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Obere Extremität

Erschienen in:

21.01.2022 | Review Article

A structured approach to shoulder pathologies in overhead athletes

Classification and key considerations for successful treatment

verfasst von: Prof. Dr. Knut Beitzel, MD, M.A., Dr. Lukas N. Muench, MD, Eric McCarty, MD, Dr. Daniel P. Berthold, MD

Erschienen in: Obere Extremität | Ausgabe 1/2022

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Abstract

Shoulder pain is frequently seen in overhead athletes. The diagnosis and treatment are often difficult because of multiple factors. However, this variable group of patients can be classified into three main groups according to the requirements of their specific sports: (1) injuries caused by internal impingement (posterosuperior impingement and anterosuperior impingement); (2) injuries caused by acquired macro- or micro-traumatic instability with secondary internal impingement; and (3) injuries caused by rotator cuff-associated pain due to hyperlaxity/multidirectional instability. A structured approach to the evaluation of these athletes is presented and specific key factors are suggested to define the best treatment option.

Kibler WB (1998) The role of the scapula in athletic shoulder function. Am J Sports Med 26:325–337PubMed

Bigliani LU, Codd TP, Connor PM, Levine WN, Littlefield MA, Hershon SJ (1997) Shoulder motion and laxity in the professional baseball player. Am J Sports Med 25:609–613PubMed

Borsa PA, Laudner KG, Sauers EL (2008) Mobility and stability adaptations in the shoulder of the overhead athlete. Sports Med 38:17–36PubMed

Borstad JD, Ludewig PM (2005) The effect of long versus short pectoralis minor resting length on scapular kinematics in healthy individuals. J Orthop Sports Phys Ther 35:227–238PubMed

Braun S, Kokmeyer D, Millett PJ (2009) Shoulder injuries in the throwing athlete. J Bone Joint Surg Am 91:966–978PubMed

Burkhart SS, Morgan CD, Kibler WB (2003) The disabled throwing shoulder: spectrum of pathology part I: pathoanatomy and biomechanics. Arthroscopy 19:404–420PubMed

Cools AM, Borms D, Castelein B, Vanderstukken F, Johansson FR (2016) Evidence-based rehabilitation of athletes with glenohumeral instability. Knee Surg Sports Traumatol Arthrosc 24:382–389PubMed

Cools AM, Declercq G, Cagnie B, Cambier D, Witvrouw E (2008) Internal impingement in the tennis player: rehabilitation guidelines. Br J Sports Med 42:165–171PubMed

Cools AM, Johansson FR, Borms D, Maenhout A (2015) Prevention of shoulder injuries in overhead athletes: a science-based approach. Braz J Phys Ther 19(5):331–339. https://doi.org/10.1590/bjpt-rbf.2014.0109CrossRefPubMedPubMedCentral

10.

Cools AM, Struyf F, De Mey K, Maenhout A, Castelein B, Cagnie B (2014) Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete. Br J Sports Med 48:692–697PubMed

11.

Corpus KT, Camp CL, Dines DM, Altchek DW, Dines JS (2016) Evaluation and treatment of internal impingement of the shoulder in overhead athletes. World J Orthop 7:776PubMedPubMedCentral

12.

Crockett HC, Gross LB, Wilk KE, Schwartz ML, Reed J, OMara J, Reilly MT, Dugas JR, Meister K, Lyman S (2002) Osseous adaptation and range of motion at the glenohumeral joint in professional baseball pitchers. Am J Sports Med 30:20–26PubMed

13.

DeFroda SF, Goyal D, Patel N, Gupta N, Mulcahey MK (2018) Shoulder instability in the overhead athlete. Curr Sports Med Rep 17:308–314PubMed

14.

Drakos MC, Rudzki JR, Allen AA, Potter HG, Altchek DW (2009) Internal impingement of the shoulder in the overhead athlete. J Bone Joint Surg Am 91:2719–2728PubMed

15.

Fleisig GS, Andrews JR, Dillman CJ, Escamilla RF (1995) Kinetics of baseball pitching with implications about injury mechanisms. Am J Sports Med 23:233–239PubMed

16.

Gagey O, Boisrenoult P (2004) Shoulder capsule shrinkage and consequences on shoulder movements. Clin Orthop Relat Res 419:218–222

17.

Gaskill TR, Millett PJ (2011) Management of multidirectional instability of the shoulder. J Am Acad Orthop Surg 19:758–767PubMed

18.

Gerber C, Nyffeler RW (2002) Classification of glenohumeral joint instability. Clin Orthop Relat Res 400:65–76

19.

Gulotta LV, Lobatto D, Delos D, Coleman SH, Altchek DW (2014) Anterior shoulder capsular tears in professional baseball players. J Shoulder Elbow Surg 23:e173–e178PubMed

20.

Harryman DT, Sidles JA, Clark JM, McQuade KJ, Gibb TD, Matsen FA (1990) Translation of the humeral head on the glenoid with passive glenohumeral motion. J Bone Joint Surg Am 72:1334–1443PubMed

21.

Hickey D, Solvig V, Cavalheri V, Harrold M, Mckenna L (2018) Scapular dyskinesis increases the risk of future shoulder pain by 43 % in asymptomatic athletes: a systematic review and meta-analysis. Br J Sports Med 52:102–110PubMed

22.

