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27/02/2020 0 Comments

LA MUERTE DE UN HOMBRO ANÓNIMO LANZADOR

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¿Cómo hemos llegado aquí? Ya hemos visto en Historia de un hombro lanzador: DRIG,  que la vida del hombro implica una progresiva pérdida de rotación interna glenohumeral y que la historia puede acabar bastante mal, con la pérdida de la «vida deportiva». 

Pero ¿porqué es tan malo tener DRIG?

Tener DRIG va a provocar una serie de alteraciones biomecánicas:

Alteraciones en la atrocinemática glenohumeral21,23,63.
En los movimientos de flexión glenohumeral el centro de rotación de la cabeza humeral en la glenoides tiende a desplazarse anterosuperiormente23;
y en los movimientos de rotación externa, como en la fase de armado de un lanzamiento, la cabeza se desplaza posterosuperiormente10,12,21,25.
Alteraciones en la cinemática escapulotorácica4.
Disminución de la fuerza, como se ha podido demostrar en estudios donde se medía la fuerza isocinética1,33. Y en concreto suele haber una pérdida importante en la ratio: Fexc de Rot Ext/Fconc de Rot Int22.
Se ha demostrado que el DRIG aumenta la incidencia de lesiones13,38,49,68.

Y las alteraciones biomecánicas que conlleva tener DRIG pueden ser  una de las causas de una serie de lesiones:

Dolor inespecífico del hombro20
Impingement subacromial: Por un lado, las personas con impingement a menudo presentan DRIG31,38,60; y por otro, es una de las causas reconocidas que pueden provocar síntomas de impingement10,23,37,64.
Impingement interno patológico38.
Insuficiencia del ligamento colateral ulnar15.
Lesiones labrales10,32,38.
Exostosis17: Se trata de una calcificación en la inserción capsular glenohumeral posteroinferior, debido a estrés crónico de tracción; y suele haber un final brusco de rango de rotación interna.
Cuando se producen estas lesiones, muchos hombros tratan de seguir sus vidas deportivas, y a veces se acumulan patologías en el hombro y alteraciones biomecánicas, pudiendo producirse este triste desenlace: La muerte del hombro.

Pero no siempre que existe una alteración biomecánica tiene porqué existir una lesión… Leer Las lesiones son más complejas que un tres en raya. Una alteración biomecánica implica normalmente un movimiento poco eficiente y un mayor estrés local sobre determinados tejidos, pudiendo aparecer dos escenarios posibles:

  1. Los tejidos se adaptan alestrés adicional generando una habituación al estrés.
  2. El exceso de estrés genera la lesión en el tejido concreto.

“Fue un gran hombro!. Vaya remates hacía! Nunca se le vio un mal gesto! Ha sido un gran ejemplo para futuras generaciones de hombros”

La historia de este hombro podía haberse evitado. Un buen programa de trabajo compensatorio, especialmente de movilidad de rotación interna, y no tendríamos que estar ahora frente a su lápida. Es muy triste. De hecho vamos a dedicar una entrada para explicar como evitarlo.

Entrenador! Puede que la vida de un hombro esté ahora mismo en tus manos!

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