Hip and Thigh Taping and Wrapping Techniques for Injury Management

Quadriceps Strain Wrapping

The technique for the quadriceps is similar to the hamstring but utilizes the anterior thigh:

1. Positioning: Standing athletic stance with a heel lift and slight knee flexion.
2. Ace Wrap: Apply a 6” single Ace wrap from distal to proximal, overlapping by $\frac{1}{2}$. Instruct the patient to contract the quadriceps during application.
3. Directionality: Wrap in a lateral-to-medial circular pattern below the site of pain.
4. Finishing: Cover with 2” or 3” elastic tape (never Powerflex) using a spiral or herringbone pattern.

Hip Spica Techniques

The "Hip Spica" is a specialized wrap used to stabilize the hip joint and provide targeted support for either hip flexor or adductor (groin) strains.

Hip Spica for Hip Flexor Strain

This technique aims to limit hip extension and assist in hip flexion:

• Positioning: The patient should "square hips," bend the knees, and bend slightly at the waist. Maintain hip and knee flexion. Use a heel lift under the involved extremity.
• Ace Wrap: Use a 6” single, double 4”, or double 6” Ace wrap based on patient size.
• Application: Begin on the distal anterior thigh, wrapping in a lateral direction around the posterior thigh (overlapping by $\frac{1}{2}$). Pull the wrap through the groin and around the waist at the level of the iliac crests.
• Tension: Apply tension as the wrap is brought from posterior to anterior, pulling the hip into flexion (upwards).
• Finishing: Cover with 2” or 3” elastic tape or 1.5”/2” white tape in a continuous pattern from distal to proximal.

Hip Spica for Adductor/Groin Strain

While similar to the flexor spica, the direction of tension is reversed to assist in hip adduction and limit abduction:

• Positioning: Square hips, bend knees, and internally rotate the hip.
• Application: Begin on the anterior thigh, wrapping in a medial direction. Wrap around the posterior thigh (overlapping by $\frac{1}{2}$) and through the groin to the waist.
• Tension: Apply tension as the wrap is brought from lateral to medial, pulling the hip into adduction.
• Finishing: Cover with elastic tape or white tape from distal to proximal.

Hip Pointer Management

A hip pointer is a contusion to the iliac crest, which may involve the greater trochanter (GT) and associated bursae. Because athletes often have limited protective adipose tissue in this area, they are highly susceptible to direct trauma.

Taping Technique for Hip Pointer

The goal is to stabilize the area and limit lateral flexion away from the side of the injury:

1. Positioning: Place the patient side-lying on the uninjured side, positioned in lateral flexion (side-bending) toward the injured side.
2. Anchoring:
   • Proximal Anchor: Just below the ribs, starting lateral to the umbilicus and ending lateral to the spine using 1.5” white tape.
   • Distal Anchor: On the lateral aspect of the mid-femur using 1.5” white tape.
3. The "X" Pattern: Apply 1.5” white tape in an "X" pattern from proximal to distal. The first "X" should run from anterior-medial to posterior-lateral; the second should run from posterior-medial to anterior-medial.
4. Final Compression: Apply 3” Elastikon tape. Pull the lateral side of the mid-thigh toward the middle of the rib cage, and apply a strip from the medial side of the mid-thigh up toward the lateral side of the spine. Use half-strips across the "X" moving from posterior to anterior to cover the entire hip.

Summary Table of Wrapping Goals