Rodriguez-Santiago Belmarie, Castillo Brenda, Baerga-Varela Luis, Micheo William F
Department of Physical Medicine, Rehabilitation, and Sports Medicine, University of Puerto Rico, School of Medicine, San Juan, PUERTO RICO.
Physical Medicine and Rehabilitation Department-MossRehab, Elkins Park, PA.
Curr Sports Med Rep. 2019 Sep;18(9):330-337. doi: 10.1249/JSR.0000000000000628.
Rotator cuff (RTC) injuries are common in master athletes, especially overhead athletes. Risk factors include aging and degeneration as nonmodifiable and volume of activity, muscle weakness, and loss of motion as modifiable. The clinical presentation involves limited range of motion (ROM), pain at rest and at night. Injury classification into traumatic versus nontraumatic and tendinopathy, partial or full-thickness tears helps to establish a treatment plan. RTC injury rehabilitation protocols are criteria-based, multimodal, and divided into four phases. The acute phase addresses pain, inflammation, ROM, and RTC protection. The recovery phase addresses kinetic chain abnormalities, flexibility, and strength, and the functional phase involves exercises directed toward specific sport activities. Return to sports is based on clinical recovery, kinetic chain principles, and adequate sports technique. Nonsurgical management is recommended in most cases, and surgical management is considered if symptoms progress, especially for full-thickness tears.
肩袖损伤（RTC）在高水平运动员中很常见，尤其是从事过头运动的运动员。风险因素包括不可改变的衰老和退变，以及可改变的活动量、肌肉无力和活动度丧失。临床表现包括活动范围（ROM）受限、静息和夜间疼痛。将损伤分为创伤性与非创伤性、肌腱病、部分或全层撕裂有助于制定治疗计划。RTC损伤康复方案基于标准、多模式，分为四个阶段。急性期处理疼痛、炎症、ROM和肩袖保护。恢复期处理动力链异常、灵活性和力量，功能期包括针对特定体育活动的锻炼。恢复运动基于临床恢复情况、动力链原则和足够的运动技术。大多数情况下建议非手术治疗，如果症状进展则考虑手术治疗，尤其是对于全层撕裂。
