Uma yonke imidlalo noma imisebenzi yomzimba ehlobene nokusetshenziswa kwezingalo inokuthile okufanayo, kuwuhlobo lokulimala. Nakuba ababhukudi ngokuvamile yibona abathinteka kakhulu (ihlombe lombhukudi odumile), i-rotator cuff nayo ingalimala lapho isibhakela, idlala ithenisi noma iphakamisa izinsimbi. Ukuze uqonde ukuthi kungani ulimele le ndawo yehlombe, into esemqoka ukuqonda umsebenzi kanye nohlu lokunyakaza ama-cuffs analo.
Ngezansi sizokutshela ukuthi yiziphi izicubu ezakhayo, yimiphi imisebenzi enayo, izinhlobo ezivame kakhulu zokulimala kanye nokwelashwa okukhethekile ukunciphisa ubuhlungu.
Iyini i-rotator cuff?
I-rotator cuff yigama elisetshenziselwa ukuchaza iqembu lemisipha emine yamahlombe. Le misipha yile i-supraspinatus, i-infraspinatus, i-subscapularis y nxazonke encane. Le misipha inamathisela ihlombe lehlombe ku-humer. I-rotator cuff idlala indima ebaluleke kakhulu ekugcineni i-humerus ngaphakathi kwesokhethi yehlombe lehlombe ngesikhathi sokunyakaza kwehlombe. Ngenkathi ifaka isandla kulokhu kuzinza, kubalulekile futhi ukuqaphela ukuthi i-rotator cuff ayibambi inhloko ye-humeral endaweni, nokuthi izinga elithile lokuhumusha (ukunyakaza) kwekhanda le-humeral phakathi nemisebenzi efana nokwelula ngemuva kunempilo ngokuphelele.
Imisipha ye-rotator cuff inamaphuzu okunamathiselwe ahlukene ku-scapula kanye ne-humerus, ngakho-ke ingakwazi ukusebenza njengeqembu lemisipha uma kuziwa ekuzinziseni, kokubili ngokuhlanganyela nangomuntu ngamunye. Isibonelo, kuyaziwa ukuthi yonke imisipha emine isebenza cishe ngokulinganayo ku- ukuthunjwa kwehlombeKodwa-ke, i-supraspinatus isebenza ngokuphawulekayo ngaphezu kwe-subscapularis ku- ukugoba phambili. Ngokufanayo, okuphambene kwenzeka ku- ihlombe isandiso emuva.
Kunezindlela ezihlukahlukene ongalimaza ngazo i-cuff yakho ye-rotator, futhi uhlobo lokulimala kwakho kungase kube enye yezindlela esinquma ngazo ukuthi kungenzeka kangakanani ukuba kubi kakhulu. Ukulimala kwehlombe kwangaphambilini kanye nobunye ubuhlungu obuqhubekayo, njengobuhlungu obuphansi emuva, kuye kwaboniswa ukuthi yizici ezinkulu ezandisa amathuba okuthuthukisa ukulimala kwe-rotator cuff. Lapho abantu behlakulela ukulimala kwe-rotator cuff, izikhalazo ezivame kakhulu abantu abanazo ubuhlungu futhi i ukungakwazi ukwenza imisebenzi ejwayelekile yokuphila kwansuku zonke. Lokhu kungenxa yokuthi iqembu le-rotator cuff libaluleke kakhulu ekuhambeni kwehlombe kanye nokubekezelelana komthwalo wehlombe, okuyikhono lehlombe lokuthwala isisindo noma ukudonsa amandla.
umsebenzi we-cuff
Imisipha emine ye-rotator cuff inemisebenzi emithathu eyinhloko: zungeza i-humerus, cindezela ikhanda le-humeral ku-glenoid fossa (i-concavity ekhanda le-scapula ethola ikhanda le-humerus) kanye hlinzeka ngokulinganisela kwemisipha kwamanye ama-musculature ehlombe. Ukucindezelwa kwekhanda le-humeral kusokhethi ye-glenoid kusiza kakhulu ukuzinza kwehlombe.
