Orofaziale Behandlung von „Overhead Athletes“ mit langwierigem Schulterproblem (GIRD-Syndrom) – Multidisziplinäre Zusammenarbeit zwischen spezialisiertem Manualtherapeuten und Zahnarzt

Zusammenfassung

Viele „Overhead Athletes“ leiden am Glenohumeral Internal Rotation Deficit Syndrome (GIRD; glenohumerales Innenrotationsdefizit). Die persistierenden Schulterbeschwerden werden durch Überbelastung im oberen Quadranten verursacht. Bislang ist der Einfluss der orofazialen Region und der dentalen Okklusion auf die (motorische) Funktion bei den betroffenen Patienten nicht systematisch erforscht.

Diese Fallserie untersuchte bei (semi)professionellen Overhead Athletes die Einschränkung ihrer Innen- und Außenrotation sowie der statischen Kraft in 4 Bewegunsrichtungen. Aufgrund der Resultate wurde aus der 1. Gruppe eine 2. Gruppe gebildet, die 3 manualtherapeutische Behandlungen und anschließend eine Dentalschiene erhielt.

Die multidisziplinäre Behandlung durch den Zahnarzt und einen (spezialisierten) Manualtherapeuten reduzierte signifikant die Beschwerden und Dysfunktionen. Eine orofaziale klinische Diagnose nach den Richtlinien der Diagnostic Criteria/Temporomandibular Dysfunctions (DC/TDM) und der okklusale kinästhetische Sensibilisierungstest (OKST) scheinen prognostische Indikatoren für die Behandlung des GIRD-Syndroms zu sein.

Abstract

Many overhead athletes suffer from the glenohumeral internal rotation deficit syndrome (GIRD). The persistent shoulder complaints originate in excessive strain in the upper quadrant. The influence of the orofacial region and the dental occlusion on the (motor) function of the patients has not been explored systematically to date.

This case study series investigated restriction of internal and external rotation as well as isometric strength in 4 movement directions in (semi) professional overhead athletes. On the basis of the results a second group was generated from the first group which received 3 manual therapeutic treatments followed by a dental splint.

The multidisciplinary treatment of the dentist and the (specialised) manual therapist significantly reduced the complaints and dysfunction. An orofacial clinical diagnosis according to the guidelines of diagnostic criteria/temporomandibular dysfunctions (DC/TDM) and the occlusal kinaesthetic sensitisation test (OKST) seem to be prognostic indicators for the treatment of the GIRD syndrome.

Schlüsselwörter

Overhead Athletes - Glenohumeral Internal Rotation Deficit Syndrome (GIRD) - orofazial - dentale Okklusion - Manualtherapie

Keywords

overhead athletes - glenohumeral internal rotation deficit syndrome (GIRD) - orofacial - dental occlusion - manual therapy

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