Case Report
Scapular Taping in the Treatment of Anterior
Shoulder Impingement
The puqose of this case report is to describe how taping designed to promote
proximal scapular stability was used in conjunction with other physical therapy
interventions to manage a patient with anterior shoulder impingement. The
taping technique is described in detail. The eualuation and treatment of a
patient with an 8-month histo7y of shoulder pain are described as an example
of when this type of taping procedure may be indicated. nis case report demonstrates that a patient was able to return to all of his regular overhead sports
activities without pain following scapular taping used in combination with a
home exercise program. Presumably, the improved resting position of the scapula corrected faulty scapulothoracic joint movements. [Host HH. Scapular taping in the treatment of anterior shoulder impingement. Phys Ther.
1995; 75:80+ 812.1
Key Wonls: Comernative treatment, Scapula, Shoulder impingement.
Athletes who participate in sports that
require repeated overhead motions,
such as those involved in swimming,
tennis, or throwing sports (eg, baseball), and who have faulty shoulder or
scapular movement patterns appear to
be most at risk for developing shoulder pain.lx2 "Overhead or "overhand
movements can be defined as glenohumeral movements in the range of 90
degrees, or greater, of flexion, abduction, or a combination of the two
motions. Sports that require these
motions subject the shoulder to a large
range of motion, repetitively, which
can result in anterior shoulder instability and eventually microtrauma of the
soft tissue surrounding the glenohumeral joint.l.3 This injury can lead to
impingement of the rotator cuff tendons, which, over time, can cause a
rotator cuff tear.3 This problem is most
often treated with physical therapy
and physician-prescribed nonsteroidal
anti-inflammatory medications.l.+5 If
no improvement is seen in the patient's condition within 3 months,
surgery is often performed.3~4
The purpose of this case report is to
illustrate the use of scapular taping in
a patient with impingement of his
right rotator cuff tendons. Taping was
used only after the patient's symptoms
were not relieved by attempting to
correct his faulty overhead movements
through exercise and education in the
use of proper scapular positioning.
Scapular taping and exercises appeared to be effective in relieving
symptoms, and the patient was able to
return to all of his overhead recre-
ational and sports activities without
pain. The taping, I believe, promotes
proximal stability of the scapula, allowing humeral motion without the
subsequent pain that can result from
impingement of the rotator cuff tendons. The taping technique is thought
to affect the resting position of the
scapula and assist in maintaining the
proximal shoulder-girdle stability necessary to perform elevating motions of
the arm. With the tape holding the
scapula in a more proper alignment,
the patient can then use the shoulder
without further stressing the impinged
tendons. Additionally, the tape provides a feedback mechanism allowing
the patient to feel "normal" alignment
and positioning of the shoulder
complex.
l n t d e w Data
HH Host, PT, is a doctoral student in the Program in Movement Science, Washington University
School of Medicine, Box 8502, 660 S Euclid Ave, St Louis, MO 63110 (USA)
(hhhost@ansci.wustl.edu).
A right-handed, 40-year-old, Caucasian
man with a diagnosis of right shoulder
pain was referred to physical therapy
by his orthopedic surgeon. At the time
7his article was submitted July ZG,1994, and was accepted May 8, 1995.
Physical Therapy / Volume 75, Number 9 / September 1995
803/ 27
(NaprosynBt), without noticeable
benefit.
Physical Examination Dafa
During the patient's initial physical
therapy visit, an ordinal self-report
rating scale was used to assess the
intensity of his pain at rest and during
shoulder movements. He rated his
pain intensity by assigning a number
from a 0 to 10, where 0 represented
no pain and 10 represented the worst
imaginable pain.6 The patient reported
a 0 pain rating for both (right and left)
shoulders while at rest.
.
