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Die Behandlung der Schulter als Bestandteil der Handrehabilitation

  • Thilo Oliver Kromer
Chapter
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Zusammenfassung

Schulterbeschwerden gehören zu den häufigsten Beschwerden, mit denen Therapeutinnen in der Praxis konfrontiert werden (van der Heijden 1999). In vielen Fällen treten sie episodenhaft auf und verbessern sich nicht ohne Behandlung im Laufe der Zeit (Croft et al. 1996; Winters et al. 1999). Trotzdem scheinen viele Betroffene zunächst doch einfach abzuwarten oder zu versuchen, die Beschwerden selbst in den Griff zu bekommen (Croft et al. 1996; Östör et al. 2005). Daher dauert es in der Regel länger, bis sie einen Arzt oder eine Physiotherapeutin aufsuchen. Dies mag u. a. dadurch begründet sein, dass einseitige Schulterbeschwerden besser kompensiert werden können als beispielsweise Rückenschmerzen. Nicht nur die lokale Diagnostik und Differenzierung schulterspezifischer Pathologien, sondern auch die Abgrenzung zu anderen Bereichen, wie z. B. der Halswirbelsäule oder dem neuralen System, sowie die allgemeine Differentialdiagnose stellen eine große Herausforderung für die Therapeutin dar. Ein weiterer wichtiger Punkt ist es, den Patienten im Kontext seines alltäglichen Umfelds, seiner Tätigkeiten und Aufgaben, seiner Einstellungen usw. zu erfassen, um somit zum momentanen Status beitragende und Einfluss nehmende Faktoren zu erkennen und in die Therapie mit einzubeziehen. Ziel dieses Kapitels soll es sein, einen grundlegenden und sehr praktischen Überblick über die allgemeine Anatomie und die Anatomie in vivo der Schulter zu geben. Die Darstellung der Biomechanik findet zunächst allgemein statt und damit geltend für die Kapitel Schulter, Ellbogen und Hand, gefolgt von wichtigen biomechanischen Aspekten des Schulterkomplexes. Folgend werden die subjektive und physische Befunderhebung sowie die wichtigsten Pathologien und deren Behandlung dargestellt. Evidenzbasierte Fakten fließen mit ein, soweit sie zum besseren Verständnis beitragen oder eine direkte Konsequenz auf die praktische Arbeit haben.

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© Springer-Verlag Berlin Heidelberg 2019

Authors and Affiliations

  • Thilo Oliver Kromer
    • 1
  1. 1.HeidelbergDeutschland

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