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Was steckt hinter dem Impingementsyndrom beim Sportler?

Skapuladyskinesie und glenohumerales Innenrotationsdefizit

What is behind the impingement syndrome in athletes?

Scapular dyskinesia and glenohumeral internal rotation deficit

  • Leitthema
  • Published:
Arthroskopie Aims and scope

Zusammenfassung

Hintergrund

Das posteriore Impingement des Sportlers stellt eine fordernde Einschränkung dar und tritt besonders bei Wurfsportarten auf. Grundlage ist oftmals ein glenohumerales Innenrotationsdefizit (GIRD) oder eine Skapuladyskinesie.

Ziel der Arbeit

Diese Arbeit soll den aktuellen Stand in der Erkennung, Differenzierung und Behandlung von GIRD und Skapuladyskinesie erläutern.

Material und Methoden

Der Fokus liegt in der Erkennung und speziellen Behandlung des posterioren Impingements.

Ergebnisse

Der Wurfmechanismus oder ähnliche Bewegungen führen zu konsequenter Überlastung der statischen und dynamischen Strukturen des Schultergelenks, wodurch oftmals ein GIRD und eine Skapuladyskinesie entstehen können. Durch die kinetische Änderung der Mechanik besteht ein erhöhtes Risiko für Verletzungen des posterioren Labrums und der Rotatorenmanschette. Konsequente Therapieschemata mit stufenweisem Aufbau zeigen gute Ergebnisse mit Normalisierung der Symptomatik in Profiathleten.

Diskussion

Dem posterioren Impingement liegt oftmals ein GIRD oder eine Skapuladyskinesie zugrunde. Diese Pathologien müssen erkannt und anschließend mit entsprechenden Therapieschemata behandelt werden, sodass die grundlegende Mechanik wiederhergestellt wird. Hier sind bei engmaschiger Kontrolle gute Ergebnisse beim Wiedererlangen des Aktivitätslevels und die Verminderung von Begleitverletzungen möglich.

Abstract

Background

Posterior impingement in athletes represents a demanding limitation especially in forms of sport involving throwing. The reason is often a glenohumeral internal rotation deficit (GIRD) or scapular dyskinesia.

Objective

This article presents the current state of the art in the recognition, differentiation and treatment of GIRD and scapular dyskinesia.

Material and methods

The focus is on the recognition and special treatment of posterior shoulder impingement.

Results

The throwing mechanism or similar movements lead to continuous overload of the static and dynamic structures of the glenohumeral joint, which often results in GIRD and scapular dyskinesia. The kinetic alterations of the mechanics results in an increased risk for injuries of the posterior labrum and rotator cuff. Consistent treatment schemes with a stepwise build-up show good results in professional athletes with normalization of the symptoms.

Conclusion

Posterior impingement is often due to GIRD or scapular dyskinesia. These pathologies must be recognized and subsequently treated in an appropriate stepwise regimen so that the fundamental mechanics can be restored. With close control good results with respect to returning to the previous activity level and the reduction of accompanying injuries are possible.

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Authors and Affiliations

  1. 2. Orthopädische Abteilung, Herzjesu Krankenhaus Wien, Wien, Österreich

    M. Eigenschink

  2. Traumazentrum Wien, Unfallkrankenhaus Meidling, Wien, Österreich

    M. Eigenschink

  3. Schulterzentrum.wien, Health Pi Medical Center, Wollzeile 1–3, 1010, Wien, Österreich

    P. R. Heuberer

Authors
  1. M. Eigenschink
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Correspondence to P. R. Heuberer.

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Interessenkonflikt

P. Heuberer gibt an, dass er in beratender Funktion für Arthex Inc. (Naples, FL, USA) tätig ist. M. Eigenschink gibt an, dass kein Interessenskonflikt besteht. Die Firma Arthrex Inc. (Naples, FL, USA) hatte keinen Einfluss auf Design, Datenerhebung oder Ergebnisse dieser Arbeit.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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P. Heuberer, Wien

S. Siebenlist, München

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Eigenschink, M., Heuberer, P.R. Was steckt hinter dem Impingementsyndrom beim Sportler?. Arthroskopie 34, 427–431 (2021). https://doi.org/10.1007/s00142-021-00476-5

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  • DOI: https://doi.org/10.1007/s00142-021-00476-5

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