Foot Taping Why, How and When

Foot TapingWhy, How and When
Arnold Ross, DPM
Low-Dye foot taping, named after Dr. Ralph Dye, can play an important role in treating patients early and effectively, especially in regards to foot orthotics.
Often, a patient's initial complaint is not clearly structural or functional. Low-Dye taping provides an excellent evaluation tool. Low-Dye taping helps to realign foot bones, which helps to optimize ligament/muscle function and improve foot biomechanics. If the taping creates significant relief, there is a strong indication that functional orthotics may be an appropriate treatment.
Low-Dye taping also can provide therapeutic relief of functional problems on the initial visit. Treating early and effectively is probably the most important practice-building tool available. Patients want to know what is wrong. But they also want relief. Low-Dye taping can alleviate symptoms on the initial visit, or while orthotics are being sent in for adjustments, repairs, etc.
Patients often ask, "How can these few strips of tape help so much?" Since most mechanical foot problems are related to overpronation and flexibility of the subtalar/midtarsal joints, taping helps to minimize these factors. The combination of transverse and frontal plane tape helps to realign foot bones, improving foot function.
As you know, the foot keeps its structural integrity with:
1. Bone-on-bone surface contact pressures
2. Ligaments holding bones together
3. Muscular power to hold and manipulate the foot
Low-Dye taping reestablishes bone-on-bone stability, like the keystone in an arch, aligning foot bones and leg bones so that ligament and muscle function are optimized, easing the tensions and pressures associated with overpronation. More importantly, taping can provide a quality control function to your orthotic therapy. If taping is successful and orthotics do not provide satisfactory results, you should carefully evaluate the casts, cast corrections and orthotics. KLM , Arnold Ross, DPM, and Keith Gurnick, DPM, are always available to help you with orthotic cases.
From a practice management standpoint, your nurses and assistants can prepare the patient for taping and casting while you are seeing another patient. This helps patient traffic to flow quicker. Tape-strapping also can be a separate reimbursable procedure.
Problems related to taping are few. The most common is tape allergy. A small but significant number of patients will break out with a rash, at times with vescicular development. If this occurs, taping must be discontinued and other care initiated. Alternatives are to tape with an underwrap, use hypoallergenic tape or insert varus wedges into patient shoes.
Many patients also think they must keep their taped feet dry at all times. Applying paraffin wax to the tape allows patients to shower, bathe and swim, making tape therapy much more acceptable to active, busy patients.
Taping Techniques
Taping techniques are not universal. This article documents one method. However, I encourage you to experiment to find a technique that meets your practice and patient requirements.
Gather a roll of one-inch tape, a roll of two-inch tape, pretape spray and some paraffin wax. Place patient's foot in a neutral position. As you tape, make sure the foot's neutral position is maintained.
Step 1: Spray foot with pretape. Apply two strips of one-inch tape from the fifth MPJ around the heel to the first MPJ. To help support the first MPJ, pull tape tighter.
Step 2: Then apply three strips of two-inch tape across the planatar aspect of the arch, wrapping the tape medially and laterally up onto the dorsal surface of the foot. It is not necessary to wrap the tape completely across the dorsal surface. This will be done at the end of the taping process. The important point to remember is to wrap the tape up far enough to hold the tape firmly in place to resist slippage.
Step 3: Apply another one-inch wrap from the fifth MPJ, over the planatar arch straps, around the heel and up to the first MPJ.
Step 4: Place a single two-inch wide strap across the dorsal surface of the foot, connecting the medial and lateral strappings. Place another single two-inch wide strap across the plantar surface of the foot.
Finally, rub paraffin wax on the surface of the tape. This simple trick helps prevent socks and shoes from sticking to the tape, as well as keeps the tape intact in showers, baths, and pools.
Retape every three to five days. It is often a good practice to tape the patient when orthotics are dispensed to improve the break-in period. For patients with plantar lesions, you can add an aperture or dispersion pad. Or, with sessamoiditis, include a dancer's pad. I encourage you to experiment with your own variations.
Personally, I have found that taping is an indispensable tool for numerous foot, leg and postural complaints. More importantly, Low-Dye taping is an effective tool for prescribing orthotics and also for following up to ensure that orthotics control foot function.

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