From Elite Sports Medicine, Connecticut Children's Medical Center, Farmington, CT (Dr. Gelber), the Cleveland Indians Professional Baseball Organization, Cleveland, OH (Dr. Soloff), the Cleveland Clinic Sports Health Center, and the Orthopedic and Rheumatologic Institute, Cleveland (Dr. Schickendantz).
J Am Acad Orthop Surg. 2018 Mar 15;26(6):204-213. doi: 10.5435/JAAOS-D-15-00585.
Overhead athletes subject their shoulders to extreme repetitive torque, compression, distraction, and translation stresses, resulting in adaptive changes of the soft tissues and osseous structures within and around the glenohumeral joint. These anatomic adaptations result in biomechanical enhancements, which improve performance. Understanding the difference between necessary and adaptive changes and pathologic findings is critical when making treatment decisions. Injuries to the shoulder of the overhead athlete can be generally classified into three groups: internal impingement, internal impingement with acquired secondary anterior instability, and primary anterior or multidirectional instability. Although advances in surgical techniques have allowed surgeons to address the pathology in these groups, merely attempting to restore the shoulder to so-called normal can adversely alter adaptive changes that allow high levels of performance.
上肢运动员的肩部会受到极端重复的扭力、压缩力、分离力和平移力的作用，导致盂肱关节及其周围的软组织和骨骼结构发生适应性变化。这些解剖学上的适应性变化带来了生物力学上的增强，从而提高了运动表现。在做出治疗决策时，理解必要的和适应性的变化以及病理发现之间的区别是至关重要的。上肢运动员的肩部损伤通常可以分为三组：内部撞击、内部撞击伴获得性前向不稳定、原发性前向或多向不稳定。尽管手术技术的进步使外科医生能够解决这些组的病理学问题，但仅仅试图将肩部恢复到所谓的正常状态，可能会对允许高水平表现的适应性变化产生不利影响。