Figure 1 Dotted outline illustrates the position of the patient's scapula, and the
solid outline shows where the scapula should "normally"be positioned. His right scapula
is in aposition of downward rotation (inferior-medial border of the scapula closer to
spinous processes than superior-medial border). Taping technique can help improue the
resting position of the scapula and make it more like the "nom1"position.
of the initial visit, he reported an
%month history of progressively worsening symptoms. His primary complaint was of intermittent pain in the
anterior-superior glenohumerdl joint
with activities requiring the use of his
right arm for overhead motions. He
was employed as a laboratory research
technician and was recreationally very
active, participating in some type of
sports activity daily. He stated he had
been regularly weight training (on
Nautilus equipment,' performing the
entire circuit of upper- and lowerextremity exercises) three times per
week and played racquetball and
tennis 1 to 2 days per week, on a
year-round basis and had been doing
so for at least 10 yean. The only modification made by the patient, secondary to onset of his right shoulder pain,
was that 2 months after the symptoms
first developed, he stopped playing
tennis because he could not serve
without severe pain. When the patient
first came to physical therapy, he
reported slight pain in his right shoulder during each weight-training session, but a great increase in pain the
morning following each session. He
also reported having pain when trying
to throw a baseball. He described the
pain as being in his anterior-superior
right glenohumeral joint and reported
a "popping" sensation when he lifted
hls right arm overhead. The patient
had been seen by two different physicians, and he said they told him that
radiographs were negative for evidence of fracture or moderate to severe ligamentous disruption. He repolted taking prescribed nonsteroidal
anti-inflammatory medication
*Sports/Medical Industries, PO Box 1783, Depart PT, DeLand, FL 32721.
??yntex Laboratories Inc, 3401 Hillview Ave, P O Box 10850, Palo Alto, CA 94303.
The patient reported pain (pain rating=5) during right shoulder flexion
(in the 150°-180° range) and abduction (in the 140°-170' range) while
standing. He had full, pain-free motion
of the left shoulder. Additionally,
when the patient was positioned supine with his shoulder abducted approximately 30 degrees, it was noted
he had medial (internal) (0'-BO) and
lateral (external) (00-1000) rotation of
his right shoulder that exceeded normal values.' His left shoulder medial
rotation was 0 to 80 degrees, which is
also greater than the normal range,
but he had normal lateral rotation on
that side. Although intratester rehbility of these measures was not assessed, measurements of shoulder
range of motion have been shown to
be reliable when repeated by the
same physical therapist.*,9The intrarater intraclass correlation coefficients for shoulder rotation ranged
from .93 to
Additionally, high
intratester reliability of goniometric
measurement of both upper- and
lowerextremity joints has been established by several researchers.8-11
While the patient was standing, a
visual inspection of his posture revealed he had bilateral forward shoulders, with the right shoulder more
forward than the left shoulder ("forward was defined as the shoulder,
from a lateral view, appearing anterior
from the mid-coronal plane). From a
posterior view, the right scapula appeared to be more abducted fmm the
vertebral spinal processes than the left
scapula. The right humeral head ap-
Physical Therapy / Volume 75, Number 9 / September 1995
-
Table 1. Manual Muscle Test Results for Initial and Final Visits
Initial Visit
Muscle Group
Right
Final Visit
Left
Right
Left
Shoulder flexors
Shoulder abductors
Shoulder medial (internal) rotations
4-/5
5/5
5/5
5/5
Shoulder lateral (external) rotations
4-/5
415
5/5
5/5
Biceps
5/5
5/5
5/5
5/5
Triceps
5/5
5/5
5/5
5/5
Supraspinatus
opinion of several authors and is not
based on data or research findings.
Additionally, at rest, the left scapula's
medial border remained parallel to the
thoracic spinous processes along the
entire extent, whereas the right scapula was in a position of downward
rotation (ie, the inferior, medial border
of the scapula was closer to the thoracic spinous processes than the superior, medial border of the same scap
ula) (Fig. 1). Intratester reliability of
measuring these scapular positions has
not been assessed by this examiner or
others.
