{"id":27508,"date":"2022-09-30T14:11:49","date_gmt":"2022-09-30T17:11:49","guid":{"rendered":"https:\/\/www.fitnessbrasil.com.br\/?p=27508"},"modified":"2025-05-28T18:43:55","modified_gmt":"2025-05-28T21:43:55","slug":"dor-no-quadril-treinamento-de-forca-e-sindrome-do-impacto-femoroacetabular","status":"publish","type":"post","link":"https:\/\/www.fitnessbrasil.com.br\/es\/newsfitbr\/dor-no-quadril-treinamento-de-forca-e-sindrome-do-impacto-femoroacetabular\/","title":{"rendered":"Dor no quadril, treinamento de for\u00e7a e s\u00edndrome do impacto femoroacetabular"},"content":{"rendered":"\n\n\n

Por \u00c1derson Loureiro, colunista Fitness Brasil<\/p>\n\n\n\n\n\n\n\n

A dor no quadril \u00e9 causa comum de incapacidade funcional com complexas modifica\u00e7\u00f5es morfol\u00f3gicas<\/strong>, sinais cl\u00ednicos (1) e dor cr\u00f4nica em diversos p\u00fablicos, desde pessoas com idade avan\u00e7ada at\u00e9 atletas jovens (2). As les\u00f5es no quadril configuram 10% das visitas nos consult\u00f3rios relacionadas \u00e0 medicina do esporte e levam \u00e0 interrup\u00e7\u00e3o dos treinamentos em adultos jovens. Estas les\u00f5es apresentam um diagn\u00f3stico desafiador assim como o tratamento<\/strong>, por conta das diversas fontes e mecanismos que podem acarret\u00e1-las (2), entretanto deve ser destacado que estas les\u00f5es podem resultar no risco aumentado para o desenvolvimento de osteoartrose (OA) (1). Dentre as potenciais causas para a r\u00e1pida deteriora\u00e7\u00e3o articular do quadril a S\u00edndrome do Impacto Femoroacetabular (SIFA) destaca-se principalmente no adulto jovem (3). A SIFA \u00e9 caracterizada por altera\u00e7\u00f5es na anatomia do acet\u00e1bulo e da regi\u00e3o proximal do f\u00eamur que, invariavelmente, leva \u00e0 ruptura do labrum que \u00e9 essencial para estabilidade e prote\u00e7\u00e3o da articula\u00e7\u00e3o do quadril (3).<\/p>\n\n\n\n

A etiologia da SIFA se apresenta dentre alguma das tr\u00eas formas morfol\u00f3gicas: cam (came), pincer ou mista (Fig. 1). A morfologia do tipo cam apresenta forma\u00e7\u00e3o \u00f3ssea na transi\u00e7\u00e3o do colo com a cabe\u00e7a femoral, resultando na n\u00e3o esfericidade da cabe\u00e7a e sua jun\u00e7\u00e3o com o acet\u00e1bulo. Por outro lado, o tipo pincer, usualmente associada \u00e0 retrovers\u00e3o acetabular, \u00e9 resultado do aumento da cobertura acetabular sobre a cabe\u00e7a femoral. O tipo mista apresenta tanto pincer quanto cam morfologias e de acordo com Trigg e colegas (2020) \u00e9 a forma mais comum entre as causas de SIFA (2)(4)(5)(4).<\/p>\n\n\n\n

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Figura 1. Vista supero-inferior da articula\u00e7\u00e3o do quadril. a) quadril normal; b) quadril tipo CAM; c) quadril tipo pincer; d) quadril tipo misto<\/em><\/figcaption><\/figure>\n\n\n\n

Como afirmei anteriormente sobre a rela\u00e7\u00e3o da SIFA no desenvolvimento da osteoartrose do quadril, tem sido considerado por pesquisadores que esta les\u00e3o pode advir de fatores secund\u00e1rios (ex: deformidades cong\u00eanitas e\/ou do desenvolvimento) ou prim\u00e1rios (presumivelmente alguma deformidade adjacente da cartilagem articular)<\/strong>. Entretanto, recentemente as evidencias suportam a hip\u00f3tese que a t\u00e3o reconhecida osteoartrose prim\u00e1ria \u00e9 tamb\u00e9m secund\u00e1ria para o sutil desenvolvimento anormal da articula\u00e7\u00e3o, sendo o mecanismo da SIFA nestes casos, mais importantes que o estresse causado por impacto excessivo (6).<\/p>\n\n\n\n

