你肩膀痛嗎？為什麼肩膀容易受傷疼痛？ (by 好痛痛)
請問人身上的關節中活動度最大的是哪個關節？肩膀。
請問連接人的軀幹與上肢的關節是哪個關節？肩膀。
打排球的人肩膀容易受傷、游泳的人肩膀容易受傷、打棒球的人肩膀容易受傷、重訓健身也常肩膀受傷。
無論是復健科、骨科還是物理治療所看肩膀痛的人總是一大堆。
為什麼肩膀如此容易受傷？
好痛痛先帶你來瞭解一下肩膀的構造。
肩膀是球窩關節
肩膀之所以可以擁有關節中最大的活動度，是因為它是球窩關節。什麼是球窩關節？
下圖就是球窩關節的活動示意。
但和上圖的球與碗的示意圖不一樣的地方是，你的肩膀的碗很小很淺。它能如此靈活的轉動必然會有所犧牲，肩膀犧牲掉的是穩定度，成為一個容易受傷的關節。 PTT 的 MuscleBeach 板和受傷相關的文章中和肩膀相關的佔 30% 排名第一 (核心肌群含下背痛排第二)。
除了肩膀，你個髖關節也是球窩關節。
肩膀的活動度
好的，那現在我們來測試一下大家的肩膀的活動度：
如果你可以順暢做到上述動作，並且沒有疼痛的感覺，恭喜你：沒事，你的活動角度很好～
※附註一下：內轉的角度是骨科物理治療書上寫的 (41.2~54.5°)，但是大部分人都可以超過這個角度，至少可達到 70° 。
但如果你有卡卡的、疼痛的感覺，或是做不到，有需要可以去找復健科或是物理治療所來幫你檢查看看是哪邊出問題。
肩膀的骨頭們
肩膀是由肱骨、鎖骨、肩胛骨構成。肱骨也就是你的上臂；鎖骨你是知道的，鎖骨牛奶我想你也是知道的，科科～；
肩胛骨就是你背部上半部脊椎兩側那兩片三角形骨頭。其實你肩膀活動的時候，並不是只有盂肱關節那邊在動，你的肩胛骨也是會跟著動的！！
肩膀的軟組織們
軟組織包含了肌肉、肌腱、韌帶、脂肪墊、滑液囊等等。肩膀這邊的軟組織很多，我們只先簡介穩定肩膀用的旋轉肌、韌帶和滑液囊。
肩膀旋轉肌 = 棘上肌 + 棘下肌 + 小圓肌 + 肩胛下肌
旋轉肌負責穩定你的肩膀，他們是運動傷害的常客，有時候會被骨頭夾到，有時候會因為受傷而關機導致其他代償問題。未來我們講到其他傷害時會時常提到。
肩膀的韌帶們
除了旋轉肌以外，韌帶也是負責穩定肩關節的重責大任。有他們在，你的肩膀才能固定住不會飛走。
另外骨頭間還有滑液囊，目的是為了減少摩擦，滑液囊位置如下圖。「肩胛下肌的肌腱下滑液囊」那個名字還真有夠長，不如叫作「地獄咆哮阿姆斯特朗炫風阿姆斯特朗劉德滑液囊」。
肩膀作為一個不穩定的關節，加上肩膀的肌肉很少是單一獨立產生動作，通常都是整組一起動作，淺層肌群和深層肌群(例如旋轉肌)一起動作，因此肩膀在運動傷害上要診斷病灶是很困難。
常見的肩膀傷害有神經傷害、肌腱炎、冰凍肩(五十肩)、肩關節挾擠症候群(旋轉肌肌腱或滑液囊被骨頭夾到哭哭)、盂肱關節不穩定等等。這些我們未來會談到。
建議有肩膀問題的人，需要花一些耐心去診斷與治療，復健科看軟組織、骨科看骨頭、物理治療師可以做動作評估檢測與運動治療。你可以使用我們製作的診所與治療所搜尋器(點此連結)，或是透過臉書詢問我們訪問過的診所與物理治療所。
延伸閱讀：肩膀常見病痛、受傷
好痛痛復健科、骨科、物理治療、運動訓練搜尋器
參考資料：骨科物理治療學 (禾楓出版)、基礎肌動學 (ELSEVIER 出版)
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。
請問我的肩膀可以做上面三張圖的動作，也可以彎到背上，但是洗臉時就沒有辦法上下動很痛，睡覺時拉棉被也很痛，側睡壓到也痛，坐著伸手拿茶杯也不行，嚴重影響睡眠，我做了三個月的復健，電療熱敷拉脖子，我也做了MRI確定頸椎沒有問題，這三個月類固醇、止痛消炎的藥都有吃，請問我現在要怎麼辦？TT
換個醫生，或是嘗試自費醫療。
https://blog.easepain.tw/atx-yao-ssu-yuan/health-insurance-vs-own-expense-physiotherapy/
五十肩真困擾
自費徒手治療+乖乖復健運動~
Read 90869 More Information here to that Topic: blog.easepain.tw/by-easepain/shoulder-intro/
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