Lower trapezius
Serratus anterior
Middle trapezius
Upper trapezius
a Painful.
peared, based on palpation, to be
slightly anterior to the anterior border
of the acromion, whereas on the left
the humeral head was centered under
the acrornion. Winging of both scapulae was evident along the entire length
of the vertebral borders of the scapula;
however, winging of the right scapula
was greater than that observed of the
left scapula. 'Winging" of the scapula
occurs around the vertical axis and is
almost universally used to describe a
posterior displacement of the vertebral
border of the scapula.12
Faulty scapulohumeral rhythm was
thought to occur when the patient
flexed and abducted his right humerus. The observed fault was an
immediate and excessive scapular
abduction and elevation during the
initiation of either humeral motion and
what appeared to be excessive (greater than 60") scapular abduction at the
end range (180") of abduction and
flexion. Scapular abduction was a p
proximated based on visual estimates
during the movements and measured
once the patient achieved full flexion
or abduction. The measurement was
made with a goniometer with the
stationary arm parallel to the thoracic
spinous processes and the movable
arm following the medial border of
the scapula. Some authors '+I7 state
that during complete (180" or full)
humeral flexion or abduction, the
range of scapular movement does not
normally exceed 60 degrees, whereas
the range of glenohumeral movement
is approximately 120 degrees of motion. The excessive scapular abduction
and elevation were not observed with
flexion and abduction of the left
shoulder. The patient was given verbal
directions to keep his scapula "down"
(depressed) and "back (adducted)
while repeating right humeral flexion
and abduction. At first, tactile cues
were provided by the therapist, but
after one to two attempts the patient
was able to do this independently.
While attempting to maintain his scap
ula in a depressed and adducted position, he was able to perform right
shoulder flexion and abduction without pain.
The resting scapular positions were
compared while the patient was standing. The medial border of the right
scapula was abducted 9 cm away
from the fourth thoracic spinous process, whereas the medial border of the
left scapula was abducted 5 cm away
from the same spinal landmark. The
normal distance from the medial scapular border to the thoracic spinous
processes is believed to be 5.08 cm (2
in).12J8J9This value, however, is the
Physical Therapy /Volume 75, Number 9 / September 1995
There was notable tenderness to palpation over the right bicipital and
rotator cuff tendons. There was no
tenderness to palpation on the left
side. Palpation of these tendons was
performed in positions as described by
several
Differentiation
of the rotator cuff tendons was not
made, as it has been shown that the
four rotator cuff tendons blend intimately together to form a continuous
rotator ~uff.l7,~l
Weakness (as determined with manual
muscle testing) with pain was found
when testing the right shoulder flexors
and abductors and during testing of
the supraspinatus muscle (Tab.
All of the manual muscle tests were
performed as previously described by
Ker~dall,~
except for a test attempting
to isolate the supraspinatus muscle,
which was done as described by Jobe
and Bradley 3 and Townsend et a1.Z
Manual muscle testing grades can be
reliable within examiners, under special conditions, according to several
resear~hers.~3,~*
Intertester reliability is
not high.23.25
When performing tests that were used
to assess muscle length, the patient
exhibited shortness in the latissimus
dorsi muscle (lacked 40" on the right
and 30" on the left) and the pectoralis
minor muscle (right posterior acromion approximately 5 cm [2 in] up
from table and left posterior acromion
approximately 2.5 crn [I in] up from
the table), bilaterally. These tests were
performed as described by Kendall?
and neither test provoked pain in the
805 / 29
-
ing other overhead activities with
resistance (eg, lifting weights)' are
both strong indicators of anterior
shoulder impingement.
Table 2. Stretching and Strengthening Exercises
Exercise
1. Pectoralis minor muscle
stretch-supine
Description
Patient positioned supine, hook-lying7with another person
pressing, with the heel of hand over the patient's coracoid
process, down and out at approximately a 45" angle away
from the body.
2. Latissimus dorsi muscle
stretch-supine
Patient positioned supine, hook-lying in same position in
which "tightness" is assessed7;care is taken to ensure that
the patient does not arch the lower back.
3. Wall push-up with scapular
adduction-standing
Starting position-patient positioned standing, facing the wall
with forearms resting on wall (thumbs facing away from
wall) and shoulders flexed to approximately 90". Patient
slides arms up wall making shape of letter "V" (similar
position as strength test position of lower trapezius
muscle7),until end range is reached or to just before pain
starts. If able to go through full motion without pain, patient
lifts arms away from the wall while retracting scapulae.
