Shoulder pain is relatively common in Mexico (2, 5, 8). Among the various anatomic
sites and will shoulder the fourth most common and represents Ca.10% of
injuries (Table 1). The injury rate is significantly lower than in so-called “overhead
athlete “like swimmers (66%), vollybollspelare (44%) and javelin thrower (29%) (5).
Previous studies have shown that work with your arms in a student led mode of ‘overhead athlete’
increases the risk of injury (4). Compared with previously mentioned sports require golf swing yet
an extreme abduction or extreme rotation of the shoulder, resulting in lower injury rates than
expected, although the arms are working above shoulder level, both early and late swing.
Table 1. Golf Injuries localized to the shoulder in various studies
________________________________________________________________________________________
Professional
Amateur
PGA (8)
LPGA (8)
PGA Seniors (5)
Men (8) U.S. Women (8) U.S. Men + Women (2) Sweden
________________________________________________________________________________________
11.4%
7.5%
7.7%
11.0%
16.1%
7%
________________________________________________________________________________________
Overload is the main cause of golf injuries. A professional golfer swings
maybe 2000 times or more in one week (5). Although the tissue of these players are
trained for this movement, the tissue during certain periods subjected to a load
exceeds what it can withstand the tissue that is broken down faster than it builds up. In amateur golfer
can, in the ambition to lower hcp, a sudden overload easily occur when the training intensified.
In one höghandicapare, even a “bad” swing technique may cause a certain
muscle groups are overloaded as a result of constant high tension. Other causes of
debt problems may be an earlier injury golfer incurred in another context
such as a front axelluxation of a hockey player who later makes itself felt in
golf swing.
Etiology and clinical examination
In younger and older players are different foundations. The older players have more often
degenerative changes in load can lead to trouble. Degenerative
Change begins with some of approx. 35 years of age and then becomes increasingly frequent in the
population (1, 5, 10). The changes can be acromioclavicular (AC)-led osteoarthritis,
exostoser, rotator cuff degeneration mm. as a result may cause narrowing of subacromiella
room. In the young player can have considerable ledglapp be a negative factor (4)
due to repetitive stress can develop into an unstable shoulder. It is above all the “leading
axis (the axis pointing towards the ball in baksvingen) most often injured. On top of baksvingen
is the leading arm for maximum horizontal adduction. This movement stress the
acromioclaviculära joint (7) and / or the subacromiella room which can give rise to
AC-headed inflammation and impingement. The horizontal adduction can be simulated
with the clinical test known as cross-body test (Figure 1). At the “follow-through, at the end of
golf swing, is the leading arm in abduction-extension-outward rotation corresponding
the clinical testing called apprehension test (Figure 2). This test is often positive if it
is a leading debt instability.
For the other arm / shoulder (= non-conductive) are the opposite ie that the
on top of baksvingen in abduction-extension-external rotation position, and at
follow-through in horizontal adduction. In the young player with debt problems
may be primarily suspect instability as a cause of discomfort. If pain is
localized dorsalt in humeroscapulära ledspringan may be because rotatorcuffen in
clamping due to the anterior instability (5).
Treatment
In the treatment of these injuries must be the root cause analysis and
then specific therapy instituted. In young players, where instability is most common
root cause, it is always important to review the status of muscle. It should initially begin stabilizing
muscle rehabilitation in the form of progressive styrkträning of rotatorcuff (11) and interscapulär
muscle (6) and also the major muscle groups around the shoulder such as:. pectoralis major
and latissimus dorsi (3). If this type of rehabilitation are not sufficient and a demonstrable
instability exists for stabilizing surgery be necessary (9). In older players with
impingement examined initially anti-inflammatory medication as well as progressive
Force rehabilitation in pain-free area. If this therapy is not successful, the next
step would be an operational subacromiell decompression.
References
1. Brewer BJ: Aging of the rotator cuff. Am J Sports Med 7: 102-10, 1979
2nd Forsberg A: Unpublished data. 1998
3rd Jobe FW, et al.: Rotator cuff function during a golf swing. Am J Sports Med 14: 388-92, 1986
4th Jobe FW, Pink M: The athlete’s shoulder. J Hand There 7: 107-10, 1994
5th Jobe FW, Pink M: Shoulder pain in golf. Clin Sports Med 15: 55-63, 1996
6th Kao JT, Pink M, Jobe FW, et al.: Electromyographic analysis of the scapula muscles during a golf swing.
Am J Sports Med 23: 19-23, 1995
7th Mallon WJ, Colosimo AJ: acromioclavicular joint injury in competitive Golfers.
J South Orthop Assoc 4: 277-82, 1995
8th McCarroll JR: The frequency of golf injuries. Clin Sports Med 15: 1-7, 1996
9th Montgomery WHr, Jobe FW: Functional outcomes in athletes after modified anterior capsulolabral
reconstruction. Am J Sports Med 22: 352-8, 1994
10th Ogata S, Uhthoff HK: Acromial enthesopathy and rotator cuff tear. A Radiologic and Histologic postmortem
Investigation of the coracoacromial arch. Clin Orthop 39-48, 1990
11th Pink M, Jobe FW, Perry J: Electromyographic analysis of the shoulder during the golf swing.
Am J Sports Med 18: 137-40, 1990