I-Rotator cuff ibaluleke kakhulu ukuzinzisa kanye nokuvimbela ukuhumusha ngokweqile kwekhanda le-humeral, kanye nokukhiqizwa kwe ukuzungezisa kwangaphandle kwe-glenohumeral ngenkathi ephakamisa ingalo. Ngokungangabazeki, lesi sakhiwo sidlala indima ebalulekile ku- ukunyakaza okulinganiselwe nokuhlelekile kwe-humerus, kodwa futhi ekugcineni ukuzinza kwe-glenohumeral joint (ihlombe elihlangene).
Phakathi nokuvivinya umzimba okuvamile, amandla adluliselwa yi-rotator cuff awela phakathi kwama-newton angu-140 no-200. I-rotator cuff igxilisa i-glenohumeral ehlangene ngamabhangqwana anamandla ezindizeni ze-coronal neziphambanayo. Ubuhlobo be-biomechanical phakathi kwemisipha ye-rotator cuff kanye nendlela yamandla isinika ukuqonda okungcono kokuthi kungani ukwehluleka kwe-rotator cuff kwenzeka.
Izinhlobo Zokulimala Kwe-Rotator Cuff
Ubuhlungu behlombe kuwuphawu lwesithathu oluvame kakhulu lwe-musculoskeletal oluhlangatshezwana nalo emisebenzini yezokwelapha ngemva kobuhlungu beqolo nentamo. Izinhlobonhlobo zezifo ezingase zibe khona zingadala ubuhlungu behlombe; ukuklebhuka nokufakwa kwe-rotator cuff kuphakathi kwezimbangela ezihamba phambili.
I-Rotator cuff idlala indima ebalulekile ekuzinzeni okumile nokuguquguqukayo kwelunga le-glenohumeral. Ukungasebenzi kwayo kubalulekile njengoba kwenzeka kaningi futhi kungase kudinge ukwelashwa ngokuhlinzwa. Ngaphezu kwalokho, lapho ukungenelela kokuhlinzwa kulandelwa, umbuzo uphakama ngokuthi iyiphi indlela yokulungisa okufanele isetshenziswe.
Ukulimala kwemisipha: ukudabuka
Ukulimala kwemisipha ye-rotator cuff cishe kungenzeka ngenxa yemvelo ebuhlungu, njenge-a ukuwa noma a ukususwa wehlombe Lokhu kungenxa yokuthi le misebenzi izophusha ihlombe elihlangene lidlule uhla lwayo lokunethezeka lokunyakaza, nalo nalo welula umsipha, ukudala ukuhlukana kwemicu yemisipha. Imisipha ingase iqine, lapho eminye kodwa hhayi yonke imicu yemisipha ihlukana noma idabuke/iklebhule yonke ndawonye.
Izinga lalokhu kulimala ngokuvamile lizonqunywa ngokusekelwe kuzimpawu nomsebenzi, noma ngezinye izikhathi ngophenyo olwengeziwe, olufana noku i-resonance kazibuthe. Lezi zilonda kungenzeka zidale a ubuhlungu obungapheli ezungeze isifunda se-shoulder blade, okungaba nzima ukukubona. Ukulimala kwemisipha kungenzeka kube kubi kakhulu lapho kusetshenziswa imisipha, njengokuphatha igrosa esindayo noma ukufaka ibhantshi.
Izinyembezi ze-Rotator cuff zimelela ukulimala kwehlombe okuvame kakhulu ezigulini zabantu abadala kanye nesici esivamile esibangela ubuhlungu behlombe nokukhubazeka emsebenzini. Izinguquko ze-histopathologic ezihilelekile ekugqabukeni kwe-cuff tendon ngokuvamile zenzeka kancane kancane, ngaphandle kwezimo ezingavamile zokuvuvuka okubuhlungu okubuhlungu. Izinyembezi ingxenye interstitial (lapho isici singaphakathi ngokuphelele kwento ye-cuff) noma oxhumana nabo, okubonisa ukuqhekeka kwe-tendon fibrils engxenyeni engezansi ye-cuff ngokuxhumana phakathi kwesikhala esihlangene kanye nesici.
