Urdaneta City University

Graduate School
Urdaneta

Title:
UNDERSTANDING BASIC TAPING,WRAPPING AND BRACING FOR
INURIES:INJURY/ILLNESS PREVENTION AND WELLNESS

Introduction:

All physical exercise can hurt and cause damage to different parts of the body.
Sports injury prevention is about trying to mitigate trauma to muscles, tendons,
ligaments, joints, bones, and nerves when active. Preventative or rehabilitative
measures include: applying safe exercise practices, using protective equipment,
wearing appropriate sports clothing and footwear, trying orthotics devices, awareness of
hygiene and nutrition, going on sports training courses, attending sports clinics, and
consulting physiotherapists about physical techniques. These measures help budding
sports men and women discover unique fitness plans to develop overall wellbeing.
Knee injuries represent the most common problem facing the sports medicine
community. As sports participation continues to increase, so does the likelihood of
sustaining a debilitating knee impairment. Thus, prevention, treatment, and
rehabilitation of these injuries are important to both the athlete and the treating
physician. Surgery is often a viable option; however, most of these injuries are treated
conservatively with rest, therapy, and bracing .

Both taping and bracing are just a part of life for every athlete. No matter what the injury
is, even after ample time off to rest and heal, it needs a little support to allow athletes to
return to their previous level of competition. While both taping and bracing can greatly
reduce risk of re-injury, the question is which one is best. Although an athlete may need
both and eventually they can use one or the other depending on the injury, certain
wounds will flourish from either a brace or tape depending on the situation

Body of the Reports

TOPIC :BASIC TAPING

Taping is a very short-term solution to what could be a long-term problem. Athletic tape

is a quick fix, but it is best used to reinforce a joint that has previously recovered from
an injury.

Taping for sports protection

When a player injures a joint, such as an ankle sprain in athletics or elbow injury in
tennis, the injured joint should be taped to limit movement, stabilise the joint and protect
the trauma site from further damage. Joint soft tissue is particularly vulnerable to
damage after injury. By taping, such as with zinc oxide tape, the joint is reinforced and
kept in position. If joints are weak, players can tape joints prior to sport as a means of
support to reduce risk of injury.

Tapes used on joints are less elastic to restrict movement, but tapes used on the
muscles that stick directly to the skin, such as elastic adhesive bandages, aim to
provide controlled support to movement and expand with the muscle with flex and
contraction.

Compression tapes that do not stick to the skin directly are usually used after a sporting
injury to treat the trauma site, and are either wrapped around the wounded limb or joint.
In sports matches, such as rugby and tennis, first aid officers or paramedics, usually
have such bandages on hand. Some sports coaches in athletics and boxing also keep
such tapes available in the event of sports injury.

Taping techniques for Prevention of Common Injuries

Protecting the knee

To help provide support to knee ligaments, begin with placing a 3.8cm roll of tape under
the heel of the affected leg.

1. Attach anchors to the top and bottom with Elastoplast Sport Elastic Adhesive

Bandage 7.5cm. Add another two at the top and bottom with Elastoplast Sport
Rigid Strapping Tape 3.8cm for further strength. Apply two diagonal straps
using Elastoplast Sport Rigid Strapping Tape 3.8cm. Start from the outside of the
calf, passing the inside of the knee cap to the inside of the thigh. Then attach a
strap going in the opposite direction, from the inside of the calf passing the inside
of the knee cap to the outside of the thigh.

2. Repeat the taping several times to increase support.

3. Apply two vertical straps (shown in white) from the top to the bottom anchors on
the inside of the leg.
 4. Overwrap with Elastoplast Sport Elastic Adhesive Bandage 7.5cm using an

overlapping spiral with a figure-8 at the knee joint to completely cover the rigid
tape. (This will help provide extra protection). 

Protecting the ankle

This simple taping method offers maximum support in helping to prevent lateral
ligament sprains. 

1. Using, Elastoplast Sport Rigid Strapping Tape 3.8cm, attach anchors (A) first and

then 3 stirrup straps (B).

2. Apply two figure-6’s around the foot, starting from the inside to the outside,
returning to the inside after crossing the front of the foot (C).

3. Apply a half-heel lock to provide further support to the rear ankle area. Begin on
the inside of the lower leg (D) and move down and across the outside of the
ankle towards the front of the heel. Pass the tape under the foot and across the
inside of the heel at a 45o angle (E). Pass the tape back to the outside of the
ankle to finish on the inside of the lower leg where you started.

