Taping Sprained Ankle: How much tape would you bring?

[Jack Elliott]

On the off-chance (but not entirely zero-chance) that I might sprain my one normal ankle (the other is fused) while on the trail I just picked up a roll of 1.5'' wide leukotape and have reviewed articles* on how to tape up an ankle.

This tape ain't the lightest stuff around.

Anyone know how much tape one would expect to use for a proper ankle-taping?

====================
* Wish I could find a nice series of illustrations to print out and put in the first aid kit. All I have been able to find online are videos and photos. Videos are useless on the trail and photos are not so clear.

[K C]

If you sprain your ankle a grade 3 it would be more important to make a makeshift crutch out of a stick or treking pole. A grade 2 sprain would call for maybe a couple of figure 8's around your ankle and midfoot in line with your ATFL, or use an extra sock around your ankle an use guyline to make the 8. This would be to stabilize it to prevent inversion. I would say about 2 yards

[Mary D]

IMHO, elastic (Ace) bandage would be better; wrapping with tape could easily cut off circulation when the joint swells, which it inevitably will.

I carry veterinary wrap (self-adhering foam wrap) which I would also use for holding bandages on my dog should he cut himself. I tried it on myself as an ankle wrap; with a little duct tape reinforcement on the outside, it will work just fine for a sprained ankle. Vet wrap, which can be found at any livestock store and some pet stores, is far lighter than elastic bandage. However, when rolled tightly it fuses with itself after a while, so it needs to be replaced every year or two. (I found this out to my embarrassment when I produced it in my WFA class!) Anyway, for me vet wrap does double duty as well as being lighter than Ace bandage. If you don't have a dog, of course, you probably have no use for the vet wrap.

You could combine a bandana (used as a triangular bandage) with vertical "splints" of duct tape. Both these items are carried by almost all backpackers, so that means no extra weight or bulk!

I highly recommend a Wilderness First Aid course for everyone–the most important gear for first aid is between your ears! In WFA you learn to improvise with what's at hand rather than carrying a big bulky first aid kit for one or two persons.

[Don Morris]

I prefer to use elastic bandages for this and other related problems. They are more versatile and probably somewhat lighter. The Red Cross Advanced First Aid textbooks, various editions, have fairly clear illustrations that can be easily copied. We all remember what books were, don't we?

Be careful and cautious in dealing with problems of this type. It is very difficult, if not impossible to distinguish between sprains and fractures when an ankle gets "crunched.". Also be aware that once you have taped or wrapped the injured joint, you need to check for obstructed circulation distal ("downstream" – away from the heart- on the other side of the wrap) for adequate circulation. This can easily change over time,especially if you are walking – one of the reasons I prefer elastic bandages.

[David Drake]

Thanks for the heads-up, Mary. I carry a small roll of Coban (sounds similar to the vet wrap) and I just checked it–not totally fused, but getting there. So replaced with a new roll. With the cardboard core removed a roll of 2" by (not sure) a few yards weighs 0.2 oz.

[Charles P]

I tape my right ankle twice a week to play soccer. Been doing that for 20 years. Its an old abused ankle with pretty worn out ligaments. I wear boots on the trail just to keep it safe, no trail runners for me. I can turn it on a dime. I also carry about 4' of sport tape with me in case I need to tape it. It's just a specific thing I have to worry about.

[Jake D]

Regular white 1.5" tape i use about a half roll for 1 ankle on most of my athletes.

i don't know about leukotape but normal white tape is effective as an ankle taping for 30-45 minutes. if it gets wet even less.

an ankle brace would be much more effective if you are prone to ankle sprains. at work we suggest the ASO lace up + velcro version or similar.
http://www.medibrace.com/assets/images/aso2.jpg

if you are just worried about "oh crap" an 4-6" wide ace bandage and a SAM splint would be better and more versatile. if you are worried about weight then a 6" wide x 3' piece of cardboard will work in a pinch. multiuse and effective to splint many things.

Taping your own ankle is tough and confusing if you don't do it a lot. I tape other peoples ankles all the time and i'd have to think about it to do it on myself again

Don, I disagree that it is "almost impossible" to distinguish a sprain and a fracture. I learned that probably the 2nd week of "lower extremity evaluation" class. look up "Bump test", "compression test" and if you want to have some fun and maybe get punched in the face.. Tuning fork test.

Jake, ATC

[Daniel Cox]

>Wish I could find a nice series of illustrations to print out and put in the first aid kit. All I have been able to find online are videos and photos. Videos are useless on the trail and photos are not so clear.

