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Prävention von Schulterverletzungen bei Überkopfsportarten

Prevention of shoulder injuries in overhead sports

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Zusammenfassung

Hintergrund

Schulterverletzungen und sportbedingte Schulterschmerzen stellen für Sportler, die insbesondere Überkopfsportarten betreiben, eine erhebliche Belastung dar. Die Herausforderungen bei der Verletzungsprävention liegen in der Identifizierung relevanter Risikofaktoren und der Entwicklung sowie Umsetzung angepasster Verletzungspräventionsprogrammen.

Zielsetzungen

Zielsetzung war das Erarbeiten und Darstellen der relevanten Risikofaktoren für Schulterverletzungen und evidenzbasierter Verletzungspräventionsprogramme für Überkopfsportler.

Material und Methoden

Klinische Studien und Expertenmeinungen wurden mit Bezug auf Risikofaktoren und Präventionsprogramme für Überkopfsportler ausgewertet.

Ergebnisse

Für die meisten potenziellen Risikofaktoren ist die Evidenz begrenzt und/oder sie sind nicht veränderbar. Zu den modifizierbaren Risikofaktoren gehören eine vorbestehendes GIRD („glenohumeral internal rotation deficit“), ein eingeschränkter Bewegungsumfang (ROM), ein Ungleichgewicht der Muskelkraft für Innen- und Außenrotation zum Nachteil der Außenrotation und eine Skapuladyskinesie. Es wurde festgestellt, dass mit zunehmender Ermüdung bei gesteigertem Trainings- und Wettkampfvolumen das Risiko von Schulterverletzungen zunimmt. Mehrere Präventionsprogramme konnten die Häufigkeit von Schulterverletzungen senken. Bei allen Programmen scheint die Compliance von großer Bedeutung zu sein.

Schlussfolgerung

Verschiedene Risikofaktoren für Schulterverletzungen des Überkopfsportlers konnten identifiziert werden. Während einige wichtige Risikofaktoren nicht modifizierbar sind, können andere durch spezifische Präventionsprogramme adressiert werden. Um das Verletzungsrisiko zu verringern, sind die Akzeptanz der Programme durch die Überkopfsportler und somit deren Compliance von großer Bedeutung.

Abstract

Background

Shoulder injuries and sports-related shoulder pain represent a significant burden for athletes who participate in overhead sports. The challenges in injury prevention lie in identifying relevant risk factors and implementing viable injury prevention programs.

Objectives

Determination of relevant risk factors of shoulder injuries and of evidence-based injury prevention programs for overhead athletes.

Materials and methods

Evaluation and critical review of clinical studies and expert opinions regarding risk factors and injury prevention programs for overhead athletes.

Results

Most of the potential risk factors have limited evidence and are not modifiable. Among the modifiable risk factors, it was shown that pre-existing glenohumeral internal rotation deficit (GIRD), limited range of motion, imbalance of muscle strength for internal and external rotation to the disadvantage of external rotation, and scapular dyskinesia can increase the risk of chronic shoulder pain due to overuse. Training and competition volume have been found to increase the risk of shoulder injury as fatigue increases. Several prevention programs reduced the incidence of shoulder injuries. For all programs, compliance seems to be of major importance.

Conclusion

Risk factors for shoulder injuries have been identified and can be assessed in overhead athletes. While many important risk factors are non-modifiable, several others can be addressed by specific prevention programs. Several successful programs have been developed. Compliance and acceptance among overhead athletes are of major importance to reduce the risk of injury.

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Authors and Affiliations

  1. Orthopädie Ost, Lerchenfeldstr. 10, 9500, Wil, Schweiz

    Christian Jung

  2. Institut für Rehabilitationsmedizinische Forschung, Universität Ulm, Bad Buchau, Deutschland

    Lena Tepohl

  3. Osnabrücker Zentrum für muskuloskelettale Chirurgie (OZMC), Klinikum Osnabrück GmbH, Osnabrück, Deutschland

    Casper Grim

  4. Sportklinik Stuttgart GmbH, Stuttgart, Deutschland

    Frieder Mauch

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  1. Christian Jung
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Correspondence to Christian Jung.

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C. Jung, L. Tepohl, C. Grim und F. Mauch geben an, dass kein Interessenkonflikt besteht.

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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Jung, C., Tepohl, L., Grim, C. et al. Prävention von Schulterverletzungen bei Überkopfsportarten. Obere Extremität 17, 4–11 (2022). https://doi.org/10.1007/s11678-021-00672-7

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