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Taping

11,889 bytes added, 16:13, 6 October 2013
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[[File:Fixing Blisters Small.jpg|right|thumb|500px|I worked the aid station at Umstead 100, fixing runners' feet.]]
Taping may be required to [[Blister Prevention|prevent blisters]] or if they occur anyway, to help treat them. Different tapes have different properties, and it's best to gain experience with different tapes before using them in a race. Even putting a piece of tape on the edge of your hand will give you an idea of how well it stick and how flexible it is.
{{DISPLAYTITLE:Taping your feet to prevent or treat blisters}}
* You can tape a blister with or without popping it. Popping a blister is a bad idea, but sometimes it's necessary if the blister will spread.
* Taping should be a last resort; try to fix the underlying problem first.
=How taping helps=
Taping can help in several different ways:
# Taping can act as another layer, so that your socks move against the tape, not against your skin. This can reduce the friction on your skin, but the sheering forces remain. A tape with a smooth texture is best for this.
# Taping can spread the sheering forces, so that instead of being concentrated in one spot, like the ball of your foot, it is spread over a wider area. You need an inflexible tape for this, and sometimes a little tension when applying the tape.
# A variation of #2 above is to use the tape to stabilize a punctured or open blister. Even slight movement of the detached skin over the underlying flesh can be painful, and a layer of tape and help prevent this.
# It is possible to change the shape of your foot slightly by applying the tape with some tension. I normally only do this when taping blistered toes. This requires an inflexible tape and just the right amount of tension; too much will cause more problems.
# Tape can be used to prevent dirt entering a punctured or open blister, which may limit infection. Use a little antiseptic ointment on the opening and cover with tape.
# While taping can provide some padding, the tape is normally too thin to have much benefit. Building up multiple layers does not provide much more padding, and can increase pressure locally.
=Tapes=
I've used various tapes on myself and other runners, as well as conducting some specific comparison tests. I've applied multiple tapes on dry skin, wet skin and wet skin with adhesive promoter and left them in place until they fall off to see how they hold up. The wet skin tests had semi-macerated skin, where I'd kept the skin wet for several hours to mimic race conditions. * '''Micropore<ref> Leukotape P'''. This is the only tape I've found that sticks to skin that is already wet without an adhesive promoter. If you only have one tape, this should probably be it. [http://www.amazon.com/BSN-Medical-Leukotape-Sports-Tape/dp/B000H94TAQ Leukotape P at Amazon.com].* '''Hypafix'''. I have not used Hypafix extensively, but I've been impressed with its characteristics. It's inflexible, thin, soft and the edges don't fray too badly. [http://www.zombierunner.com/store/categories/foot_care/tapes/product6product968.html Micropore Hypafix at Zombie Runner</ref>].* '''Kinesio-Tex''' . This is a soft tape that stretches in one direction. I find that it does not stick well without an adhesive promoter, though rubbing the tape to warm it before applying will help it stick a little better. I also find the edges tend to fray, so I will often use some Micropore to stick the edges down. I find this is a good tape for between toes, where its softness is important. * '''Micropore'''. This was my default tapebefore I discovered [http://www.amazon.com/BSN-Medical-Leukotape-Sports-Tape/dp/B000H94TAQ Leukotape P], partly because I have been using Micropore from my earliest memories due to my skin condition. Micropore is very thin, smooth and inflexible, but not very sticky, so you need to should use it with an adhesive promoter. The biggest problem with Micropore is It will stick to dry skin and adhere well if given time, but that it is not very durableonly viable for pre-taping. I find It's thinness means it doesn't add much bulk nor does it will last well enough for a racefray, but I like to tape a day or two ahead of time to make sure the tape is right, and it can suffer wear in peel up at the mean timeedges sometimes. * '''Leukotape P <ref> [http://www.zombierunner.com/store/categories/foot_care/tapes/product967product6.html Leukotape P Micropore at Zombie Runner</ref>]* '''Elastikon''' . This tape is thickerthan any of the others, slightly rough textured, inflexible tapebut flexible and porous. It works very well when I rarely use it, but it's worth considering if you need something more robust than Microporea flexible tape.