Fırat Tüzün, Türker Tolga
Hacettepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Altindag, Ankara 06100, Turkey.
Pathophysiology. 2012 Jun;19(3):179-83. doi: 10.1016/j.pathophys.2012.04.008. Epub 2012 May 26.
Several theories have been proposed to explain the mechanism of non-traumatic supraspinatus tendinopathy, which causes rotator cuff tendinitis and rotator cuff ruptures. However, these theories have not addressed all potential causes of rotator cuff tendinopathy. We propose that the microanatomy of the supraspinatus muscle and its response to gravity is the mechanism that responsible for non-traumatic supraspinatus tendinopathy and rotator cuff tears. Gravity causes chronic traction to the supraspinatus muscle, which results in elongation in the sarcomere length. Elongated sarcomere length causes compression on the micro vessels in the muscle which compromises internal microcirculation of the muscle and tendon. Poor microcirculation triggers ischemia and ischemia triggers inflammation process in the muscle and the tendon. This results in a higher incidence of tendinopathy. We also propose a new physiotherapeutic approach that may provide improved healing for rotator cuff tendinopathy.
已经提出了几种理论来解释非创伤性冈上肌腱病的发病机制，这种疾病会导致肩袖肌腱炎和肩袖撕裂。然而，这些理论并未涵盖肩袖肌腱病的所有潜在病因。我们认为，冈上肌的微观解剖结构及其对重力的反应是导致非创伤性冈上肌腱病和肩袖撕裂的机制。重力会对冈上肌造成慢性牵拉，导致肌节长度延长。肌节长度延长会压迫肌肉中的微血管，从而损害肌肉和肌腱的内部微循环。微循环不良会引发缺血，而缺血会触发肌肉和肌腱中的炎症过程。这就导致了肌腱病的高发率。我们还提出了一种新的物理治疗方法，可能会改善肩袖肌腱病的愈合情况。
