Ankle Strapping - Taping Ankle with Injured Ligaments - Dr Gill

[Music] hello and welcome to another clinical skills session today I'm sat down by a foot no in in seriousness um today we're going to be looking at how to strap uh an ankle after it's been injured perhaps with an inversion injury um so affecting the lateral aspect of the ankle and affecting the ligaments there so a lot of the time you'll see people um strapping various body parts with physio or KT tape and you know there's a lot of reason that these are useful things when regard to having an athlete you know dealing with a chronic injury however we should not be using this when it comes to strapping an ankle that has had a significant injury and we're concerned about strain stress or maybe even rupture of the ligaments instead we're going to use this white zinc oxide tape now this is particularly important because unlike the KT Tape zinc oxide tape is very rigid there's no stretch to it so where we place the foot Bound by this is where the foot will stay that is important because with damage to the ligaments we want to trying to reduce excess movement which we will achieve with zinc oxide tape but wouldn't with KT Tape also as a minor thing KT Tape needs scissors to cut whereas with this you can often just rip um with your own Fingers um because we can go across horizontally but not longitudinally so in terms of strapping up an ankle what we need to do is have the Cal supported so that the ankle is free uh in space so that you can work for it ideally have the patient on a bed and yourself seated in the chair before we start obviously we're going to want to gel our hands as ever and then we are going to confirm where we've got an issue with the ankle so is there pain here slightly okay so we on this ankle we're suspecting issue with the atfl the anterior taor fibula ligament so we're going to start off by actually creating a loop at the top of the ankle just before the calf this is going to be our locking strap so in terms of strapping the ankle we're going to start off with just a small um loop around the leg so if you can lift up the leg for me and we're going to make sure this comes around the ankle but hasn't gone all the way around so we've still got a gap now that nearly going all the way around is very important we want to keep this space the reason being is if the ankle has been damaged it will swell most likely at night and if we've put a constrictive band all the way around the ankle when the tissue swells that's going to cause an awful lot of pain so this will allow us to Anchor our other straps to it but we want to make sure it hasn't gone completely circumferential around the leg we're going to start off by uh putting a srup on when we're doing this we need to try and keep the patient's foot dorsiflex as best we can sometimes the patient can help with that and we're going to start off just by putting stirrups into the ankle so we're going to begin where we've um put the lock off tape and that's going to help us we're going all the way down pressing in around over the lateral malleolus up and then across the medial malleolus and we're again we're going to tear tear off we need to make sure that's nicely stuck down everywhere now it's very important that we have the ankle dorsiflexed as we're doing this because we're going to try and keep the foot in this position which the zinc oxide take what let us do you could argue we're trying to lock the ankle in position and we're probably going to put another of these on as well coming a little bit further forward this time and coming a little bit further back so we're covering much further around the base of the heel around and then coming up along at the back and again tearing off nice and simply okay and we're going to make sure this is nicely pressed down okay so at this point we can see how we're getting a little bit of reduction in movement because we're holding the foot dorsy flexed and this will cause the zinc oxide tape to attempt to stretch so some people will apply two um some people will do three of these and if need be the um and the patient is able to without pain they can keep try and help keep their foot inor so I'm going to put three on again coming back round the ankle and dorsy fling up to the front and we want to make sure that everything is nice and stuck down before we move forwards okay the next bit that we're going to do is our figure of sixes so we're starting off on uh the medial side of the leg again beginning from our locked off position coming down over the lateral malola around the base of the heel and back to where we started and we can do one going the opposite direction as well so coming across all the way down across the medium Alis this time and then back up to where we've got that cross yes we have obviously crossed over the tape here but that shouldn't cause quite the same problem because we're further down the leg now some people will stop at this point with just the U the figure of in place which might be reasonable if we're dealing with a mild sprain but I think it's better to go the the whole hog and put on an additional um area where we're going to put a heel lock in place so again we're going to start off on the medial side going a little bit higher round to the side to the back end of the lateral malleolus and we're going to come around over the base of the heel and we're coming back around across and all the way up again so once more we've attached back to the um our starting point and I'm going to do another one of those again coming across but a wee bit lower so all the way down around around the back of the ankle so dorsy flexing up as we do so up and in now once we've done that we've got quite a lot of tissue at the um sides so again we're going to want to try and lock that off so if you could lift up the foot for me all the way up and we're going to lock where we did last time Bring It round and making sure that we're not going circumferential all the way through through so with this nicely strapped in we can see there is some movement of the for but I'm not getting um that much we can say that we've stabilized the ankle but we're going to see much reduction of movement in terms of that uh lateral uh and medial movement there so we're protecting over this area now as you go throughout the day moving your foot forwards and backwards this zinc oxide tape is going to begin to give slightly so you need to have enough with you to make sure you can replace this every 24 hours in order to give maximal protection to the ankle and we're just going to show you now with the KT Tape which we've applied earlier on how much movement you get there compared to what we've got here so to highlight the point we made at the very start here is the ankle which uh We've dressed up with KT or physio tape just for um you know a bit of prep before for the session and as you can see there is just a huge amount of movement here this is not going to provide support to an injured ankle ligament so don't use physio tape when it comes to strapping a suspected um ligamentous damage on an ankle make sure you use the zinc oxide tape and with that the zinc oxide tape as you're pushing and ping during the day you know moving using your foot as it were then that will begin to give over time so make sure you replace the zinc oxide tape every 24 hours so that you're not putting that ankle at risk of undue movement keeping in mind that it's the movement with these ligaments damaged that can actually re uh lead to um fractures of uh the uh the bones underneath when we get that excess movement with the bones pushing into one another so that completes our overview of how to uh provide strapping to a sprained ankle if you found this useful please uh give the video a like and maybe put put down on the comment what other areas of acute medicine you'd like us to look at take care and we'll see you in the next one cheer