* '''Elastikon<ref> [http://www.zombierunner.com/store/categories/foot_care/tapes/product1.html</ref>''' This tape is thicker than any of the others, slightly rough, but flexible and porous.* '''Kinesio-Tex''' This is a soft tape that stretches in one direction. I find that it does not stick well without an adhesive promoter, though rubbing the tape to warm it before applying will help it stick a little better. I also find the edges tend to fray, so I will often use some Micropore to stick the edges downElastikon at Zombie Runner]. * '''Duct Tape.''' I strongly recommend against using duct tape, as it is not breathable, so the skin tends to become saturated underneath. Duct Tape also tends to wrinkle, creating creases that cause further problems. Like many other tapes, you need to use it with an adhesive promoter to get it to stick effectively. Watch the edges, as they tend to catch and then the tape then rolls up. I have used Micropore on the edges, with some success. If you really want to use Duct Tape, look for the Gorilla Tape brand, as the adhesive is better than most. {| class="wikitable"!!!Thickness!!Texture!!Flexibility!!Adhesion!!Edges Fraying!!Edges Peeling!!Tape Edges with Micropore?!!On dry skin!!On wet skin!!On wet skin with adhesive promoter|-|Leukotape P||Thin||Smooth||Inflexible||Good||Slight Fraying||Slight||Optional||Good adhesion||Reasonable adhesion||Good adhesion|-|Hypafix||Thin||Smooth||Inflexible||Good||Negligable Fraying||Some||Optional||Good adhesion||No adhesion||Great adhesion|-|Kinesio-Tex||Medium||Medium||Flexible in one direction||Very poor||Lots of fraying||Prone||Required on cut edges||Good adhesion, but edge peal||No adhesion||Reasonable adhesion, but edge peal|-|Micropore||Very thin||Very Smooth||Inflexible||Poor||No Fraying||Slight||N/A||Good adhesion||No adhesion||Good adhesion|-|Elastikon||Thick||Coarse||Flexible||Good||Some fraying||Prone||Recommended||Good adhesion, but edge peal||No adhesion||Good adhesion|-|}=Adhesive PromoterBlister Supplies=The images below are from my supplies for taping and blister fixing. If you need to assemble a smaller kit, here are my recommendations for the bare minimum, in order of importance:* '''FriarLeukotape P'''s Balsam<ref> http://www.zombierunnerIf I could only have one type of tape, it would be this one.com/store/categories/foot_care/adhesives/product125.html Friar* '''Scissors's Balsam/Tinture of Benzoin at Zombie Runner</ref>''. If you' Also known as Tincture of Benzoinre just cutting the tape, this helps tapes stick much bettermost scissors will work fine. I find it important If you are using them to apply the balsam pop a blister then they need to be small and sharp. * '''Alcohol Swabs'''. Cleaning the area where the tape before taping is going important, and if you have to be placed; If you miss pop a spotblister, then it's vital. You can use some kitchen roll (or gauze) and rubbing alcohol instead. * '''Adhesive promoter.''' You can get away without this, but it can make a big difference to how well the tape will tend to lift up in that spotsticks. If you over do use adhesive promoter, then you need a small makeup brush to apply itand some powder so it does not stick to the socks. Any type of powder will work, you can remove the excess with rubbing alcohol including talcum or smother it with talcum baby powder. Tincture of Benzoin (friar's balsom) is the cheapest option. * '''Mastisol<ref> Hypodermic needles'''. I find these needles are so much better for popping a blister than scissors, but they are harder to get hold of. You will probably have to mail order them; as pharmacists don't like to sell hypodermics to people that don't have a prescription to justify their use. I get mine from [http://www.zombierunnerallegromedical.com/store/categories/foot_care/adhesives/product1026Allegro Medical].html Mastisol at Zombie Runner</refgallery widths=300px heights=200px caption="Blister Treatment Supplies">''' This File:IMG 0097.JPG|Leukotape P, showing the slightly course textureFile:IMG 0100.JPG|Hypafix tape, which has a backing