4. Overwrap the tape withElastoplast  5cm to provide mild compression and to

further secure the taped area. Using the figure-8 formation and a spiral,
completely cover the rigid tape.

TOPIC :BASIC BRACING

Athletic braces are a longer lasting fix for sports injuries, but like taping, they too have
their flaws. One of the most popular bracing choices is the elastic brace. While the
compression provided by these stretchy sleeves will help keep the joint warm, it fails to
provide support, making it little better than athletic tape.

A real brace will be made out of thicker material than the typical elastic bandage. The
best braces will have solid pieces of polymer to help immobilize the injured joint.
However, these immobilization braces do have their disadvantages.

Bracing for sports protection

Braces can be worn by athletes during sport activity to reinforce muscles and joints,
reducing the risk of injury. If a player has an existing injury, braces are worn as a means
to prevent further injury to the knee, ankle or back.

Lower back or spinal injuries are common in certain sports, such as gymnastics and
tennis where the body is rotated with joints and vertebrae under pressure as the body
shifts weight. Spinal braces stabilise the back vertebrae keeping them in position and
under less friction pressure, also improving posture.

Depending on the type of sport, which parts of the body are most under pressure, or
where an existing injury is located, braces may be designed to stabilize ligaments and
joints, such as hinged knee brace or the patella stabilizers brace. Dual action knee
straps of often used to treat runner's knee.

The use of braces in sports medicine has long been surrounded by debate. Does
the benefit of a brace justify the potential discomfort and cost? This question must be
evaluated in the context of brace use and the desired purpose. Different braces serve
different functions. The American Academy of Orthopaedic Surgeons (AAOS) has
defined three categories of knee braces.

1 Rehabilitative braces—postoperative braces designed to allow protected range of

motion

2 Functional braces—provide stability to the unstable knee and improve function

3 Prophylactic braces—prevent injury to a normal knee

In addition to the three proposed categories, unloader and patellofemoral braces

have become popular in contemporary orthopedics. Unloader (knee osteoarthritis)
braces are designed to improve the function in patients with unicompartmental arthritis
and supplement other conservative management. This chapter will evaluate the current
literature available for braces in each of these categories and clarify their purpose,
function, and usefulness.

Rehabilitative Braces

Rehabilitative braces are designed to provide two functions, to protect a

reconstructed/repaired ligament and allow early motion. However, the effectiveness of
attaining and the clinical need for both of these purposes has been called into question
by the contemporary literature. These braces can be off-the-shelf types with thigh and
calf enclosures, hinges, hinge-brace arms, and straps that encircle the brace
components (Fig. 54-1). The hinges can be unlocked to allow restricted range of motion
and the braces are typically long to improve the lever arm and stability. Custom braces
are available at an added cost. Rehabilitation braces are most prevalent in the context
of anterior cruciate ligament (ACL) reconstruction and postoperative protocols.
Figure 54-1 ACL rehabilitation braces. A, Breg T-Scope; postoperative ACL
brace. B, Donjoy TROM adjuster; postoperative brace. C, Össur Innovator DLX; dial for
the postoperative brace.