Huffman GR, Tibone JE, Mcgarry MH, Phipps BM, Lee YS, Lee TQ (2006) Path of glenohumeral articulation throughout the rotational range of motion in a thrower’s shoulder model. Am J Sports Med 34:1662–1669PubMed

23.

Jobe FW, Kvitne RS, Giangarra CE (1989) Shoulder pain in the overhand or throwing athlete. The relationship of anterior instability and rotator cuff impingement. Orthop Rev 18:963–975PubMed

24.

Keller RA, De Giacomo AF, Neumann JA, Limpisvasti O, Tibone JE (2018) Glenohumeral internal rotation deficit and risk of upper extremity injury in overhead athletes: a meta-analysis and systematic review. Sports Health 10:125–132PubMedPubMedCentral

25.

Kibler WB, Press J, Sciascia A (2006) The role of core stability in athletic function. Sports Med 36:189–198PubMed

26.

Kibler WB, Uhl TL, Maddux JW, Brooks PV, Zeller B, McMullen J (2002) Qualitative clinical evaluation of scapular dysfunction: a reliability study. J Shoulder Elbow Surg 11:550–556PubMed

27.

Knesek M, Skendzel JG, Dines JS, Altchek DW, Allen AA, Bedi A (2013) Diagnosis and management of superior labral anterior posterior tears in throwing athletes. Am J Sports Med 41:444–460PubMed

28.

Laudner K, Meister K, Noel B, Deter T (2012) Anterior glenohumeral laxity is associated with posterior shoulder tightness among professional baseball pitchers. Am J Sports Med 40:1133–1137PubMed

29.

Lintner D, Noonan TJ, Kibler WB (2008) Injury patterns and biomechanics of the athlete’s shoulder. Clin Sports Med 27:527–551PubMed

30.

Münch L, Beitzel K, Willinger L, Imhoff AB (2018) Shoulder pain in athletes—5 steps from diagnosis to successful treatment. MMW Fortschr Med 160:44–47PubMed

31.

Myers JB, Laudner KG, Pasquale MR, Bradley JP, Lephart SM (2006) Glenohumeral range of motion deficits and posterior shoulder tightness in throwers with pathologic internal impingement. Am J Sports Med 34:385–391PubMed

32.

Neri BR, ElAttrache NS, Owsley KC, Mohr K, Yocum LA (2011) Outcome of type II superior labral anterior posterior repairs in elite overhead athletes: effect of concomitant partial-thickness rotator cuff tears. Am J Sports Med 39:114–120PubMed

33.

Osbahr DC, Cannon DL, Speer KP (2002) Retroversion of the humerus in the throwing shoulder of college baseball pitchers. Am J Sports Med 30:347–353PubMed

34.

Owens BD, Campbell SE, Cameron KL (2013) Risk factors for posterior shoulder instability in young athletes. Am J Sports Med 41:2645–2649PubMed

35.

Ren H, Bicknell RT (2013) From the unstable painful shoulder to multidirectional instability in the young athlete. Clin Sports Med 32:815–823PubMed

36.

Silva RT, Hartmann LG, de Souza Laurino CF, Biló JR (2010) Clinical and ultrasonographic correlation between scapular dyskinesia and subacromial space measurement among junior elite tennis players. Br J Sports Med 44:407–410PubMed

37.

Spiegl UJ, Warth RJ, Millett PJ (2014) Symptomatic internal impingement of the shoulder in overhead athletes. Sports Med Arthrosc Rev 22:120–129PubMed

38.

Szeto GP, Straker L, Raine S (2002) A field comparison of neck and shoulder postures in symptomatic and asymptomatic office workers. Appl Ergon 33:75–84PubMed

39.

Wagner H, Pfusterschmied J, Tilp M, Landlinger J, von Duvillard SP, Müller E (2014) Upper-body kinematics in team-handball throw, tennis serve, and volleyball spike. Scand J Med Sci Sports 24:345–354PubMed

40.

Walch G, Boileau P, Noel E, Donell ST (1992) Impingement of the deep surface of the supraspinatus tendon on the posterosuperior glenoid rim: an arthroscopic study. J Shoulder Elbow Surg 1:238–245PubMed

41.

Wilk KE, Meister K, Andrews JR (2002) Current concepts in the rehabilitation of the overhead throwing athlete. Am J Sports Med 30:136–151PubMed

42.

Wilk KE, Obma P, Simpson CD, Cain EL, Dugas J, Andrews JR (2009) Shoulder injuries in the overhead athlete. J Orthop Sports Phys Ther 39:38–54PubMed

Titel: A structured approach to shoulder pathologies in overhead athletes
Classification and key considerations for successful treatment
verfasst von: Prof. Dr. Knut Beitzel, MD, M.A.
Dr. Lukas N. Muench, MD
Eric McCarty, MD
Dr. Daniel P. Berthold, MD
Publikationsdatum: 21.01.2022
Verlag: Springer Medizin
Erschienen in: Obere Extremität / Ausgabe 1/2022
Print ISSN: 1862-6599
Elektronische ISSN: 1862-6602
DOI: https://doi.org/10.1007/s11678-021-00676-3

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