dislocated shoulder – study b (Photo credit: Jon Winters)

The left shoulder and acromioclavicular joints, and the proper ligaments of the scapula. (Photo credit: Wikipedia)

The shoulder complex consists of four separate joints, which afford it incredible mobility in all planes of motion, but at the expense of its stability.

The glenohumeral joint (GHJ) relies on the integrity of muscular and capsuloligamentous structures rather than bony conformation for its
stability. Injury or paralysis of muscles around the shoulder complex may lead to GHJ subluxation.

Glenohumeral subluxation is a secondary complication to hemiplegia caused by a CVA, in which the head of the humerus drops out of the joint. Across the literature, anywhere from 17 to 66 percent of patients experience a shoulder subluxation after a CVA (Peters & Lee, 2003).

Patients with such a subluxation experience pain and decreased ability to perform activities of daily living. In fact, the pain caused by a glenohumeral subluxation has not been isolated. Some research even claims that shoulder subluxation is not the etiology for shoulder pain experienced post-CVA.

procedure of  taping

step 1. check the sulcus sign, and measure it. (no of finger)

step 2. check the range of movement, pain severity, end feel, capsular   tightness. record for pre and post checking for comparison.

step 3. shave the area of shoulder, scapular region up to inferior angle of scapula.

step 4. Take sticking plaster dynaplast of 4″ width. Measurement of para spinaltaping length. Measure from superior border of trapezius muscle till the inferior angle of scapula and cut the tape. Remove the polythene from the tape and stretch the tape to full length.

step 5. Postural alignment &  positioning:  make the patient stand erect so he/she gets a upright posture. correct the abducted scapula to neutral position

step 6. Stick the tape paraspinally starting from superior border of trapezius muscle up to lower sub costal area. take a note while taping that the black center line on the tape should align with the medial border of scapula. take care that there should not be any creases while taping the tape.

step 7. Preparation of second strapping of the tape. Measure from the medial tip of spine of scapula up to deltoids tuberosity level(insertion of deltoids).  cut the tape from middle up to one inch in line with black line in the middle of tape. then split it in the form of “Y” shape. then stretch it to full length.

Step 8. stick base of Y at deltoids tuberosity level. stick it in such a that the middle line of tape come over the anterior tip of acromian process. so that the half of tape  is anteriarly and half laterally  covering the shoulder for proving a better stability. out of the two strip of Y end, upper end in line of the spine of scapula and other strip towards inferior angle of scapula.

check the reduction in sulcus size

To view a video of the procedure please click on the link

Related articles

1. Griffin A, Bernhardt J. Strapping the hemiplegic shoulder prevents development
   of pain during rehabilitation: a randomized controlled trial. Clin Rehabil. 2006
   Apr;20(4):287-95. PubMed PMID: 16719027.http://www.ncbi.nlm.nih.gov/pubmed/16719027
2. Painful Hemiplegic Shoulder.Robert Teasell MD, Norine Foley MSc, Sanjit K. Bhogal MSc http://www.ebrsr.com/uploads/Module-11_hemiplegic-shoulder.pdf
3. S. Beth Peters^1† and Gregory P. LeeProfessor². Functional Impact of Shoulder Taping in the Hemiplegic Upper Extremity. Occupational Therapy in Health Care. 2003, Vol. 17, No. 2 , Pages 35-46 http://informahealthcare.com/doi/abs/10.1080/J003v17n02_03?journalCode=ohc
4. Kinesiology Tape: The Little Miracle Worker (drkristakip.wordpress.com)
5. Exercises for a Loose Shoulder – Orthopedics Doctor Houston TX (orthopedicsportsdoctor.com)
6. Shoulder Pain (mycerebellarstrokerecovery.com)
7. Shoulder Pain: Multi-factorial, confusing, and tiring to treat (My Rant) (jessephysio.wordpress.com)
8. Build Big Strong Shoulder Muscles For V Shape Upper Body Build Big Deltoids (extrememuscles4u.wordpress.com)
9. How Are You Healing Today? (ofekfamilychiropractic.wordpress.com)
10. Shoulder Girdle: A Delicate Balance (theverticalworkshop.wordpress.com)
11. Hemiplegic shoulder pain: defining the problem and its
    management. Bender L, McKenna K. Disabil Rehabil. 2001 Nov 10;23(16):698-705. Review. PubMed PMID:11732559. http://www.ncbi.nlm.nih.gov/pubmed/11732559

12.  Therapeutic Taping for the Shoulder. Dr. Dyanna Haley-Rezac, PT,DPT, OCS, CSCS, CKTP. Dr. Scott Rezac, PT, DPT, OCS, CSCS, CKTP, CEAS

    13. Kinesio@Taping in Stroke:Improving Functional Use of the Upper in hemiplegic. Eva Jaraczeweska. http://www.kinesiotaping.com/images/kinesio-association/pdf/research/2006-1.pdf

    14. Strapping the hemiplegic shoulder prevents development of pain during rehabilitation: a randomized controlled trial.Griffin A, Bernhardt J. Clin Rehabil. 2006 Apr;20(4):287-95. http://www.ncbi.nlm.nih.gov/pubmed/16719027

    15. Hemiplegic shoulder pain: defining the problem and its management. Bender L, McKenna K. Disabil Rehabil. 2001 Nov 10;23(16):698-705.

    16. Arthrographic distension for adhesive capsulitis (frozen shoulder). Buchbinder R, Green S, Youd JM, Johnston RV, Cumpston M. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD007005.

    17. Functional Impact of Shoulder Taping in the Hemiplegic Upper Extremity. S. Beth Peters^1† and Gregory P. LeeProfessor²

    2003, Vol. 17, No. 2 , Pages 35-46
    http://informahealthcare.com/doi/abs/10.1080/J003v17n02_03?journalCode=ohc