Position is held 2-3 s; patient then returns arms to wall and
slides them back to starting position. Maintenance of
proper bacWtrunk posture is very important with this
exercise.
4.Shoulder medial/lateral
(intemal/external)
rotation-prone
~ . ~towels used anterior to
Patient positioned p r ~ n ewith
humeral head to maintain proper glenohumeral
alignment and shoulder abducted 90". Patient laterally
rotates (0"-90") and medially rotates (0"-70"),
concentrating on pure glenohumeral movement. This
exercise was started with just the weight of the patient's
arm and quickly progressed to using small dumbbells
(1-5 lb).
5. Shoulder medial/lateral
rotation with
Thera-Band@,b-standing
Patient positioned standing as illustrated in Kisner and Colby
text" and using ~hera-Bandm
to perform IateraVmedial
rotation of the shoulder. Patient with shoulder in neutral,
adducted starting position with the Thera-band"
attached opposite from the direction in which he or she
will pull. Patient started with yellow and moved up to
blue Thera-bandmthroughout the treatment.
6. Lower trapezius muscle
strengthening-prone
This exercise is performed in same position in which the
strength is assessed7,except secondary to this patient's
weakness he started with just lifting his arm into the test
position but with his elbow flexed and he eventually
progressed to lifting a straightened arm with maintenance
of proper scapular position (depression, lateral rotation of
inferior angle, and adduction of the scapula). Last, he did
the exercise with lightweight dumbbells.
Assessment
The patient's history and data from the
physical examination support the
diagnosis of anterior impingement of
the right shoulder. The patient's history was the first indicator of an impingement syndrome. His inability to
perform the maneuver that caused the
impingement (his tennis serve)X4and
his pain and discomfort after perform-
The patient reported decreasing right
shoulder pain until his fourth visit.
During his fourth visit, he reported
that after helping a friend move some
heavy furniture he hurt h s right shoulder and had pain, even at rest, with an
intensity rated at 4. He complained
that he was again having pain during
flexion and abduction and that he was
Davis Co; 1985:258-259, 6 2 0 .
bThe Hygenic Corp, 1245 Home Ave, Akron, OH 44310-2575.
30 / 806
Treatment
Because the patient was able to resolve his pain with verbal and tactile
cues on the first visit, I directed my
initial treatment toward teaching him
to flex and abduct his right humerus
while attempting to maintain proper
scapulohumeral position throughout
the range of motion. He was also
given exercises (Tab. 2) to stretch the
short muscle groups and strengthen
those muscle groups that were weak.
He wanted to continue with his recreational activities, but it was emphasized to him that he should avoid any
activities that caused his pain. He was
able to continue llfting weights, but
decreased the resistance during all of
his arm exercises by 4.5 to 9.1 kg
(10-20 lb). The patient was encouraged to correct his scapular position
during performance of these exercises.
If he experienced pain on any of the
resistance exercises, he was instructed
not to elevate his arms higher than the
point of pain.
" Kisner C, Colby LA. merapeutic Exercise: Foundations and Techniques. Philadelphia, Pa: FA
right shoulder. It should be noted that
although goniometric measures are
reported to express an existence of a
specdic muscle's shortness, this relationship has not been exanlined by
research. As a rule, limitations in joint
range of motion measurements may
be due to a variety of causes and
cannot be said to be only due to muscle tightness.26
Subjective measures such as the patient's postural faults, both in a standing, resting position and with elevation
of his right humerus into flexion and
abduction (faulty scapulohumeral
positioning); his painful arcs of motion; his tenderness to palpation of the
rotator cuff tendons and biceps tendon; his strength deficits; and his
muscle shortness in specific muscle
groups all suggested the patient had
an anterior impingement of his right
shoulder. This finding is based on
several authors' classification of a
stage I1 anterior shoulder
impingement.+5.13.14
Physical Therapy / Volume 75, Number 9 / September 1995
Scapular Taping Technique
Figure 2a.
