Jobe F W, Pink M
Department of Orthopaedics, University of Southern California, School of Medicine, Los Angeles.
J Hand Ther. 1994 Apr-Jun;7(2):107-10. doi: 10.1016/s0894-1130(12)80079-2.
Throughout the ages, instability has been noted to be the underlying problem in shoulder dysfunction of the young, overhand-throwing athlete. Impingement and rotator cuff tears are progressive symptoms of this instability. The classic theory of impingement describes a mechanism for "outside impingement," which is most often seen in the older, nonathletic population. The mechanism for "inside impingement" in the younger, athletic population is a pinching of the cuff undersurface on the posterosuperior glenoid labrum. In this younger group, the first treatment of choice is rehabilitation. If that fails, the surgical procedure with successful outcome is the ACLR coupled with a progressive rehabilitation program.
长期以来，不稳定一直被认为是年轻的、从事过顶投掷运动的运动员肩部功能障碍的根本问题。撞击和肩袖撕裂是这种不稳定的渐进性症状。经典的撞击理论描述了一种“外部撞击”机制，这在年龄较大的非运动员人群中最为常见。年轻运动员人群中的“内部撞击”机制是肩袖下表面被挤压在肩胛盂后上唇上。在这个较年轻的群体中，首选的治疗方法是康复治疗。如果康复治疗失败，成功率较高的手术方法是关节镜下肩袖修复术（ACLR）并配合渐进性康复计划。
