Tape underwrap, or pre-wrap, is commonly used to treat sprains, strains and cuts. But Ron Cooper, ATC, athletic trainer for Olathe East High School in Olathe, Kansas, tells us what many athletic trainers already know: Cramer's Tape Underwrap makes an excellent patellar tendon strap!

Ron says, "I learned about this technique by watching other athletic trainers and by word-of-mouth. This use of underwrap has been around for at least 5-10 years."

The ease and simplicity of making a patellar strap from Cramer's underwrap is appealing to Ron. "It's simple to make," he says. "The athlete places the pre-wrap about 8-10 inches above the knee and wraps it around their thigh 10-12 times, as tight as they like. Next, the athlete's palms roll down over pre-wrap, creating a cord. Finally, just roll the strap down to desired spot."

Using underwrap for patellar tendon support has several advantages over straps or braces made specifically for that purpose. The biggest advantage, Ron says, is comfort. "Pre-wrap is flexible and form-fitting to the knee. Most purchased straps are connected by Velcro, which can irritate the underside of the knee causing pain and discomfort."

Ron also likes the control afforded by underwrap. "The level of tension and pressure is determined by the athlete, increasing comfort during the activity. The strap also stays in place better and longer. Purchased patellar straps are typically made out of neoprene, which get wet and slide when an athlete perspires. You'll see athletes tugging at the device, trying to twist it into place. But the pre-wrap is made of a foam substance that holds better to the athlete's body." Although neoprene holds heat and helps muscles stay warm, Ron says that sometimes neoprene straps feel almost too hot at times.

Cost is another plus for the underwrap strap. "A pre-made strap costs the athlete $20-$30," he says, "but schools usually buy underwrap in bulk. Even if athletes had to buy the pre-wrap themselves, a $3 roll would make quite a few straps."

The downside to the underwrap strap is that it must be recreated each time, Ron says. "Despite that, I rarely see athletes buying ready-made straps after learning to make them from underwrap." A patellar tendon strap of any type should not be used as a means of prevention, Ron reminds us. "The strap only helps relieve stress and pressure on an athlete's knee. Supports, braces, or straps can't replace the importance of flexibility and strength in the quadriceps and hamstrings. The goal should be to build stronger knees so the athlete won't have to wear a patellar tendon strap."

Ron recommends short arc movements-- where the knee doesn't go over the front of the foot--to improve strength and reduce stress on knees. "Parallel squats, where the hamstrings are at a 90 degree angle to the shin, put too much stress on knees and tear down the tissue supporting the patella."

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