Moreau C E, Moreau S R
Horrigan Sports Chiropractic Soft Tissue and Athletic Injuries, Los Angeles, CA 90067, USA.
J Manipulative Physiol Ther. 2001 Jul-Aug;24(6):425-30. doi: 10.1067/mmt.2001.116423.
To describe the clinical management of recurrent shoulder instability in a professional hockey player by using chiropractic management and rehabilitation exercises.
A 23-year-old professional hockey player with recurrent left shoulder pain and instability. He had two previous unsuccessful shoulder operations to correct the instability. He reported that the shoulder "slips out" in positions of abduction and external rotation or when the left arm is moved suddenly above shoulder height. The patient was still playing hockey professionally at the time of the initial visit and did not want to have to take time off for another surgery, so he chose to attempt a conservative approach.
The patient had undergone strength training for rehabilitation after each of the previous two shoulder operations and had very strong rotator cuff and scapular musculature. Proprioceptive testing revealed a poor response in the left shoulder compared with the right shoulder. Two subjective outcome measures were used to determine the effectiveness of the treatment protocol in reducing the symptoms of recurrent shoulder instability. Much of the treatment focused on proprioceptive training, soft tissue mobilization, and improving joint function.
This case demonstrates the potential benefit of chiropractic management and proprioceptive exercises to decrease the symptoms of recurrent shoulder instability.
通过整脊治疗和康复锻炼描述一名职业曲棍球运动员复发性肩关节不稳定的临床管理。
一名23岁的职业曲棍球运动员，有复发性左肩疼痛和不稳定症状。他之前曾两次进行肩部手术以纠正不稳定，但均未成功。他报告说，在外展和外旋位或左臂突然举过肩高时，肩部会“滑出”。初次就诊时，该患者仍在职业曲棍球比赛，不想因再次手术而请假，因此他选择尝试保守治疗方法。
该患者在前两次肩部手术后均接受了康复力量训练，肩袖肌群和肩胛肌肉非常强壮。本体感觉测试显示，与右肩相比，左肩反应较差。使用两项主观结果指标来确定治疗方案在减轻复发性肩关节不稳定症状方面的有效性。大部分治疗集中在本体感觉训练、软组织松动和改善关节功能上。
本病例证明了整脊治疗和本体感觉锻炼在减轻复发性肩关节不稳定症状方面的潜在益处。