Post–Anterior Cruciate Ligament Reconstruction Bracing

There are two main reasons to brace after ACL reconstruction—to protect the repair
and avoid loss of extension. Various authors and surgeons have different opinions and
protocols regarding bracing; some are based on experience and some based on the
literature. This was clearly illustrated in a survey conducted by Marx and colleagues of
397 AAOS members with regard to ACL surgery. When surgeons were asked whether
they braced patients postoperatively for 6 weeks, 40% responded “no” and 60% “yes.”
Then, when asked if they recommended braces postoperatively for sports participation,
38% responded “no” and 62% “yes.” Despite the disparity in clinical opinion, there have
been many prospective randomized clinical trials that evaluated the effect of a
postoperative rehabilitation brace and a multitude of systematic reviews (Table 54-1).
Table 54-1 Summary of Literature: Bracing After Anterior Cruciate Ligament
Reconstruction
 Harilainen and associates completed a randomized controlled study with a braced
and an unbraced group. The braced group used a rehabilitation brace for 12 weeks
postoperatively with a gradual increase in weight bearing, whereas the unbraced group
was allowed immediate range of motion with the use of crutches for 2 weeks. The 1-, 2-
and 5-year follow-up examinations revealed no differences in Tegner activity level,
Lysholm knee score, laxity, or isokinetic thigh muscle strength.
Brandsson and coworkers12 also completed a prospective randomized clinical trial
on the usefulness of postoperative rehabilitation braces in 50 patients. ACL
reconstruction was completed with a bone-patellar tendon-bone (BPTB) autograft and
patients were randomized to undergo rehabilitation for 3 weeks with or without a brace.
Patients were followed for 2 years and, at the early follow-up visits rehabilitation with a
brace resulted in fewer problems with swelling, a lower prevalence of hemarthrosis and
wound drainage, and less pain throughout the early recovery period compared with
rehabilitation without a brace. The 2-year follow-up revealed no differences between
groups with regard to Tegner activity level, International Knee Documentation
Committee (IKDC) rating, one-legged hop and isokinetic strength, or KT-1000 knee
laxity.
Another randomized prospective clinical trial was completed by Moller and
colleagues. They randomized 62 patients to 6 weeks of rehabilitation with or without a
brace followed by a specific program for up to 6 months. In the early follow-up period,
the braced group had slightly higher Tegner scores. At the 2-year follow-up, there were
no differences in Lysholm, visual analogue scale (VAS) scores, range of motion,
isokinetic strength, or laxity. The authors concluded that a postoperative knee brace
provides no additional benefit. Risberg and associates, in a prospective randomized
study, compared an unbraced population with a braced population that included the use
of a postoperative rehabilitative knee brace for 2 weeks and then a functional brace for
an additional 10 weeks. There were no differences between the groups except at the 3-
month point. Despite greater thigh atrophy, the braced group showed an improved
Cincinnati knee score. Otherwise, KT-1000 laxity, Cincinnati knee score, goniometry-
measured range of motion testing, computed tomography (CT), thigh atrophy
measurement, Cybex testing, functional knee tests, and VAS scores all were equal at 6
weeks, 3 and 6 months, and 1 and 2 years. It should also be noted that 24% of subjects
in the brace group discontinued use prior to the 3-month time period.
 A complete analysis of bracing after ACL reconstruction was done by McDevitt and
coworkers. The authors prospectively randomized 95 patients over three institutions to
brace wear for 1 year post–ACL reconstruction or no brace. All patients had a BPTB
autograft and were held in extension for 3 weeks postoperatively and then followed up
at 2 years. No significant differences were found between the groups in knee stability,
functional testing with the single-leg hop test, IKDC scores, Lysholm scores, knee range
of motion, or isokinetic strength testing. Two braced subjects had reinjuries and three
nonbraced subjects had reinjuries.
The referenced studies are, for the most part, high-quality prospective randomized
clinical trials that showed no quantifiable long-term benefit to postoperative bracing
following ACL reconstruction with regard to activity level, subjective outcome, or knee
laxity. However, some surgeons believe that a brace in the immediate postoperative
period can provide the patient additional comfort. Hiemstra and colleagues looked at
patients braced for the first 2 days, with a follow-up of 14 days. They found that bracing
did not provide any additional pain relief in the acute period above and beyond that for
nonimmobilized patients.
Bracing has also been proposed as a way to reduce any potential flexion
contracture. Petsche and Hutchinson have identified loss of knee extension as the
biggest problem after ACL reconstruction. Potential causes include surgical technique,
graft placement, and postoperative contracture. Melegati and coworkers have evaluated
the effect of bracing BPTB ACL reconstructions in extension for the first week. In this
study, 36 subjects were allocated to an extension bracing group or a brace group with 0
to 90 degrees of motion for the first week. All patients were then allowed unrestricted
motion after the first week. They found that at the 4- and 8-week postoperative points,
there was a significant difference with regard to the two groups; the extension brace
group had extension closer to that of the normal knee.
Mikkelsen and coworkers have evaluated the concept that the 0-degree setting on
a brace does not represent true anatomic 0 degree and that this discrepancy affects the
postoperative knee extension in patients who have undergone ACL reconstruction. Five
subjects were placed in postoperative dressings and extension braces. Radiographs
were taken to determine alignment. With the brace set at 0 degree, no subject had an
anatomically straight leg (mean, +2.8 degrees) when compared with the −5-degree
(mean, −2.5 degrees) and −10-degree (mean, −4.1 degrees) settings. Then, in a
prospective study of ACL-reconstructed knees, they compared the differences between
a hyperextension brace (−5 degrees) and an extension brace (0 degree)
postoperatively. No significant differences were found between the groups in terms of
knee flexion, sagittal knee laxity, or postoperative pain. However, only 2 of 22 patients
in the hyperextension brace group had an extension loss more than 2 degrees, whereas
12 of 22 in the extension brace group had a loss more than 2 degrees.
In summary, knee bracing in the postoperative period continues to be used by
many practicing surgeons for a variety of reasons. However, the evidence that a brace
confers additional stability, improves range of motion, protects the graft, reduces pain,
or improves subjective outcomes is limited. Most prospective randomized clinical trials
have shown no difference between braced and unbraced subjects at long-term follow-
up. To the contrary, if the brace is used to maintain extension, there is a moderate
amount of literature that supports bracing in the acute postoperative period to prevent
flexion contractures.

