{"id":5641,"date":"2022-12-13T15:46:52","date_gmt":"2022-12-13T14:46:52","guid":{"rendered":"https:\/\/martinkonvicka.cz\/?p=5641"},"modified":"2022-12-13T16:52:53","modified_gmt":"2022-12-13T15:52:53","slug":"lopatka-a-jeji-vliv-na-bolest-ramene","status":"publish","type":"post","link":"https:\/\/martinkonvicka.cz\/en\/lopatka-a-jeji-vliv-na-bolest-ramene\/","title":{"rendered":"Lopatka a jej\u00ed vliv na bolest ramene"},"content":{"rendered":"
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Jak lopatka funguje a jak souvis\u00ed s ramenem?
\nJak se pohybuje?
\nJak\u00e9 jsou druhy naru\u0161en\u00ed jej\u00ed funkce a jak je odstranit?
\nNa co se zam\u011b\u0159it p\u0159i n\u00e1pravn\u00e9m cvi\u010den\u00ed?
\n\n<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Obr. 1 Lopatka<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"lopatka\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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\u00daVOD<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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<\/p>

Lopatka je ploch\u00e1 kost troj\u00faheln\u00edkov\u00e9ho tvaru nach\u00e1zej\u00edc\u00ed se na z\u00e1dech. Poskytuje stabiln\u00ed oporu pro svalovou aktivaci sval\u016f horn\u00ed kon\u010detiny a slou\u017e\u00ed jako p\u0159ena\u0161e\u010d s\u00edly mezi st\u0159edem t\u011bla (s\u00edlu vytv\u00e1\u0159\u00ed) a horn\u00ed kon\u010detinou (s\u00edlu p\u0159ij\u00edm\u00e1)<\/strong> (2).<\/p>

Krom\u011b kloubn\u00edho spojen\u00ed s\u00a0kl\u00ed\u010dn\u00ed kost\u00ed (akromioklavikul\u00e1rn\u00ed kloub) nem\u00e1 \u017e\u00e1dn\u00e9 dal\u0161\u00ed kostnat\u00e9 \u010d\u00e1sti, kter\u00e9 by ji dr\u017eely na t\u011ble. Dr\u017e\u00ed ji tedy p\u0159ev\u00e1\u017en\u011b svaly a vazy. Jak\u00e9koliv naru\u0161en\u00ed jejich funkce v\u00fdrazn\u011b zhor\u0161\u00ed schopnost jej\u00ed stabilizace (1). Ta je kl\u00ed\u010dov\u00e1 pro stabilitu a zdrav\u00ed ramenn\u00edho kloubu. \u00a0<\/p>

Jednodu\u0161e \u0159e\u010deno, pokud nebude lopatka ve spr\u00e1vn\u00e9m postaven\u00ed nebo nebudete m\u00edt pod kontrolou jej\u00ed pohyby, vy\u00fast\u00ed to v\u00a0bolest nebo zran\u011bn\u00ed ramene.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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POHYBY LOPATKY<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Pohybuje se ve t\u0159ech z\u00e1kladn\u00edch sm\u011brech<\/strong><\/p>

  • doln\u00ed \/ horn\u00ed rotace doln\u00edm \u00fahlem lopatky<\/li>
  • p\u0159edn\u00ed a zadn\u00ed n\u00e1klon kolem horizont\u00e1ln\u00ed osy<\/li>
  • Vyto\u010den\u00ed k\u00a0p\u00e1te\u0159i (vn\u011bj\u0161\u00ed rotace) a vyto\u010den\u00ed od p\u00e1te\u0159e (rameno jde dop\u0159edu – vnit\u0159n\u00ed rotace)<\/li><\/ul>

    Naru\u0161en\u00ed t\u011bchto pohyb\u016f se projevuje odst\u00e1v\u00e1n\u00edm doln\u00edho nebo medi\u00e1ln\u00edho okraje lopatky (obr.2), zved\u00e1n\u00edm lopatky p\u0159i vzpa\u017een\u00ed nebo nadm\u011brnou doln\u00ed rotac\u00ed p\u0159i poklesu pa\u017ee(obr.3).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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    Obr. 2 Odst\u00e1vaj\u00edc\u00ed doln\u00ed a medi\u00e1ln\u00ed okraj lopatky<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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    Obr. 3 Nadm\u011brn\u00e1 doln\u00ed rotace lopatky
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    Nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010diny naru\u0161en\u00ed pohybu a metody pro jejich n\u00e1pravu\n<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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    1) Zkr\u00e1cen\u00ed mal\u00e9ho prsn\u00edho svalu a kr\u00e1tk\u00e9 hlavy bicepsu<\/strong><\/p>

