Advice about sports taping my shoulder?

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10/05/2012 at 18:16

I had osteo arthritis and a compressed tendon in my acromio-clavicular joint. Had a keyhole AC joint excision nearly 4 years ago - basically to scrape bone spurs out of the joint and cut a groove out of the underside of the clavicle to give the tendon more room. It worked up to a point but not brilliantly.

It doesn't bother me while running, but I've recently taken up triathlons and a hard swimming session always leaves it hurting for a couple of days. I'm now wondering if I could tape it up while swimming to support the joint and help keep everything in roughly the right place.

Can anyone advise me on this please? Is sports tape even waterproof?

P.S. Recent background info: I've been to numerous NHS, private and sports specific physios over the last few years. Spent a small fortune just to always end up being told "Well, shoulders are difficult to sort out..." Any rehab exercises I'm given always end up hurting enough that I'm advised to discontinue them. The ones that don't hurt also don't seem to have any effect on the problem. Have now given up rehab exercises in favour of deep tissue massage every so often to iron out all the knots and bunched up muscles that constantly accumulate. I have reduced muscle mass and strength in that shoulder but no reduction in range of motion. Any advice will be most gratefully received. Thanks in advance!

10/05/2012 at 22:13
Hi,
Sounds like a tricky shoulder to manage. There are a couple of taping techniques you can try, the challenge is to provide support without restricting movement.
I would use a kinesiology tape as it's flexible, I think Zinc Oxide would be too restrictive. I'm not sure all K tape is waterproof but Rock Tape supposedly is and they say you can swim in it.
I'd start with simple AC joint taping - a layer or two of tape directly over the AC joint with a slight downward pressure. If this doesn't help you could try scapula support taping, unfortunately this is very hard to do on yourself and hard to explain. If you look on youtube there are a few examples. You draw your shoulder blade back and down a little to a comfortable position, then use tape to support it there.
I'll look for a link for you....
10/05/2012 at 22:17
This looks ok;

http://www.youtube.com/watch?v=wphVs_goKH8&feature=youtube_gdata_player
11/05/2012 at 11:17

Thank you very much Tom. I'm in work just now and at a PC with no speakers so can't hear what's being said in the clip, but the taping technique looks almost exactly like what I was imagining it might.

I've done years worth of 'setting' exercises where I'm supposed to hold my shoulder down and slightly back, which is fine when I'm just standing or sitting about. But as soon as I do anything weight bearing, I always minutely shift it forward again and bring other muscles into play. Been told it's due to years of pain and weakened muscles and I'm still automatically 'protecting' the damaged bit. Find it almost impossible not to do it even when facing right into a mirror and lifting very light weights. I can see how and where I'm moving wrong, but I just can't quite manage to correct it. I'm hoping that taping it might help to keep things in the right place so that I can more easily isolate the bits that need strengthened...

I shall look into Rock Tape and finding an assistant and let you know how I get on with it. Thanks again! I appreciate your taking the time to find that clip and checking it out - I'm always dubious about following medical advice found on YouTube!

11/05/2012 at 11:34

I've no idea where you live or how much it costs but I believe Jeremy Lewis is the person to go to for tricky shoulders.  I think he's based at the Chelsea and Westminster

Edited: 11/05/2012 at 11:35
11/05/2012 at 17:06

Ah. Unfortunately I'm in Scotland! Bah. If I was within 200 miles I'd ask to be referred but I think 500 or so is just a liiiiiiitle bit far away for me. I've googled him though and he does seem to have written quite extensively about my particular problem. I'll have a good read through all his stuff I can find online. Thanks for that!

13/05/2012 at 14:29

In my capacity as 'bloke on the interent' I would suggest that taping is not a good idea.

When you saying doing setting excercises is that done with the shoulder doing any work? something like external rotations so that you get to use your lower lats.

It does sound like you want to do a set amount of work and are expecting your shoulder to adapt up to that level of work - which means recruiting muscles which put your shoulder in a 'bad' position.. I would suggest stepping back to a level of work you can do with good form and working up from that. Your shoulder is a parameter you have to fit your training around.

Also before taping, have you looked at your swimming technique to make sure that is the safest possible for your shoulder. For instancce a common problem with swimmers is that they use the muscle on the top of the shoulder (the trapezius) to bring the arm forward. I cant see how a little bit of tape will change your technique. A better investment might be understanding the purpose of swim drills so that you are using your muscles with good form rather than hoping tape will put bits of your body in the right postion.

