GH joint resting position
40-55 ABD, 30 horizontal ADD
AC joint resting position
arm at side
AC joint close pack position
90 abd
AC joint capsular pattern (3)
pain at extremes of ROM, especially horizontal add and full elevation
SC joint resting position
arm at side
SC joint close pack position
full elevation and protraction
SC joint capsular pattern (3)
pain at extremes of ROM, especially horizontal add and full elevation
grade 1 sprain/strain (3)
few fibers of ligament/muscle torn, minor loss of function, pain on stretch
grade 2 sprain/strain (2)
partial tearing of muscle/ligament, mod to major loss of function
grade 3 sprain/strain (3)
complete rupture, surgery required, pt response is often weak and painless
shoulder joint capsule: medial attachment
margin of glenoid cavity outside the labrum
shoulder joint capsule: lateral attachment (2)
anatomic neck of humerus and strengthen by RTC tendons
purpose of GH joint ligaments
restrictive leash to limit forces and ROM at various shoulder positions during movement
functions of GH joint ligaments
Compress and center humerus on glenoid during abd and rot
inferior GH ligament contributes
most to stability when the GH joint is at 90 deg or more
Superior GH ligament contributes
most stability when arm is at side (0 degrees)
Middle GH ligament contributes
ant joint stability
Overuse can stress
capsule/lig and lead to GIRD/GERG
What motion increases ant instability
forceful abd/ER stress ant band of inf capsule
Coracoacromial Arch
Coracoid process, acromion process, and coracoacromial lig (ant, post, sup)
coracoacrominal arch serves as a (5)
protection from direct trauma to the humeral head, muscles, tendons, and bursae overlying the humeral head, prevents sup dislocation
Subacromial and Subdeltoid Bursae separate (6)
supra tendon and the humeral head from the acromion, coracoid process, coracoacromial ligament, and deltoid
primary causes of shoulder impingement syndrome (5)
inflammation in subacromial space, RTC tendon degeneration (reduced blood flow), osteophytes, hooked acromion, GH joint hyper mobility
what muscles are most commonly involved in RTC tear?
Supraspinatus and infraspinatus