    Tyto dva svaly se up\u00ednaj\u00ed se na v\u00fdb\u011b\u017eek (processus coracoideus) lopatky a t\u00e1hnou ji do p\u0159edn\u00edho n\u00e1klonu.<\/strong> Horn\u00ed kon\u010detina je pak ve vnit\u0159n\u00ed rotaci a spodn\u00ed okraj lopatky odst\u00e1v\u00e1 od hrudn\u00edku (obr.3).<\/p>

    Vhodn\u00e9 je v\u00a0tomto p\u0159\u00edpad\u011b protahov\u00e1n\u00ed bicepsu a mas\u00e1\u017e mal\u00e9ho prsn\u00edho svalu mas\u00e1\u017en\u00edm m\u00ed\u010dkem viz. obr.4.<\/p>

    Obr.4 Mas\u00e1\u017e mal\u00e9ho prsn\u00edho svalu m\u00ed\u010dkem<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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    2) Dysbalance sval\u016f v\u00a0oblasti lopatky:<\/strong><\/p>

    a) Sn\u00ed\u017een\u00e1 aktivace a s\u00edla pilovit\u00e9ho svalu (Serratus anterior) a doln\u00edch snopc\u016f trap\u00e9zov\u00e9ho svalu zp\u016fsobuje ztr\u00e1tu horn\u00ed rotace a nadm\u011brn\u00fd p\u0159edn\u00ed n\u00e1klon lopatky<\/strong> (2). K\u00a0tomu se p\u0159ipojuje p\u0159et\u00ed\u017een\u00ed a ztuhlost horn\u00ed \u010d\u00e1sti trap\u00e9zov\u00e9ho svalu.<\/strong> N\u00e1sledkem toho je rameno v\u00a0p\u0159edsunut\u00e9m postaven\u00ed. P\u0159i pohybu horn\u00ed kon\u010detiny doch\u00e1z\u00ed ke zv\u00fd\u0161en\u00e9mu tlaku na kloubn\u00ed hlavici pa\u017en\u00ed kosti, kter\u00e1 nem\u00e1 dostatek prostoru pro pohyb. T\u00edm doch\u00e1z\u00ed k\u00a0bolestem ramene (impingement syndrom) a p\u0159et\u00ed\u017een\u00ed p\u0159edn\u00edch vaz\u016f.<\/p>

    \u0158e\u0161en\u00edm tohoto probl\u00e9mu se jev\u00ed pos\u00edlen\u00ed pilovit\u00e9ho svalu a doln\u00edch snopc\u016f trap\u00e9zov\u00e9ho svalu sou\u010dasn\u011b s\u00a0uvol\u0148ov\u00e1n\u00edm horn\u00edch snopc\u016f trap\u00e9zov\u00e9ho svalu. To dok\u00e1zali ve studii (4), kde lid\u00e9 se sedav\u00fdm zam\u011bstn\u00e1n\u00edm s\u00a0bolest\u00ed v\u00a0kr\u010dn\u00ed a ramenn\u00ed oblasti cvi\u010dili 3x t\u00fddn\u011b 20 minut po dobu deseti t\u00fddn\u016f cvi\u010debn\u00ed program, kter\u00fd byl postaven na 2 z\u00e1kladn\u00edch cvic\u00edch (viz. obr.5). Cvi\u010den\u00ed prov\u00e1d\u011bli v\u00a0deseti a\u017e patn\u00e1cti opakov\u00e1n\u00edch ve t\u0159ech a\u017e p\u011bti s\u00e9ri\u00edch. Jejich c\u00edlem bylo pos\u00edlit pilovit\u00fd sval a doln\u00ed snopce trap\u00e9zov\u00e9ho svalu. V\u00fdsledky byly nadm\u00edru pozitivn\u00ed. Do\u0161lo k v\u00fdrazn\u00e9mu sn\u00ed\u017een\u00ed bolestivosti a ke zv\u00fd\u0161en\u00ed s\u00edly p\u0159i zved\u00e1n\u00ed ramene.<\/p>

    b) Nerovnov\u00e1ha sval\u016f zaji\u0161\u0165uj\u00edc\u00edch horn\u00ed rotaci (oslaben\u00fd pilovit\u00fd a trap\u00e9zov\u00fd sval) a doln\u00ed rotaci (p\u0159et\u00ed\u017een\u00fd a zkr\u00e1cen\u00fd mal\u00fd sval prsn\u00ed, zdviha\u010d lopatky a rombick\u00e9 svaly)<\/strong> (1).<\/p>

