{"id":20134,"date":"2025-06-05T15:47:36","date_gmt":"2025-06-05T13:47:36","guid":{"rendered":"https:\/\/www.wheeleo.eu\/schmerz-und-gang-eine-oft-ignorierte-verbindung\/"},"modified":"2025-12-19T11:18:48","modified_gmt":"2025-12-19T10:18:48","slug":"schmerz-und-gang-eine-oft-ignorierte-verbindung","status":"publish","type":"post","link":"https:\/\/www.wheeleo.eu\/de\/schmerz-und-gang-eine-oft-ignorierte-verbindung\/","title":{"rendered":"Schmerz und Gang: eine oft ignorierte Verbindung?"},"content":{"rendered":"\n<p>Einige schmerzlindernde Gangbilder sind bekannt, fast schon karikaturhaft: deutliches Hinken, ausweichende Belastung, sch\u00fctzende Haltung\u2026 Aber andere sind <strong>diskreter<\/strong>, subtiler. Und wenn <strong>der Schmerz sich nicht \u00e4u\u00dfert<\/strong>, wird der Zusammenhang zwischen der Gangver\u00e4nderung und einem schmerzhaften Ursprung schwer herzustellen. <\/p>\n\n<p>Und doch ist dieser Zusammenhang <strong>essenziell<\/strong> zu erkennen.<\/p>\n\n<h2 class=\"wp-block-heading\">Wenn der Schmerz sich nicht \u00e4u\u00dfert, aber sichtbar ist<\/h2>\n\n<p>Angesichts eines Schmerzes \u2013 oder der Angst, einen zu empfinden \u2013 reagiert der K\u00f6rper. Er passt sich an. Der Patient ver\u00e4ndert nat\u00fcrlich seine Haltung, seine Belastung, seine Art zu gehen. Er entwickelt <strong>schmerzlindernde Kompensationen<\/strong>.   <\/p>\n\n<p>Diese Anpassungen sind manchmal so effektiv, dass der Schmerz verschwindet. Oder zumindest <strong>wird er nicht mehr wahrgenommen<\/strong>. In einigen F\u00e4llen hat sich der Patient <strong>nie \u00fcber Schmerzen beklagt<\/strong>\u2026 und doch ist sein Gangbild ver\u00e4ndert.  <\/p>\n\n<p>Ergebnis: In der Konsultation beobachten wir eine Gangver\u00e4nderung <strong>ohne Beschwerden<\/strong> oder Schmerzerinnerung. Der Zusammenhang verschwimmt. Und mit ihm unsere klinische Argumentation.  <\/p>\n\n<h2 class=\"wp-block-heading\">Die Falle des Anscheins<\/h2>\n\n<p>Wenn man den Schmerz nicht als m\u00f6gliche Ursache in Betracht zieht, riskiert man:<\/p>\n\n<ul class=\"wp-block-list\">\n<li><strong>Eine andere Ursache suchen<\/strong>: motorische Defizienz, Gleichgewichtsst\u00f6rung, Gelenksteifigkeit\u2026<\/li>\n\n\n\n<li><strong>\u00dcbungen verschreiben<\/strong>, die darauf abzielen, den Gang zu korrigieren\u2026 ohne Wirkung, da <strong>die Ursache nicht behandelt wird<\/strong>.<\/li>\n\n\n\n<li><strong>Unfreiwillig das Kompensationsschema verst\u00e4rken<\/strong>, indem man am eigentlichen Problem vorbeihandelt.<\/li>\n<\/ul>\n\n<h2 class=\"wp-block-heading\">Physiotherapeuten, bleiben wir wachsam<\/h2>\n\n<p>Als Bewegungsexperten ist es auch unsere Aufgabe, Detektiv zu sein. Ein ver\u00e4ndertes Gangbild <strong>ohne Schmerzklage bedeutet nicht die Abwesenheit von Schmerz<\/strong>. <\/p>\n\n<p><strong>Auf schwache Signale achten<\/strong>, die Anamnese des Patienten erforschen, seine \u00c4ngste hinterfragen, die ausl\u00f6senden Kontexte beobachten: all das kann einen maskierten Schmerz aufdecken.<\/p>\n\n<p>Und vor allem: <strong>die Ursache behandeln<\/strong>, um die Kompensation aufzuheben.<\/p>\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n<p><strong>Wichtig:<\/strong><\/p>\n\n<ul class=\"wp-block-list\">\n<li>Schmerz kann den Gang tiefgreifend ver\u00e4ndern, <strong>auch ohne Beschwerden<\/strong>.<\/li>\n\n\n\n<li>Einige schmerzlindernde Gangbilder sind <strong>schwer zu erkennen<\/strong>.<\/li>\n\n\n\n<li><strong>Den Schmerz identifizieren<\/strong> (oder die Erinnerung daran) ist unerl\u00e4sslich, um die Rehabilitation zu leiten.<\/li>\n<\/ul>\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n<p>Die Kompensation ist manchmal so erfolgreich\u2026 dass wir die Ursache \u00fcbersehen.