virtuele ruimte van bursa met er onder de
supraspinatuspees
verschillende namen impingement, SIS, SAIS, subacromial pain syndrome, rotator cuff disease
Indeling op vlak van locati e
Internal impingement atleten (werpers), in glenohumeraal gewricht gebeurt elke keer
opnieuw een compressie
o Binnen in schoudergewricht, vooral aan achterzijde
External impingement
o Buitenkant van schoudergewricht,
tussen acromion & rotator cuff spieren
o Rotator cuff pees ingeklemd onder
acromion
o Subcoracoïd
Coracoïd is te groot, geeft bij
interne rotatie een conflict met
Humeruskop
Biomechanica
Vernauwing tunnel type acromion (1,2,3)
2
,Oorzaak is meer multifactorieel
Scapula positie
Vorm scapula
Stabiliteit en functie rotator cuff
Aangeboren peeskwaliteit
Microtrauma en heling respons
Neer theorie
Oorzakelijke ‘spur’
Evolutie naar cuffscheuren
Acromioplastie als behandeling
Incidentie schouderpijn (alle) 3,2 – 4,2 per 1000 personen
Impingement 44 – 65 % van alle schouderklachten
Vaak terugkerend tot in 50 %
Overhead sporters and manual jobs
Sub-acromiaal impingement syndroom (sias )
Kenmerken
Gradueel verloop
Pijn bij elevatie/abductie vd arm
Nachtelijke pijn
Uitstralende pijn anterolaterle humerus
Indruk van krachtsverlies en stijfheid
Klinische tests
Neer
Hawkins-Kennedy
Jobe/empty can test
Painful arc
Vectoren frontaal vlak
o Opwaartse kracht deltoïd
o Gebalanceerd door rotator cuff
Vectoren axiaal vlak
o Subscapularis en infraspinatus
Belang van correcte
o Co-activatie en timing
4
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