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- 您请求的操作仅限于组中的用户:===保守- I型和II型===初始治疗应遵循[[POLICE原则|POLICE]]方案,包括保护、最佳负荷、冰敷、压缩、抬高和在最初48小时内转诊。应使用吊带固定肩膀,同时在休息时保持肩膀处于抬高的位置。用胶带支撑关节也是有用的。绷带可以固定在原位直到疼痛消退。对于I型损伤,恢复正常活动通常需要2-4周,II型为4-6周,III型为6-12周。对于在此框架内症状未改善的患者,可能需要关节内类固醇注射,然而,缺乏关于康复方案的证据。“Reid等人”在对目前的实践进行系统回顾后制定了最佳实践指南
====急性期====运动范围(ROM):被动,主动辅助,主动*肩胛关节(GHJ):内旋,外旋,屈曲至容忍度 ;毛巾滑动,钟摆运动[[文件:肩部钟摆运动。png|左|拇指|176x176px]][[文件:肩胛骨拉伸,坐位收缩。png|拇指]][[文件:肩部IntExt Slide.png|中心|拇指]]]*肩胛骨:*使用L杆进行内外旋转的主动辅助运动:GHJ外展30°至45°,前屈30°至40°[[文件:Ghjt外展拉伸。png|左|拇指|267x267px]][[文件:胸大肌拉伸。png|拇指|中|193x193px]]软组织:管理紧绷*胸小肌拉伸 * GHJ后部:[[肩部内撞击|睡眠者拉伸]]
等长运动:应该是多角度、次大、次痛的
闭合运动链;(无重量)*手支撑在各种平面和水平的仰角,控制肩胛骨的位置和进展到90°*手肘支撑内旋转/外旋转*墙壁滑动,[[背部教育程序|肩胛骨时钟]]*墙壁俯卧撑[[File:Ghjt slides.png|左|拇指|215x215px]] [[File:支撑手肘旋转。png|中心|拇指]]====恢复阶段====避免加重伤害: example of exercises are bench press, prone press-ups, shoulder press or dips. Proximal stability must be reached before strength. Range of motion: regain full range of motion of GHJ (including horizontal adduction), IR/ER at 90° abduction GHJ and capsular stretches. [[File:Sleeper stretch shoulder.png|center|thumb]] Closed kinetic chain: increase the loads of previous closed kinetic chain exercises. Add active arm elevation and rotation. [[File:4 Point Kneeling Superman.jpg|center|thumb]] [[File:Scapula Proprioception with Ball.png|center|thumb]] [[File:Scapula Stabilisation with Ball.png|center|thumb]] Axial loaded active ROM (transition from closed kinetic chain to open kinetic chain (OKC)):
*wall slides with trunk and lower limb work *wall slides in the scapular plane
Kinetic chain: *trunk and hip extension (scapular retraction) e.g. low row exercises [[File:Shoulder Low Row with Theraband.png|center|thumb]] *trunk and hip flexion (scapular protraction) e.g. punches[[File:Shoulder Punch with Resistance.png|center|thumb]] *bilateral and unilateral pull with trunk rotations, e.g. upper cuts[[File:Shoulder Trunk Rotations with a Band.png|center|thumb]] *Deltotrapezial complex work : exercises with cables, shrugs, abduction at various angles[[File:Shoulder Diagonal PNF with band.png|center|thumb]]
Plyometric exercises (dynamic stretch shortening): medicine ball toss and catch, tubing plyometric exercises. Sport specific exercises: a two-hand overhead side to side throw for the overhead athlete.
{{#ev:youtube|aLj--YqCXhw|412}} Physio Fitness | Physio REHAB | Tim Keeley"Weight-lifter's shoulder" pain from an unstable AC joint | Feat. Tim Keeley | No. 27 | Physio REHAB. Available fromhttps://www.youtube.com/watch?v=aLj--YqCXhw&t=2s ==== Return to sport ==== Return to sport guideline: *Grade I: 2-4 weeks *Grade II: 4-8 weeks *Grade III: 6-8 weeks