Rehabilitation der Schulterinstabilität[1]

Zusammenfassung

Zur Schulterinstabilität können sowohl strukturelle als auch nicht strukturelle Komponenten beitragen. Damit die Wiederherstellung der funktionellen Stabilität gelingen kann, müssen diese Faktoren bei der Klassifikation der Beschwerden und folglich auch bei ihrer Behandlung berücksichtigt werden. In diesem Artikel wird einerseits ein Klassifikationssystem diskutiert, das die Schulterinstabilität unter Berücksichtigung der strukturellen und nicht strukturellen Komponenten in 3 Klassen einteilt, und andererseits die Tatsache, dass die entsprechenden Pathologien ein Kontinuum darstellen. Strukturelle Ursachen lassen sich chirurgisch behandeln, aber nicht strukturelle Ursachen (z. B. veränderte neuromuskuläre Kontrolle innerhalb der Rotatorenmanschette) sollten auf konservative Weise behandelt werden.

Das Ziel dieses Artikels bestand in einer Beschreibung der verschiedenen Formen der Instabilität und einer Anleitung zu angemessener Behandlung, die unnötige chirurgische Eingriffe vermeiden und eine effektive Rehabilitation gewährleisten soll.

Abstract

Both structural and non-structural components can contribute to shoulder instability. Classification and therefore management must recognise these factors to achieve functional stability. This paper discusses a classification system proposing three types of shoulder instability recognising the structural and non-structural components and that a continuum exists between pathologies. Structural causes can be addressed with surgical intervention, but non-structural causes such as altered neuromuscular control within the rotator cuff should be addressed conservatively.

The purpose of this article is to describe the types of instability and guide appropriate management, helping to avoid surgery in inappropriate cases and ensure that effective rehabilitation has been achieved.

Schlüsselwörter

Schulterinstabilität - Klassifikationssystem - Behandlung - Rehabilitation

Key words

shoulder instability - classification system - management - rehabilitation

1 Der Originalartikel Rehabilitation for Shoulder Instability ist erschienen in British Journal of Sports Medicine 2009; 44: 333 – 340.

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1 Der Originalartikel Rehabilitation for Shoulder Instability ist erschienen in British Journal of Sports Medicine 2009; 44: 333 – 340.