If you look at the Swimsmooth website there is a stretching exercise which I think they call a Y stretch. Its a good model to think about how the arms should come forward. The arm is bent with the elbow in and then pushed forward (if standing the arm is pushed up toward the ceiling). This should encourage the use of the 'right muscles'.

13/05/2012 at 14:39

I had But a shoulder problem dating from 2003  which prevented me from swimming for most of 2003. Took a long time for it to be dianosed as a SLAP lesion for which I had an athroscopy in 2004. I got back into swiming and got round an Ironman in 2005. However I would say that overall it probably took a good 3/4 years for the shoulder to feel right. So I would say that it could takes a longer time than might expect and that there isnt really a short cut.

If you look at swim forums where shoulder problems are common they talk about 2 years for it to feel right - and these are guys who probably have muscles that are in good shape.

13/05/2012 at 14:45

and another thing ...

you mention hard swim sessions. I would suggest that until you are confident that you know what good technique is, and that you are swimming with good technique, dont do hard swim sessions. Do technique sessions.

Aside from your problems with your shoulder it is not a bad strategy to think of the swim as the warm up. So in a race go easy on the swim and then hammer it on the bike and the run. Technique sessions (with good technique) will probably give you better pay back in the short term and the long term than hard swim sessions (with bad technique).

13/05/2012 at 14:46

... and relax

19/05/2012 at 17:18

Bos1: sorry, I wasn't ignoring you - I didn't notice your loooong reply until today!

Firstly, the setting exercises are hardly exercise at all. Badly named. It's just moving your shoulder kind of back and down a bit and holding it there. Not difficult to do but difficult to maintain - you're supposed to remember to constantly hold it in the right place - when sitting, typing, walking, driving, running - all the time!

I recently had my swim technique assessed by a friend of a friend who used to swim for Scotland and who sounded like she knew what she was talking about. She said that I was bringing my arms forward to enter the water too much diagonally (in front of me) rather than just straight forward, and also that I was shortening the whole stroke and instead of keeping my arms extended and pulling back for the whole stroke I was cutting it short, bending them at the elbow and bringing them out of the water too soon. I listened to her advice and concentrated carefully on making the adjustments she said, only to have my shoulder hurt twice as much as normal the next day! I can only assume that I'm swimming a bit oddly to work round the shoulder problems I've got.

Can you explain in a bit more detail what you mean about using your traps to bring the shoulder forward please? I do go to swim training sessions involving swim drills etc, but it's just basic adult swim drills at my local council pool - the coach just tells us what to do and doesn't critique individual swimming techniques or suggest improvements. Perhaps I should look into finding myself a good swim coach for some 1-2-1 sessions.

Thanks for pointing me towards the Swimsmooth site - I didn't know about it. As for recovery time and muscle condition etc, while like I said I do have reduced strength/muscle mass in my bad shoulder compared with the good one, I've still got way more upper body strength than most other females as I used to do a lot of heavy weight training/powerlifting. I was actually told that that was likely what started the problem off - when I had my surgery done I was in a ward with half a dozen other people all getting the exact same surgery and they were all huge big chunky blokes. The surgeon said he'd never seen the condition on a female before, and almost never on a guy who wasn't either a rugby player or a weightlifter...

Cheers for your advice - I really appreciate it.

19/05/2012 at 18:00

P.S. Just had a good look round the Swimsmooth site and after taking a while to figure out what some of the technical terms mean, I discovered straight away at least three big things that are wrong with my stroke...

IronCat5    pirate
19/05/2012 at 18:42

I've had a seperated AC joint in the past, and this year poor swimming technique caused it to flare up, keeping me out of the pool for almost 2 months.

I think the best thing you can do (apart from physio and therabands etc) is to get one-to-one lessons and learn how to swim properly. Poor technique, mainly stroke recovery is often the cause of shoulder issues. If your catch is wrong it can also load up the AC joint.

19/05/2012 at 19:59

Cat5, I'm starting to think that's exactly what I'll need to do. Having had a good read at that site and how much damage you can do to yourself with bad technique, I'm now wondering a bit if bad swimming technique could have been something that contributed to my shoulder problem right from the start.

