The "bench-presser's shoulder": an overuse insertional tendinopathy of the pectoralis minor muscle
The "bench-presser's shoulder": an overuse insertional tendinopathy of the pectoralis minor muscle
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DOI：
10.1136/bjsm.2006.032383
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发表时间：
2007-08-01
影响因子：
18.4
通讯作者：
du Toit, Donald F.
中科院分区：
文献类型：
--
作者：
Bhatia, Deepak N.;de Beer, Joe F.;du Toit, Donald F.
背景：肩袖肌、二头肌腱和胸大肌的肌腱病是运动员肩部疼痛的常见原因。过度使用胸小肌插入肌腱病是以前未被描述的引起举重运动员/运动员肩痛的原因。目的：描述过度使用胸小肌插入肌腱病的临床特征、诊断试验和结果。方法：2005-2006年间，南非开普敦开普敦肩研究所诊断和治疗了7名患有胸小肌/肌腱的运动员。结果：在5名患者中，启动和加重的因素是仰卧式练习的表现(因此而被称为“板凳加压肩”)。内侧喙突压痛、疼痛的主动收缩试验和仰卧位操作、在超声引导下将麻醉剂注射到末端后疼痛减轻，在没有任何其他临床/放射学明显病理的情况下，诊断为胸大肌轻微插入肌腱病。所有7例患者均在超声引导下于胸小肌末端注射皮质类固醇，然后进行一段时间的休息和伸展运动。结论：本研究描述了继发于卧压式举重的胸小肌附着性肌腱病的临床特征和处理。提出了一种新的基于疼痛部位的举重运动员肩部病理分类方法。
Background:Tendinopathies of the rotator cuff muscles, biceps tendon and pectoralis major muscle are common causes of shoulder pain in athletes. Overuse insertional tendinopathy of pectoralis minor is a previously undescribed cause of shoulder pain in weightlifters/sportsmen.Objectives:To describe the clinical features, diagnostic tests and results of an overuse insertional tendinopathy of the pectoralis minor muscle. To also present a new technique of ultrasonographic evaluation and injection of the pectoralis minor muscle/tendon based on use of standard anatomical landmarks (subscapularis, coracoid process and axillary artery) as stepwise reference points for ultrasonographic orientation.Methods:Between 2005 and 2006, seven sportsmen presenting with this condition were diagnosed and treated at the Cape Shoulder Institute, Cape Town, South Africa.Results:In five patients, the initiating and aggravating factor was performance of the bench-press exercise (hence the term “bench-presser’s shoulder”). Medial juxta-coracoid tenderness, a painful active-contraction test and bench-press manoeuvre, and decrease in pain after ultrasound-guided injection of a local anaesthetic agent into the enthesis, in the absence of any other clinically/radiologically apparent pathology, were diagnostic of pectoralis minor insertional tendinopathy. All seven patients were successfully treated with a single ultrasound-guided injection of a corticosteroid into the enthesis of pectoralis minor followed by a period of rest and stretching exercises.Conclusions:This study describes the clinical features and management of pectoralis minor insertional tendinopathy, secondary to the bench-press type of weightlifting. A new pain site-based classification of shoulder pathology in weightlifters is suggested.