It can be a bit confusing, but even somewhat sloppy wrapping is better than nothing.
The simplest I can explain it is:
First, tape isn't rolled the correct way, makes it very hard to wrap an ankle if you aren't practiced. Coban and ACE wraps are so much easier because they unroll 'over the top instead of from underneath.

Either way- start on the inside of the injured ankle (between your feet) with the running end of the tape, run it over your ankle bone, to the back side of the anklebone and under your foot, midway between your arch and heel, around to the outside of your foot. Now run it up the outside, in front of your ankle and over the top of where your shin turns into your foot. Pass the tape around the back of your achilles, and down over your ankle bone, on the front side.
This makes one complete 'figure 8'. For the rest of the passes, follow the path of the first wrap, but offset the tape by about 1/3 the width. 5-6 passes should cover your entire foot from arch to calf.

If you're using something stretchy like coban or ACE wrap, pull it 3/4 tight, leave some stretch for swelling.

I would personally bring enough coban to do two ankles, or one ACE wrap.

Edit: Dang Posted too soon. An old PA I worked for used to hammer the 'Ottawa Ankle Rules' to do a basic field assessment. They're simple to remember, and don't require a lot of associated medical knowledge.

Essentially strongly suspect a break if any of these cause extreme pain:
1)Squeeze- above the inside and outside of your leg about 2 inches above the bumps that make your ankle (malleolus)
2)Push on the bump that is just below the inside of your ankle (navicular bone)
3)Walk 4 steps un-aided

[Jake D]

"3)Walk 4 steps un-aided"

except your Fibula is a (nearly) non weight bearing bone and you could easily walk on a broken fibula that wasn't displaced. Compression test will cause an increase in pain for a + sign.

what i posted are standard special tests for lower leg fracture evaluation. they are simple, easy and take 30 seconds.

either way when you're in the woods it will come down to weight bearing or non weigh bearing. you will either be able to hobble out or have to hop, crutch, or get carried out. so getting picky about it isn't really a big thing.

[Mike In Socal]

Check out Rocktape. http://rocktape.com/how-to-use/

Mike

[Mike In Socal]

…

[Daryl and Daryl]

Michael,

Thanks.

Daryl

[Jake D]

as per usual, they pick the voodoo rather than years of medical experience.

congrats you are predictable.

[Daniel Cox]

"Compression test will cause an increase in pain for a + sign."
The compression test and criterion 1 of the OAR check for the same thing.

In fact, really both the special tests you posted are similar in intent as the OAR.

There's really only so many ways you can poke a joint to determine if something is wrong, so it's no surprise that most tests are largely the same.

There's nothing wrong with either method, essentially if squeezing above and below the medial/lateral malleoli don't cause pain, and they can bear weight, it's fairly safe to say nothing is broken.

[Jack Elliott]

Thank you everyone.

I'm probably overthinking this, I tend to do that. I've never sprained an ankle.

Some options, in order of increasing weight:

1. Bring nothing to deal with a sprain. I don't have weak ankles — or "ankle" since one is now fused and would take a firefighter's Pulaski to break, spraining that guy is simply not possible — so I've only the other one to consider.

2. I already bring a little tape to cover blisters (love the idea of sticking bits to release paper), so I could multipurpose and bring a few extra feet and learn how to wrap a sprain. Weight and length to be determined according to taping method (at end of this post).

3. Bring an Ace dressing. 50 grams.

4. Bring my McDavid nylon lace-up and Velco ankle brace that I got when my ankle was healing, 140g.

5. Bring an Ace and my SAM splint (or a bit of cardboard as has been suggested). SAM is 130g +50 for Ace = 180g

ON THE MATTER OF THE TAPING METHOD, Daniel describes a Figure-8 method, and the illustration on the Rocktape site that Mike mentioned (pictures here) also shows the Figure 8 method.

But I also find plenty of other sites which show a stirrup method, such as this on the NISMAT site.

Is one method mo' bettah than the other? The stirrup method looks like it requires a bunch more tape.

[Jake D]

i was mostly refuting the weight bearing part of it. it is not an accurate test for a fibula fx. Tibia.. yes you will probably be down. but you will probably hear and feel that go anyway.

The figure 8 shown is for kinesio tape only. it MAY do something to help chronic sprains but it will not do jack for an acute sprain. there is just not enough mechanically going on there to provide support.

this is similar to how i tape..

[Terry Trimble]

Jack,
I have been plagued with ankle injuries since I was small child.