Prophylactic Knee Braces

Many athletes at all levels of competition have experienced the agony and devastation
of significant knee injuries. Thus, prevention and prophylactic knee bracing have
received considerable attention over the last 50 years. This is perhaps most evident in
football, in which there is a high percentage of knee injuries; 20% of professional
football players never return from ACL reconstruction and those that do often do not
reach their preinjury level of play. Anderson and colleagues4 were the first to report a
prophylactic brace that was predominantly used to protect the MCL of professional
football players; however, they also speculated that the brace provided increased
anterior and posterior stability. They noted that there was no adverse impact on
performance for the braced athlete. No controlled studies were completed at that time,
yet bracing in professional and collegiate football experienced a rapid increase. In this
section, we will review studies regarding the benefits and drawbacks of prophylactic
bracing (Fig. 54-2; Table 54-2).

Figure 54-2 Prophylactic and functional knee braces. A, Breg X2K High Performance;

indicated for ACL, PCL, MCL, and lateral collateral ligament (LCL) instabilities. B, Össur
CTi Custom; custom-made brace; indicated for ACL, MCL, LCL, PCL, rotary, and
combined instabilities. C, DonJoy AirArmor; moderate to severe ACL, PCL, MCL, and
LCL instabilities. D, DonJoy Playmaker; neoprene with hinges, for mild to moderate
ligament instabilities.

Table 54-2 Summary of Literature: Prophylactic Knee Braces

The reports by Anderson and associates led to a significant increase in brace use
and studies to evaluate their efficacy in the early and mid-1980s. These early studies
failed to demonstrate an appreciable benefit to brace wear, and some documented
increased injuries and performance impairments, In 1985, the American Academy of
Orthopaedic Surgeons stated that “Efforts need to be made to eliminate the
unsubstantiated claims of currently available prophylactic braces and to curtail the
inevitable misuse, unnecessary costs, and medical legal problems.”The American
Orthopaedic Society of Sports Medicine and the Journal of Bone and Joint Surgery took
a similar position. The American Academy of Pediatrics went a step further and
recommended that prophylactic lateral knee bracing not be considered standard
equipment for football players because of lack of efficacy and the potential for causing
harm.
There are two basic types of prophylactic knee braces designed to prevent or
reduce the severity of knee injuries. One type includes lateral bars with a single axis,
dual axis, or polycentric hinges. The second type uses a plastic shell that encircles the
thigh and calf and has polycentric hinges. The effect on performance and degree of
protection provided must be evaluated on an individual basis. There have been a few
large studies regarding brace usefulness and functional effects.

