Taping the Achilles tendon is a common practice used to provide mechanical support, reduce strain, and offer pain relief for conditions like Achilles tendinopathy. The effectiveness of this intervention relies entirely on the correct initial positioning of the patient and the ankle. This precise configuration allows the tape to function as an external checkrein, limiting the movement and stretch that may aggravate the injured tendon during activity.
Establishing the Patient’s Body Posture
The patient is typically positioned sitting on a treatment table or bench, with the knee on the affected side slightly bent and the foot extended off the edge. This seated posture provides the clinician with optimal access to the lower leg and foot.
The slight bend in the knee is designed to relax the gastrocnemius muscle. Since the gastrocnemius crosses both the knee and ankle joints, keeping the knee relaxed prevents undue tension on the muscle belly. This relaxation isolates the passive stretch primarily to the ankle joint, which is necessary for the most effective application of the tape.
The Critical Step: Achieving Maximum Dorsiflexion
The most important factor in Achilles tendon taping is applying the tape while the ankle is held in maximal passive dorsiflexion. This movement, pulling the toes toward the shin, places the Achilles tendon under its greatest stretch. Applying the tape in this lengthened state ensures it restricts the painful end-range of motion, mechanically offloading the tendon during weight-bearing activities.
Taping the tendon on stretch pre-tensions the tape, creating an external restraint against plantarflexion (toe-pointing motion). If the foot were relaxed during application, the tape would provide no functional limitation. To achieve this maximal stretch, the clinician firmly cups the patient’s heel and forefoot, manually pushing the foot toward the shin. This manual pressure must be sustained throughout the application of the foundational tape strips.
Securing and Maintaining the Position During Application
Maintaining the foot in maximal dorsiflexion is necessary while applying the initial anchor strips of tape. The clinician must use a firm, stabilizing grip to prevent the patient’s foot from relaxing out of the stretched position. One common method involves bracing the forearm against the patient’s tibia (shin bone) for counter-pressure while cupping the heel to exert the dorsiflexion force. This grip ensures the heel bone, or calcaneus, remains securely stabilized and the ankle joint is held at its end range.
The foundational tape strips, particularly those running vertically along the Achilles tendon, must be applied with significant tension, often between 50% and 100% of the tape’s stretch capacity. These strips are the workhorses of the tape job, and they must be applied rapidly and smoothly to the skin at the heel and calf without losing dorsiflexion. Crucially, the ends of the tape strips (the anchors) must always be laid down with zero tension. This prevents skin irritation and ensures secure adherence, locking in the maximally stretched position.