Vagy Jared
Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States.
Front Sports Act Living. 2022 Mar 21;4:829480. doi: 10.3389/fspor.2022.829480. eCollection 2022.
This case study presents a 38-year-old, female rock climber with posterior elbow pain who was evaluated and treated using Telehealth. The use of telehealth for a clinical exam requires a larger emphasis be placed on posture observation and movement analysis since hands on assessment techniques cannot be used. During the patient exam, movement analyses identified scapulohumeral positional faults and dyskinesis, while self-palpation and self-midline resistance testing helped identify that the triceps tendon was the pathological tissue. A comprehensive rehabilitation program was developed based on concepts of regional interdependence to treat contributing factors in the scapular region and source tissues in the brachial region. After 10 weeks, the climber's pain decreased from 4/10 to 0/10. She made a full recovery back to her previous grade of V8 bouldering and was able to complete a V10 longstanding boulder project pain-free. This is the first case study of its kind to identify unilateral scapular dyskinesia in a patient with suspected triceps tendinopathy and to demonstrate a positive treatment effect by combining scapular strength exercises with eccentric exercises addressing the affected tissue.
本案例研究介绍了一名38岁的女性攀岩者，她肘部后侧疼痛，通过远程医疗进行了评估和治疗。由于无法使用直接触诊评估技术，在临床检查中使用远程医疗时，需要更加强调姿势观察和运动分析。在患者检查过程中，运动分析发现了肩肱位置异常和运动障碍，而自我触诊和自我中线阻力测试有助于确定肱三头肌腱是病变组织。基于区域相互依存的概念制定了一个全面的康复计划，以治疗肩胛区域的相关因素和臂部区域的源组织。10周后，攀岩者的疼痛从4/10降至0/10。她完全恢复到了之前V8抱石的水平，并且能够无痛完成一个V10的长期抱石项目。这是同类案例研究中的首例，识别出疑似肱三头肌腱病患者的单侧肩胛运动障碍，并通过将肩胛力量训练与针对受影响组织的离心训练相结合，展示了积极的治疗效果。
