肩膀常見痛痛：肩夾擠症候群、五十肩(冰凍肩)、旋轉肌撕裂傷 (by ATX 姚斯元物理治療師)
先前肩膀簡介那篇文章講了肩膀的構造，肩膀的關節活動角度是全身最大的，能夠讓你同時三個方向轉來轉去，而且曾有研究指出人類的肩膀是所有動物中投擲東西最有效率、最快的！！
不信的話你跟家裡的貓主子或狗孩子比賽丟石頭看看啊～
這麼爽這麼厲害的肩膀，等價交換的就是他很容易受傷、疼痛。
今天要淺聊三個常見的肩膀痛痛：肩夾擠症候群、五十肩(冰凍肩)、選轉肌撕裂傷。
肩夾擠症候群 – 運動員最討厭的一種肩膀傷痛！
肩夾擠顧名思義就是一定有東西被其他東西夾到。
誰被誰夾到？
棘上肌 或 二頭肌長頭肌腱 或 肩峰下滑液囊 被 肱骨和肩胛骨(肩峰、肩峰韌帶、喙突)夾到。
像肩膀活動度這麼大的關節，他會需要複雜的肌肉與肩胛骨一起合作才能順利、良好的動來動去。
但如果某些肌肉無力了，或是肩胛骨和肩關節的連動出了問題，就很有可能造成肱骨(上臂骨頭)在肩關節裡脫軌，使得手臂每次往上抬的時候都會讓棘上肌或二頭肌長頭肌腱或肩峰下滑液囊被肱骨和肩胛骨(肩峰、肩峰韌帶、喙突)夾到。
通常需要舉手過肩的運動的人，都會有比較高肩夾擠症候群的風險，例如游泳、排球、網球、棒球、重量訓練中的軍式推舉等等。
五十肩 (冰凍肩) – 鼎鼎有名的肩膀卡住
五十肩大概是全台灣最耳熟能詳的疾病之一了，好發於年長女性，但其實男性、年輕的人也可能中標。五十肩這個幾乎人人都琅琅上口的病名，你以為會非常常見，但其實只有2~5%的人會得到真正的五十肩，有時候可能是別的肩膀問題被誤以為是五十肩。
所以到底什麼是五十肩？
五十肩是肩關節中肱骨與肩胛骨之間的沾黏性關節囊炎。關節裡面發炎、沾黏、變硬，不再讓你順利滑來滑去。你的手因此無法順利抬起，無法做某些動作。那種感覺就像是肩膀被魔法師放了冰箭術一樣，所以又稱冰凍肩。
如果你得到了五十肩也不用太擔心，五十肩大部分是能以物理治療有效解決的，只要好好規律做關節鬆動術，同常半年、一年後五十肩都可以康復。
不過，有些人會拼命去活動自己的肩關節，想自行把關節鬆開，但這樣常常會有反效果，造成更發炎或是肩夾擠。建議還是交給專業的來弄。
旋轉肌撕裂傷 – 運動人嚇到吃手的肩膀惡魔
讓我們複習一下，旋轉肌分成四條，分別是棘上肌、棘下肌、小圓肌、肩胛下肌。最常撕裂的是棘上肌。
當你揮動肩膀的次數過多、力量過大、或是揮空時，就有可能造成旋轉肌受傷。嚴重的旋轉肌撕裂傷甚至可能伴隨肩膀脫臼。常見的例子是搬重物的時候造成旋轉肌撕裂傷。
由於旋轉肌撕裂傷會影響到你肩關節活動的角度，所以有時候會被誤以為是五十肩。
通常不嚴重的旋轉肌撕裂傷休息一段時間後就比較不痛了，但這不代表他完全康復。因為對於旋轉肌來說，只有十分輕微的撕裂傷比較好癒合，大多數的撕裂傷會導致旋轉肌無力。無力後就容易讓肩關節的活動脫軌。
脫軌可能造成什麼現象？
就是上面段落提到的，會增加肩夾擠的風險。
那我可以如何愛護肩膀？
假如你肩膀受過傷，對肩膀有些不安全感，十分擔心它有天又有什麼三長兩短。那建議可以把肩胛的穩定度訓練起來，例如訓練下斜方肌(lower trapezius)和前鋸肌(Serratus anterior)。推薦一個很棒的影片給大家自己練習練習：
但其實這些訓練都需要非常精細的控制，建議想認真練肩膀的話找專業的教練或物理治療師幫助你會比較好。
對了，前幾天郭仕政物理治療師寫到的 Redcord 紅繩懸吊系統不只可以誘發核心肌群，事實上它也是很好的誘發肩胛穩定的工具。
註：本部落格文章是以科普、衛教為出發點，不代表任何人的生理狀況。每個人的身體皆不相同，有任何疑問請詢問自己的醫師、物理治療師、專業教練。
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