Acromion Process
Coracoid Process
Subscapular Fossa
Glenoid Fossa
“Plane of the scapula”
Where the head of the humerus sits
Spine of Posterior Scapula
Supraspinous Fossa of Posterior Scapula
Infraspinous Fossa of Posterior Scapula
Body of Posterior Scapula
Medial Border of Posterior Scapula
Lateral Border of Posterior Scapula
Superior Border of Posterior Scapula
Superior Angle of Posterior Scapula
Inferior Angle of Posterior Scapula
Humerus Head
Humerus Anatomical Neck
Humerus Surgical Neck
Humerus Body
Humerus Deltoid Tuberosity
Humerus Greater Tubercle
Humerus Lesser Tubercule
Humerus Bicipital/ Intertubercular Groove
The Joints of the Shoulder Complex:
True Joints:
Sternoclavicular (SC)
Acromioclavicular (AC)
Glenohumeral (GH)
Functional Joints:
Scapulothoracic
Coracoacromioal
Acromioclavicular Joint - AC Ligament
Acromioclavicular Joint - Coracoacromial Ligament
Acromioclavicular Joint - Trapezoid Ligament APART of Coracolavicular Ligament
Acromioclavicular Joint - Conoid Ligament APART of Coracolavicular Ligament
Sternoclavicular Joint Costoclavicular Ligament
Sternoclavicular Joint Interclavicular Ligament
Sternoclavicular Joint Anterior SC Ligament
Glenohumeral Joint
What are the ligaments of the glenohumeral joint? How many are there?
Glenohumeral Ligaments (4)
Anterior GH Ligament
Posterior GH Ligament
Inferior GH Ligament
Transverse Humeral Ligament
Coracohumerual Ligament
The Glenohumeral Joint (Rotator Cuff) provides …
Dynamic support
Rotator Cuff Teres Minor
Rotator Cuff Infraspinatus
Rotator Cuff Supraspinatus
Rotator Cuff Subscapularis
What are the motions of the scapulothoracic joint?
Elevation (Shrug)
Depression (Down)
Protraction (Pull Forward)
Retraction (Pull Back)
Upward Rotation (Inferior Angle Sliding up and down)
Downward Rotation (Returning to rest from the above)
Coracoacromial Arch
Not a true joint
Formed by Coracoacromial ligament
Prevent superior translation of the humerus
What are the Anterior and Posterior Shoulder Girdle Muscles
Anterior
Pectoralis Minor
Serratus Anterior
Subclavian
Posterior
Levator Scapulae
Rhomboids
Trapezius
Pectoralis Minor
O: Ribs (3,4,5)
I: Coracoid process
A: Protraction of scapula (pulls it forward)
N: Medial pectoral n.
Serratus Anterior
O: Angles of ribs (1-8)
I: Medial border of scapula
A: Scapular protraction (brings inward)
N: Long thoracic
Subclavis
O: 1st rib (between clavicle and 1st rib)
I: Inferior clavicle
A: Depresses clavicle ( brings down- to hold into place)
N: Nerve to subclavius
Levator Scapulae
O: Transverse processes of C1-C4
I: Superior/medial portion of scapula
A: Scapular elevation Neck extension
N: Nerve roots C2-C4
Rhomboid Major
O: T2 – T5
I: Medial border of scapula
A: Scapular retraction ( pulling back)
N: Dorsal scapular n.
Rhomboid Minor
O: C7 – T1
I: Medial border of scapula
A: Scapular retraction
N: Dorsal scapular n.
Upper Trapezius
O: Ext occipital protuberance
Occiput (Base of your skull)
SP of C7 (Spinus Process - Broad and Wide Origin and Insertion)
I: Lateral 1/3 clavicle
Acromion process
A: Scapular elevation
Neck extension
N: Spinal Accessory n.
The Shoulder Joint Muscles
Anterior
Pectoralis major
Coracobrachialis
Biceps brachii
Subscapularis (RC)
Posterior
Infraspinatus (RC)
Teres minor (RC)
Superior
Deltoid
Supraspinatus (RC)
Inferior
Latissimus dorsi
Teres Major
Triceps brachii
Pectoralis Major
O: Clavicle
Sternum
Ribs
I: Lesser tubercle (humerus)
A: Adduction
Horizontal adduction
Flexion
N: Medial & lateral pectoral nn.
