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Die schmerzhafte Werferschulter: evidenzbasiertes Übungsprogramm bei Skapuladyskinesie

Shoulder pain in overhead throwing athlete: an evidence-based training program for treating scapula dyskinesis

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Zusammenfassung

Die Position und Bewegung des Schulterblatts ist ein Schlüsselelement für einen harmonischen Bewegungsablauf des Armes. Ein Abheben und eine Fehlrotation des Schulterblatts wird als Skapuladyskinesie bezeichnet. Sie kann auch bei beschwerdefreien Personen auftreten. Bei intensiver sportlicher Belastung kann allerdings eine Skapuladyskinesie die Sehnenstrukturen durch den gestörten Bewegungsablauf belasten und reizen, was zu Schmerzen führt. Deshalb sind die Harmonisierung der Skapulabewegung und die Stabilisierung des Schulterblatts wichtige Pfeiler zur Regeneration entzündeter Schulterstrukturen (z. B. Bizepssehne, Rotatorenmanschette). Elektrophysiologische Untersuchungen zeigen, dass die skapulastabilisierende Muskulatur effektiv trainiert werden kann. Diese Übungen wurden in ein stufenförmiges Programm integriert, das im Artikel vorgestellt wird: Die Basis aller Übungen ist eine optimale Rumpfstabilität. Darauf aufbauend werden die Eigenwahrnehmung, die Stabilisierung und gezielte translatorische Bewegung in isometrischen Übungen trainiert. Sofern diese Übungen schmerzfrei durchführbar sind, werden auch komplexe dynamische Bewegungen geübt, um schlussendlich die sportartspezifischen Bewegungen zu integrieren.

Abstract

A key element for a harmonic movement of the arm is the position and motion of the scapula. A pathologic position and movement of the scapula what is called scapula dyskinesia may irritate the tendons and cause pain in high performing athletes. Scapula dyskinesia, however, may also occur in asymptomatic patients. Harmonizing the sequence of movements and restoration of the dynamic scapular stability are basic steps to regenerate the irritated tendons (e.g. biceps tendon, rotator cuff). Electrophysiological studies have shown that the scapula stabilizing muscles can effectively be exercised. These exercises are part of a step by step program which is described in this article. In the first place, core stability is essential. Furthermore, proprioception, stability and translational movement exercises are in the focus initially. If these exercises can be performed without pain, complex movements and finally sports specific exercises are added.

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Authors and Affiliations

  1. Schulter- und Ellenbogenchirurgie, Sportorthopädie, Klinik und Poliklinik für Orthopädie, Universitätsklinikum Carl Gustav Carus Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland

    Philip Kasten, Christian Kopkow & Julian Dexel

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  1. Philip Kasten
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  2. Christian Kopkow
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  3. Julian Dexel
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Correspondence to Philip Kasten.

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Kasten, P., Kopkow, C. & Dexel, J. Die schmerzhafte Werferschulter: evidenzbasiertes Übungsprogramm bei Skapuladyskinesie. Obere Extremität 8, 164–169 (2013). https://doi.org/10.1007/s11678-012-0199-4

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