Torres-Ramos F M, Biundo J J
Louisiana State University Medical Center, Department of Medicine, New Orleans 70112.
Arch Phys Med Rehabil. 1992 Nov;73(11):1107-11.
A 56-year-old man developed left shoulder pain three weeks after starting a cardiac rehabilitation program, which consisted of submaximal aerobic and progressive resistive exercises. Pain in the left shoulder intensified and weakness developed one week later. He sought medical attention ten weeks after the onset. Physical examination showed only weakness of left shoulder abduction and external rotation with mild atrophy of the left supraspinatus and infraspinatus muscles. Electrodiagnostic study showed fibrillation potentials and positive sharp waves in the left supraspinatus and infraspinatus muscles with delayed conduction to the supraspinatus. The left suprascapular notch was injected with local steroid. Within one week, improvement occurred, and one month later the patient was pain free and stronger. The motor latency returned to normal, and no fibrillations nor positive waves were seen. The patient returned to his previous functional level. Suprascapular neuropathy should be considered as a cause of shoulder pain and weakness in a person involved in any strengthening exercise program. A steroid injection of the suprascapular notch performed early may avoid the need for surgery.
一名56岁男性在开始心脏康复计划三周后出现左肩疼痛，该计划包括次最大强度有氧运动和渐进性抗阻运动。一周后，左肩疼痛加剧并出现无力症状。发病十周后他寻求医疗帮助。体格检查仅显示左肩外展和外旋无力，伴有左冈上肌和冈下肌轻度萎缩。电诊断研究显示左冈上肌和冈下肌有纤颤电位和正锐波，且向冈上肌的传导延迟。在左肩胛上切迹注射了局部类固醇。一周内症状有所改善，一个月后患者疼痛消失且力量增强。运动潜伏期恢复正常，未见纤颤和正波。患者恢复到之前的功能水平。肩胛上神经病变应被视为参与任何强化锻炼计划的人出现肩部疼痛和无力的一个原因。早期在肩胛上切迹注射类固醇可能避免手术的需要。
