Association of glenohumeral internal rotation deficiency (GIRD) with increased risk of rotator cuff injuries

Rameni zglob, radi svoje pokretljivosti nam omogućuje pokrete rukom u svim smjerovima, što nam omogućuje da radimo razne stvari i bavimo se raznim aktivnostima. Tek kada se nešto ozbiljno desi, onda shvatimo koliko nam je rame ustvari bitno dok je zdravo. Ozljede ramena su vrlo česte radi nestabilnosti samog zgloba. Sportaši koji se bave bacačkim sportovima, dodatno opterećuju već nestabilno rame, nekada čak idu i do nekih granica, a tu je velika mogućnost ozljeđivanja. Rukomet je dinamičan sport gdje ima puno kontakata i grube igre. Bez bacanja lopte se ne može igrati rukomet, a upravo kod bacanja lopte najviše stradava rame. Kod ponavljajućeg pokreta bacanja, dolazi do opterećenja vanjskih rotatora, koji se jačaju i izdužuju, a unutarnji rotatori oslabe i skrate se. Sam sportaš to ne osjeti, ali nakon dužeg vremena s takvim stanjem dolazi do GIRD – a, nesrazmjera u vanjskoj i unutarnjoj rotaciji. GIRD nije uzrok bolesti nego posljedica, a te posljedice se najviše vide na oštećenju rotatorne manšete. Bitnu ulogu u svemu tome ima program prevencije, gdje prvo treba na vrijeme uočiti problem, zatim dijagnosticiranjem potvrdimo jesmo li u pravu ili ne i onda tek možemo krenuti u intervenciju. Multidisciplinarni pristup cijelom procesu je izrazito važan, radi širine specijalnosti i samim time različitog mišljena na isti problem, a u sredini nam se nalazi pojedinac, kojeg nikako ne smijemo držati po strani nego mora biti upoznat sa svime što radimo i planiramo.Because of their agility, shoulder joints are offering us movement in all directions which gives us the opportunity to do a number of different activities. Just when simething seriously goes wrong, we can comprahend the importance of a healthy shoulder. The shoulder injuries happend most often because of the joint instability. Throwing sports additionally pressure the already unstable joint which improves the possibility of injury. Handball is a dynamic sport with a lot of harsh contact. Playing handball without throwing the ball is not a possibility, however the movement of throwing the ball is the most common cause of injury. With repeated movement of throwing, the outside rotators are under a lot of pressure, which are streching and becoming stronger, while inside rotators are becoming weaker and shorter. The person cannot feel that, but with the longer period of repeating this movement, the GRID happens, defined as difference between interior and exterior rotation. GRID is not the cause of ilness, it is its result, which can mostly be seen on the damaged rotator cuff. Big role in all of this has the notion of prevention, with most important point being the realisation of problem, and then by diagonsticing deciding if it is needed to start intervention. Multidisciplinary approach towards whole process is incredebly important, because of the width of the specialisation it is possible to get a number of different opinions on the same issue with the person being in the middle of focus with the highlighted importance of keeping the patient informed on everything that is going on