TOPIC: ADVANTAGES AND DISADVANTAGES

Advantages and Disadvantages of BRACING

No Benefit to Prophylactic Bracing

Teitz and coworkers79 used the members of Division I in the National Collegiate
Athletic Association as its study population. They reviewed statistics from 71 colleges in
1984 and 61 colleges in 1985; 6307 players in 1984 and 5445 players in 1985 were
analyzed. The player’s position, incidence of injury, type, mechanism, and severity of
injury, playing surface, level of skill, and prior knee injury were considered contributing
factors. The results showed that in 1984 and 1985, players who wore braces had a
significantly higher injury rate than players who did not wear braces. Four different types
of prophylactic knee braces were worn, and no attempt was made to differentiate
between them with data analysis. The severity of injuries did not differ between the two
groups. Player position, playing surface, mechanism of injury, or type of brace did not
affect the rates of injury. Injuries were more common during contact and at every skill
level in players who used braces. The incidence of ACL injury was similar in both
groups, but braced players had more meniscal injuries. The severity of injury was
assessed by measuring playing time lost and the need for surgery. Surgical rates were
similar for both groups. Although the average playing time lost was less for players who
used braces, the increased incidence of injury produced an overall time lost that was
greater in players using braces. They concluded that prophylactic bracing would not
prevent injuries and might actually be harmful.
Hewson and colleagues31 also completed a study of braced and unbraced football
populations over an 8-year period (1977 to 1985). The nonbraced period was reviewed
from 1977 to 1981. Following this, the Anderson Knee Stabler (Omni Life Science,
Vista, Calif) was mandatory for all practices and games for players at greatest risk,
including linemen, linebackers, and tight ends. In the mandatory brace group, 28,191
exposures occurred and, in the nonbraced group, 29,293 exposures. Information was
analyzed by type of injury, severity of injury, player’s position, days lost from practice or
games, and rate of knee injury/season/100 players at risk. Results showed that the
number of knee injuries was similar for the braced and nonbraced groups and the type
and severity of injury were similar in all categories. Rovere and associates 66 also
performed a 2-year study that included all players on the Wake Forest football team
using the Anderson Knee Stabler prophylactically during practice and games. A 2-year
nonbrace group control period was evaluated and compared with a subsequent braced
group. The time and mechanism of injury, diagnosis, and treatment were noted. Brace
use did not significantly alter the relative frequency of injuries by player or position, and
it was noted that brace wearing was associated with cramping and added financial
expenditures.
Grace and coworkers26 evaluated 580 high school football players over a 2-year
period; 250 nonbraced athletes were matched according to size, weight, and position
with 247 athletes wearing single-hinged braces and 83 athletes wearing double-hinged
braces. The athletes who wore the prophylactic single-hinged braces had a significantly
higher knee injury rate (P < .001), and the athletes wearing double-hinged braces had a
greater number of injuries (no statistical significance). Foot and ankle injuries occurred
three times more frequently in the braced group (P < 0.01). Different playing surfaces
were used, and no documentation of prophylactic ankle taping was noted. The study
results not only questioned the efficacy of prophylactic knee braces, but also called
attention to the potential adverse effects on adjacent joints.

Potential Benefit to Prophylactic Bracing

The previous studies suggested no benefit and potential detrimental effects to
prophylactic bracing. However, there have also been well-designed studies that
purported a benefit for specific football positions. Initially, Garrick and
Requa25 completed a review of available studies and noted two studies that suggested
a benefit to bracing, those by Schriner 67 and Taft and Funderburk.76 However, these
studies were only presented at a conference and were never published. Furthermore,
there were significant methodologic concerns with the study designs. Garrick and
associates were unable to develop a conclusion with regard to brace use secondary to
the lack of well-designed clinical trials.
Then, in 1990, Sitler and colleagues 70 reported the results of a prospective, well-
controlled research study regarding the effectiveness of a single, upright biaxial brace in
a 2-year study of 1396 U.S. Military Academy cadets playing intramural tackle football
as their mandatory competitive sport. The military population afforded control of the
athletic shoe, athlete exposure, brace assignment and compliance, playing surface, and
knee injury history. The study was completed over 2 years and at the beginning of each
year the subject was assigned to a braced or unbraced group. The brace selected was
the DonJoy Protective Knee Guard (DonJoy Braces, Coconut Creek, Fla) a double-
hinged, single, upright, off-the-shelf brace applied to the leg with a brace-constrained,
no-slip strap and neoprene thigh and calf straps. Individuals with ACL deficiencies,
reconstructions, or repairs were excluded from the study. Knee injuries were defined as
those that were severe enough to cause a missed practice or game. Nonsurgical
evaluation was confirmed by at least two of the three orthopedic surgeons, and the
injury was classified accordingly. There were 71 injuries and the overall knee injury rate
was 2.46/1000 athlete exposures. The unbraced group had a significantly higher rate of
injury than the braced group (3.40/1000 versus 1.50/1000 athlete exposures,
respectively). There was also a trend noted toward decreased severity of injury in the
braced group. This was a well-designed study with significant control, and the authors
concluded that in this study population there is a benefit to prophylactic brace use.
Another well-done study was completed by the Big Ten Sports Medicine
Committee. They conducted a 3-year prospective, multi-institutional analysis of medial
collateral ligament (MCL) sprains in college football players. 2,3 In their study, 987
previously uninjured participants were classified according to their frequency of wearing
preventive knee braces. These subjects were then studied and the brace use patterns
from 100 injuries were analyzed. The investigators evaluated the following factors:
• Patterns of MCL sprains that occurred in unbraced knees

