Anatomy, Joint Orientation and Arthrokinematics Shoulder

Glenohumeral Joint

Joint Orientation

Labrum

Transverse Ligament

Coracohumeral Ligament

Superior Glenohumeral Ligament

Middle Glenohumeral Ligament

Inferior Glenohumeral Ligament

Posterior Capsule

Restraints To Motion Limitation in Flexion, Extension and Abduction Coracohumeral Ligament Superior Glenohumeral Ligament Inferior Glenohumeral Complex (End of Range) Most common capsular loss of overhead motion

Restraints To Motion Limitation in External rotation at 0° Coracohumeral Ligament Superior Glenohumeral Ligament Limitation in External Rotation at 45° Middle glenohumeral ligament Limitation in External Rotation at 90° Anterior Band of Inferior Glenohumeral Ligament

Restraints To Motion Limitation in Internal rotation at 0° and 45 ° Posterior Capsule Limitation in Internal Rotation at 90° Posterior Band of Inferior Glenohumeral Ligament

Arthrokinematics Convex- Concave Rule Concave- Convex Rule Fixed Concave Surface, Moving Convex Surface Glide occurs in opposite direction Concave- Convex Rule Fixed Convex Surface, Moving Concave Surface Glide occurs in same direction

Arthrokinematics

Arthrokinematics Glenohumeral Joint Convex on Concave Glide in opposite direction to Roll Flexion Humerus rolls anteriorly and glides posteriorly Abduction Humerus rolls superiorly and glides inferiorly Ignore external and internal rotation as the rules do not apply here

Arthrokinematics As humerus rotate the capsule acts like a hammock and swings During external rotation the humeral head begins to glide anteriorly, capsule tightness up and pull humeral head posteriorly

Arthrokinematics If anterior inferior aspect of the capsule is lax it doesn’t restrict humeral head motion Therefore no posterior glide occurs Anterior dislocation can occur Tightening of posterior capsule

Acromioclavicular Joint

Joint Orientation

Coracoclavicular Ligament

Sternoclavicular Joint

Joint Orientation

Ligamentous Anatomy Ligament

Arthrokinematics

Arthrokinematics

Scapulohumeral Rhythm

Scapulohumeral Rhythm 0 – 90 Degrees

Scapulohumeral Rhythm – 0 – 90 Degrees

Scapulohumeral Rhythm 90- 180 Degrees

Scapulohumeral Rhythm – 90 – 180 Degrees

Scapulothoracic Joint

Anatomy

Scapular Movements- Elevation and Depression

Scapular Movements- Upward and Downward Rotation

Scapular Movements- Anterior and Posterior Tilting

Scapular Movements- Protraction and Retraction

The End