肩关节周围炎 shoulder periarthritis (frozen shoulder)

[Ho Kwok Leung]

厨师容易患有肩周炎（肩关节周围炎）主要与其职业特点和工作环境密切相关，以下是具体原因分析：

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### **1. 重复性动作导致慢性劳损**
- **频繁抬臂与旋转**：厨师需长时间进行翻炒、颠勺、切菜等动作，导致肩关节反复外展、旋转和负重。例如，大锅翻炒时，手臂需持续抬高并用力，易造成肩袖肌群（如冈上肌、冈下肌）和肌腱的磨损。
- **肌肉疲劳积累**：高强度重复动作使肩部肌肉长期处于紧张状态，导致局部血液循环变差，炎症因子堆积，最终引发无菌性炎症。

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### **2. 不良姿势与静态负荷**
- **工作台高度不适**：厨房操作台若高度不合理（如过低），厨师需弯腰或耸肩作业，导致肩颈部肌肉代偿性紧张，增加关节压力。
- **固定姿势过久**：长时间保持切菜、雕刻等动作，肩关节处于固定角度，可能压迫周围软组织，加速退行性病变。

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### **3. 体力负荷过重**
- **搬运重物**：搬运食材、大型锅具或重型厨具时，若姿势不当（如单侧用力、突然发力），可能引发肩关节急性拉伤或慢性劳损。
- **工具重量影响**：专业厨具（如铸铁锅）重量较大，长期使用会增加肩部负担，尤其是单侧用力时易导致肌肉失衡。

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### **4. 环境因素加剧损伤**
- **温湿度变化**：厨房高温潮湿环境可能使肌肉短暂放松，但频繁进出冷库或接触冷气会导致肌肉突然收缩，影响血液循环，加重炎症。
- **缺乏防护措施**：多数厨房未配备人体工学工具（如防滑减重厨具），或未提供肩部护具，进一步增加损伤风险。

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### **5. 工作强度与休息不足**
- **长时间工作**：厨师通常连续作业数小时，肩部肌肉缺乏足够休息，导致修复能力下降，炎症反复发作。
- **心理压力**：高强度工作节奏可能使身体长期处于应激状态，肌肉持续紧张，加剧肩关节负担。

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### **如何预防与缓解？**
- **调整工作习惯**：使用高度适宜的操作台，交替使用左右手操作，定时休息并做肩部拉伸（如钟摆运动、手臂绕环）。
- **强化肌肉训练**：通过哑铃侧平举、弹力带训练等增强肩袖肌群力量，提升关节稳定性。
- **改善工具与防护**：选择轻量化厨具，使用护肩或热敷贴缓解疲劳，避免突然搬运重物。
- **及时就医**：若出现肩部持续疼痛或活动受限，需尽早进行理疗（如超声波、针灸）或康复训练。

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综上，厨师职业的特殊性使其肩关节长期承受高负荷和重复性压力，通过优化工作方式、加强防护和锻炼，能有效降低肩周炎风险。

### **Why Are Chefs Prone to Shoulder Periarthritis?**
Chefs are highly susceptible to shoulder periarthritis (frozen shoulder) due to the unique demands and working conditions of their profession. Below is a detailed analysis of the contributing factors:

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### **1. Repetitive Movements Leading to Chronic Strain**
- **Frequent Arm Raising and Rotation**: Tasks like stir-frying, wok-tossing, and chopping require repeated shoulder abduction, rotation, and weight-bearing. For example, lifting and maneuvering heavy woks for extended periods can wear down the rotator cuff muscles (e.g., supraspinatus, infraspinatus) and tendons.
- **Muscle Fatigue Accumulation**: High-intensity repetitive motions keep shoulder muscles in constant tension, impairing blood circulation and promoting the buildup of inflammatory factors, eventually triggering aseptic inflammation.

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### **2. Poor Posture and Static Load**
- **Improper Workstation Height**: If kitchen counters are too low, chefs may hunch or shrug their shoulders, causing compensatory muscle tension in the neck and shoulders and increasing joint pressure.
- **Prolonged Static Postures**: Maintaining fixed positions during tasks like chopping or food carving can compress soft tissues around the shoulder joint, accelerating degenerative changes.

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### **3. Heavy Physical Loads**
- **Lifting Heavy Objects**: Carrying ingredients, large pots, or heavy equipment with improper techniques (e.g., unilateral force, sudden exertion) may cause acute strains or chronic shoulder injuries.
- **Tool Weight Impact**: Professional cookware (e.g., cast iron pans) adds significant stress to the shoulders, especially when used unilaterally, leading to muscle imbalances.

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### **4. Environmental Factors Aggravating Injuries**
- **Temperature and Humidity Fluctuations**: High heat and humidity in kitchens may temporarily relax muscles, but frequent exposure to cold storage or sudden temperature shifts can trigger muscle contractions, impair blood flow, and worsen inflammation.
- **Lack of Protective Measures**: Most kitchens lack ergonomic tools (e.g., anti-slip, lightweight utensils) or shoulder supports, further increasing injury risks.

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### **5. Work Intensity and Insufficient Rest**
- **Long Working Hours**: Chefs often work continuously for hours without adequate rest, reducing the shoulder’s ability to recover and allowing inflammation to recur.
- **Psychological Stress**: High-pressure environments keep muscles in a prolonged state of tension, exacerbating shoulder joint strain.

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### **Prevention and Relief Strategies**
- **Adjust Work Habits**: Use ergonomic workstations, alternate hands during tasks, take regular breaks, and perform shoulder stretches (e.g., pendulum swings, arm circles).
- **Strengthen Muscles**: Enhance rotator cuff strength with exercises like lateral raises and resistance band training to improve joint stability.
- **Optimize Tools and Protection**: Use lightweight utensils, shoulder braces, or heat patches to reduce fatigue, and avoid abrupt heavy lifting.
- **Seek Early Treatment**: For persistent pain or limited mobility, pursue physical therapy (e.g., ultrasound, acupuncture) or rehabilitation exercises promptly.

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In summary, the high physical demands and repetitive motions inherent to a chef’s job place prolonged stress on the shoulder joint. By improving ergonomics, adopting protective measures, and strengthening muscles, chefs can significantly reduce their risk of developing shoulder periarthritis.