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Shoulder Dislocation
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Shoulder Dislocation - August 20, 2007 12:34:15 PM
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TLB
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Anyone have a handout or good reference for shoulder stability taping on competitive athletes. Any help is appreciated.
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Todd
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RE: Shoulder Dislocation - August 20, 2007 7:44:25 PM
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buckeye
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I am not aware of any shoulder taping that will prevent a shoulder dislocation. If it was possible to tape the shoulder to limit mobility, the tape would become loose in a short period of time - this has been demonstrated with ankle taping (a joint with much less freedom of movement). There are some harnesses on the market that do a fair job of limiting elevation and external rotation. If you are working with an overhead athlete, it is doubtful anything will help. I will watch the thread to see if anyone has some proven ideas.
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RE: Shoulder Dislocation - August 21, 2007 2:00:12 PM
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Tom Reeves DPT ATC
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I agree with scross
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RE: Shoulder Dislocation - August 21, 2007 3:33:21 PM
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TLB
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From: Arizona
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Yes there is a taping procedure to help stabilize a shoulder, football players are taped this way all the time. Guess I'll have to buy the book, thanks anyway.
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RE: Shoulder Dislocation - August 21, 2007 3:49:21 PM
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Alex Brenner PT MPT OCS
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Are we talking about the AC joint or GH joint? For football players, the AC joint is the most commonly dislocated joint. I do not know of any techniques to prevent the separation, however, I do have a few techniques that I use for players that have subacute or chronic AC joint problems that allows them more comfort to continue to play competitively. It involves leukotape (spelling?) taping technique with some gel or foam padding.
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RE: Shoulder Dislocation - August 22, 2007 12:09:33 PM
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orthotherapist
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I have used similar techniques (McConnell Taping) but I do not think that it would work on competitive athletes (not in game/practice anyway as it is restrictive but it may work during rehab to help attain certian goals)
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RE: Shoulder Dislocation - August 23, 2007 6:32:24 AM
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Sebastian Asselbergs
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It is interesting to consider the muscle mass of the competitive athlete. Then visualize the tape on the skin. What effect can the skin-taping have on the actual biomechanics of the joint under the commonly large forces (look at the levers) and the inherently unstable glenohumeral joint? Even with AC joint taping, I think one is really only stimulating the level of proprioceptive feedback and providing a "sense" of stability. The tape on the shoulder really does NOT provide any real stability, UNLESS one uses the thorax, other shoulder and the affected upper arm to anchor the tape. It will take about three to four rolls and long criss-cross strips through the axilla to really block the unwanted motion mechanically. And then of course, the shoulder and arm are quite useless in most sports.....The Sully brace is really NO different than tape - nice propriocepsis enhancement...and much easier to apply.
So, is the technique and specific application of tape important? Sure, it has to address the needed AROM, the direction of motion that needs to be neuromuscularly restricted and the duration of the sport and the comfort of the athlete. Most taping applications can be deduced from the injury presented, the direction needing limitation and ROM necessary for competition/activities.
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Mundi vult decipi
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RE: Shoulder Dislocation - August 23, 2007 7:26:03 AM
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SJBird55
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I'd beg to differ, Bas. The brace has more than just proprioceptive enhancements. Motion can be limited. Shoulder instability braces are used to reduce the likelihood of the shoulder moving in the undesired region and will have straps to limit motion.
Am J Sports Med. 2004 Sep;32(6):1430-3. Nonoperative management for in-season athletes with anterior shoulder instability.
Buss DD, Lynch GP, Meyer CP, Huber SM, Freehill MQ.
More on shoulder bracing: http://engineering.union.edu/~worthm/Braces.htm
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RE: Shoulder Dislocation - August 23, 2007 10:15:53 AM
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TLB
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Thanks everyone. SJ that brace looks like it would fit the bill, thanks again.
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RE: Shoulder Dislocation - August 30, 2007 11:25:23 PM
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SJBird55
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Bas, I didn't read the article, the abstract caught my eye... it happened to be the only one that I could find that actually mentioned bracing. I don't even know what kind of braces were used in the article. I was providing it for TLB to use as a potential resource - sometimes there are references within articles that are more helpful than the actual article.
I do believe that there is a difference between braces though. Think of the positioning that often happens with instability and if a brace appears to limit the undesireable motion via strapping and such, it's probably going to work. Off track here, but with horses, a martingale limits head raising. The amount of control of any product, whether used on animal or human (and we are animals too) depends on the properties of the materials chosen to limit motion and how they are anchored and the feedback the animal/person receives to assist in avoiding the motion.
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RE: Shoulder Dislocation - August 31, 2007 6:35:53 AM
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Sebastian Asselbergs
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SJ, I fully agree with your second paragraph. I think my main issue was (and is) with the presence of braces, taping techniques, and their significant lack of decent studies. The one you posted was just a great example of how poor the evidence really is for this stuff. That they work for many is an experience of many of us who have dealt with sports medicine. But because there is such a dearth of research, it may be good for anyone looking for good references (see first post) to consider that there are really NONE. And that that makes the appliaction of braces or tape, a strictly personal issue.
IOW Todd, think about what you want to accomplish with the stuff, what directions to limit, what material may do that best and that the main effect of the stuff is very likely going to proprioceptive....
Anyone else wants my opinion? 
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Mundi vult decipi
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RE: Shoulder Dislocation - August 31, 2007 7:19:48 AM
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SJBird55
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Again, Bas... depending on the materials used, it could be a whole lot more than proprioceptive in nature. In the Martingale example... the product is made of leather and firmly attached. It definitely limits the undesired motion. Is it proprioceptive in nature? Maybe, but it really does limit the unwanted motion and chances are it becomes more of a learned response of - oops, can't do that, which makes products that really do limit motions more of a motor reprogramming or motor learning kind of thing versus proprioceptive. Yes, there may be some proprioception involved - the person/horse can actually feel the brace after it is put on the body, but I'm not of the opinion that all braces are only proprioceptive - it depends on the brace and the materials used. Ankle braces would be probably more proprioceptive in nature. Shoulder braces on the other hand - to really say depends on the actual brace, in my opinion.
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RE: Shoulder Dislocation - August 31, 2007 7:24:04 AM
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Sebastian Asselbergs
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It really depends on the research too. Have they shown that the humeral head is actually more stable in the glenoid? Or is there still a large motion possible? I have seen too many rugby players who have managed to keep the brace in one piece and well-applied, and yet, plop their shoulder out again....And those braces that are strong enough and limiting enough to protect against THAT - are not really useful ion training or practice. There are immobilisers.
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Mundi vult decipi
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RE: Shoulder Dislocation - August 31, 2007 7:25:32 AM
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Sebastian Asselbergs
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...and guess what stimulates and is essential in the "motor reprogramming or motor learning kind" - propriocepsis....
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RE: Shoulder Dislocation - September 4, 2007 10:56:02 PM
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tf8560
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From: miami
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TLB I have 3 high school football players w/ dislocated shoulders. We tape them all the time. I know how but hard to describe, will try to get you a resource. What we generally use for bracing (as do the major universities) is the shoulder stabilizer SPA by donjoy. It attaches directly to the shoulder pads. It wont prevent everything and if shoulder pads are not worn snug its of no use. Also we find the SAWA brace to be effective but down here in florida it is to hot and compliance is not great. The shoulder stabilizer SPA is a version of the SAWA brace that hooks directly to shoulder pads. Look up SAWA brace on google for some info or go to djortho.com
Tom Fletcher, PT
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