Sterno clavicular joint tape

[NJPryce]

Hi

I am currently treating a 50 year old man with an instability/ hypermobile sterno clavicular joint. I would like to try some taping for a few months with some stabilisation exercises to see if the pain will diminish and to allow for some over head activities. If you have any ideas how to do this please let me know

thanks
Jo-Dee:eek:

[emad]

Hello Jo:

Still vague patient presntation ,What is the problem with your patient ? Is there trauma ? Why taping months ?What is that tape ?

Cheers
Emad

[Diane]

Hi Jo-Dee,
You picked a hard place to tape. I had just one patient with this problem, long long ago, and remember her vividly. She was a young woman who wanted to become a concert pianist. The condition is kind of rare. There's no way to fix it surgically, or at least there wasn't back then (mid eighties). The patient I had did not have a lot of pain, just annoying (to her) mechanics. The clavicle would literally rotate and displace forward and downward and outward from the sternum. I felt pretty helpless, as I recall.

Does your patient have visible displacement like that? Or just pain? If it's just pain, you'll have an easier time than I did.

If I had a second chance to treat someone with this problem, I would treat the shoulder complex everywhere except the SC joint, in order to de-stress it. As for taping, you'll likely not be able to tape the actual joint because the skin is so slidey over it; the best you'll do probably is to tape for enhanced proprioception.

If the main problem is pain, not visible displacement, then use just small strips of stretchy tape (Kinesio tape is great) over the joint for neuromodulation/downregulation. Work out what works best for that patient by putting on a little strip, then asking them to move, and asking them if the movement feels more 'normal' / less 'painful' . If they seem hesitant, don't be shy, take the tape straight off and try a new strip in a different orientation. When you get it right, the patient will let you know, don't worry. They'll look relieved and they will confirm verbally.

I've done quite a bit of experimentation with tape and have found that minimal amounts are best especially on the front side of the body where the skin is more sensitive/thinner. You might do well to consider the shoulder girdle as a ring around the ribcage, and tape it elsewhere as well, again to de-stress the SC.

[NJPryce]

Thanks for the replies

Sorry let me expand on the clinical picture. There was no history of trauma. The clavicular pain began insiduously and initially appeared whilst attending pilates classes. Over a few weeks there was an audible clunking which occured when overhead positions or 4 point kneeling positions where adopted. The patient participates in pilates 3 times a week and goes to gym 4times a week to do cardio. A picture of overuse perhaps. The patient has very good scapular control and shoulder stability. The only other relevant finding was a hypomobile C-T junction and an old facet problem C4/C5 on right. The hypermobility now presents with displacement anteriorly and inferiorly with arm movements. There is a noticable movement and a boggy end feel on accessory glides.
I am going to use leukotape with cover roll as my prefered taping as it will stay on despite showering. I am hoping to alter the proprioceptive input as well as to limit the excursionof the displacement.

[emad]

i think rest from the overuse or mis-use ia appropriate here ,besides taping to time of days and hours . i believe hypermobility and clickings are not problem .

cheers
emad