I've always swum a lot - used to do between 2 and 4K three or four times a week after weight training sessions - but never had any proper training or coaching. Using strength to compensate for lack of finesse can only have added to the problem of my not moving correctly in the first place.

23/05/2012 at 01:02

Had composed a witty and eloquent disquition on the matter in hand when I was BSODed.
I have only just finished swearing.

Grrrrrrr

23/05/2012 at 01:06

@r-w-d

Disclaimer I am not an expert, just a bloke on the intenet with an over inflated assessment of the worth of my opinions.

I had three physios mess around with my shoulder. The middle one had me setting my shoulder in the manner you describe. just setting without anything else - there wasnt much in the way of improvement. Physios 1 and especially 3 had me doing external rotations. Over time I think this has helped me with posture swimming etc.

After my op I went on a swim weekend. Coach noted that I was swimming much like water polo player, using shoulders extensively (think of water polo player swimming with ball just in front). so proper technique meant unlearning that.

One of the things that physio no 3 pointed out was how I was using the upper trap to lift my arm - effectively the pysio and swim coach were noting the same thing.

If you are standing in front of a mirror (you can keep your clothes on for this part) with arms hanging by side and lift an arm out wide and up in a semi-circle so that the arm ends up pointing at the ceiling, the shoulder tends to drift up. When physio first pointed this out there was an excessive upward shoulder movemet which then kind of 'dragged the arm up after (I have exaggerated for dramatic effect).

The contrast to that would be if you start with your elbow close in to the side, bend the arm and bring the arm up to the level of the shoulder. The shoulder naturally tends to stay down, because the movement is started with the lats engaged. At this stage you should look like a fully clothed Indian saying 'How'. If you then extend the the arm up toward the ceiling you will have put your hand in the same position as in the previous para but the shoulder stays back and down during the movement.

The other contrast in the movements is that the wider route will tend to make you crossover. The second movement will tend to have you making the stroke extending straight forward (or upward if you are standing in front of the mirror), reducing the risk of crossover.

An intersting things happens if you introduce rotation. The second method is easier to do if you rotate. no rotation tends to encourage the wide arm crossovery style.

Edited: 23/05/2012 at 01:11
23/05/2012 at 01:31

So after all that blah blah I would suggest do some work (eg external rotations) with shoulder appropriately set. Need to do some work to have some muscle to swim with.

As part of swim warm up, try this. Standing up, elbow in to side, bend up elbow and then extend straight overhead. (when extending up, extend stright up from the shoulder, you should not be extending toward a midpont over your head, should be perpendicular up from shoulder). One arm at a time. Do both sides. Slow and then speed up.

Swim drills should include rotation drills as this will help get you in best position.

Swim drills should also include zipper drill. Zipper drill focuses on the recovery stage, rotate properly and then run the hand up your side up to the armpit and then extend forward. When done properly you will have a high elbow during the recovery, and the elbow will be like a shark fin (ie above you, not hanging out to the side). You will also have noted that shape of this drill works out very similar to the 'How' paragraph in the previous post. It also should be easier for you to extend straight forward and say bye bye to that nasty crossing thing.

 

IronCat5    pirate
23/05/2012 at 08:00

Sounds similar to mine Bos. I think it was zip drill that broke me

24/05/2012 at 00:30

@cat5

my issue was with a SLAP lesion (which is a tear in the cartilege around the shldr joint).

Sounds like you were unlucky with the zip drills. Most drills should be done easily, so perhaps the zip drill was when you found the problem rather than causing the problem? Anyway hope it is going well.

Also, didnt mention before but I agree that coaching is a good thing. not always a sure thing, as some coaches may be better than others, but defo a good thing.

12/08/2012 at 20:00

Hi there, seems like you have issues resulting from previous injuries. Have you ever considered muscle function testing? http://www.bio-mechanix.co.uk/ is in Scotland and does MAT (muscle activation techniques) which helps re-activating muscle function. If injured your body compensates using other muscle (muscle groups) to keep you 'functioning' and starts overuse of those muscles that are not ment to be the 'main movers'. with shoulder girdle injuries it is a lot more complex as there is most likely more than just one muscle / tendon involved. Being extremely sore after having been shown optimal (correct) movements could be a sign for it. Hope, this helps  

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