Strapping is a cross bandage technique commonly used in physiotherapy and sports medicine to maintain and consolidate weakened joints or muscles while maintaining their function.

Strapping is a restraint system made by interweaving bands to prevent an injured joint, muscle or tendon from reproducing the movement that damaged it. Strapping has a dual function: an analgesic function because it prevents painful movement, and a curative function because it allows the wound to heal.

Strapping bands

Several types of bands are used for strapping:

• the bases: they do not have a restraining function but serve as an anchoring point for the active bands;
• Active splints: these are the compression bands themselves, which allow the joint to be blocked in the desired position;
• Foam fabrics: they provide a certain level of comfort by protecting the skin from any irritation caused by the friction of the active bands.

Strapping is practiced both in the therapeutic field to treat a sprain, tendonitis, dislocation, muscle damage and even a fracture, as in the field of sport, where joint or muscle injuries are commonplace.

Strapping allows business continuity while “securing” the affected limb.

However, it will only be truly effective if it is doubled with rehab sessions.

Public concerned or at risk

Before carrying out strapping, it should be ensured that this type of treatment is adequate by first carrying out a reliable diagnosis and additional examinations if necessary.

Achieving good strapping is not an amateur job and requires skill and a certain habit. A well done strapping should effectively support the injured area without compressing it. It should relieve pain, promote healing and reduce edemas. Badly done strapping does not hold anything or maintains poorly, and therefore is useless, or worse, it aggravates the injury.

The steps of a strapping

Almost any joint can be strapped: wrist, thumb, elbow, shoulder, ankle, knee, foot, ribs, etc.

The doctor or physiotherapist must first decide which movement (s) he wants to block or limit, and which movements he wants to keep. Then he chooses the bands he will use: elastic or not, sticky or not, and prepares them by cutting them to the right length.

Ankle strapping

1. Protect the ankle with the foam tape.
2. Apply a base plate in the middle of the foot and a second at the base of the calf.
3. With a 6 cm wide self-adhesive elastic band, start to surround the foot: make a complete turn starting from the base.
4. Then place the ankle at 90 ° in slight eversion (ankle turned inward).
5. Stretch the elastic band (outer side of the foot) to accentuate the eversion of the ankle.
6. Go around the base of the calf.
7. Stretch the elastic band and repeat a turn under the foot.
8. Repeat points 5, 6 and 7, crossing the strip on each pass.
9. Then pass the strapping strip through the back of the heel several times crossing it.
10. Finish around the calf, cut the band.

Wrist strapping

1. Cut two self-adhesive elastic bands 6 cm wide by 20 cm long, and two self-adhesive elastic bands 3 cm wide by 40 cm long.
2. Place the first 6 cm wide base around the wrist, a few inches from the base of the hand.
3. The first 3 cm wide strip rests on the base, hooks the thumb and comes back to fix itself around the base.
4. The second 3 cm strip is also applied around the thumb joint as opposed to the first. It is important not to tighten the bands around the thumb, and to check that there are no creases.
5. The last 6 cm band is placed around the wrist, slightly higher than the first, in contact with the base of the hand.

Knee strapping

1. Prepare several self-adhesive strips 6 cm wide: 2 anchoring bands at mid-thigh, 2 anchoring bands at mid-calf, and 6 bands approximately 30 cm long.
2. Place the knee at 5 ° of flexion.
3. Place the first anchor bands around the calf and thigh.
4. Apply the first cross band: fix it on the inside of the thigh, hold it firmly, stretch it by passing it under the kneecap, tie it on the outside of the calf around the calf.
5. Apply the symmetrical strip crossing it with the first one.
6. Apply the first lateral band: fix it on the outer side of the thigh, hold it firmly, stretch it and fix it on the outer side of the calf.
7. Apply the second side strip on the inside.
8. Replace two crossed strips parallel to the first, slightly offset and always tight.
9. Replace two anchor strips on top of the first ones.

Precautions to take

• The strapping bands must be sufficiently tight to ensure effective support, and sufficiently flexible to avoid compression and the tourniquet effect. The art of strapping lies in the right mix of tension. If we notice that the strapping blocks the venous circulation, there is no other solution than to do it again;
• On the other hand, too loose strapping can give a false sense of security and risk compromising healing;
• Care must be taken that there are no folds in the bands, they are very uncomfortable;
• Adhesive tapes, or even sometimes cohesive tapes, can be irritating or allergic. The prior application of certain products can help to limit these problems;
• Finally, so that tearing off an adhesive strip does not resemble forced hair removal, it is best to shave first.

The strapping bands are made of more or less elastic fabric. A good quality tape should allow the same tension to be maintained over its entire length. They come in the form of a roll. There are different materials for different purposes.

The different band models

• Stretch cotton crepe bands, or Velpeau bands, allow flexible support of a limb following a sprain, muscle tear or dislocation;
• The stretch bands in cotton and polyamide, or Nylex bands, provide light support for the joints and are particularly well suited to round shapes (knee, elbow);
• Cotton elastic adhesive bands are ideal for strapping. They have a much greater power of retention than the two previous models and provide good joint support. It is these types of bands that were used in the examples that we have developed above. These self-adhesive strips can also be used to attach splints;
• Synthetic cohesive tapes stick, and re-stick, on themselves. However, despite their elasticity, they are not very compressive.