May 2, 2017Tale of the Tape
With athletes choosing to specialize in a sport at younger and younger ages, athletic trainers are seeing more and more overuse injuries. It’s often hard to determine if the pain is primarily from acute overuse or resulting from a breakdown in the kinetic chain in the athlete’s movement patterns.
I recently experienced the latter with a freshman volleyball player who presented with a sore shoulder two days after the start of her first preseason camp. Thanks to a little investigating and a dedicated Kinesio Taping regimen, I was able to minimize the athlete’s pain and keep her on the court.
The Kinesio Taping Technique was first introduced in 1979 by chiropractor Kenzo Kase, DC, as a primary treatment method for reducing pain. He believed applying an elastic therapeutic tape (designed specifically to mimic the properties of the skin) directly to the skin would produce a physiological change that would return the body to homeostasis.
Kinesio Taping can be used in all stages of the injury cycle depending upon the needs of the athlete and the knowledge of the Kinesio Taping Practitioner.
As the technique has developed, depending upon the direction and tension applied to the tape and stretch placed upon the skin, multiple layers of the human body can be affected. Kinesio Taping can be used in all stages of the injury cycle depending upon the needs of the athlete and the knowledge of the Kinesio Taping Practitioner.
When the volleyball player first mentioned her sore shoulder, she reported anterior shoulder pain located in the pectoralis major and minor regions. It presented mainly during hitting and when her shoulder was in abduction/external rotation, with periodic “burning” in her anterior chest. Tests were negative for any structural injuries. However, her pectoralis major and minor were found to be shortened and tight during muscle testing.
As a result, I applied a release technique to these areas. The initial Kinesio Taping application used was an inhibition — distal to proximal with 15 to 25 percent of available tension — to keep the pectoralis major and minor from returning to their shortened position. The lower trapezius and upper trapezius muscles were also facilitated — proximal to distal with 15 to 35 percent of available tension — to assist with scapular protraction.
Although the Kinesio Taping applications helped to decrease the athlete’s pain and increase her range of motion, we still weren’t sure where her shoulder pain originated. We got our answer after asking more in-depth questions about her injury history. Turns out, she was diagnosed with a stress reaction to her left navicular mere months before arriving on campus, which wasn’t included in her pre-participation medical history. Sure enough, evaluation of her left ankle and hip showed gluteus medius weakness of 3/5 when compared to the right side and 3/5 inversion.
To address this weakness, I applied a facilitation technique of the Kinesio Taping method to her gluteus medius. Upon re-testing for muscle strength, a 5/5 was obtained.
With an origination point for the athlete’s shoulder pain, we moved into further scapulohumeral rehabilitation and treatment of the gluteus medius weakness. For the shoulder specifically, I added a modified throwers 10 program and performed a Kinesio Taping inhibition to the deltoid and supraspinatus muscles and a mechanical correction (downward and inward pressure over the anterior humeral head with 50 to 75 percent of available tension) for limiting anterior translation of the humeral head during hitting. To address the gluteus medius, I continued the Kinesio Taping facilitation technique, while also adding strengthening exercises.
Once the season started up, we continued to manage any pain that arose and continued rehabilitation exercises. I modified the Kinesio Taping application to inhibit the athlete’s upper trapezius, facilitate the teres minor and major, and limit the shoulder position during the cocking and follow-through phases of hitting. The athlete didn’t miss any practices or matches as the season progressed.