After a really bad backyard pool skateboard accident at the Clinton Keith pool in Elsinore,Ca. My left ankle instantly blew up to size of cantaloupe and black and blue. I was soaking my ankle in bucket of ice water contemplating all the times I sprained my ankles over the years since a child I figured around some were between 250 to 300 times between both ankles. Most of the time I just kept going and walked or skate it off. It was such a regular thing with me I owned my own pair crutches.

After the accident I had to Quit my sponsor Vans shoe team and wear converse leather "Y" brace basketball high tops to keep on going. I found a figure 8 wrap bandage that had plastic mesh that had a nice soft fabric lining infused in to the mesh with a velcro closer that worked for me because I can adjust the pressure were it was needed. I tried a quite a few slip on ankle braces that went around your ankle and arch they hurt my arch so much I had to take them off. The closet ankle bandage to the one I own is the InvaCare universal ankle wrap from allegro medical.

So when my ankle finally healed I just wore high top shoes all the time and my ankles still hurt.
About 5 years ago I switched to straight lasted low top shoes for support and my ankle strengthen and they did not hurt anymore. Now I Just watch my foot placement and be careful so I don't twist or sprain them anymore I have had a few minor twist and I just walk them off and the pain subsides after about 5 minutes.

I have a question for you when I was 38 a surgeon said they will fuse my ankles in 20 years I was wondering how you get around on the fused ankle and does it decrease your mobility.
Terry

[josh wagner]

if you're going to bring anything i'd take an ace bandage. the ability to take it on and off and reuse it makes it better than tape IMO. for instance: you get to camp and there's an icy mountain stream nearby. you can take the ace off, wash it, and soak your foot in the water while you eat dinner. plus you can take it with you every trip. reuse, reduce, recycle…

[Ben H.]

I am surprised so many people are recommending ace bandages. I've hurt my ankles too many times to remember. I've had them wrapped in tape and ace bandages. I've worn many types of braces. I feel I get the best support from lace-up type braces, but they are heavy and bulky. A close second is a taped ankle and I barely notice the tape is there. A distant third is an ace bandage. I never felt like I got much support from an ace bandage. The constant compression helps with swelling but that is about it. Plus they are bulky and fall apart fairly easily. I am certainly concerned about turning an ankle in the back country, but I never thought about bringing an ace bandage.

[Jack Elliott]

Now that this has been batted about, I'd like to get back to my question: how much tape is needed for the stirrup-type style?

[Jake D]

I told you in my first post. I use about 1/2 of a roll of white tape. maybe a bit more if i wanted it a bit more beefy (3 fig 8s instead of 2, 2 each side heel locks instead of 1 each)

it is a temporary fix. if you are that worried take the brace you have and it will be great over and over again.

ALSO with white tape or leuko tape you are going to want pre-wrap. which is light but bulky if you don't have a 1/4 roll. without it you will have to shave your ankle or taking tape off will be heinous. it also helps prevent tape cuts and blisters.

[Jack Elliott]

Hey Jake, you're right, thank you — you did say how much you normally use.

However, your description, "(3 fig 8s instead of 2, 2 each side heel locks instead of 1 each)," sounds like you're not using the stirrup method, but an augmented figure-8 method?

Here's the stirrup method: http://www.nismat.org/traincor/ankle_tape.html that I'm asking about.

As for heinous hair removal when pulling off tape, well, Mrs Elliott gets her legs waxed so I reckon (or hope) I'm man enough to deal with the pain, too.

[Jake D]

Same as that link does except i do heel locks and 2 figure 6's according to this site
http://www.soccermaniak.com/images/ankle5.jpg

remember i'm dealing with soccer, football, lacrosse, rugby etc athletes that play 1-2 hours.

so without fig 8s. call it about 1/2 roll since you still need to close up the open spaces. either way you might be able to get 2 out of 1 roll if you are efficient.

If you have a thin ace bandage around i would practice doing the heel locks on yourself.

http://www.soccermaniak.com/images/ankle8.jpg is how i do them.. then opposite for the other side. start at the top angle down behind heel, around, under, finish on top.

[Jack Elliott]

Thanks, Jake. Got it.

[Nick Gatel]

Jack,

I know you are looking for taping methods, but I suggest the Ace bandage too since you don't have a problem — just wanting to be prepared. The Ace bandage can also be used for a twisted knee or even a sling — multi-purpose. I would rather have a loose Ace than a too tight taping job.

Also pulling tape from an un-shaved ankle isn't fun — in spite what the ladies can bear — they can bear children too :)

[Author]

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