Elbow hyperextension occurs when the joint moves beyond its normal anatomical limit of extension, often causing strain or injury to the ligaments and joint capsule on the anterior side. This movement is commonly seen in sports involving throwing, falling on an outstretched arm, or contact. The primary goal of athletic taping is to create a physical block, or a “hyperextension lock,” that mechanically restricts the final few degrees of extension without severely limiting the functional range of motion needed for activity. This technique provides external joint support, allowing for potential participation while the joint heals or to prevent re-injury.
Necessary Supplies and Skin Preparation
A successful hyperextension tape job starts with gathering the correct materials to ensure both support and skin integrity. You will require:
- Adhesive spray.
- A roll of pre-wrap or underwrap.
- Non-elastic rigid strapping tape (typically 1.5 inches wide).
- A wider elastic adhesive bandage (EAB) for securement.
- Sharp bandage scissors to cut the tape precisely and safely.
Before applying any materials, the skin must be clean and dry, free of sweat, oils, or lotion, as these will compromise the tape’s adherence. Applying a thin layer of adhesive spray helps create a tacky surface, which is particularly important on the upper arm where muscle movement can cause the tape to loosen prematurely. The elbow should then be positioned in approximately 20 to 30 degrees of flexion to ensure the mechanical block is set at the desired point and to prevent discomfort when the arm is relaxed.
Applying the Hyperextension Lock
The first step in securing the lock is to apply a layer of thin pre-wrap starting just below the mid-forearm and extending up to the mid-upper arm, covering the entire area where the tape will be applied. Next, anchor strips of non-elastic tape are placed circumferentially over the pre-wrap at both the distal (forearm) and proximal (upper arm) ends. When applying the proximal anchor, the athlete should lightly contract the biceps muscle. This allows the muscle to expand under the tape, preventing the anchor from becoming too tight and constricting circulation when the muscle is flexed during activity.
The hyperextension check is created using three to five strips of non-elastic tape cut to span the distance between the two anchors. These rigid strips are applied directly across the anterior elbow crease (cubital fossa) in a slightly fanned or “X” pattern, starting on one anchor and ending on the other. It is important to apply these check strips with a firm pull to create the necessary tension, as they are designed to resist the final range of motion.
The central part of the fan is placed directly over the joint line, with the subsequent strips overlapping by about half their width to increase the surface area of resistance. This layered application of rigid tape across the joint crease provides a strong, non-stretching barrier to full extension. The tension applied to these strips must be carefully balanced to stop hyperextension while still permitting the slight flexion needed for the arm to be functional.
Once the hyperextension check strips are in place, they must be stabilized with additional reinforcement strips applied longitudinally along the sides of the elbow, or by adding a second layer of fan strips. The entire application is then secured by covering all exposed pre-wrap and the ends of the check strips. This is best done using a wider, elastic adhesive bandage (EAB) applied in a spiral pattern over the anchors and the fan strips, which smooths the edges and prevents the rigid tape from peeling off during movement.
Assessing the Taping and When to Consult a Professional
Immediately after the tape is applied, it is necessary to assess the circulation to the hand and forearm to ensure the tape is not too tight. Signs of circulatory compromise include:
- Numbness.
- Tingling.
- A cold feeling in the hand.
- A change in the skin’s color, such as a pale or bluish tint.
The athlete should be able to comfortably wiggle their fingers and maintain normal sensation and warmth; if any of these signs are present, the tape job must be removed immediately and reapplied with less tension.
A functional assessment is also required to confirm the tape is achieving its purpose. The athlete should attempt to fully straighten the elbow; the tape should create a palpable, firm block that stops the arm just short of the painful or excessive range of extension. The joint must still be able to move through its functional range of motion for the intended activity, such as throwing or lifting, without undue restriction or discomfort.
While taping can offer mechanical support for minor strains or prophylactic use, it is not a substitute for medical diagnosis or treatment. You should seek immediate professional medical attention if:
- The injury was accompanied by an audible pop.
- There is severe and unrelenting pain.
- The athlete is unable to bear weight or use the arm.
- Visible deformity around the elbow joint, such as an obvious misalignment, is present.