Thursday, October 3, 2019

Braces, straps and tape: what do they do and do they really help?


The US Open was a prime example of the popularity of taping and straps used by athletes. Many of these elite tennis players displayed support to a vulnerable area:  Serena had her ankles taped, Andrescuu  wore  a thigh and wrist strap plus a spiral cord on her forearm, Nadal taped his fingers, Medvedev had athletic tape on his right arm and left leg. Supports, straps and tapes are fascinating to me;  I like to imagine what injury lies below.  I could not figure out the spiral cord on Andrescuu’s forearm and searched the web for its medical indication;  during the finals I giggled when I learned from the commentators it was an extra hair tie she “just liked the feel of.” 

In truth, many of these voguish looking applications are worn simply because they feel good, easing the ache of joints and muscles. A sore area can feel supported with tape or straps, allowing the athlete better performance.   After repeated wear during successful play, they may become part of the outfit due to psychological dependence.   The placebo effect is huge.

Nevertheless, if they are holding the pros together, they must be worthwhile, right?  I often apply them as treatment in my practice with time limits for use. It is a proactive move towards healing that can give instant relief.  Braces are indicated for instability, such as a sprained ankle or wrist.  Taping is great as a posture and positional reminder.  ACE wraps can hold therapeutic patches on or also serve as more flexible, comfortable support and motion limiters.  Straps are mostly worn during activity serving to dampen the vibration and motion occurring in a tendon.

Braces prevent excessive motion, as ankle, wrist and some knee braces do.  They not only provide rest but also limit irritating activity by stopping the offending motion.  Some braces also lessen the irritating vibration caused by repetitive motion such as a patellar tendon, ITB or elbow strap.   Braces can be very effective as long as they are properly fit and appropriate for the problem they are treating.  If worn all day for over 5 days, they can lead to muscle weakness. If they are recommended to be worn 24/7, a weaning protocol of 4 hours on, 4 hours off, with increasing time off over several     weeks will prevent a flare up due to straining a weakened area. 

Taping is trendy.  Overhead athletes sometimes wear shoulder tape;  the idea is to guide and support the rotator cuff muscles in a direction of normal function.  Taping can also provide mild support depending on how many layers are applied.  Kinesiotherapy tape is most commonly used, made by different companies and providing different amounts of stretch and support.  When tape is used over a muscle area, the idea is to re-enforce the muscle motion pattern and guide a joint into better position and direction.  Athletic tape (usually white) is thicker and less stretchy;  this is used to wrap a joint in layers to restrict motion and provide support. This is commonly used by athletic trainers on the field.  Taping also protects from abrasion. 




With the wide variety of braces, taping methods, and straps available, you will likely need professional help to choose the best treatment for you.  Over the counter products can work, but if you do not get immediate relief, they are not effective.  If you can’t choose, applying an ACE wrap, snugly but not too tight can provide relief.  ACE wraps are comfortable, can be tightened or loosened, and can provide moving support.  I often recommend them to be worn at night with a pain relieving, anti-inflammatory cream such as aspercreme underneath. 

Many of the tapes and braces simply make you feel better by giving the joint a hug and making it feel supported and less vulnerable. The nerve endings in our skin and joints respond to  touch and pressure both positively and negatively.  It it feels good, use it.  If it makes the pain worse, forget it.   If it is doctor recommended but does not feel comfortable, ask for a different kind.  As always, listen to your body signals.  Don’t spend too much money on these products.  And don’t use them as a crutch to push through pain.  If you are having pain for more than a few days that bothers you all day and especially at night, see a doctor.