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- 您请求的操作仅限于组中的用户:===其他注意事项=== 修复GIRD组件:在第一次治疗后立即开始,并在整个过程中继续进行。专注于增加后肩软组织灵活性的拉伸技术通常被纳入到头顶运动员的预防和治疗方案中。横体和卧式拉伸练习被描述为一种拉伸技术,用于提高肩后侧软组织的灵活性,增加肩关节内旋和水平内收的运动范围。[参考文献]王志强,王志强,王志强。[https://www.ncbi.nlm.nih.gov/pubmed/24175603改进后的卧式拉伸和改进后的横体拉伸,增加了头顶投掷运动员肩部内旋的运动范围。]骨科与运动物理治疗杂志。2013年12月,43(12):891 - 4。“‘卧铺拉伸术’患者侧躺,肩部前屈90°,肩胛骨手动固定后收,肩关节被动内旋。患者应该在肩部后部感觉到拉伸,而不是在前部,如果有,那么减轻强度并将躯干稍微向后旋转可以减轻拉伸的强度。横体拉伸是另一种常用的后囊拉伸,可以通过移动手臂进入水平内收来进行。这种拉伸被证明对拉伸后囊和增加内部活动度更有优势。McClure P, Balaicuis J, Heiland D, Broersma M, Thorndike C, Wood A.拉伸方法对后肩紧度的随机对照比较。骨科与运动物理治疗杂志。 (2007) 37:108-114 {{#ev:youtube|pBkQ91fX2Ok}} {{#ev:youtube|hduMDqOgMAs}} Joint mobilizations (mobs): GH anterior-posterior joint mobs can be used to help stretch the posterior capsule and increase internal rotation, however, if instability is noted on the initial exam, joint mobs should be avoided. Grade IV, end range, dorsal-glide mobilizations are performed with the patient supine with shoulder placed into 90 abduction, and either in neutral or end range internal rotation of the humerus (refer to pictures). Thoracic and cervicothoracic manipulation: spinal manipulations can be used to improve mobility in these regions and have proven therapeutic short and long term effects. Several studies have shown a significant improvement in symptoms of shoulder impingement syndrome when a thoracic manipulation was combined with exercise. The benefits of a thoracic or cervicothoracic manipulation for internal impingement have yet to be studied, but based on the similar presentation of these two syndromes and the low-risk to benefit ratio of manipulation, these procedures may add a huge benefit to treatment. Bang M, Deyle G. Comparison of Supervised Exercise With and Without Manual Physical Therapy for Patients With Shoulder Impingement Syndrome. Journal of Orthopaedic and Sports Physical Therapy. (2000) 30:126-137 Boyles R, Ritland B, Miracle B, Barclay D, Faul M, Moore J, Koppenhaver S, Wainner R. The Short-Term Effects of Thoracic Spine Thrust Manipulation On Patients With Shoulder Impingement Syndrome. Manual Therapy. (2009) 14:375-380 Whole body kinetic chain exercises: Incorporating this early in rehab has been recommended in order to prepare the athlete's whole body for return to activity. Core stability, leg balance, and diagonal movement patterns can be used to incorporate the entire kinetic chain while simultaneously involving the shoulder as well. One example of this is simply adding a degree of instability to an exercise; doing external rotation exercises while sitting on an exercise ball or while performing a single leg stance by standing on the opposite leg of the arm you are working.