• Daily brace wear records of the study group

• Importance of the relationship between unbraced knee injury patterns and brace wear
tendencies in study group participants

Confirmation that a reportable MCL sprain had occurred was the combined
responsibility of the team athletic trainer and the team physician; this was based on
clinical determination and examination. The total number of injuries was recorded. With
regard to brace use, 50.7% of the 55,722 knee exposures were with braces. The pattern
of where, when, and how often an individual participant chose to wear braces most
closely paralleled those of his peers playing the same position and their string. The line
players tended to wear braces almost 75% of the time in both games and practices. The
linebackers and tight ends wore braces 50% of the time in practices and 40% during
games. Finally, players in the skill positions wore braces only 26% of the time in
practices and 10% during games. The effectiveness of preventive braces was examined
by comparing only those injury rates for players with and without braces who were in the
same position groups playing during the same sessions. For players in practice, all
position groups displayed lower injury rates with brace use. During games, the same
trend held true for the linemen and linebacker–tight end group but not for the skill
position players. Although none of these numbers were statistically significant, a
consistent trend in favor of the braces did emerge. For those in the two position groups
(linemen and linebackers–tight ends) who were at greatest risk of such injury, the injury
rates were lower for those players wearing braces. The protective tendency of the
braces to reduce risk of injury was greatest in the linebacker–tight end positions.
However, this group did not wear braces as often as expected because they were
allegedly torn between protecting their knees and keeping up with the speed of their
competition.

Performance Impairments With Bracing

There does appear to be a potential role for prophylactic brace use in specific situations
with specific athletes. However, this preventative benefit must be weighed against any
potential performance impairments that the brace could cause. These impairments may
be a direct effect of increased intramuscular pressures, muscle performance, knee joint
kinematics, and associated energy costs. The following studies must be reviewed in the
context of the time during which they were conducted. Many braces now in use have
improved on the initial concepts and shortcomings of the braces historically used and
reported in the studies reviewed here.
Styf and associates73 have studied the intramuscular pressures associated with
functional braces. The intramuscular pressures of eight healthy athletes were recorded
at rest and during and after exercise in the supine, sitting, and standing positions. There
were three braces used in this study, a catheter was connected to an electromagnetic
transducer, and intramuscular pressures were measured by an infusion technique.
Pressures at rest increased significantly, in all positions, in braced study participants.
Muscle relaxation pressure during exercise also increased significantly. Muscle
relaxation pressures decreased to prebracing levels after removal of the brace or the
distal straps. The results of this study suggested that external compression from a knee
brace on leg muscles may induce premature muscle fatigue by reducing perfusion of
the working muscle. More recently, Lundin and Styf 43 have demonstrated that there is a
direct correlation between thigh and tibial strap tensions and intramuscular values.
There is also an inverse relationship with local blood perfusion.
Houston and Goemans35 evaluated the performance of braced and unbraced
knees. Seven athletes with knee instability underwent four tests. Maximal torque output
was measured during knee extension. Isometric torque was measured at a knee angle
of 90 degrees at increasing velocities (30, 90, 180, and 300 degrees/second). Maximal
unloaded angular velocity was measured during leg extension. Vertical velocity and
power were determined using a short stair run. In addition, blood lactate concentration
was measured 1 minute after a 15-minute ride on a bicycle ergometer. Maximal torque
during isokinetic knee extension without braces was found to be significantly higher, and
the differences between braced and unbraced study participants increased as velocity
increased. Maximal unloaded knee extension velocity was 20% faster for unbraced
individuals during the stair run. In addition to reporting impaired performance for braced
study participants, an increased energy expenditure was observed; the blood lactate
level increased 41% for braced participants.
This finding of ncreased energy expenditure was also supported by Zetterlund and
associates84 who showed increased energy cost during treadmill running at a slow rate
in 10 players. They found that oxygen consumption and heart rate significantly increase
for braced athletes. However, energy consumption is not the only adverse effect
reported with bracing. In the context of proprioception, Osternig and Robertson 53 noted
significant changes in joint position sense and electromyographic activity in six healthy
volunteers when a brace was worn compared with when it was not worn.
Furthermore, Sforzo and colleagues68 showed that wearing a dual-hinged brace
did not affect the performance of 25 male football players but did inhibit 10 women’s
collegiate lacrosse team members. The testing protocol involved the use of a Cybex II
lower extremity isokinetic dynamometer to measure peak quadriceps torque, rise time,
and time to fatigue. A Monark cycle ergometer (HealthCare International, Langley,
Wash) fitted with a Lafayette impulse counter (Lafayette Instrument Company,
Lafayette, Ind) was then used to perform a 30-second maximal effort Wingate test of
anaerobic power. Serum lactate accumulation was determined as the difference
between postexercise and resting lactate levels. Although the overall performance score
was significantly different, the differences were not significant for any one of the
parameters.
On the other hand, Veldhuizen and associates 81 did not support the theory that
bracing weakens the knee. There was no significant difference between braced and
unbraced healthy study participants performing testing for isokinetic muscle strength, a
60-m dash, a vertical jump height test, and treadmill running. Knutzen and
coworkers37–39 have studied the knee joint kinematics of six braced individuals who
ran a 12- to 13-km/hour pace. Knee stability and function were studied during maximum
knee flexion in the swing phase, maximum knee flexion during the support phase,
maximum external tibial rotation, and maximum internal tibial rotation. It was concluded
in this and other reports that rotation and abduction-adduction decrease for braced
individuals but does not affect performance.78
Greene and colleagues27 have demonstrated the effects of bracing on speed and
agility, as well as the tendency of the brace to migrate, in 30 college football players.
Players in full gear ran a 40-yard dash and performed a four-cone agility drill either
wearing braces on both knees or wearing no brace, serving as matched controls. Brace
migration and subjective measures were recorded after each trial. In the 40-yard dash,
times did not significantly differ when using the AirArmor 1 (AirArmor Sports, Scottsdale,
Ariz) and OMNI (OMNI Life Science, East Taunton, Mass) braces compared with
nonbraced control times. Times with other braces were significantly slower, with the
Breg (Breg, Vista, Calif) having the slowest time, followed by DonJoy, McDavid
(McDavid USA,Woodridge, Ill) and AirArmor. The AirArmor 1 and McDavid braces
showed significantly less superior-inferior migration in the 40-yard dash than the other
braces. These findings indicate that specific braces have differential effects on the
athlete and that fit is an important factor if migration is prevented.