<\/p>\n<div class=\"jet-woo-product-gallery blocks-jet-woo-product-gallery-grid\" data-gallery-settings=\"{&quot;enableGallery&quot;:false,&quot;enableZoom&quot;:false,&quot;zoomMagnify&quot;:1,&quot;caption&quot;:true,&quot;zoom&quot;:true,&quot;fullscreen&quot;:true,&quot;share&quot;:true,&quot;counter&quot;:true,&quot;arrows&quot;:true,&quot;hasVideo&quot;:false,&quot;videoType&quot;:&quot;&quot;,&quot;videoIn&quot;:&quot;content&quot;,&quot;videoAutoplay&quot;:false,&quot;videoLoop&quot;:false,&quot;videoFirst&quot;:false}\" data-is-block=\"jet-gallery\/gallery-grid\">\n<div class=\"jet-woo-product-gallery__content jet-woo-product-gallery__trigger--top-right jet-woo-product-gallery-grid-primary-\" data-featured-image=\"\">\n\t<div class=\"jet-woo-product-gallery-grid grid-col-desk-4 grid-col-tab-2 grid-col-mob-1\">\n\t\t\n\t\t\t\n<div class=\"jet-woo-product-gallery__image-item\">\n\t<div class=\"jet-woo-product-gallery__image\">\n\t\t<a class=\"jet-woo-product-gallery__image-link\" href=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/01-intro.png\" itemprop=\"image\" title=\"01 - intro\" rel=\"prettyPhoto[jet-gallery]\" data-e-disable-page-transition=\"\"><img decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/01-intro-150x150.png\" class=\"wp-post-gallery\" alt=\"\" title=\"01 - intro\" data-caption=\"\" data-src=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/01-intro.png\" data-large_image=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/01-intro.png\" data-large_image_width=\"1080\" data-large_image_height=\"1350\" \/><\/a>\t<\/div>\n<\/div>\n<div class=\"jet-woo-product-gallery__image-item\">\n\t<div class=\"jet-woo-product-gallery__image\">\n\t\t<a class=\"jet-woo-product-gallery__image-link\" href=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/02.png\" itemprop=\"image\" title=\"02\" rel=\"prettyPhoto[jet-gallery]\" data-e-disable-page-transition=\"\"><img decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/02-150x150.png\" class=\"wp-post-gallery\" alt=\"\" title=\"02\" data-caption=\"\" data-src=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/02.png\" data-large_image=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/02.png\" data-large_image_width=\"1080\" data-large_image_height=\"1350\" \/><\/a>\t<\/div>\n<\/div>\n<div class=\"jet-woo-product-gallery__image-item\">\n\t<div class=\"jet-woo-product-gallery__image\">\n\t\t<a class=\"jet-woo-product-gallery__image-link\" href=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/03.png\" itemprop=\"image\" title=\"03\" rel=\"prettyPhoto[jet-gallery]\" data-e-disable-page-transition=\"\"><img decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/03-150x150.png\" class=\"wp-post-gallery\" alt=\"\" title=\"03\" data-caption=\"\" data-src=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/03.png\" data-large_image=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/03.png\" data-large_image_width=\"1080\" data-large_image_height=\"1350\" \/><\/a>\t<\/div>\n<\/div>\n<div class=\"jet-woo-product-gallery__image-item\">\n\t<div class=\"jet-woo-product-gallery__image\">\n\t\t<a class=\"jet-woo-product-gallery__image-link\" href=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/04.png\" itemprop=\"image\" title=\"04\" rel=\"prettyPhoto[jet-gallery]\" data-e-disable-page-transition=\"\"><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/04-150x150.png\" class=\"wp-post-gallery\" alt=\"\" title=\"04\" data-caption=\"\" data-src=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/04.png\" data-large_image=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/04.png\" data-large_image_width=\"1080\" data-large_image_height=\"1350\" \/><a class=\"jet-woo-product-gallery__image-overlay\"><span>+ 4 More Images<\/span><\/a><\/a>\t<\/div>\n<\/div>\n<div class=\"jet-woo-product-gallery__image-item item-hidden\">\n\t<div class=\"jet-woo-product-gallery__image\">\n\t\t<a class=\"jet-woo-product-gallery__image-link\" href=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/05.png\" itemprop=\"image\" title=\"05\" rel=\"prettyPhoto[jet-gallery]\" data-e-disable-page-transition=\"\"><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/05-150x150.png\" class=\"wp-post-gallery\" alt=\"\" title=\"05\" data-caption=\"\" data-src=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/05.png\" data-large_image=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/05.png\" data-large_image_width=\"1080\" data-large_image_height=\"1350\" \/><\/a>\t<\/div>\n<\/div>\n<div class=\"jet-woo-product-gallery__image-item item-hidden\">\n\t<div class=\"jet-woo-product-gallery__image\">\n\t\t<a