Evaluación y plan de tratamiento fisioterapéutico del síndrome subacromial en tenistas

Abstract

Las afectaciones del hombro en tenistas son muy frecuentes hoy en día, entre ellas, el síndrome subacromial, que impacta significativamente en el rendimiento deportivo. Este acontecimiento se da entre otros factores, por la repetición del saque en el tenis, un gesto de gran potencia que representa el 45-60% de los golpes durante el juego, y que, junto con la gran movilidad e inestabilidad del hombro, puede predisponernos a diversas lesiones debido al elevado estrés mecánico. Nuestro objetivo principal consiste en identificar este síndrome subacromial y en conseguir la recuperación y el retorno a la actividad deportiva de la persona. Su diagnóstico se basará sobre todo en la información dada por la anamnesis y por una completa exploración de pruebas diagnósticas. Según los resultados de las pruebas de pinzamiento, el dolor, la fuerza y el ROM, se clasificará al/a la paciente en el grupo de alta irritabilidad, moderada irritabilidad o baja irritabilidad. Estos mismos criterios serán utilizados para determinar el avance de fase. Cada grupo tendrá unas actuaciones y procedimientos terapéuticos específicos. El tratamiento será adaptado a la persona, este constará de la compaginación de terapia manual y una selección de ejercicios que realizará el/la paciente activamente, los cuales se irá dificultando progresivamente. En resumen, la implementación de este plan de actuación clínica respaldado por la evidencia científica actual no solo ofrece una estructura sólida y fundamental para el/la profesional de la salud que lo aplique, sino que también puede brindar beneficios significativos para la persona atendida. PALABRAS CLAVE: Síndrome de Abducción Dolorosa del Hombro; Dolor de Hombro, Diagnóstico clínico, Rehabilitación, Terapia por Ejercicio, Tenis.

Shoulder injuries in tennis players are very common today, among them, subacromial syndrome, which significantly impacts athletic performance. This condition arises, among other factors, due to the repetition of serving in tennis, a powerful motion that accounts for 45-60% of strokes during the game, and which, along with the great mobility and instability of the shoulder, can predispose us to various injuries due to the high mechanical stress. Our main objective is to identify this subacromial syndrome and achieve the recovery and return to sports activity of the individual. The diagnosis will be based primarily on information obtained from the anamnesis and a thorough examination of diagnostic tests. Based on the results of impingement tests, pain, strength, and ROM, the patient will be classified into the group of high irritability, moderate irritability, or low irritability. These same criteria will be used to determine phase advancement. Each group will have specific therapeutic actions and procedures. The treatment will be tailored to the individual, consisting of a combination of manual therapy and a selection of exercises that the patient will actively perform, which will become progressively more challenging as the treatment progresses. In summary, the implementation of this clinical action plan, supported by current scientific evidence, not only provides a solid and fundamental structure for the health professional applying it but also can offer significant benefits to the individual being treated. Página 6 de 55 ABSTRACT Shoulder injuries in tennis players are very common today, among them, subacromial syndrome, which significantly impacts athletic performance. This condition arises, among other factors, due to the repetition of serving in tennis, a powerful motion that accounts for 45-60% of strokes during the game, and which, along with the great mobility and instability of the shoulder, can predispose us to various injuries due to the high mechanical stress. Our main objective is to identify this subacromial syndrome and achieve the recovery and return to sports activity of the individual. The diagnosis will be based primarily on information obtained from the anamnesis and a thorough examination of diagnostic tests. Based on the results of impingement tests, pain, strength, and ROM, the patient will be classified into the group of high irritability, moderate irritability, or low irritability. These same criteria will be used to determine phase advancement. Each group will have specific therapeutic actions and procedures. The treatment will be tailored to the individual, consisting of a combination of manual therapy and a selection of exercises that the patient will actively perform, which will become progressively more challenging as the treatment progresses. In summary, the implementation of this clinical action plan, supported by current scientific evidence, not only provides a solid and fundamental structure for the health professional applying it but also can offer significant benefits to the individual being treated. KEYWORDS: Shoulder impingement shoulder; Shoulder Pain; Clinical Diagnosis; Rehabilitation; Exercise Therapy; Tennis.