scapular taping technique: First strip of Cover-Rolf" in place.
unable to reduce his pain with his
own attempts at proper scapular positioning. I was able to decrease his
pain by holding his right scapula in a
more correct position during humeral
flexion and abduction (this was accomplished by manually holding the
scapula back into a more adducted
position, assisting with upward rota-
tion and preventing it from elevating
excessively). This suggested that scapular taping might be helpful. The
patient's scapula was taped to decrease the excessive abduction and
winging and also to promote upward
rotation, as opposed to the downwardly rotated position that was his
resting position.
*Distributed by Beiersdorf Inc, Norwalk, CT 06856-5529.
Physical Therapy / Volume 75, Number 9 / September 1995
Cover-roll@stretch*was used to protect the patient's skin, and the taping
was done using Leukosport@(Leukotape@P) tape.*The taping was initiated by first applying two 10.2cmwide (4-in-wide) Cover-Roll@strips to
protect the skin. The first strip was
applied pulling proximally from the
right upper trapezius muscle belly
region distally to approximately 5 to
7.6 cm (2-3 in) below the inferior
angle of the right scapula (Fig. 2a).
Another protective Cover-Roll@strip
was then applied from the posteriorlateral right acrornion diagonally
across the back and ended just lateral
to the thoracic spinous processes (Fig.
2b). Several 3.8-cm-wide (1.5-in-wide)
Leukosport@strips of tape were then
applied, with the first two strips of
tape starting at the mid-muscle belly
region of the right upper trapezius
muscle and pulling downward and in
toward the spinous processes attaching the tape just medial and inferior to
the inferior angle of the scapula (Fig.
2c). Additional strips of tape were
then applied by starting with each
piece from the mid-muscle belly region of the upper tmpezius muscle
and continuing outward to the
posterior-lateral acromial process. Each
strip of tape was applied in order to
pull the scapula back into adduction
and slightly downward (from its starting, elevated position) (Fig. 2d). The
strips of tape followed the line of pull
of the lower and middle trapezius
muscles. The tape was applied with
the patient in a sitting position while
an assistant or the therapist supported
the patient's shoulder under the axillary region to relax the scapular muscles (especially the upper trapezius
muscle). The tape was applied tightly,
but loose enough to allow movement
of the scapula with flexion or abduction of the humerus. A total of 8 to 10
strips of Leukospofl tape were used
with this patient.
After the tape was applied (Fig. 2e),
the patient had pain-free full flexion
and abduction of the right humerus.
Assessment of the patient's motion
with the tape in place allowed for
immediate assessment of the tape's
these four visits, the patient reported
that his pain was progressively
decreasing.
On the patient's ninth visit, he was
able to abduct and flex the right humerus through a complete 180-degree
range of motion and perform his
home exercise program without pain
and without the tape, so the scapular
taping was discontinued. The patient
stated he continued to have occasional, brief periods of pain, but with
consciously making an effort to hold
his scapula "down and back," he
could relieve the pain entirely.
The patient was not seen for the following 3 weeks because he was out
of town. His next visit was his 10th
and final visit. He reported no pain
with any of his work or recreational
activities, although he would have an
occasional "twinge" of pain (whlch he
rated as 1-2) in the anterior right
shoulder the day after a weight-lifting
session, but he stated the pain was not
as severe as before. The patient reported he had not yet resumed playing tennis.
Figure 2b.
Scapular taping technique: Second strip of Cover-Roll@in place.
effectiveness, and it could be decided
based on whether the patient had pain
whether additional pieces of tape
were required for further support.
