Der Schmerzpatient 2018; 1(01): 38-43
DOI: 10.1055/s-0043-122100
Georg Thieme Verlag KG Stuttgart · New York

Schulterschmerz durch Läsionen der Rotatorenmanschette

Jeremy Lewis
Weitere Informationen


25. Januar 2018 (online)

Um Patienten mit subakromialem Impingement-Syndrom oder partieller asymptomatischer Rotatorenmanschetten-Ruptur zu behandeln, ist Physiotherapie genauso geeignet wie eine chirurgische Intervention. Nur wenn ein abgestuftes dreimonatiges Übungsprogramm nicht zur Symptomlinderung führt, sollte operiert werden.

  • Literatur

  • 1 Boettcher CE, Cathers I, Ginn KA. The role of shoulder muscles is task specific. J Sci Med Sport 2010; 13: 651-656 doi:10.1016/j.jsams.2010.03.008
  • 2 Carr AJ, Cooper CD, Campbell MK. et al. Clinical effectiveness and cost-effectiveness of open and arthroscopic rotator cuff repair [the UK Rotator Cuff Surgery (UKUFF) randomised trial]. Health Technol Assess 2015; 19: 1-218 doi:10.3310/hta19800
  • 3 Carr A, Cooper C, Campbell MK. et al. Effectiveness of open and arthroscopic rotator cuff repair (UKUFF): a randomised controlled trial. Bone Joint J 2017; 99-B: 107-115 doi:10.1302/0301-620X.99B1.BJJ-2016-0424.R1
  • 4 Charalambous CP, Sahu A, Alvi F. et al. Return to work and driving following arthroscopic subacromial decompression and acromio-clavicular joint excision. Shoulder & Elbow 2010; 2: 83-86 doi:10.1111/j.1758-5740.2010.00048.x
  • 5 Connor PM, Banks DM, Tyson AB. et al. Magnetic resonance imaging of the asymptomatic shoulder of overhead athletes: a 5-year follow-up study. Am J Sports Med 2003; 31: 724-727
  • 6 Feltner M. Three-dimensional interactions in a two-segment kinetic chain. Part II: Application to the throwing arm in baseball pitching. International Journal of Sports Biomechanics 1989; 5: 420-450 doi:10.1123/ijsb.5.4.420
  • 7 Frost P, Andersen JH, Lundorf E. Is supraspinatus pathology as defined by magnetic resonance imaging associated with clinical sign of shoulder impingement?. J Shoulder Elbow Surg 1999; 8: 565-568
  • 8 Girish G, Lobo LG, Jacobson JA. et al. Ultrasound of the shoulder: asymptomatic findings in men. AJR Am J Roentgenol 2011; 197: W713-719 doi:10.2214/AJR.11.6971
  • 9 Hegedus EJ, Cook C, Lewis J. et al. Combining orthopedic special tests to improve diagnosis of shoulder pathology. Phys Ther Sport 2015; 16: 87-92 doi:10.1016/j.ptsp.2014.08.001
  • 10 Hegedus EJ, Goode AP, Cook CE. et al. Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests. Br J Sports Med 2012; 46: 964-978 doi:10.1136/bjsports-2012-091066
  • 11 Henkus HE, de Witte PB, Nelissen RG. et al. Bursectomy compared with acromioplasty in the management of subacromial impingement syndrome: a prospective randomised study. J Bone Joint Surg Br 2009; 91: 504-510 doi:10.1302/0301-620X.91B4.21442
  • 12 Huijbregts P. Biomechanics and pathology of the overhead throwing motion: A literature review. The Journal of Manual and Manipulative Therapy 1998; 6: 17-23
  • 13 Jonas WB, Crawford C, Colloca L. et al. To what extent are surgery and invasive procedures effective beyond a placebo response? A systematic review with meta-analysis of randomised, sham controlled trials. BMJ Open 2015; 5: e009655 doi:10.1136/bmjopen-2015-009655
  • 14 Kibler WB, Chandler J. Baseball and Tennis. In: Griffin LY. editor Rehabilitation of the Injured Knee. St Louis: Moseby; 1995
  • 15 Lewis J. Rotator cuff related shoulder pain: Assessment, management and uncertainties. Man Ther 2016; 23: 57-68 doi:10.1016/j.math.2016.03.009
  • 16 Lewis J, Green A, Yizhat Z. et al. Subacromial impingement syndrome: Has evolution failed us?. Physiotherapy 2001; 87: 191-198 doi:10.1016/S0031-9406(05)60605-0
  • 17 Lewis JS, Tennent TD. How effective are diagnostic tests for the assessment of rotator cuff disease of the shoulder?. In: MacAuley D, Best TM. editors Evidenced Based Sports Medicine. 2nd ed.. London: Blackwell Publishing; 2007
  • 18 Lewis JS. Subacromial impingement syndrome: A musculoskeletal condition or a clinical illusion?. Physical Therapy Review 2011; 16: 388-398 doi:10.1179/1743288X11Y.0000000027
  • 19 Magee D. Orthopedic Physical Assessment. 6th ed. Philadelphia: Elsevier; 2014
  • 20 McClelland D, Paxinos A, Dodenhoff RM. Rate of return to work and driving following arthroscopic subacromial decompression. ANZ J Surg 2005; 75: 747-749
  • 21 Miniaci A, Mascia AT, Salonen DC. et al. Magnetic resonance imaging of the shoulder in asymptomatic professional baseball pitchers. Am J Sports Med 2002; 30: 66-73
  • 22 Milgrom C, Schaffler M, Gilbert S. et al. Rotator-cuff changes in asymptomatic adults. The effect of age, hand dominance and gender. J Bone Joint Surg Br 1995; 77: 296-298
  • 23 Mohamadi A, Chan JJ, Claessen FM. et al. Corticosteroid Injections Give Small and Transient Pain Relief in Rotator Cuff Tendinosis: A Meta-analysis. Clin Orthop Relat Res 2017; 475: 232-243 doi:10.1007/s11999-016-5002-1
  • 24 Moseley JB, OʼMalley K, Petersen NJ. et al. A controlled trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med 2002; 347: 81-88
  • 25 Reed D, Cathers I, Halaki M. et al. Does supraspinatus initiate shoulder abduction?. J Electromyogr Kinesiol 2013; 23: 425-429 doi:10.1016/j.jelekin.2012.11.008
  • 26 Roach NT, Venkadesan M, Rainbow MJ. et al. Elastic energy storage in the shoulder and the evolution of high-speed throwing in Homo. Nature 2013; 498: 483-486 doi:10.1038/nature12267
  • 27 Sciascia A, Thigpen C, Namdari S. et al. Kinetic chain abnormalities in the athletic shoulder. Sports Med Arthrosc 2012; 20: 16-21 doi:10.1097/JSA.0b013e31823a021f
  • 28 Seroyer ST, Nho SJ, Bach BR. et al. The kinetic chain in overhand pitching: its potential role for performance enhancement and injury prevention. Sports Health 2010; 2: 135-146
  • 29 Shi LL, Edwards TB. The role of acromioplasty for management of rotator cuff problems: where is the evidence?. Adv Orthop 2012; 2012: 467571 doi:10.1155/2012/467571
  • 30 Sihvonen R, Paavola M, Malmivaara A. et al. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med 2013; 369: 2515-2524 doi:10.1056/NEJMoa1305189
  • 31 Wattanaprakornkul D, Halaki M, Boettcher C. et al. A comprehensive analysis of muscle recruitment patterns during shoulder flexion: an electromyographic study. Clin Anat 2011; 24: 619-626 doi:10.1002/ca.21123