Hawkins R J, Kennedy J C
Am J Sports Med. 1980 May-Jun;8(3):151-8. doi: 10.1177/036354658000800302.
Athletes, particularly those who are involved in sporting activities requiring repetitive overhead use of the arm (for example, tennis players, swimmers, baseball pitchers, and quarterbacks), may develop a painful shoulder. This is often due to impingement in the vulnerable avascular region of the supraspinatus and biceps tendons. With the passage of time, degeneration and tears of the rotator cuff may result. Pathologically the syndrome has been classified into Stage I (edema and hemorrhage), Stage II (fibrosis and tendonitis), and Stage III (tendon degeneration, bony changes, and tendon ruptures). The impingement syndrome may be a problem for the young, active, and competitive athlete as well as the casual weekend athlete. The "impingement sign" which reproduces pain and resulting facial expression when the arm is forceably forward flexed (jamming the greater tuberosity against the anteroinferior surface of the acromion) is the most reliable physical sign in establishing the diagnosis. Flexibility exercises, strengthening programs, and special training techniques are a preventive and treatment requirement. Rest and local modalities such as ice, ultrasound, and antiinflammatory agents are usually effective to lessen the inflammatory reaction. Surgical decompression by resecting the coracoacromial ligament or a more definitive anterior acromioplasty may rarely be indicated.
运动员，尤其是那些参与需要反复过顶使用手臂的体育活动的运动员（例如，网球运动员、游泳运动员、棒球投手和橄榄球四分卫），可能会出现肩部疼痛。这通常是由于冈上肌和肱二头肌肌腱的易损无血管区域受到撞击所致。随着时间的推移，可能会导致肩袖的退变和撕裂。从病理学角度来看，该综合征已被分为I期（水肿和出血）、II期（纤维化和肌腱炎）和III期（肌腱退变、骨质改变和肌腱断裂）。撞击综合征对于年轻、活跃且有竞争力的运动员以及偶尔在周末运动的运动员来说都可能是个问题。当手臂用力向前屈曲时（将大结节挤压在肩峰的前下表面）会重现疼痛及相应面部表情的“撞击征”，是确立诊断时最可靠的体征。灵活性训练、强化训练计划以及特殊训练技巧是预防和治疗的必要措施。休息以及冰敷、超声和抗炎药物等局部治疗方法通常能有效减轻炎症反应。极少情况下可能需要通过切除喙肩韧带或更彻底的前路肩峰成形术进行手术减压。
