Jerosch J, Castro W H, Sons H U
Orthopädische Klinik und Poliklinik, Universität Düsseldorf.
Sportverletz Sportschaden. 1990 Dec;4(4):180-5. doi: 10.1055/s-2007-993619.
Dysfunction of the shoulder joint is based not only on anatomic conditions. The consideration of the special kinesiology of the shoulder helps to understand the shoulder pathology. This mainly applies to young "overhead athletes" like swimmers, handball-, basketball-, volleyball-, and racketplayers. These disciplines cause stress on the anterior joint structures (capsule, ligaments, labrum, subscapularis tendon) and lead to anterior instability. This includes anterior subluxation or even dislocation. Finally, an impingement syndrome with the typical symptoms can frequently result from these conditions. The impingement-syndrome of the elderly must be considered as a primary disease, whereas the young overhead athlete suffers from the impingement syndrome as a secondary disease and does not take the first place in therapy. The first step in therapy should to be treat the muscular imbalance of the shoulder. To gain a regular pattern of motion the rotator cuff must be strengthened. This regimen is likely to be successful in 80-90% of the cases. If the conservative therapy fails the surgical treatment may come into consideration. Arthroscopic surgery has the advantage not to affect the proprioceptivity. To retain the previous level of performance an adequate rehabilitation programme is essential for the athlete.
肩关节功能障碍不仅基于解剖学状况。考虑肩部特殊的运动学有助于理解肩部病理学。这主要适用于年轻的“过头运动运动员”，如游泳运动员、手球运动员、篮球运动员、排球运动员和网球运动员。这些运动项目会对关节前部结构（关节囊、韧带、盂唇、肩胛下肌腱）造成压力，并导致前部不稳定。这包括前半脱位甚至脱位。最后，这些情况常常会导致具有典型症状的撞击综合征。老年人的撞击综合征必须被视为一种原发性疾病，而年轻的过头运动运动员的撞击综合征则是继发性疾病，在治疗中并非首要考虑因素。治疗的第一步应该是治疗肩部的肌肉失衡。为了获得正常的运动模式，必须加强肩袖。这种治疗方案在80% - 90%的病例中可能会成功。如果保守治疗失败，可能会考虑手术治疗。关节镜手术的优点是不会影响本体感觉。为了保持以前的运动水平，对运动员来说，一个适当的康复计划至关重要。
