Wilk K E, Arrigo C
HealthSouth Rehabilitation Corporation, Birmingham, AL.
J Orthop Sports Phys Ther. 1993 Jul;18(1):365-78. doi: 10.2519/jospt.1993.18.1.365.
The rehabilitative process of the overhead athlete represents a significant challenge to the clinician. Overhead athletes (thrower, tennis player, swimmer) repetitively subject their shoulder joints to high microtraumatic stresses that, due to the accumulative effects, may lead to a variety of shoulder injuries. This type of athletic patient exhibits uniquely specific physical characteristics, such as hypermobility of the anterior shoulder capsule, excessive external rotation, hypomobility of the posterior capsule, limited internal rotation, and generalized ligamentous laxity of the glenohumeral joint. However, the overhead athlete must exhibit functional stability for pain-free sports participation. Functional stability is accomplished through the proficient balance of static (passive) and dynamic (active) stabilizers. During the rehabilitation process, various concepts, such as neuromuscular control, proprioception, force couple efficiency, plyometrics, eccentrics, and scapular stability, can enhance dynamic functional stability for the overhead athlete. The evaluation and treatment of the shoulder patient is in perpetual change, and the purpose of this paper is to discuss several current concepts in the rehabilitative treatment of the athletic shoulder patient.
过头运动项目运动员的康复过程对临床医生来说是一项重大挑战。过头运动项目运动员（投掷运动员、网球运动员、游泳运动员）反复使肩关节承受高微创伤应力，由于累积效应，这些应力可能导致各种肩部损伤。这类运动患者表现出独特的身体特征，如肩前关节囊活动过度、外旋过度、后关节囊活动不足、内旋受限以及盂肱关节普遍的韧带松弛。然而，过头运动项目运动员必须具备功能稳定性才能无痛地参与运动。功能稳定性是通过静态（被动）和动态（主动）稳定器的熟练平衡来实现的。在康复过程中，各种概念，如神经肌肉控制、本体感觉、力偶效率、增强式训练、离心运动和肩胛稳定性，都可以增强过头运动项目运动员的动态功能稳定性。肩部疾病患者的评估和治疗一直在不断变化，本文的目的是讨论当前在运动性肩部疾病患者康复治疗中的几个概念。