class=\"jet-woo-product-gallery__image-link\" href=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/06.png\" itemprop=\"image\" title=\"06\" rel=\"prettyPhoto[jet-gallery]\" data-e-disable-page-transition=\"\"><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/06-150x150.png\" class=\"wp-post-gallery\" alt=\"\" title=\"06\" data-caption=\"\" data-src=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/06.png\" data-large_image=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/06.png\" data-large_image_width=\"1080\" data-large_image_height=\"1350\" \/><\/a>\t<\/div>\n<\/div>\n<div class=\"jet-woo-product-gallery__image-item item-hidden\">\n\t<div class=\"jet-woo-product-gallery__image\">\n\t\t<a class=\"jet-woo-product-gallery__image-link\" href=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/07.png\" itemprop=\"image\" title=\"07\" rel=\"prettyPhoto[jet-gallery]\" data-e-disable-page-transition=\"\"><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/07-150x150.png\" class=\"wp-post-gallery\" alt=\"\" title=\"07\" data-caption=\"\" data-src=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/07.png\" data-large_image=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/07.png\" data-large_image_width=\"1080\" data-large_image_height=\"1350\" \/><\/a>\t<\/div>\n<\/div>\n<div class=\"jet-woo-product-gallery__image-item item-hidden\">\n\t<div class=\"jet-woo-product-gallery__image\">\n\t\t<a class=\"jet-woo-product-gallery__image-link\" href=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/08.png\" itemprop=\"image\" title=\"08\" rel=\"prettyPhoto[jet-gallery]\" data-e-disable-page-transition=\"\"><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/08-150x150.png\" class=\"wp-post-gallery\" alt=\"\" title=\"08\" data-caption=\"\" data-src=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/08.png\" data-large_image=\"https:\/\/www.wheeleo.eu\/wp-content\/uploads\/2025\/06\/08.png\" data-large_image_width=\"1080\" data-large_image_height=\"1350\" \/><\/a>\t<\/div>\n<\/div>\n\t\t\t<\/div>\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>Einige schmerzlindernde Gangbilder sind bekannt, fast schon karikaturhaft: deutliches Hinken, ausweichende Belastung, sch\u00fctzende Haltung\u2026 Aber andere sind diskreter, subtiler. Und wenn der Schmerz sich nicht \u00e4u\u00dfert, wird der Zusammenhang zwischen der Gangver\u00e4nderung und einem schmerzhaften Ursprung schwer herzustellen. Und doch ist dieser Zusammenhang essenziell zu erkennen. Wenn der Schmerz sich nicht \u00e4u\u00dfert, aber sichtbar ist [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":20136,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[398],"tags":[],"profils-type":[],"expertise":[],"situation":[402],"profils-et-pathologies":[],"class_list":["post-20134","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-artikel","situation-weitere-artikel-gesundheitsfachkraft"],"_links":{"self":[{"href":"https:\/\/www.wheeleo.eu\/de\/wp-json\/wp\/v2\/posts\/20134","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.wheeleo.eu\/de\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.wheeleo.eu\/de\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.wheeleo.eu\/de\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.wheeleo.eu\/de\/wp-json\/wp\/v2\/comments?post=20134"}],"version-history":[{"count":2,"href":"https:\/\/www.wheeleo.eu\/de\/wp-json\/wp\/v2\/posts\/20134\/revisions"}],"predecessor-version":[{"id":20211,"href":"https:\/\/www.wheeleo.eu\/de\/wp-json\/wp\/v2\/posts\/20134\/revisions\/20211"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.wheeleo.eu\/de\/wp-json\/wp\/v2\/media\/20136"}],"wp:attachment":[{"href":"https:\/\/www.wheeleo.eu\/de\/wp-json\/wp\/v2\/media?parent=20134"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.wheeleo.eu\/de\/wp-json\/wp\/v2\/categories?post=20134"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.wheeleo.eu\/de\/wp-json\/wp\/v2\/tags?post=20134"},{"taxonomy":"profils-type","embeddable":true,"href":"https:\/\/www.wheeleo.eu\/de\/wp-json\/wp\/v2\/profils-type?post=20134"},{"taxonomy":"expertise","embeddable":true,"href":"https:\/\/www.wheeleo.eu\/de\/wp-json\/wp\/v2\/expertise?post=20134"},{"taxonomy":"situation","embeddable":true,"href":"https:\/\/www.wheeleo.eu\/de\/wp-json\/wp\/v2\/situation?post=20134"},{"taxonomy":"profils-et-pathologies","embeddable":true,"href":"https:\/\/www.wheeleo.eu\/de\/wp-json\/wp\/v2\/profils-et-pathologies?post=20134"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}