Zusammenfassung
Degenerative Gelenkerkrankungen stehen im öffentlichen und medizinischen Interesse und sind zudem wirtschaftlich bedeutsam. Dennoch sind wesentliche Zusammenhänge wie der Einfluss sportlicher Aktivitäten derzeit nicht abschließend geklärt. Ein Grund hierfür liegt in der multifaktoriellen Genese und in unterschiedlichen Behandlungs- und Präventionskonzepten.
Grundsätzlich wird in Sportarten mit hohem Anteil an Rotations- und Scherkraftbeanspruchungen bei gleichzeitig hochintensiver Belastung von einem gering erhöhten Arthroserisiko ausgegangen. Allerdings resultiert eine Arthrose dabei häufig aus Verletzungen. Dagegen scheinen moderate sportliche Belastungen nicht mit einem erhöhten Arthroserisiko einherzugehen. Die Beurteilung hat dementsprechend auf der Basis der Sportart, der Trainingsintensität, von Vorverletzungen und Vorschäden, der Körperkomposition und einer möglichen additiven beruflichen Belastung zu erfolgen. Aus Sicht der Prävention und Rehabilitation von degenerativen Gelenkerkrankungen hat der Sport dagegen eine gesteigerte Bedeutung. Einerseits kann körperliche Aktivität degenerativen Gelenkerkrankungen vorbeugen, andererseits konnte durch einen gezielten Einsatz sportlicher Belastungen eine positive Wirkung in der Behandlung von Arthrosen belegt werden.
Abstract
Degenerative joint diseases are a matter of public and medical interest and are also of economic importance. Nevertheless, essential relationships, like the influence of athletic activities, have not yet been clarified. Reasons are the multifactorial genesis and various treatment and prevention concepts. Basically, a slightly elevated risk of OA is assumed in high-intensity sports with a high proportion of rotational and shear forces, which is, however, closely tied to possible injuries. By contrast, moderate athletic activity does not appear to be associated with an elevated OA risk. The assessment must be made on the basis of the kind of sports activities, training intensity, prior injuries and overuse, body composition, and possible additive occupational stress. Sports activities are important for prevention of OA and for rehabilitation. On the one hand, physical activity can prevent degenerative joint diseases, on the other hand, differentiated application has been confirmed to be beneficial in the treatment of OA.
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Priv.-Doz. Dr. Frank Mayer
Med. Klinik, Abteilung Rehabilitative und Präventive Sportmedizin, Universitätsklinik Freiburg
Hugstetter Straße 55
79106 Freiburg
eMail: mayer@msm1.ukl.uni-freiburg.de