that is seems cut down the middle. You can see the thinness and porous nature of this tape. File:IMG 0098.JPG|Kinesio-Tex tape, showing three of the commonly available widths. You can see the way the tape has a backing, making it easier to cut to an unusual shape. File:IMG 0095.JPG|Micropore tape in two widths, showing the thinness and the flat texture. File:IMG 0099.JPG|Elastikon tape, showing the texture, which is rather course. File:IMG 0183.JPG|Cleaning the area is critical. Simple alcohol swabs work better than Friar's Balsam – it reasonably well, but a gauze pad soaked in rubbing alcohol is claimed more effective. File:IMG 0189.JPG|Adhesive promoters are nearly always needed to get tape to be 7-10 times stickerstick well. I'm Tincture of Benzoin (friar’s balsom) is cheaper than Mastiol, but not sure if as strong. The spray bottle that Tincture of Benzoin comes in is truerather useless, but so I transfer to a smaller bottle and use a brush to apply it . Some type of powder should be used so the excess adhesive promoter does work remarkably wellnot stick where it’s not wanted. Easy to applyI use Zeasorb, but expensive! =Adhesive Remover=* baby powder is as good for this. [http://www.zombierunner.com/store/categories/foot_care/adhesives/product125.html Friar'''Detachol<ref>Eloquest Healthcare Detachol s Balsam/Tinture of Benzoin at Zombie Runner] and [http://www.eloquesthealthcarezombierunner.com/productsstore/categories/foot_care/adhesives/detacholproduct1026.html Mastisol at Zombie Runner].File:IMG 0187.JPG|I’ve found these Scotch non-stick scissors to be good for cutting the tape as they don’t gum up as quickly as others and are long enough to cut the tape in one snip. The folding scissors can be handy, especially for delicate cuts of the tape like the butterfly needed for between the toes. I don’t use scissors to cut blisters. File:IMG 0102.aspx</ref>''' JPG|This adhesive remover works great for removing tape, especially around blisters. You still have to be careful, easing up the edges and applying some of the detachol, but it's quite easy. I use a cotton bud to rub the detachol at the point where the tape meets the skin. It seems to leave no residue or upset the skin in any way. [http://www.eloquesthealthcare.com/products/detachol.aspx Eloquest Healthcare Detachol]File:IMG 0188.JPG|These nail snips are useful for trimming awkward nails, but can be used to pop a blister. Generally it’s better to use a needle, but sometimes I’ve used these as a last resort. File:IMG 0101.JPG|I’ve found these handy for trimming problem nails, and for filling down calluses. File:IMG 0190.JPG|Twezers are useful for positioning tape accurately, and occasionally for repositioning torn skin. Sometimes I’ve used tweezers to hold a blister in place while it’s popped. File:IMG 0184.JPG|I prefer to use hypodermic needles for popping blisters. The 18 gauge needle works well at producing a reasonable size hole that is less likely to reseal, though multiple punctures may be necessary. The finer gauge 25 gauge can be used on thicker skin. The very fine 33 gauge needle is for blood glucose testing; I don’t often use these, but they are far easier to buy than a hypodermic. (Pharmacies are reluctant to sell hypodermics without some obvious medical justification, so I get mine online in bulk.)File:IMG 0185.JPG|Here’s a close up of the needles for comparison. If you look closely at the hypodermics, you can hopefully see the shape of the tip, which is very sharp and punctures the skin easily. (You may have to click to get full size image.)File:IMG 0186.JPG|Another close up, with a coin to give scale. File:IMG 0103.JPG|If you’re working on other runner’s feet during a race, you need to keep track of time. File:IMG 0192.JPG|If you're fixing runner's feet at a race, then somewhere comfortable for them and you is important. This 'zero gravity' reclining chair allows them to relax without [[Stretching|stretching]] their hamstrings or stressing their hip flexors. It raises their feet enough to let you work on them, though the stool that's shown is useful as you still need to be quite low. Notice the foam sleep mat, which will help keep the runner from getting too cold. File:Petzl MYO XP Full.jpg|A good [[Running Lights|light]] can be vital in poor lighting conditions.</gallery> 
=How to tape a blister=
I've practiced taping my own blisters, and worked the Umstead 100 aid station, taping many runners feet.
