THE SHOULDER COMPLEX

exhaustedcrumMechanics

Oct 24, 2013 (3 years and 5 months ago)

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THE SHOULDER COMPLEX

Anatomy
-

Bones

Anatomy
-

Ligaments

Anatomy
-

Muscles


Flexors


Pectoralis

Major


Deltoid


Coracobrachialis



Biceps
Brachii



Extensors


Latissimus

Dorsi



Deltoid


Teres

Major


Triceps
Brachii

Anatomy
-

Muscles


Abduction


Deltoid


Supraspinatus



Biceps
Brachii


Adduction


Pectoralis

Major


Latissimus

Dorsi



Infraspinatus



Teres

Major


Coracobrachialis



Trapezius

(Scapula)


Rhomboideus

Major & Minor (Scapula)

Anatomy
-

Muscles


Internal Rotation


Pectoralis

Major


Latissimus

Dorsi



Deltoid


Subscapularis



Teres

Major


External Rotation


Supraspinatus



Infraspinatus



Teres

Minor


Deltoid

Anatomy
-

Muscles


Horizontal Abduction


Deltoid


Infraspinatus


Teres

Minor


Horizontal Adduction


Deltoid


Pectoralis

Major


Anatomy
-

Muscles


Elevators


Trapezius

(Scapula)


Levator

Scapulae (Scapula)


Depressors


Latissimus

Dorsi

(
Humerus
)


Trapezius

(Scapula)


Pectoralis

Minor (Scapula)

Scapular Motion


Elevation


Levator

scapulae


Rhomboid major/minor


Serratus

Anterior


Trapezius

(Upper)


Depression


Serratus

Anterior


Trapezius

(Lower)


Pectoralis

Major

Scapular Motion


Protraction


Serratus

Anterior


Retraction


Rhomboid Major/Minor


Trapezius

(Middle/Lower)


Upward Rotation


Serratus

Anterior


Trapezius

(Upper/Lower)


Downward Rotation


Rhomboid Major/Minor


Levator

Scapulae

Brachial Plexus

Winging Scapula


Can occur because of weakness of the
periscapula

muscles (especially the
serratus

anterior and
middle/lower
trapezius
) and occurs secondary to long
thoracic nerve trauma


Scapula stabilization is necessary for normal arm
movement

Forward/Rounded Shoulder
Posture


Caused by a slouched posture, shortened
anterior chest muscles, elongation of the
posterior
interscapula

muscles
(lower/middle
trapezius

and rhomboids),
and abnormal cervical and thoracic spine
curvatures


Consequences of FSP: degeneration of
AC joint,
bicipital

or rotator cuff tendinitis
or
impingment
, muscle weakness,
myofascial

pain and trigger points,
posterior capsular tightness, excessive
back flexion, and thoracic outlet
syndrome


Shoulder Injuries


Sternoclavicular

Sprain


MOI: Indirect force transmitted through the
humerus

by a blow that strikes the poorly padded
clavicle by twisting of a
posteriorly

extended arm.

Shoulder Injuries


Acromioclavicular

Sprain


MOI:


Direct impact to the tip of the shoulder that forces
the
acromion

process downward, backward, and
inward while the clavicle is pushed down against the
rib cage


Fall on an outstretched arm

Step
-
Off
Deformity

Shoulder Injuries


Glenohumeral

Joint Sprain


MOI:


Anterior: Arm is forced into abduction, external
rotation, or direct blow.


Posterior: A forceful movement of the
humerus

posteriorly

when the arm is flexed.

Shoulder Injuries


Anterior
Glenohumeral

Dislocation


MOI:


Direct impact to the posterior or
posterolateral

aspect of the shoulder.


Forced abduction, external rotation, and extension

Shoulder Injuries


Posterior
Glenohumeral

Dislocation


MOI: Forced adduction and internal rotation or a
fall on an extended and internally rotated arm

Shoulder Injuries


Superior Labrum
Anteroposterior

(SLAP)
Lesion


MOI: Compression and inferior traction

Shoulder Injuries


Shoulder Impingement Syndrome


MOI:


Mechanical compression of the
supraspinatus

tendon, the
subacromial

bursa, and the biceps
brachii

(long head) tendon causing a decrease in
space in the
coracoacromial

arch


Postural alignments: Forward head, rounded
shoulders, increased
kyphotic

curve

Shoulder Injuries


Frozen Shoulder (Adhesive
Capsulitis
)


Contracted and thickened joint capsule that is
tight around the humeral head with little synovial
fluid.


The
individual progressively
resists any
movement to the shoulder making it stiff or
“frozen” because of the pain

Shoulder Injuries


Thoracic Outlet Compression
Syndrome


Compression on the brachial plexus,
subclavian

artery, and
subclavian

vein in
the neck and shoulder.


MOI:


Compression of the neurovascular bundle
between the first rib and clavicle


Compression between the anterior and
middle scalene muscles


Compression by
pec

minor as the bundle
passes beneath the
corocoid

process or
between the clavicle and first rib


Presence of a cervical rib (an abnormal rib
originating from a cervical vertebra and the
thoracic rib)

Shoulder Injuries


Biceps
Brachii

Rupture


MOI: Powerful concentric or eccentric contraction

Shoulder Injuries


Bicipital

Tenosynovitis


MOI: Repeated stretching of the biceps in highly
ballistic activities (pitchers, tennis players,
volleyball players, and javelin throwers) may cause
an irritation of the tendon and the synovial sheath

Throwing Mechanics


Windup


Cocking


Acceleration


Deceleration


Follow
-
through

Shoulder Pad Fitting


Width of shoulders is measured to determine proper size of pads


The inside shoulder pad should cover the tip of the shoulder in a direct line with the
lateral aspect of the shoulder


Deltoid should be covered, and all motion required by athlete’s positions
hould

be
permitted


Neck opening must allow athlete to raise their arms overhead but not allow the pad
to slide back and forth


Straps underneath the arm must hold pads firmly in place but must not constrict soft
-
tissue

Cantilever

Non
-
Cantilever

QUESTIONS/COMMENTS?