Neueste Therapien bei Schulterverletzungen auf dem Internationalen GOTS-Kongress der Sportmedizin im Juni in Berlin
Ein ungünstiger Sturz und schon ist es passiert – die Schulter ist ausgekugelt. Einfach einrenken und weitermachen funktioniert nicht. Welches die besten und neuesten Therapien bei Schulterluxationen und anderen Verletzungen sind, erklären Experten auf dem Internationalen GOTS-Kongress der Sportmedizin in Berlin.
Profisportler renken sich in den Kontaktsportarten, besonders im Fußball und Handball und immer häufiger auch beim American Football, die Schulter aus. Bei den Breitensportlern steht das Radfahren (Stürze) an erster Stelle, gefolgt vom Snowborden, wo der Sportler sich nicht richtig abfangen kann.
Die jüngeren Sportler werden fast alle operiert
Die Therapien bei den Verletzungen sind altersabhängig. PD Dr. Frieder Mauch, Chefarzt im Department Sportorthopädie/Sporttraumatologie Obere Extremität / Schulterendoprothetik / MRT in der Sportklinik Stuttgart: „Die jüngeren Sportler zwischen 18 und 25 Jahren werden nahezu alle operiert. Die Gefahr, dass das Gelenk wieder herausrutscht ist sonst mit 90 bis 95 Prozent zu hoch. Anders sieht es bei den über 30 Jährigen aus. Hier helfen nach dem Einrenken oft eine feste Bandage, drei Wochen Ruhigstellung und eine anschließende spezielle Krankengymnastik.“
Grundsätzlich wird aber jede Schulter erst eingerenkt, dann erfolgt eine gründliche Diagnostik und erst anschließend eine Operation oder eine konservative Therapie. Bei unkomplizierten Luxationen kann minimalinvasiv arthroskopisch operiert werden. Bei labileren Gelenken, die immer wieder auskugeln, sind mehrere Aufbau-Operationen für die Knochen, auch offene OP, nötig.
Keine Unterschiede zwischen Profi- und Leistungssportlern
Zwischen der Behandlung von Profi- und Breitensportlern gibt es dabei prinzipiell keine Unterschiede. „Nur bei zeitlichen Zwängen müssen wir manchmal aggressiver beraten“, so Mauch. „Was beim Breitensportler der Beruf, ist beim Profi der Sport. Wenn jemand noch dringend die Saison zu Ende spielen, oder andere Verzögerungen in Kauf nehmen muss, können wir das Gelenk erst einmal nur vorübergehend stabilisieren und später operieren.“
Mauch und seine Kollegen betreuen viele Bereiche im Leistungssport, unter anderem den VFB Stuttgart, Handball- und Basketball-Bundesligisten und den Olympiastützpunkt Stuttgart mit 19 Sportarten. Dazu agieren die Mediziner auf Sportveranstaltungen wie dem Mercedes Cup (ATP Tennis), dem Deutschen Turner-Pokal und bei den Hallen-Radmeisterschaften.
Sehnenverletzungen und Gelenkkapselabrisse – die Schulter muss viel aushalten
Doch die Schulter leidet noch unter ganz anderen Verletzungen. Gerade im Tennis entwickeln viele Athleten durch ständige Überlastung eine sogenannte Sportlerschulter. Bei den Turnern haben die Ärzte mit Sehnenverletzungen, Sehnen-, Gelenklippen- und Gelenkkapselabrissen zu tun.
Prof. Dr. med. Markus Scheibel von der Berliner Charité wird auf dem sportmedizinischen Kongress in Berlin in einem extra Kurs die neuesten minimalinvasiven Techniken in der rekonstruktiven Chirurgie für Sehnen und Bänder zeigen.
Er und seine Kollegen betreuen die Deutsche Turn-Nationalmannschaft, den Deutschen Judo- und Ringerbund, den Deutschen Schwimmerverband und Turmspringerverband. In einer wöchentlichen Sportlersprechstunde empfangen die Mediziner, die sich auf Schulter und Ellbogen spezialisiert haben, unter anderem Speerwerfer, Fußballer und Athleten aus dem Behindertensport.
Mehr Spannendes aus der Welt der Sportmedizin unter www.gots-kongress.org
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