Kristen Clever and the AC joint: The Taping Edition

As the Regionals are finishing up, athletes from around the world are anticipating an exciting Crossfit Games this year. With the Crossfit workouts being so physically and mentally taxing on the body, it is no surprise that injuries occur.
 
2010 Crossfit champion, Kristan Clever, re-sprained her AC joint (acromioclavicular joint) during the 2nd and 3rd workout of qualifications but managed to complete the 6th and 7th workout.  Even though Kristan Clever finished 4th in the Southern California Regionals this year, and out of qualification, she accepted the invitation from Reebok to the 2013 Crossfit Games. In an interview with Reebok, she mentioned that she noticed right away that something was wrong when she went down to do a burpee push up.
 
Ac joint sprains are common in contact sports such as hockey, rugby and football.  Falling on an outstretched hand or onto the shoulder itself are also common mechanisms for AC joint sprains.  Apparently with Kristan, this was an old injury that was probably exacerbated and weakened with the overhead squat (I'm just hypothesizing).

Some signs and symptoms of an AC joint sprain include:

 

  1. Severe pain along the AC joint
  2. Swelling and tenderness
  3. Step deformity (the acromion appears lower than the clavicle)
  4. Limited shoulder mobility and function

 
Obviously as part of your treatment you should ice and rest your AC joint, but what I find the most helpful early in rehabilitation is tape! Offloading the AC joint in a supported position will alleviate pain and discomfort. Pain levels can go from 8/10 to 1/10 in a matter of minutes.

Taping

 
I like using a combination of Hypafix and Leukotape for the first few weeks and then eventually decrease the amount of support by using Ktape/Rocktape or any other types of kinesiology elastic tape.  There are many variations to taping but this technique is what I usually use.

How to Tape the AC joint:

 

  1. Measure and cut the Hypafix from the middle of the deltoid to 3cm posterior to the AC joint and lay the tape down without any stretch

 
 
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   2.  Measure and cut another piece of the Hypafix from the coracoid process to the
        posterior spine of the scapula and lay that down over the first piece
 
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   3.  Measure and cut the Leukotape 0.5-1.0 cm shorter than the original two Hypafix tape
 
   4.  With the arm supported, place the Leukotape at the insertion of the deltoid and pull 
         upwards towards the AC joint.  Enough pull shoulder occur so that wrinkles appear    
         along the Hypafix tape.  Make sure the Leukotape stays off the upper trapezius muscles,
         otherwise it will be uncomfortable.
 
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   5.  With the arm still supported, the 2nd Leukptape will be anchored along to the coracoid 
        and pulled backwards towards the spine of the scapula.
 
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   6.  If you have a skin allergy to tape, it is not recommended to use tape.  Perhaps using a
         sling to provide additional support will also help with the pain.  Monitor the skin for      
         any irritation or rashes and remove as appropriate.
 
As the swelling, pain and muscle inhibition subsides, returning full range of motion and strength of the shoulder will be a priority.
 
As for Kristen, the Crossfit Games are less than 2 months away.  She has limited time to rehabilitate her AC joint and get herself back on track and hopefully on the podium!  Best of luck to Kristan and all the athletes!
 
Cheers,
Jessie Wong, Physiotherapist from the Physio Room
 
 
Photo: http://games.crossfit.com/