    Zde pom\u016f\u017ee mas\u00edrov\u00e1n\u00ed a uvol\u0148ov\u00e1n\u00ed mal\u00e9ho svalu prsn\u00edho (viz bod 1), zdviha\u010de lopatky a rombick\u00fdch sval\u016f. Pro pos\u00edlen\u00ed pilovit\u00e9ho a trap\u00e9zov\u00e9ho svalu lze pou\u017e\u00edt cviky z\u00a0obr.5. Je nutno kl\u00e1st zv\u00fd\u0161en\u00fd d\u016fraz na spr\u00e1vn\u00e9 proveden\u00ed cviku!<\/p>

    Obr. 5 Posilov\u00e1n\u00ed doln\u00edch snopc\u016f trap\u00e9zov\u00e9ho svalu (1) a pilovit\u00e9ho svalu (2)<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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    3) Vadn\u00e9 dr\u017een\u00ed t\u011bla a zran\u011bn\u00ed<\/strong><\/p>

    Nadm\u011brn\u00e1 hrudn\u00ed kyf\u00f3za a bedern\u00ed lord\u00f3za je n\u00e1sledkem nadm\u011brn\u00e9ho p\u0159edsunu ramenn\u00edho kloubu a poklesu lopatky<\/strong> (3).<\/p>

    Zde je vhodn\u00e9 mas\u00edrovat, rozh\u00fdbat a rotovat hrudn\u00ed p\u00e1te\u0159e (nezapomenout fixovat bedern\u00ed p\u00e1te\u0159).<\/p>

    Tak\u00e9 zran\u011bn\u00ed ramenn\u00edho kloubu, artr\u00f3za, zlomeniny kl\u00ed\u010dn\u00ed kosti mohou b\u00fdt p\u0159\u00ed\u010dinou naru\u0161en\u00ed pohybu lopatky.<\/p>

    4) Nedostate\u010dn\u00e1 motorick\u00e1 kontrola lopatek <\/strong><\/p>

    Ve studii (5) bylo u sportovc\u016f pou\u017e\u00edvaj\u00edc\u00ed horn\u00ed kon\u010detiny zji\u0161t\u011bno, \u017ee na stran\u011b, kde je bolelo rameno, byl v\u011bt\u0161\u00ed p\u0159edn\u00ed n\u00e1klon lopatky a sn\u00ed\u017een\u00ed motorick\u00e1 kontrola lopatek.<\/strong> Ta se testovala tak, \u017ee prov\u00e1d\u011bli rotaci v\u00a0ramenn\u00edm kloubu tak, aby lopatka nezm\u011bnila sv\u00e9 postaven\u00ed. Pokud nebyli schopni odd\u011blit pohyb lopatky od pohybu horn\u00ed kon\u010detiny, bylo to vyhodnoceno jako nedostate\u010dn\u00e1 motorick\u00e1 kontrola.<\/p>

    Z\u00a0toho plyne, \u017ee p\u0159i cvi\u010den\u00ed je \u017e\u00e1douc\u00ed um\u011bt kontrolovat pozici lopatek. K\u00a0tomu je nezbytn\u00fd vhodn\u011b nastaven\u00fd tr\u00e9ninkov\u00fd pl\u00e1n a alespo\u0148 ze za\u010d\u00e1tku dohled zku\u0161en\u00e9ho odborn\u00edka.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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    z\u00e1v\u011br<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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    Diagnostika spr\u00e1vn\u00e9ho pohybu a postaven\u00ed lopatek je kl\u00ed\u010dov\u00e1 pro prevenci a odstran\u011bn\u00ed bolest\u00ed ramen. Rovn\u011b\u017e je d\u016fle\u017eit\u00e9 nau\u010dit se lopatky p\u0159i pohybu ovl\u00e1dat (motorick\u00e1 kontrola).<\/strong><\/p>

