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Lecture 10 shoulder rehab
- 3. SHOULDER ARTICULATIONS • Sternoclavicular (SC) Joint • Acromioclavicular (AC) Joint – “False Joint” = Arch Ligament Coracoacromial Ligament between Acromion Process & Coraco Process of Scapula • Coracoclavicular Joint • Glenohumaral Joint • Scapulothoracic Joint
- 4. SHOULDER ARTICULATIONS • Sternoclavicular (SC) Joint – Articulation of Superior Sternum & Proximal Clavicle – 4 Ligaments • Interclavicular = between the 2 sternoclavicular joints provides minimal support to the joint • Costoclavicular = clavicle to 1st rib • Anterior Sternoclavicular = broad band support anterior capsule • Posterior Sternoclavicular = small + weak support posterior capsule – Fibrocartilage Disc - Prevent medial clavicle displacement Function = Movement of Distal Clavicle Test = Max shoulder Elevation cause close packed SC
- 7. SHOULDER ARTICULATIONS • Acromioclavicular (AC) Joint – Articulation of Medial Facet of Scapula’s Acromion Process & Distal Clavicle (allow minimal movement) – 2 Ligaments • Superior acromioclavicular = acromion and clavicle • Inferior acromioclavicular = acromion and clavicle • Arch “Joint” (Acromiocoraco “AC”) of Scapula – Coracoacromial (Arch) Ligament = Buffer between Rotator Cuff muscles and bony acromion process Test = Humerus abduction 90° cause close packed AC
- 8. See Type IV to VI Tearing of Deltoid and And Trapezius Fascia
- 10. SHOULDER ARTICULATIONS • Coracoclavicular Joint (Syndesmosis) – Coracoclavicular Ligament = Inferior Clavicle & Anterior-superior Coracoid process of the Scapula Function • Resist independent upward movement of the clavicle • Resist downward movement of the scapula • Resist anterior / posterior movement of scapula and clavicle Very little movement in this joint
- 12. SHOULDER ARTICULATIONS • Glenohumaral (GH) Joint – Articulation between • Glenoid Fossa of Scapula • Head of Humerus – Humeral head 3-4x articulation surface than Glenoid = instability – Ligaments • Anterior = Superior, Middle, Inferior glenohumeral lig. • Inferior lig very thick = main stabilizer in abduction • Superior = Coracohumeral lig. (very strong) – Muscles (SITS muscles) joins joint capsule • Tension holds the humerus head into the glenoid fossa (stability) – Test • Close packed position = Abduction & Lateral rotation
- 14. Anterior Glenohumeral Dislocation See Bankart Lesion
- 15. Bankart Lesion = Inferior Glenohumeral Ligament is avulsed from the anterior lip of the labrum
- 16. SLAP Lesion Injury to the superior labrum begin posteriorly and extend anteriorly disrupting the long head of the biceps tendon to the superior glenoid tubercle
- 18. SHOULDER ARTICULATIONS • Scapulothoracic Joint – Muscles joining scapula to trunk • Levator Scapula • Rhomboids • Serratus Anterior • Pectoralis Minor • Subclavius • Deltoid • Subscapularis • Supraspinatus • Infraspinatus • Teres major • Teres Minor • Coracobrachialis • Short head of the Biceps Brachii • Long head of the Triceps Brachii • Trapezius – Functions • Stability • Movement