* Cut the folds away, leaving a smooth covering.
* Dust in powder so the excess adhesive does not stick to the socks.
* If Injinji socks are not used, then the tape may rub on the next toe. It may be possible to cover part of the next toe with tape to prevent this, rather than taping every toe. <gallery widths=300px heights=200px caption="Taping a partly blistered toe">File:IMG 0106.JPG|Apply the adhesive promoter to the good skin.File:IMG 0107.JPG|Carefully wrap the toe in the tape.File:IMG 0108.JPG|After the first wrap, you should end up with a cylinder of tape, ready for the next stage.File:IMG 0109.JPG|Gently pinch the ends of the cylinder of tape together to cover the end of the toe. Aim for three large folds that can be snipped off. File:IMG 0110.JPG|Cut the folds off with small scissors. You need to cut nearly all of the fold off, but not too much as a little bit of overlap is useful for keeping the tape together. File:IMG 0111.JPG|The finished version should look like this. You can apply a strip of tape over the top of the end if you feel more security is needed. </gallery> 
==Completely blistered toe==
A completely blistered toe is unusual, but is especially problematic as there is no skin left to attach the tape to. Instead, tags of tape must be used to attach the tape to the foot.
* Mastisol is necessary; only use tincture of benzoin if Mastisol is not available.
* Micropore or Leukotape are the best tape choices.
* Wrap the toe in tape; don't make the tape too tight as this could cause constriction. If the blister is not burst, care must be taken that the tape does not force the blister to spread further. You can't use adhesive promoter at this point as there is only blister you could adhere to.
* Gently smooth the tape over the end of the toe, pinching into a few large folds.
* Cut the folds away, leaving a smooth covering.
* Apply tape 'bridges' between the tape over the toe and the foot itself.
* Dust in powder so the excess adhesive does not stick to the socks.
* If Injinji socks are not used, then the tape may rub on the next toe. It may be possible to cover part of the next toe with tape to prevent this, rather than taping every toe. <gallery widths=300px heights=200px caption="Taping a completely blistered toe">File:IMG 0107.JPG|Carefully wrap the toe in the tape. There is no adhesive promoter at this point as the toe is completely blistered. File:IMG 0108.JPG|After the first wrap, you should end up with a cylinder of tape, ready for the next stage.File:IMG 0109.JPG|Gently pinch the ends of the cylinder of tape together to cover the end of the toe. Aim for three large folds that can be snipped off. File:IMG 0110.JPG|Cut the folds off with small scissors. You need to cut nearly all of the fold off, but not too much as a little bit of overlap is useful for keeping the tape together. File:IMG 0112.JPG|Apply adhesive promoter to the skin behind the blistered area, and over the top of the tape where the tag in the next stage will be applied. File:IMG 0113.JPG|Use a tag of tape to link the tape covering the blistered toe to the foot itself. </gallery>==Between the toes==A blister between the toes can be quite painful, and can easily spread under the foot. * [[Blister Prevention#Blisters between toes|Prevention tips]]* Clean the area as well as possible, which can be difficult in this area. * A blister between the toes will sometimes require popping if the athlete is to continue running. * Tincture of benzoin is recommended.* A combination of Kinesio-Tex and Micropore or Leukotape is required. * Apply the adhesive promoter to the skin of above and below the blister.* Cut a butterfly shape out of the Kinesio-Tex tape, so that the narrow section will fit between the toes. * Apply the butterfly shape; help will be needed holding the toes apart. * Use Micropore or Leukotape to tape the ends of the butterfly down.* If time is limited, a simple strip of Kinesio-Tex tape could be used.* Dust in powder so the excess adhesive does not stick to the socks.