Implication:

With sweat and movement, the binding force of the tape will break down and the
support will be reduced. The support power of tape while enduring continued activity is
only, at maximum, about 30 minutes.

Also make sure to seek medical help if you are not able to clean the wound properly.
In case you have diabetes a proper wound care is of special importance. Always
discuss any concerns you may have with your doctor and/or podiatrist, even for the care
of minor wounds and skin cracks – especially on your feet.

Conclusion:

Depending on the severity of the injury and the area of the body that is injured, both
taping and bracing have their distinct advantages. In general, the smaller, bonier bits of
the body - like thumbs, fingers, toes, and wrists - are best supported by tape. These
small bits of the body are meant to be mobile, something that tape can provide.

Alternatively, areas that support the weight of the body, like knees and ankles, will
benefit from bracing. The braces give additional support to the joints that are already
subject to a lot of wear and tear from the body's own weight.

Both braces and tape are best used under the instruction of a trained professional.
Factors taken into consideration when deciding on padded sportswear, taping a limb or
wearing a joint brace, depends on the likelihood of physical trauma during exercise, the
contact level of the sport, if the injury is new or recurring, and the location and extent of
the wound. Padding, taping and bracing are some of the options available to athletes for
protecting their bodies from injury. Trained sports professionals can best advise on
pads, tapes and braces, or devices such as straps, splints, belts, guards, and slings that
can help players reduce sports injury.

Recommendation:

Always see your doctor if the wound is deep, bleeding or shows signs of infection like
reddening, swelling or warmth

Also make sure to seek medical help if you are not able to clean the wound properly.
In case you have diabetes a proper wound care is of special importance. Always
discuss any concerns you may have with your doctor and/or podiatrist, even for the care
of minor wounds and skin cracks – especially on your feet.

They are best to work best to support healing injuries, but by not exercising the joint at
the end stages of healing, the brace is not helping strengthen the injured area. It is, in
fact, making it weaker.

Reference:

https://blog.muellersportsmed.com/taping-vs-bracing-which-is-right-for-your-injury

https://www.elastoplast.com.au/strapping-and-injuries/strapping-taping-bandaging/taping-to-prevent-
injury

https://musculoskeletalkey.com/knee-bracing-for-athletic-injuries/