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.
• Support Strips (Checkrein):  Apply a 0.5-inch (1.25 cm) strip of athletic tape around the base of the proximal phalanx of the index finger and continue around the proximal phalanx of the thumb, returning to the proximal phalanx of the index finger. Repeat this step again. Ensure that you pinch the layers of the tape together in the web space between the thumb and index finger.  Next, apply a small strip of tape (a.k.a. locking strip) around the band of tape connecting the thumb and index finger.  Apply another 0.5-inch (1.25 cm) strip of athletic tape from the middle phalanx of the index finger to the middle finger in same location. This adds strength to the overall finger/thumb checkrein and aids in prevention of injuries happening to the index finger and associated joints.
• Support Strips (Buddy Finger):  For added strength and protection, connect the index finger to the middle finger using a strip of 0.5-inch athletic tape around the middle phalanx of each finger. Ensure that you put a piece of foam, lace pad or rolled up piece of pro-wrap between the index and middle finger (web space) prior to taping them together.

Post-Tape Testing

• Check motor control, sensation, and circulation (MSC) after application.
• Manually assess the hand and fingers 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 hand and fingers 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.