The patient's scapula was retaped on
visits 5 through 8, with no more than
4 days between visits. The tape
seemed to hold tightly for 2 to 3 days,
at which time the patient reported he
could feel it loosening and his painful
symptoms would return. At that time,
32 / 808
the patient was instructed to remove
the tape and return for another visit to
have the scapula retaped. During each
visit, immediately prior to taping, the
patient would flex and abduct his right
humerus to determine whether these
motions were stdl causing pain. With
each of these visits (visits 58), the
patient continued to have complaints
of pain (ratings equal to 3-5) without
the tape during motions of right humeral flexion and abduction. Over
Final impairment measurements were
taken on this date to determine
whether the patient had changed from
the initial visit. In a standing, resting
position, the right scapula's medial
border was now 5 cm from the spinous process of T 4 . A slight winging
was still evident in the right scapula,
but the winging was not as great as
during his initial visit. The muscle test
attempting to isolate the right supraspinatus muscle was now 4+/5
(pain-free), and all other muscle tests
revealed bilateral upper-extremity
strengths of 5/5 with no pain Gab. 1).
The diference between ratings of 4+
and 5 is that with a rating of 5 the
patient can hold the test position
against gravity and maximal pressure,
whereas with a rating of 4+ the patient can hold against gravity and
moderate pressure.' The patient's
muscle shortness had improved in
both his latissimus dorsi and pectoralis
minor muscles, bilaterally, although he
still did not have normal length. With
assessment of his pectoralis minor
muscle length, while positioned su-
Physical Therapy /Volume 75, Number 9 / September 1995
the past 3 weeks. He stated he was
playing racquetball without pain,
along with practicing his tennis serve.
It was recommended that he continue
with his home exercise program. A
second follow-up phone call was
made, 3 months after his last visit and
the patient reported that he was no
longer having any pain and had resumed playing tennis a few times a
week, along with his other recreational activities.
Several factors will determine successful treatment of a patient with shoulder impingement syndrome. One of
the most impomnt criteria must be
reduction of the patient's complaints
of pain. Second, the return of the
patient to his or her prior activity level
provides a measure of successful outcome. Impingement of the rotator cuff
is presumably the result of poor
shoulder-girdle mechanics and may be
due to hypomobility (shortening of
soft tissue), hypermobility (lengthening of soft tissue that can eventually
lead to damage to the labrum), or
strength imbalances of one or more
muscles about the shoulder girdle.*'
AU of these factors may have contributed to the anterior shoulder impingement of the patient described in thii
case report.
Figure 2 ~ .Scapular taping technique: Application of Leukosport@tape, with support given under patient's axilla.
pine, the patient's posterior acromion
was about 2.5 cm (1 in) above the
table surface on the right and about
1.3 cm (0.5 in) above the table surface
on the left. With measurement of the
latissimus dorsi muscle length, the
patient was now lacking 15 degrees
(from 180') on the right and 10 degrees on the left. The patient was
encouraged to start practicing his
tennis serve, and to progress with this
activity over the next 4 to 6 weeks.
Additionally, he was also instructed to
continue with his stretching exercises
and rotator cuff strengthening, at least
three times a week.
Phone Follow-up
I spoke with the patient 1 month after
his last visit, and he reported that he
had not had right shoulder pain for
Physical Therapy / Volume 75, Number 9 / September 1995
I believe scapular taping is indicated
when a patient is unable to alleviate
his or her symptoms, even after education in proper positioning and an
appropriate home exercise program.
The effectiveness of scapular taping
alone has not been demonstrated. I
believe, however, that scapular taping
should be used in conjunction with
other interventions, specifically selected exercises and patient education
about modification of performing
overhead activities. Scapular taping
can be used as an adjunctive therapy
to attempt to attain a more favorable
scapular alignment and alleviate p i n .
The tape should never restrict a patient's range of motion. Additionally, it
should allow the patient to perform
motions that would have been painful
without the tape in place, thus providing an immediate assessment of the
Improving the biomechanics of the
scapulohumeral and scapulothoracic
joints is what ultimately relieves the
patient's symptoms. Scapular taping
may be one way to improve scapular
alignment. Holding the scapula in
better alignment with tape may provide a prolonged stretch to the tight
structures around the shoulder. Additionally, I believe that this improvement in position helps to increase the
subacromial space. Thus, the taping
may relieve any excessive tension
placed on the involved structures of
the impingement. Muscle and collagenous tissue are both very adaptable,
and studies16,29-31 have shown that
low-load, longduration stretching is
more effective than short-term, vigorous stretching. Taping may be one
way to achieve this low-load,
prolonged-duration stretching.
