「舉手之勞」原喻事情能夠輕易辦到，但有時候「舉手」並不簡單：
研究指出肩膊痛是三種最常見的痛症之一，它會限制肩關節的活動。而痛楚會出現在肩峰前外側的位置，有時候會擴散到肱骨（上臂骨）的中外端，換言之疼痛會出現於肩膊前或後端。而患者肩膊越活動得多，痛楚便會隨之加劇，令他們力有不「遞」。當中肩周炎（又稱五十肩、冰凍肩、沾黏性肩關節囊炎）便是其中一種令肩膊疼痛的原因。然而，肩周炎所引致的肩膊痛只佔少數，2023年的瑞士《應用科學》期刊指出肩夾擠症候群(Shoulder Impingement Syndrome, SIS，下稱肩夾症)才是最常導致肩膊痛出現的原因，約佔三成半。
Raising up your arm is harder than you thought;
According to researches, shoulder pain is one of the most frequently reported pain which limits shoulder movement. The pain is often found around the anterolateral acromion and sometimes radiates to lateral mid humerus, i.e. around the front shoulder and sometimes the back. Gradual shoulder pain is presented with uprising shoulder movement. Adhesive capsulitis, or frozen shoulder is one of the factors leading to shoulder pain, yet, not the most common one. Castaldo (2023) revealed that Shoulder Impingement Syndrome (SIS) accounts approximately 35% of shoulder pain.
什麼是肩夾症？ What is SIS?
肩夾症的出現可以說是肩部結構，例如是旋轉肌袖肌肉、肌腱或是肩峰下滑囊出現了問題所致，當中包含旋轉肌袖肌腱炎、旋轉肌袖撕裂傷及旋轉肌袖斷裂或滑囊炎等等。這些結構問題會令到肩膊在不正常的軌跡活動：上臂在動作時，不能活動的肩胛(Scapular Dyskinesia)、不良肩胛姿勢及沒有適當活動幅度的胸椎會改變旋轉肌袖結構，減少其有效的穩定作用，令到肩膊慢慢向前傾，肩峰與前臂骨的空間減少，使兩者中間的組織因磨擦而發炎，終致肩膊痛的出現。
Shoulder structural problems may eventually lead to SIS, which includes rotator cuff syndrome (or even rotator cuff tears), tendonitis and bursitis. Shoulder would only move in an abnormal way under those situation; when we are rising up our arm, issues like scapular dyskinesia, improper scapular posture and lack of thoracic mobility would reduce the stability provided by rotator cuff, and so shoulder starts to translate anteriorly. The more it moves to the front, the less space between acromion and humerus left. The soft tissues are rubbed, ultimately directing to shoulder pain.
肩夾症一般較易在有重複過頭動作（投球、舉手）或圓肩的人身上出現，但不僅限於運動員，經常進行書寫工作的白領，又或是「搬上搬落」的藍領其實也屬於容易出現肩夾症的群體。
The occurrence of SIS are easily bonded with individuals having repeated overhead movement or round shoulder, but not only among athletes, it also appears in blue collar or white collar who lifts heavy load or does a lot of office work.
處理方法 Treatment
既然肩夾症與肩關節活動空間減少有關，那麼處理的方向便可以從「增加空間」入手，減少及避免組織的磨擦：
1.先以被動治療減少炎症
2a.減少炎症後以運動貼布固定肩部，運動前適當為地肌肉熱身
2b.針對特定的肌群進行訓練
3.以訓練好的肌肉將肩膊重新放入軌
Since SIS is related to narrowed space among shoulder structure, the common practice is to open up the shoulder joint and reduction on rubbing between soft tissues.
1.Reducing swelling and inflammation by modalities
2a.Using KT tape to stabilise shoulder and get enough warm up before playing sports
2b.Training on specific muscle groups
3.Retracking your shoulder dynamically
值得一提的是，研究指出運動貼布能夠在短期內有效地改落肩夾症的癥狀（因限制了肩膊前傾），但在長期的影響來看，運動治療（肌肉訓練）的方式遠比貼布有效；當然，人們能利用手術的方式去「打開空間」。不過，研究顯示手術與運動治療比，兩者在長遠的效果上相差不太遠。
One more point to be noted is that, KT tape has the best short term pain relief for SIS, by limiting the anterior translation of humerus; when looking for long term pain relief, sports therapy or resistance training take more advantages. Surgical decision usually made at the last priority yet an effective one. However, when it comes to comparison between surgery and sports therapy, they are proved to have similar pain reduction effect.
參考資料：
Castaldo, M., De Angelis D’Ossat, A., Gnessi, P., & Galeoto, G. (2023). A Systematic Review on Low-Level Laser Therapy in the Management of Shoulder Impingement Syndrome. Applied Sciences, 13(6), 3536.
Gebremariam, L., Hay, E. M., van der Sande, R., Rinkel, W. D., Koes, B. W., & Huisstede, B. M. (2014). Subacromial impingement syndrome—effectiveness of physiotherapy and manual therapy. British journal of sports medicine, 48(16), 1202-1208.
Green, S., Buchbinder, R., Hetrick, S. E., & Cochrane Musculoskeletal Group. (1996). Physiotherapy interventions for shoulder pain. Cochrane database of systematic reviews, 2013(3).
Kaya, E., Zinnuroglu, M., & Tugcu, I. (2011). Kinesio taping compared to physical therapy modalities for the treatment of shoulder impingement syndrome. Clinical rheumatology, 30(2), 201–207. https://doi.org/10.1007/s10067-010-1475-6
Klintberg, I. H., Cools, A. M., Holmgren, T. M., Holzhausen, A. C. G., Johansson, K., Maenhout, A. G., ... & Ginn, K. (2015). Consensus for physiotherapy for shoulder pain. International orthopaedics, 39, 715-720.
Kul, A., & Ugur, M. (2019). Comparison of the Efficacy of Conventional Physical Therapy Modalities and Kinesio Taping Treatments in Shoulder Impingement Syndrome. The Eurasian journal of medicine, 51(2), 139–144. https://doi.org/10.5152/eurasianjmed.2018.17421
Nazari, G., MacDermid, J. C., Bryant, D., & Athwal, G. S. (2019). The effectiveness of surgical vs conservative interventions on pain and function in patients with shoulder impingement syndrome. A systematic review and meta-analysis. PLoS One, 14(5), e0216961.
Walther, M., Werner, A., Stahlschmidt, T., Woelfel, R., & Gohlke, F. (2004). The subacromial impingement syndrome of the shoulder treated by conventional physiotherapy, self-training, and a shoulder brace: results of a prospective, randomized study. Journal of Shoulder and Elbow Surgery, 13(4), 417-423