Desta forma torna-se imprescind\u00edvel que n\u00f3s, profissionais de Educa\u00e7\u00e3o F\u00edsica e Fisioterapeutas do esporte, tenhamos muita aten\u00e7\u00e3o e sejamos criteriosos na prescri\u00e7\u00e3o e sele\u00e7\u00e3o dos exerc\u00edcios, pois trata-se de uma les\u00e3o ortop\u00e9dica por repeti\u00e7\u00e3o e cr\u00f4nica,<\/strong> diferentemente das les\u00f5es agudas que atingem muitos atletas e praticantes recreativos (ex entorses, fraturas etc).<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Treinamento de For\u00e7a<\/strong><\/p>\n\n\n\n

Especificamente sobre o treinamento de for\u00e7a (TF), diversos s\u00e3o os fatores que contribuem para capacidade da evolu\u00e7\u00e3o na performance e tamb\u00e9m na prote\u00e7\u00e3o das articula\u00e7\u00f5es. Dentre as vari\u00e1veis que mais contribuem para estas caracter\u00edsticas podemos destacar o volume muscular, a qualidade muscular e a atividade neuromuscular. Como j\u00e1 estabelecido por este autor e nosso grupo de pesquisa, pessoas com osteoartrose de quadril apresentam diversos desequil\u00edbrios musculares comparadas com o segmento n\u00e3o afetado e com indiv\u00edduos sem as les\u00f5es articulares<\/strong> (controles) (7).<\/p>\n\n\n\n

Tamb\u00e9m est\u00e1 muito bem estabelecido os benef\u00edcios que o TF entrega para crian\u00e7as, adolescentes, adultos e idosos (8)(9)(10)(11), por\u00e9m a sele\u00e7\u00e3o criteriosa dos exerc\u00edcios deve ser foco fundamental para prescri\u00e7\u00e3o<\/strong> principalmente em alunos sintom\u00e1ticos (ex: dor no quadril, dor inguinal), com desvios posturais (ex: rota\u00e7\u00e3o interna coxofemoral, pelve ante ou retrovertida) ou com hist\u00f3ria gen\u00e9tica de les\u00e3o no quadril.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Sendo assim, nosso papel como profissionais da sa\u00fade e principalmente como promotores da sa\u00fade tanto com foco na profilaxia quanto na reabilita\u00e7\u00e3o, precisamos direcionar nossa aten\u00e7\u00e3o para avalia\u00e7\u00e3o antes de qualquer elabora\u00e7\u00e3o dos programas de treinamento<\/strong>, seja para atletas de alto rendimento como tamb\u00e9m e talvez, principalmente, para os alunos\/ pacientes que se exercitam nas academias, clubes, boxes, centros de treinamento de artes marciais, est\u00fadios de dan\u00e7a, etc, pois trata-se da grande maioria da popula\u00e7\u00e3o.<\/p>\n\n\n\n

Portanto, se faz imprescind\u00edvel a anamnese e alguns testes espec\u00edficos para direcionar a sele\u00e7\u00e3o de exerc\u00edcios<\/strong> que minimizem o estresse articular, planejar o programa de treinamento de forma mais assertiva e prescrever com maior seguran\u00e7a.<\/p>\n\n\n\n

Na pr\u00f3xima coluna vamos abordar e discutir alguns exerc\u00edcios n\u00e3o indicados para pessoas que apresentam SIFA.<\/p>\n\n\n\n

Forte abra\u00e7o!<\/p>\n\n\n\n

Refer\u00eancias Bibliogr\u00e1ficas<\/strong><\/p>\n\n\n\n

1.      King MG, Lawrenson PR, Semciw AI, Middleton KJ, Crossley KM. <\/em>Lower limb biomechanics in femoroacetabular impingement syndrome: a systematic review and meta-analysis. bjsm.bmj.com [Internet]. 2018 [cited 2022 Aug 15];52:566\u201380. Available from: https:\/\/bjsm.bmj.com\/content\/52\/9\/566.abstract<\/em><\/p>\n\n\n\n

2.           Trigg, SD JS-CSM, 2020 U. Femoroacetabular impingement syndrome. journals.lww.com [Internet]. [cited 2022 Aug 15]; Available from: https:\/\/journals.lww.com\/acsm-csmr\/fulltext\/2020\/09000\/femoroacetabular_impingement_syndrome.8.aspx<\/em><\/p>\n\n\n\n

3.           Ejnisman L, Ricioli J\u00fanior W, Queiroz MC, Vicente JRN, Croci AT, Polesello GC. Femoroacetabular impingement and acetabular labral tears-Part 1: Pathophysiology and biomechanics. Rev Bras Ortop. 2020;55(5):518\u201322.<\/em><\/p>\n\n\n\n