The patient in this case report was
seen for 3 months for a total of 10
visits. It is felt that through the use of
scapular taping, his treatment was of
shorter duration than it would have
been without the taping technique.
There are several outcome r e p o r t ~ ~ ~ 5 ~ 3 ~
that have documented the time course
and results of surgical interventions in
patients with rotator cuff injury and
bicipital tendinitis, but very few provide the results of those patients
treated conservatively. Pink and Jobe33
report a 95% "success" rate for returning an athlete to his or her prior level
of competition within 3 months without surgery. Unfortunately, this reporl
contained no data to support this
claim.
Figure 2d.
Scapular taping technique: Application of Leukosport" with supporr
given under patient's axilla.
tape's effectiveness. A thorough examination of the scapula's position at rest
and during movements is most important before using taping as a treatment
technique.28One difference with scapular taping as compared with patellar
taping is that the patients must return
to the clinic every 2 to 4 days to be
retaped, as they cannot tape themselves. This is also not an easy procedure to teach a family member or
34 / 810
friend unless that person is very familiar with the anatomy and kinesiology
of the scapula and shoulder. I believe
that paramount to the success of this
treatment program is a thorough understanding by the patient of the underlying mechanical cause of his or
her pain and the importance of changing faulty movements to prevent the
pain from returning.28
There have been few studies of therapeutic outcomes and expected durations of treatment regarding conservative management of shoulder
impingement syndromes. Several
auth0rs3.~imply that if the patient with
shoulder impingement was not better
after 3 months of conservative treatment, surgery was indicated.
Although taping may have been of
benefit in treating this patient, and has
been used by this author and other
therapists in our clinic with good
success, this was not a controlled
experimental study but rather a report
Physical Therapy / Volume 75, Number 9 / September 1995
tension on the involved structures of
the impingement. Poor scapulohumeral rhythm from faulty shoulder
and scapular movements presumably
contributed to this patient's impingement, but it cannot be said with certainty that the taping and exercise
addressed these faults. I can only
surmise that the resting position of this
patient's right scapula was changed
and his pain was relieved as a result
of the treatment. Scapular taping may
be a useful adjunctive technique for
promoting proper scapular position
and should be used in conjunction
with other conservative methods of
treating patients with impingement
syndromes of the shoulder.
!p
--,I:
.(
30,'.
.
Special thanks are given to David R
Sinacore, PhD, PT, for his critical review of this manuscript. His assistance
and time are both greatly appreciated.
I also thank Shirley A Sahrmann, PhD,
PT, FAPTA, and Susan S Deusinger,
PhD, PT, for their helpful comments
and recommendations in regard to this
manuscript.
Figure 2e. scapular taping technique: Patient with tape in place. He is able topex
and abduct his right arm withoutpain.
of a single patient. Further studies are
necessary before any substantive
claims can be made about the efficacy
of scapular taping.
Conclusion
This case report describes the treatment of a patient with anterior impingement of his right shoulder with a
taping procedure designed to promote
proximal stability of the scapula and
therapeutic exercises. The improvements seen in his resting scapular
position after this treatment regimen
indicate that the taping procedure may
have provided a prolonged stretch to
short structures and possibly enabled
other muscles to function in a more
proper manner. Another possible
result of the taping procedure is that it
could have relieved the excessive
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PHARMACOLOGY
For an in-depth understanding of how
medications influence your patient's
1
2231 4-1 488.
This collection of 1 3 articles, from a two-part
special series published in Physical Therapy,
insightfully explores the relationship between
specific clinical conditions, such as cardiovascular and pulmonary disease, diabetes mellitus,
Parkinson's disease, and rheumatoid arthritis; pro-
36 / 812
hi
,
NAME
APTA
MFMHEK
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Physical Therapy / Volume 75, Number 9 / September 199j