Fisioterapia deportiva en las lesiones de la articulación acromioclavicular

por | Oct 23, 2017 | Deportistas | 17.198 Comentarios

La articulación acromioclavicular es una articulación sinovial plana que ancla la clavícula a la escápula, dándole estabilidad al miembro superior. Las lesiones de la articulación AC son unas de las más  frecuentes en deportistas, siendo la más común la luxación o subluxación. Es más frecuente en hombres que en mujeres, muchas de ellas ocurren en sujetos jóvenes en la segunda década de vida y son más frecuentes las luxaciones incompletas.

Según la clasificación de Rockwood, se dividen en seis grados y su mecanismo lesional puede ser por un traumatismo directo sobre el hombro o un traumatismo indirecto por caída  con la  mano o el codo en extensión y aducción.

El grado III de inestabilidad AC se caracteriza por el desplazamiento de la parte lateral de la clavícula un diámetro clavicular o un centímetro en la radiografía anteroposterior. En esta lesión se rompen los ligamentos AC y los coracoclaviculares, causando un desplazamiento de la parte lateral de la clavícula y la aparición de la deformidad en forma de tecla entre clavícula y acromion.

Nos centramos en el grado III porque es en el grado donde abunda la discusión entre tratamiento conservador, utilizando técnicas fisioterápicas, o tratamiento quirúrgico.

Por ejemplo, Chester et ál, 2011, citan en el meta-análisis que el tratamiento quirúrgico tiene mejores resultados a nivel estético, pero supone períodos de baja por enfermedad más largos que el tratamiento conservador. No existen diferencias en términos de fuerza, dolor, habilidades de lanzamiento e incidencia de osteoartritis de la articulación AC.

Tras la lectura de la bibliografía se deduce que la lesión de grado III puede rehabilitarse de una manera conservadora sin necesidad de intervención quirúrgica.

 

Entre los Objetivos propuestos en un programa de Rehabilitación de la articulación acromioclavicular se encuentran:

  • Eliminar el dolor final y disminuirlo durante el período de rehabilitación. Se valorará mediante la Escala Visual Analógica del dolor.
  • Mejorar la fuerza. Se valorará mediante el balance analítico muscular.
  • Conseguir el rango articular completo. Se medirá mediante Goniometría.
  • Restablecer la funcionalidad. Se evaluará con el cuestionario Disabilities of the Arm, Shoulder and Hand(DASHe).
  • Obtener óptimos resultados finales que beneficien la reincorporación del paciente a la vida diaria y deportiva. Valorando el tiempo que tardan en reincorporarse al deporte  estando al 100%.

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