apply circular strips to fill in any gaps, overlapping by one half.
Achilles tendon taping. With this method, it is best to use elasticon tape. This tape limits excessive dorsiflexion, which reduces the pull on the tendon. With the patient holding the foot in slight plantarflexion, apply an anchor just below the calf muscle where the leg tapers and apply an anchor at the midfoot. Use three strips of 3-inch elasticon, going from distal anchor to the proximal anchor in order to form a check rein. Then proceed to fill in the anchors, leaving the ankle area open.

How Does Taping Compare To Bracing?
There are several points to consider when weighing taping and bracing. Bracing may be cost effective for an entire season. Braces are easy to apply. Athletes can often apply braces themselves and braces can be easier on the skin. In addition, braces maintain support whereas taping can lose a significant part of its stabilization value after 10 to 15 minutes.

Dr. Dutra is a Fellow and President-Elect of the American Academy of Podiatric Sports Medicine. He is a team podiatrist for the University of California at Berkeley and covers all of its sports. Dr. Dutra is a former athletic trainer for California State University East Bay.

Dr. Caselli (pictured) is a staff podiatrist at the VA Hudson Valley Health Care System in Montrose, N.Y. He is also an Adjunct Professor at the New York College of Podiatric Medicine and a Fellow of the American College of Sports Medicine.