===Luxury===<gallery widths=300px heights=200px caption="Taping blister between the toes">File:IMG 0114.JPG|Cut a rectangle of Kinesio-Tex tape.File:IMG 0115.JPG|Remove the sides of the rectangle to create a butterfly shape.File:Image To Follow.JPG|Apply the adhesive promoter above and below the blistered area where the butterfly will adhere to good skin.File:IMG 0116.JPG|Apply the butterfly tape to the foot above the blister and then thread between the toes, peeling the backing as you go. You’ll need some help holding the toes apart. File:IMG 0117.JPG|Continue applying the butterfly under the foot.File:IMG 0118.JPG|The interim stage complete. File:IMG 0119.JPG|Apply more adhesive promoter on the edge of the Kinesio-Tex tape and the surrounding skin.File:IMG 0120.JPG|Apply Micropore (or Leukotape) to the edges.File:IMG 0122.JPG|This is how it should look at the end. </gallery>===Rapid===This approach is slightly quicker, but the narrow strip won't stay in place as well as the butterfly. <gallery widths=300px heights=200px caption="Taping blister between the toes (quicker)">File:Image To Follow.JPG|Apply the adhesive promoter above and below the blistered area where the strip will adhere to good skin.File:BetweenStrip.JPG|Cut a narrow rectangle of Kinesio-Tex tape.File:BetweenFirstTape.JPG|Apply the narrow strip to the foot above the blister and then thread between the toes, peeling the backing as you go. You’ll need some help holding the toes apart. File:BetweenExtraAP.JPG|Apply more adhesive promoter on the edge of the Kinesio-Tex tape and the surrounding skin.File:IMG 0126.JPG|Apply Micropore (or Leukotape) to the edges.</gallery> 
==Side of the big toe==
This is basically the same as the partially blistered toe, but there is a stronger case for cutting open the toe box of the shoe near the blister.
* Apply the adhesive promoter to the undamaged skin either side of the blister.
* Apply tape over the ball of the foot and up either side, but don't circle the foot entirely as this could constrict blood supply.
<gallery widths=300px heights=200px caption="Taping a blistered ball of the foot">
File:BallAP.JPG|Apply the adhesive promoter around the blistered area where the tape will adhere to good skin.
File:BallStartTape.JPG|Apply the tape around the forefoot, going up the sides.
File:BallFolded.JPG|Pinch the excess tape into a small number of folds.
File:BallTrim.JPG|Cut the folds off with small scissors. You need to cut nearly all of the fold off, but not too much as a little bit of overlap is useful for keeping the tape together.
File:BallFinished.JPG|The finished version.
</gallery>
==Under the heel==
This is similar to the ball of the foot, with the tape applied up either side of the heel. [[Blister Prevention# Blisters under the heel of the foot|Prevention tips]]
==Between the toes==
A blister between the toes can be quite painful, and can easily spread under the foot.
* [[Blister Prevention#Blisters between toes|Prevention tips]]
* Clean the area as well as possible, which can be difficult in this area.
* A blister between the toes will sometimes require popping if the athlete is to continue running.
* Tincture of benzoin is recommended.
* A combination of Kinesio-Tex and Micropore or Leukotape is required.
* Apply the adhesive promoter to the skin of above and below the blister.
* Cut a butterfly shape out of the Kinesio-Tex tape, so that the narrow section will fit between the toes.
* Apply the butterfly shape; help will be needed holding the toes apart.
* Use Micropore or Leukotape to tape the ends of the butterfly down.
* If time is limited, a simple strip of Kinesio-Tex tape could be used.
* Dust in powder so the excess adhesive does not stick to the socks.
==Back of the heel and Achilles==
A blister here is almost as nasty as under the ball of the foot. Flexibility is required for normal foot movement and there is pressure from the shoe.

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