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Akutverletzungen und Überlastungsschäden der Schulter im Sport

Acute and overuse injuries of the shoulder in sports

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Zusammenfassung

Hintergrund

Verletzungen der Schulter machen einen großen Teil der Sportverletzungen überhaupt aus. Dabei sind Art und Häufigkeit der Verletzungen u. a. stark vom jeweiligen Risiko- und Belastungsprofil der einzelnen Sportarten abhängig.

Fragestellung

Übersichtliche Darstellung des breiten Verletzungsspektrums der Schulter im Sport sowie Herleitung der wichtigsten Verletzungsmuster aufgrund sportartspezifischer Pathomechanismen.

Methode

Selektive Literaturrecherche in der Datenbank PubMed unter Berücksichtigung eigener Erfahrungen und Forschungsergebnisse sowie internationaler und nationaler Empfehlungen.

Ergebnisse

Aufgrund der jeweils spezifischen Belastungsprofile in den jeweiligen Sportarten treten viele Verletzungen in dafür typischen Konstellationen und Häufigkeiten auf. Dabei muss zwischen einer akuten Schädigung der Schulter, wie traumatischen Luxationen, Akromioklavikular(AC)-Gelenksprengungen, traumatischen Sehnenrupturen, Labrum- und Knorpeldefekten sowie Frakturen, die z. B. durch ein plötzliches Unfallereignis entstehen, und chronischen Veränderungen, wie Überlastungsbursitiden und -tendinitiden, sekundären Impingementformen mit Rotatorenmanschetten- und Labrumläsionen, die durch repetitive Mikrotraumata entstehen, unterschieden werden. Besonders häufig treten diese Verletzungen bei Wurf- und Schlagsportarten (z. B. Tennis, Golf, Handball und Volleyball), aber auch bei Individual- und Artistiksportarten (z. B. Schwimmen, Turnen, Tanzen und Rudern), sowie bei Kontakt- und Extremsportarten (z. B. Judo, Martial Arts, Bodybuilding, Gewichtheben, Motocross und Downhill-Mountainbiking) auf.

Schlussfolgerung

Eine umfassende Kenntnis von sportspezifischen Belastungsmustern, möglichen Therapieoptionen und Rehabilitationskonzepten ist bei der Behandlung dieser Verletzungen aus sportorthopädischer Sicht essenziell.

Abstract

Background

During sports the shoulder complex is exposed to considerable load especially where throwing is important and various pathological changes can occur. In the last two decades the shoulder in athletes has become a special term in clinical sports medicine

Methods

Selective literature review in PubMed and consideration of personal experience, research results as well as national and international recommendations

Results

In general acute lesions of the shoulder caused by sudden sport injuries, such as traumatic luxation, acromioclavicular (AC) joint disruption, traumatic tendon ruptures, labral lesions, cartilage defects and fractures have to be distinguished from chronic or long-standing pathologies due to recurrent microtrauma, such as overuse bursitis and tendinitis, as well as secondary forms of impingement along with rotator cuff tears and labral lesions. Besides common pathological changes that can be observed in almost all overhead-sports, there are also injuries that are more sport-specific due to the particular load profile in each sport. These injuries are especially common in racquet and throwing sports (e.g. golf, tennis, handball and volleyball) as well as in individual and artistic sports (e.g. swimming, gymnastics, dancing and rowing), contact and extreme sports (e.g. judo, mixed martial arts, bodybuilding, weightlifting, motocross and downhill mountain biking).

Conclusion

Knowledge about sport-specific load profiles as well as about the variety of treatment options is crucial for successful treatment of these injuries.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Scheibel, R. Doyscher, K. Kraus, B. Finke geben an, dass kein Interessenkonflikt besteht. Soweit der Beitrag personenbezogene Daten enthält, wurde von den Patienten eine zusätzliche Einwilligung nach erfolgter Aufklärung eingeholt. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Centrum für Muskuloskeletale Chirurgie (CMSC) und Centrum für Sportwissenschaft und Sportmedizin (CSSB), Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland

    R. Doyscher, B. Finke &  M. Scheibel

  2. Department für Sportwissenschaft, Universität der Bundeswehr München, München, Deutschland

    K. Kraus

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  1. R. Doyscher
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  2. K. Kraus
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  3. B. Finke
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  4. M. Scheibel
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Correspondence to M. Scheibel.

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Doyscher, R., Kraus, K., Finke, B. et al. Akutverletzungen und Überlastungsschäden der Schulter im Sport. Orthopäde 43, 202–208 (2014). https://doi.org/10.1007/s00132-013-2141-x

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