Coracobrachialis
O: Coracoid process
I: Medial 1/3 of humerus
A: Flexion
Horizontal adduction
N: Musculocutaneous n.
Biceps Brachii
O:
Glenoid (long head) (on bone itself and part of labrum)
Coracoid (short head)
I: Tuberosity of radius
A: Shoulder flexion (weak)
Elbow flexion
Supination
N: Musculocutaneous
(crosses 2 joints)
Subscapularis [RC (Rotator Cuff)]
O: Subscapular fossa
I: Lesser tubercle (the only lesser of RC)
A: Internal Rotation
N: Subscapular n.
Supraspinatus (RC)
O: Supraspinous Fossa
I: Greater tubercle
A: Abduction
N: Suprascapular n.
Infraspinatus (RC)
O: Infraspinous Fossa
I: Greater tubercle
A: External Rotation (rotating out)
N: Suprascapular n.
Teres Minor (RC)
O: Lateral border of scapula
I: Greater tubercle
A: External Rotation (same as infraspinatus)
N: Axillary n.
Teres Major
(NOT an RC Muscle) (the LATS helper)
O: Lateral border of scapula
I: Lesser tubercle
A: Extension
Adduction
Internal rotation
N: Axillary n.
Deltoid
O: Scapula
Clavicle
I: Deltoid tuberosity
A: (Fibers)
Flexion (ant.)
Abduction (mid.)
Extension (post.)
N: Axillary n.
Latissimus Dorsi
O: Thoracolumbar fascia (on the fascia)
Thoracic vertebrae
Lumbar vertebrae
I: Lesser tubercle
A:
Extension
Adduction
Internal rotation
N: Thoracodorsal n.
Triceps Brachii
O:
Lateral border of scapula (long head)
Posterior humerus (medial & lateral heads)
I: Olecranon process
A:
Shoulder extension (weak)
Elbow extension
N: Radial n.
2 joint muscle
What are the four joints that maintain shoulder function?
Glenohumeral Joint (GH)
Scapulothoracic (ST)
Sternoclavicular (SC)
Acromioclavicular (AC)
Scapulohumeral rhythm is …
Coordination of movements between the clavicle, scapula, and humerus
GH joint only has _____ degrees of abduction or flexion which is why …
120 degrees ;
ST, SC, and AC contribute the remaining 60º
Scapulohumeral rhythm has a what to what ratio?
2:1 ratio of GH:ST movement through full 180º of motion
Phase 1 of ScapRhythm :
Phase 2 of ScapRhythm :
0º-90 º total motion
90 º-180 º total motion
Phase 1 of ScapRhythm :
0º-90 º
GH contribution
60 º abduction/flexion of humerus
ST contribution
30 º upward rotation of scapula
Corresponds with 30 º of clavicular elevation at the SC joint
Costoclavicular ligament limits amount of clavicular elevation
Phase 2 of ScapRhythm :
90º-180 º
GH contribution
60 º abduction/flexion of humerus
ST contribution
30 º upward rotation of scapula
Corresponds with 30 º of posterior rotation at the AC joint
Phases of Throwing
Wind-Up (W- Wally)
Stride (S- Sam)
Cocking (C- Came)
Acceleration (A- Alive)
Deceleration (D- During)
Follow Through (F- Fun)
Phases of Throwing Cont.
Cocking - External Rotation AND its Concentric (your LATS)
Acceleration - Internal Rotation AND its Concentric
Deceleration - External Rotation AND its Eccentric (lengthening)
Follow-Through- Eccentric (lengthening)
*Force deceleration = Eccentric*
Activities requiring shoulder movement:
Reaching overhead and forward
Sequence of movement
Joint motion
Muscle activity
Contrasting Open and Closed Chain Shoulder Exercises:
Open Chain:
Individual Muscles
Focus on weakness
Closed Chain:
Multiple muscles active
More functional
Shoulder Pathology
Inherently unstable joint
Complex relationship between ligaments, joint capsule, muscles
If one goes, others must compensate
Posture and strength imbalances cause biggest problems
Concentric-eccentric relationship
Don’t forget the role of the scapula!!!