4.           Milani CJE, Moley PJ. Advanced concepts in hip morphology, associated pathologies, and specific rehabilitation for athletic hip injuries. Curr Sports Med Rep [Internet]. 2018 [cited 2022 Aug 22];17(6):199\u2013207. Available from: https:\/\/journals.lww.com\/acsm-csmr\/Fulltext\/2018\/06000\/Advanced_Concepts_in_Hip_Morphology,_Associated.8.aspx<\/em><\/p>\n\n\n\n

5.           Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage. Femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Jt Surg – Ser B [Internet]. 2005 [cited 2022 Aug 22];87(7):1012\u20138. Available from: https:\/\/online.boneandjoint.org.uk\/doi\/abs\/10.1302\/0301-620X.87B7.15203<\/em><\/p>\n\n\n\n

6.           Ganz R, Leunig M, Leunig-Ganz K, Harris WH. The etiology of osteoarthritis of the hip: An integrated mechanical concept. In: Clinical Orthopaedics and Related Research. Springer New York; 2008. p. 264\u201372.<\/em><\/p>\n\n\n\n

7.           Loureiro A, Mills PM, Barrett RS. Muscle weakness in hip osteoarthritis: a systematic review. Vol. 65, Arthritis care & research. 2013. p. 340\u201352.<\/em><\/p>\n\n\n\n

8.           Faigenbaum AD. Resistance training for children and adolescents. In: Resistance Training for the Prevention and Treatment of Chronic Disease [Internet]. 2013 [cited 2022 Sep 19]. p. 257\u201373. Available from: https:\/\/publications.aap.org\/pediatrics\/article-abstract\/145\/6\/e20201011\/76942<\/em><\/p>\n\n\n\n

9.           Fragala MS, Cadore EL, Dorgo S, Izquierdo M, Kraemer WJ, Peterson MD, et al. <\/em>Resistance training for older adults: Position statement from the national strength and conditioning association. J Strength Cond Res [Internet]. 2019 [cited 2022 Sep 19];33(8):2019\u201352. Available from: https:\/\/journals.lww.com\/nsca-jscr\/Fulltext\/2019\/08000\/Resistance_Training_for_Older_Adults__Position.1.aspxSome<\/em><\/p>\n\n\n\n

10.         Schoenfeld BJ, Grgic J. Effects of range of motion on muscle development during resistance training interventions: A systematic review. SAGE Open Med [Internet]. 2020 Jan [cited 2022 Sep 19];8:205031212090155. Available from: https:\/\/journals.sagepub.com\/doi\/abs\/10.1177\/2050312120901559<\/em><\/p>\n\n\n\n

11. \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Grgic J, Garofolini A, Orazem J, Sabol F, Schoenfeld BJ, Pedisic Z. Effects of Resistance Training on Muscle Size and Strength in Very Elderly Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials [Internet]. Vol. 50, Sports Medicine. Springer Science and Business Media Deutschland GmbH; 2020 [cited 2022 Sep 19]. p. 1983\u201399. Available from: https:\/\/link.springer.com\/article\/10.1007\/s40279-020-01331-7?fbclid=IwAR06PPIz8cf2xZExNvrnlueQp0-7SWQwT1x0bUdnZrgTOqcyiAdTrpufTjU<\/em><\/p>\n\n\n\n

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\n

Prof. Dr. \u00c1derson Loureiro <\/em><\/strong>\u00e9 doutor (PhD) em Biomec\u00e2nica (Griffith Universiity-Australia), mestre em Biomec\u00e2nica (UDESC), com especializa\u00e7\u00e3o em Medicina do Esporte (PUCRS) e Gest\u00e3o da Qualidade (UNISINOS), docente da UNISINOS, propriet\u00e1rio da Advisory \u2013 Consultoria em Avalia\u00e7\u00e3o e Prescri\u00e7\u00e3o de Treinamento, CEO da Alpha Pro System \u2013 Plataforma de Avalia\u00e7\u00e3o, Prescri\u00e7\u00e3o e Gest\u00e3o (www.alphaprosystem.com<\/a>). Instagram: @professoraderson, @alphaprosystem, @advisoryadersonloureiro<\/em><\/p>\n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":"

Por \u00c1derson Loureiro, colunista Fitness Brasil<\/p>","protected":false},"author":1505,"featured_media":27511,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":true,"footnotes":""},"categories":[229,74],"tags":[],"post_folder":[],"class_list":["post-27508","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-aderson-loureiro","category-colunistas"],"acf":[],"yoast_head":"\nDor no quadril, treinamento de for\u00e7a e s\u00edndrome do impacto femoroacetabular - Fitness Brasil<\/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:\/\/www.fitnessbrasil.com.br\/es\/newsfitbr\/dor-no-quadril-treinamento-de-forca-e-sindrome-do-impacto-femoroacetabular\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta 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