Protect the precious, before it gets out of hand

The high incidence of sports-related hand injuries calls – loudly and clearly – for protective and preventive measures

Published July 12, 2021 • 6 min read

We have established that the hand is vulnerable to a variety of injuries within a wide range of different sports. In many sports, the absence of injuries is an important condition for thriving and long-lasting sports participation (Verhagen et al., 2010). For this reason, prevention and reduction of sports injuries should be among the main concerns for trainers, medical staff and the athletes themselves. One important aspect of injury prevention is the use of protective measures or equipment in order to decrease the risk of certain injuries. Protective measures are predominantly used with primary and secondary injury prevention in mind. Primary preventive measures are those that are used in healthy athletes to prevent a first occurrence of an injury, whereas secondary preventive measures are used in already injured athletes to prevent worse (Jacobsson & Timpka, 2015).

A recap of the currently used injury prevention methods

One such measure that is widely used in various types of sports is athletic taping. The fundamental principle of (preventive) taping is to provide support, limit excessive range of motion and allow for protection against forces that cause injury (Birrer & Poole, 2004). Taping can sometimes prevent injuries caused by an external force as well as injuries resulting from excessive force generated by the hand muscles themselves. A major benefit of taping lies in its versatility, since it can be applied in many different ways, on various parts of the body. Taping can also be used therapeutically to support structures that already have been injured or to compress soft tissue to prevent swelling. Depending on the type of injury that needs to be prevented or the anatomical structure you want to protect, different taping methods can be applied. The taping method that prevents the tendons in the fingers from straining their pulley mechanism is called the H-method taping due to its specific form and placement on the finger (Schöffl et al., 2007).

This method is often used by rock climbers and Brazilian jiu-jitsu athletes, to prevent excessive strain and potential rupturing of the pulley mechanism during strenuous activity, such as powerful flexion of the fingers. It is also theorized that this type of taping ought to prevent the development of chronic tendon inflammation after a pulley mechanism injury. However, this hypothesis was never confirmed (Schöffl et al., 2007). The ring-method or circumferential taping is another method to supposedly influence biomechanical effectiveness of the pulley mechanism.

When using this technique, the tape is generally applied around the finger in a circular fashion. This taping method, however, was found to be only minimally effective in unloading the pulley mechanism to prevent and reduce pain symptoms (Schweizer, 2000). Therefore, this method of circumferential taping is rather used to prevent swelling and protect certain structures from sports-related contusion. In the full wrap finger taping method, the tape is applied extensively in a circumferential manner on the finger in its entirety.

The goal of this tape, that is for example used by goalkeepers and even volleyball players, is to protect against high impact load to the finger from different directions. However, this method significantly reduces functional finger movement and has only a limited use in sports that require mobility of the hand. Other frequent taping methods include the buddy taping method, in which two fingers or more are joined by circumferential taping in order to provide stability in sprained or dislocated finger joints (Won et al, 2014).

To support specific anatomical structures within the finger, X-method taping can be applied.

This method is frequently used in martial arts to protect the volar plate or the small collateral finger ligaments (Carruthers et al., 2016). Thumb spica taping, which is used to prevent ulnar collateral ligament sprains of the thumb, also known as skier’s thumb, is another example of a stabilizing taping method. The integrity of the aforementioned ligament is important because of its contribution to the grasping role of the thumb.

Although in some cases athletic taping has been proven to be beneficial for injury prevention and rehabilitation, some disadvantages are inherently associated with the use of non-elastic tape (Bandyopadhyay & Mahapatra, 2012; De Ridder et al., 2020; Won et al., 2014). To apply tape on the appropriate anatomical location is time-consuming and can be complex. Therefore, the assistance of a paramedical professional is often required to apply tapes in a correct way. This is particularly true for applying hand tapes, as the person who needs the tape is basically being rendered one-handed at that time. The initial stiffness that is provided by taping gradually decreases after only a brief duration of motion, which can already be felt after 2 to 3 minutes of sports activity (Bandyopadhyay & Mahapatra, 2012). In rock climbing, for instance, it is recommended to renew an H-method taping after every climbing route in order to utilize the biomechanical effect of the tape in the best possible manner. Extensive and prolonged use of tape during training and/or competition is also thought to lead to an artificial sense of stability, combined with taping dependence. Last but not least, frequently using tape comes with a hefty price tag as well.

Another conventional technique for supporting an anatomical region is elastic non-adhesive bandaging. Due to its supposed beneficial effect on joint position sense and stability, bandaging is used by both amateur and professional athletes for injury prevention. However, a recent literature review on the effectiveness of non-adhesive bandaging concluded that the only positive effect was therapeutic. No proof for an injury preventive effect of bandaging was found (Fousekis et al., 2017). Besides athletic taping and bandaging, there are other methods, such as bracing or splinting, that are used to protect and prevent injuries. Contrary to bandaging, these methods use hard materials to mechanically assist or restrict joint movement. It is worth mentioning that external bracing or splinting devices often restrict functional movement in such a manner that their use in sports is rather limited. Many competitive sports even prohibit the use of such bracing or splinting devices, because they are unsafe for players and their opponents.

So, what is next?

Based on the currently available evidence on injury prevention, we can conclude that there is an urgent need for innovation in the field of protective gear. To effectively prevent injuries to the hand, efforts should strive to further enhance risk prevention measures in the form of functional protective gear. The end goal is to increase safety and health in sports, and to prolong purposeful sports participation. Novel protective gear for the hand should aim to provide protection against the most common injury mechanisms that are associated with hand injuries, while keeping the normal functioning of the hand in mind. During its development stages, focus should be equally given to cost-effectiveness & fabrication costs, ease of use and durability of the protective gear.

Challenged by the current shortcomings within the field of protective sports gear for the hand and by the need for continuous innovation in sports technology, the idea of the novel protective sports glove Exoligamentz was born.

References

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