    P\u0159i odstra\u0148ov\u00e1n\u00ed svalov\u00fdch dysbalanc\u00ed se zam\u011b\u0159ujte na posilov\u00e1n\u00ed pilovit\u00e9ho svalu a doln\u00edch snopc\u016f trap\u00e9zov\u00e9ho svalu a uvol\u0148ujte mal\u00fd sval prsn\u00ed, biceps, zdviha\u010d lopatky a rombick\u00e9 svaly.<\/strong><\/p>

    Nezapome\u0148te tak\u00e9 na spr\u00e1vn\u00e9 dr\u017een\u00ed t\u011bla a pohyblivou hrudn\u00ed p\u00e1te\u0159e. To jsou prim\u00e1rn\u00ed podm\u00ednky pro spr\u00e1vnou polohu lopatek na hrudn\u00edm ko\u0161i.<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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    POKUD NEV\u00cd\u0160, JAK EFEKTIVN\u011a CVI\u010cIT, ABY DOCH\u00c1ZELO K N\u00c1PRAV\u011a BOLESTI A R\u016eSTU V\u00ddKONNOSTI, NAPI\u0160 MI. UR\u010cIT\u011a N\u011aCO VYMYSL\u00cdME.<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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    Reference:<\/b>\u00a0<\/p>

    1. Sn\u00e1\u0161el, M. (2015). Je posilov\u00e1n\u00ed sval\u016f rot\u00e1torov\u00e9 ma\u017eety skute\u010dn\u00fdm \u0159e\u0161en\u00edm pro va\u0161e ramena? VZ\u00edsk\u00e1no 5.12.2022, z http:\/\/coretraining.cz\/2015\/09\/je-posilovani-svalu-rotatorove-manzety-skutecnym-resenim-pro-vase-ramena\/<\/li>
    2. Kibler, W. B., Sciascia, A., & Wilkes, T. (2012). Scapular dyskinesis and its relation to shoulder injury. The Journal of the American Academy of Orthopaedic Surgeons<\/i>, 20<\/i>(6), 364\u2013372.<\/li>
    3. Kibler, W. B., & McMullen, J. (2003). Scapular dyskinesis and its relation to shoulder pain. The Journal of the American Academy of Orthopaedic Surgeons<\/i>, 11<\/i>(2), 142\u2013151.<\/li>
    4. Andersen, C. H., Andersen, L. L., Zebis, M. K., & Sj\u00f8gaard, G. (2014). Effect of scapular function training on chronic pain in the neck\/shoulder region: a randomized controlled trial. Journal of occupational rehabilitation<\/i>, 24<\/i>(2), 316\u2013324.<\/li>
    5. Struyf, F., Nijs, J., De Graeve, J., Mottram, S., & Meeusen, R. (2011). Scapular positioning in overhead athletes with and without shoulder pain: a case-control study. Scandinavian journal of medicine & science in sports<\/i>, 21<\/i>(6).<\/li><\/ol>

      <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"

      Jak lopatka funguje a jak souvis\u00ed s ramenem? Jak se pohybuje? Jak\u00e9 jsou druhy naru\u0161en\u00ed jej\u00ed funkce a jak je odstranit? Na co se zam\u011b\u0159it p\u0159i n\u00e1pravn\u00e9m cvi\u010den\u00ed? Obr. 1 Lopatka \u00daVOD Lopatka je ploch\u00e1 kost troj\u00faheln\u00edkov\u00e9ho tvaru nach\u00e1zej\u00edc\u00ed se na z\u00e1dech. Poskytuje stabiln\u00ed oporu pro svalovou aktivaci sval\u016f horn\u00ed kon\u010detiny a slou\u017e\u00ed jako p\u0159ena\u0161e\u010d […]<\/p>","protected":false},"author":6,"featured_media":5643,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"plain-container","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"disabled","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[1],"tags":[],"class_list":["post-5641","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"yoast_head":"\nLopatka a jej\u00ed vliv na bolest ramene - Martin Konvi\u010dka<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/martinkonvicka.cz\/en\/lopatka-a-jeji-vliv-na-bolest-ramene\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Lopatka a jej\u00ed vliv na bolest ramene - Martin Konvi\u010dka\" \/>\n<meta property=\"og:description\" content=\"Jak lopatka funguje a jak souvis\u00ed s ramenem? 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