Purpose

• Provide support for the thumb to prevent excessive and/or painful hyperextension or abduction movements following a ligamentous sprain (MCL or medial/ulnar collateral; LCL or lateral/radial collateral).
• Reduce pain and stress on musculoskeletal structures during recovery and improve stability and function upon return to play.

Pre-Tape Testing

• Determine MOI (traumatic injury versus repetitive overuse strain versus pathological biomechanics/malalignments versus muscular imbalances versus poor footwear).
• Ask if they have been taped before and if there were any issues encountered.
• Rule-out allergies to sprays and/or taping products.
• Inspect the skin for any signs of soft tissue injury (i.e., cuts, abrasions, blisters).
• Check motor, sensation, and circulation (MSC) before execution of the support technique.

Components and Execution Procedures

• Individual Positioning:  Seated with their elbow on a bolster and their forearm outstretched. Their hand should be in a “Hold a Cup” or “C” position (thumb is slightly extended and abducted). This positions the thumb in slight opposition and protects the ulnar collateral ligament.
• Preparation:  Apply a light misting of quick-drying adherent or skin toughner to the thumb, palm and wrist.  No pro-wrap is needed for this support technique, as it is more effective to be taped directly onto the skin.
  • NOTE:  Some individuals like pro-wrap, so if you are applying it, ensure you wrap it from the distal forearm, around the wrist and into the hand.  While applying make sure that their thumb is pushed through the pro-wrap.
• Anchors:  Apply one anchor around the proximal phalanx of the thumb using a 0.5-inch (1.25 cm) strip of athletic tape. Next, apply one anchor around the wrist using a full strip of athletic tape. Follow this anchor by applying a 0.5-inch (1.25 cm) strip of athletic tape from the back of the wrist anchor, through the thumb webspace (fold or crimp the tape as you pass this area to reduce the chances of impairing circulation), across the palm, around the wrist and ending on the wrist anchor. Ensure that the individual maintains the “C” position of the hand while applying these anchors to ensure that circulation does not become compromised.
• Support Strips (Spica or Pigtail):  Using a split roll of athletic tape, apply a strip from the medial aspect of the thumb anchor to the wrist anchor. Repeat another anchor from the lateral aspect of the thumb anchor to wrist anchor. This creates an “X” over the metacarpal-phalangeal (MCP) joint. Repeat the “X” strips three times, overlapping slightly each time.
  • NOTE: Ensure that you do not pull the thumb into excessive extension or abduction while applying these “X” strips.
• Support Strips (Hoods):  Next, apply three or four “hoods” from the posterior aspect of the wrist anchor to the palm, using full strips of the athletic tape. Start proximally and move distally towards the thumb, overlapping the strips slightly.
• Closing Strips:  Finish the support technique by re-applying the thumb and final spica loop anchors.  This will secure all tape ends.+

Post-Tape Testing

• Check motor control, sensation, and circulation (MSC) after application.
• Manually assess the thumb to test the integrity of the support technique. In other words, has the support technique limited the movement(s) that are painful?
• Functionally assess the thumb to test the integrity of support technique. This testing should be specific to the individual’s sport or activity and specific to their position in that same sport or activity.