Dashottar Amitabh, Borstad John
Division of Physical Therapy, School of Health and Rehabilitation Sciences, Ohio State University, Columbus, OH, USA.
Shoulder Elbow. 2012 Oct 1;4(4). doi: 10.1111/j.1758-5740.2012.00180.x.
Glenohumeral joint posterior capsule contracture may cause shoulder pain by altering normal joint mechanics. Contracture is commonly noted in throwing athletes but can also be present in nonthrowers. The cause of contracture in throwing athletes is assumed to be a response to the high amount of repetitive tensile force placed on the tissue, whereas the mechanism of contracture in nonthrowers is unknown. It is likely that mechanical and cellular processes interact to increase the stiffness and decrease the compliance of the capsule, although the exact processes that cause a contracture have not been confirmed. Cadaver models have been used to study the effect of posterior capsule contracture on joint mechanics and demonstrate alterations in range of motion and in humeral head kinematics. Imaging has been used to assess posterior capsule contracture, although standard techniques and quantification methods are lacking. Clinically, contracture manifests as a reduction in glenohumeral internal rotation and/or cross body adduction range of motion. Stretching and manual techniques are used to improve range of motion and often decrease symptoms in painful shoulders.
肩关节后关节囊挛缩可能通过改变正常关节力学机制而导致肩部疼痛。挛缩在投掷运动员中较为常见，但也可能出现在非投掷运动员身上。投掷运动员出现挛缩的原因被认为是对组织施加的大量重复性拉力的一种反应，而非投掷运动员挛缩的机制尚不清楚。尽管导致挛缩的确切过程尚未得到证实，但机械和细胞过程可能相互作用，增加关节囊的刚度并降低其顺应性。尸体模型已被用于研究后关节囊挛缩对关节力学的影响，并证明了运动范围和肱骨头运动学的改变。影像学已被用于评估后关节囊挛缩，尽管缺乏标准技术和量化方法。临床上，挛缩表现为肩关节内旋和/或体侧内收运动范围减小。拉伸和手法技术用于改善运动范围，并常常减轻疼痛肩部的症状。
