Purpose

• Keep the ankle in a stable, “closed-packed” position (90° or neutral position).
• Prevent excessive inversion or eversion movements of the foot at the subtalar joint, thus facilitating function and improve performance.
• Protect against re-injury upon return to play or during activity.

Pre-Tape Testing

• Determine MOI (inversion versus eversion).
• Ask if they have been taped before and it 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:  In a seated position with their foot off the end of the treatment table, ankle held in a 90° dorsiflexion. Maintain this position throughout.
• Preparation:  Apply a light mist of skin toughener or quick-drying adherent.  Apply heel and lace pads over the distal Achilles tendon and in front of the ankle joint. Apply pro-wrap to the distal aspect of lower leg, ankle, and foot. Ensure it does not extend beyond the base of the fifth metatarsal and is at least 3 to 4 inches (7.5 to 10 cm) below the base of the calf muscles.
• Anchors:  Apply 2-3 anchor strips around the leg, just below the calf muscle belly.  Apply 1-2 anchors around the midfoot. Ensure that you splay their toes to prevent circulatory restriction. Do not extend further than the lower aspect of the fifth metatarsal.
• Stirrups:  Apply three stirrups to prevent inversion/eversion of the ankle (depending on the direction the stirrups are applied).
  
  • Inversion ankle sprain: Stirrup starts at the proximal (upper) leg anchors medially, goes over the medial malleolus, under the heel and is then pulled up the lateral side of the ankle to the proximal anchor on the outside of the leg. This pulls the ankle into an everted position.
  • Eversion ankle sprain: Measure out a stirrup so that it will be the correct length from one proximal leg anchor to the other proximal leg anchor. Place the stirrup on the heel and then pull up with equal force, to place the stirrups on either side of the leg anchors. This keeps the ankle in a neutral position.

• Calcaneal Strips (aka C-Strips):  Apply five to seven calcaneal stirrups. Start from either the medial or lateral distal foot anchor on one side, go behind the heel to the other distal foot anchor. Overlap by half the width of the tape, moving upwards.  These strips help to prevent anterior shearing of the talus by squeezing the tibia and fibula together on the talar dome thereby maintaining a stable “closed packed” position.
• Figure-8:  Apply two figure eights. Start on the leg or top of the foot. If you start on the leg, loop around the distal leg, cross over the front of the ankle and loop around the foot. This forms an “8”. If you start on the foot, loop around the foot, cross over the front of the ankle and finish by looping around the distal leg, just above the ankle joint.  These help to control forefoot movement and keep the ankle in a “closed packed” position.

• Heel Locks:  Apply two heel locks. Start on the leg or the foot. If you start on the medial leg, you will apply the tape just above the front of the ankle, cross over the medial malleoli, go behind the heel, angle the tape downward and cover the side of the heel, go under the heel, and go back to the front of the ankle. Repeat on the lateral leg.  These locks control rearfoot movement and keeps the ankle in a stable “closed packed” position.

• Closing Strips:  Finish and close the tape job by applying “anchor-type strips” from the foot up the leg to cover any remaining windows and secure all tape ends. These strips help to ensure a smooth, winkle-free finish.

Post-Tape Testing

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