I have a 14 yr old patient who is a competitive swimmer who has recently developed (last six months) a very "unstable" SCJ.No history of trauma in the area. During simulated front crawl there is a very audible recurrent clunking in the Right SCJ which causes brief pain. He also experiences the clunking if he lifts up something with his right hand or puts his hands behind his back to stretch. He has very poor posture and scapular control so I have started him on a scapular control strengthening programme and have been attempting to strap the joint to increase the stability. So far any strapping we have done has been unsuccessful.
All the research I have found suggests this atraumatic spontaneous subluxation should resolve in time and that education and reassurance are the primary treatment options, surgury being a non-option due to poor outcomes etc.
I am wondering if everyone has encountered a problem like this before and how did they approach it? Any tips on strapping and direction of strapping?
Would appreciate any help or advice as am feeling a bit stuck!
Thanks
Rosie

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