Ngaphandle kokudabuka okudabukisayo, kuyabonakala ukuthi ngenxa yokuguga ziningi izinto ezibangela ukuguga ukuwohloka futhi ekugcineni ukwehluleka kwe-rotator cuff. Ucwaningo oluningana luhlonze izici ezithile zezibalo zabantu (iminyaka yobudala kanye nenkomba yesisindo somzimba) kanye nokubhema njengengxenye ebalulekile ekuqhubekeleni phambili kwezinyembezi ze-rotator cuff.
ukulimala kwe-tendon: ukubopha
Uma kuqhathaniswa nokulimala kwemisipha, ukulimala kwe-tendon ngokuvamile kuvela ekusebenziseni ihlombe eliphindaphindayo noma eliqhumayo, njengokudweba ngaphezu kwekhanda noma isibhakela. Lokhu kungenxa yokuthi i-tendon isetshenziswa ngokuphindaphindiwe kule misebenzi, idala ukugcwala kulezi zakhiwo. Uma kuqhathaniswa nokulimala kwemisipha, indawo yobuhlungu izoba a ubuhlungu obubukhali futhi obunembe kakhudlwana azungeze ngaphambi kwehlombe eduze kwekhanda elinomthunzi. Ubuhlungu kungenzeka kakhulu uma ufika phezulu, ikakhulukazi isisindo esandleni. Futhi, izinga lokulimala lizonqunywa izimpawu, umsebenzi, noma kwezinye izimo, i-MRI.
Ukufakwa kwe-cuff ye-Rotator kumelela inqubo engapheli ebonakala njengobuhlungu behlombe obungaqhubekela ekushintsheni okuhlala njalo kanye nokudabuka kwe-cuff ejikelezayo uma kungelashwa. Lesi simo singahlukaniswa sibe yi-impement syndrome yangaphandle, yangaphakathi, neyesibili.
I-clamping ngaphandle Noma i-outlet yindlela evame kakhulu yalesi simo, okubangelwa ukucindezelwa kwezintambo ze-rotator cuff njengoba zidlula ngaphansi kwe-coracoacromial arch. I-clamping kwangaphakathi kungumphumela wokuqhekeka kwendawo engaphansi yethenda ye-infraspinatus lapho ingalo ifakwa ekuthunjweni okuphezulu nokujikeleza kwangaphandle. Ukuphahlazeka okwesibili imele inqubo eguquguqukayo ebangelwa ukungazinzi okuncane kwe-glenohumeral. I i-subluxation Ukususwa kwekhanda le-humeral okwenzeka ngenxa yomsebenzi kungacindezela kakhulu isixhumi esibonakalayo se-humeral-acromial futhi ngenxa yalokho kubangele izimpawu zokungena.
Ingelapheka? ukwelashwa kobuhlungu
Ukuze siqale silawule ukulimala kule ndawo, sifuna ukwenza isiqiniseko sokuthi ukulimala kwecuff. Ulwazi lwezindawo nemisebenzi ye-rotator cuff, kanye nolwazi lokunye ukuxilonga okuhlukile, kubalulekile kubelaphi bomzimba ukuze baxhumanise izimpawu nokuxilongwa futhi banikeze ukubuyisela okuphumelelayo, uma kwenzeka ukulimala kwe-cuff. Ziphinde zikusize ukuthi unqume ukuthi ungumuntu ofanelekayo yini ekuphathweni kwe-physiotherapy, noma uma udinga i-x-ray noma umbono wochwepheshe kuqala.
Uma kubhekwa njengokulimala kwe-rotator cuff, ukwelashwa okukhethekile kwalokhu kulimala kuzoba ukuzivocavoca umzimba. Ukusebenzisana nomhlinzeki wakho womzimba, uzokwenza uhlelo lokuvuselela izivivinyo ezithile ukuze usize ukwakha amandla emisipha ye-rotator cuff ukuze ugxile ekulimaleni. Izeluleko nemfundo yabaphathi bakho nakho kuzonikezwa ukukusiza ekuthuthukisweni kwesikhathi eside kanye nokubuyela kwakho emsebenzini. Esigabeni sesikhashana, izindlela zokwelapha ezifana massage ejulile yezicubu futhi i acupuntura ukunciphisa izimpawu, okukuvumela ukuthi usebenze ngokuphumelelayo ekuvuseleleni kwakho.