The Most Common Bandaging Mistakes New Therapists Make (and How to Fix Them)

Compression bandaging is one of those CDT skills that looks straightforward—until you’re trying to build a comfortable, therapeutic wrap that stays put, supports lymph flow, and doesn’t create pressure points. New clinicians often “know the steps,” but small technical issues (tension, overlap, padding choices, limb positioning) can make the difference between a wrap that helps and a wrap that frustrates everyone.

This post covers the most common compression bandaging mistakes students and new therapists make, why they happen, and practical ways to correct them—so you can improve results, comfort, and confidence with every wrap.

Clinical note: This article is for education and professional development. Always follow your facility protocols, patient-specific precautions, and scope of practice. Hands-on instruction and supervised practice are essential for safe, effective bandaging.

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A short-stretch bandage behaves differently than long-stretch/elastic wraps. In CDT bandaging, you’re typically building a wrap that:

• Supports low resting pressure (more comfortable at rest)
• Creates higher working pressure during movement (helps fluid shift with muscle pump)
• Maintains a pressure gradient (generally higher distally, lower proximally)
• Protects skin and distributes pressure with appropriate padding and layering

That’s the goal. Now let’s get into what commonly trips people up—and how to fix it.

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• Patient reports throbbing, tingling, numbness, or “my hand feels like it’s going to explode.”
• The wrap feels rigid, painful at rest, or causes new swelling above/below the bandage.
• Fingers/toes discolor, feel cold, or capillary refill seems delayed.

New learners often equate “more tension” with “more therapeutic,” especially if they’ve used long-stretch wraps elsewhere. But short-stretch bandage systems don’t need aggressive pull to be effective.

• Use consistent, light-to-moderate tension and let the layers do the work, not brute force.
• Maintain a steady overlap rather than cranking down.
• Re-check comfort immediately, then again after the patient stands/walks/moves for a minute.
• Teach the patient clear red flags: numbness, tingling, pain, color change → remove and call.

Student tip: Your hands learn “the right pull” through repetition. Practice wrapping on a classmate or foam limb model while someone checks your tension consistency.

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• Red marks, irritation, or tenderness at the dorsum of the foot/hand, tibial crest, ankle bones, wrist, or elbow crease.
• The wrap “bites” at edges or creates sharp ridges.

When you’re focused on the outer bandage spiral, padding can feel optional. It isn’t. Padding is what helps you create even pressure distribution and protects vulnerable skin.

• Pad strategically: malleoli, Achilles, tibial crest, dorsum, met heads, styloids, skin folds, and any sensitive scars.
• Smooth padding like you mean it—wrinkles in padding become pressure points under compression.
• If reducing bulk is the goal, don’t remove protection—refine technique (better contouring, neater layers) instead.

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• Some areas look “stacked” (high overlap) while others show gaps (low overlap).
• The patient gets a ring or ridge where overlap changes.
• Bandage slips where overlap was too low.

Overlaps drift when you’re adjusting angle, trying to follow limb shape, or rushing.

• Pick an overlap rule (often ~50% overlap) and stick to it consistently.
• Watch your bandage edges like a hawk—your edges tell you your pressure gradient story.
• Slow down around transitions (ankle/heel, wrist/thumb web space, knee/elbow).

Student drill: Wrap a foam roller using perfect overlap lines. Repeat until your hands do it automatically.

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• The wrap slides down within hours.
• The distal portion loosens first.
• You see bunching around joints.

If the bandage doesn’t have a stable base, it can’t hold. This is common when:

• The distal area isn’t secure
• The first layer isn’t anchored
• The limb wasn’t positioned consistently during wrapping

• Build a stable foundation distally (hand/foot where appropriate and safe).
• Use neat, secure early turns without over-tightening.
• Confirm the limb is positioned in a functional alignment before you start (see Mistake #6).

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• You see small ridges in the bandage.
• Patient feels pinching or burning under one spot.
• Post-removal marks show a sharp line.

Wrinkles often come from:

• Twisting the bandage roll
• Changing direction abruptly
• Trying to “fix” a loose section by yanking harder on one turn

• Keep the bandage flat and control the roll close to the limb.
• If you see a wrinkle forming, stop and correct it right then (don’t bury it).
• Tension should be even; adjust by re-laying, not yanking.

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• The wrap feels fine in the clinic but becomes painful when the patient moves.
• Creases appear behind the knee/elbow or at the ankle/wrist.

Wrapping a limb in an awkward position “locks in” that shape. When the patient changes position, the bandage can bite.

• Wrap in a functional position:
  • Ankle more neutral (not pointed)
  • Wrist neutral as appropriate
  • Consider gentle knee/elbow flexion if that’s the functional resting posture, while avoiding bunching
• Re-check fit with movement testing after bandaging (stand, walk, open/close hand if applicable).

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• Swelling increases above the top edge.
• Patient feels a “tourniquet” sensation near the top.
• The limb looks puffy above the wrap line.

A therapeutic gradient requires planning—layering, overlap consistency, and appropriate proximal tapering.

• Think “more support distally, less proximally,” and avoid a tight top edge.
• Finish with clean transitions and avoid abrupt compression changes.
• If the limb is highly conical, you may need specific padding strategies and careful shaping to avoid edge pressure.

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• Patient quietly tolerates discomfort until they remove the wrap (or stop coming).
• Skin irritation escalates.
• Anxiety increases around treatment.

New clinicians can get “task-focused.” But bandaging is a patient experience as much as a technique.

Build this into your routine:

• Ask comfort questions during and after: “Any tingling? Any sharpness? Any hot spots?”
• Teach 3 simple home checks:
  1. Comfort (pain/numbness/tingling = problem)
  2. Color/temperature changes distally
  3. Skin integrity at removal (blisters, intense redness, broken skin)
• Give clear instructions for what to do if symptoms appear (remove, notify, seek medical help as appropriate).

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• Patient can’t fit into shoes/clothes.
• They avoid moving the limb because it’s cumbersome.
• They “forget” to wear it because it’s too hard.

Early wraps are often bulky because students use too many layers, too much padding, or inconsistent shaping.

• Prioritize smart contouring over “more material.”
• Use padding intentionally (targeted protection rather than blanket bulk when appropriate).
• Create a plan for footwear/clothing (especially lower extremity). Adherence is therapeutic.

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• One day’s wrap works great; next session you can’t reproduce it.
• Another clinician takes over and the plan becomes inconsistent.

Documentation feels like extra work—until you need troubleshooting data.

Document the essentials:

• Materials used (type/widths of short-stretch bandage, padding/foam)
• Approximate layering approach
• Patient tolerance and response
• Wear schedule + education provided
• Any modifications for shape, scars, skin issues, or pain points

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Before you start:

• ✅ Skin check + patient-reported sensation check
• ✅ Choose proper materials and sizes for limb shape
• ✅ Pad bony prominences / sensitive areas
• ✅ Position limb functionally
• ✅ Decide your overlap strategy (and commit to it)
• ✅ Plan your top edge and transitions (avoid abrupt end pressure)

After you finish:

• ✅ Comfort check (no sharp pain/numbness/tingling)
• ✅ Distal color/temp check
• ✅ Functional movement test
• ✅ Patient education: red flags + what to do + wear guidance

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If you’re a student or new clinician, the fastest way to improve is hands-on training with structured feedback—because the “small stuff” (tension, overlap, contouring, padding choices) is what separates a decent wrap from an excellent one.

At Norton School, our lymphedema education approach is built around practical, repeatable CDT skills—so you can leave training ready to bandage with confidence, comfort, and clinical reasoning.