Shoulder Complex and Scapular Movements Notes

The Shoulder Complex

  • The shoulder complex consists of a group of articulations that can be divided into two main components:
  1. Shoulder Girdle:
    • Comprises the:
      • Sternoclavicular joint
      • Acromioclavicular joint
      • Scapulothoracic joint
  2. Shoulder Joint (Glenohumeral Joint)
  • Scapulohumeral Rhythm: Coordinates movement between the scapula and humerus.
  • Important for overall shoulder function.

Scapular Movements

  • The main movements of the scapula:
  • Elevation
  • Depression
  • Protraction (Abduction)
  • Retraction (Adduction)
  • Medial (Downward) Rotation
  • Lateral (Upward) Rotation

Articulation Details

  • Joint Structure and Movements:

  • Elevation:

    • Joints: Scapulothoracic, Acromioclavicular, Sternoclavicular
    • Plane: Frontal
    • Axis: Sagittal
    • Limiting Factors: Tension in the costoclavicular ligament, inferior sternoclavicular joint capsule, trapezius, and others.

  • Depression:

    • Joints: Scapulothoracic, Acromioclavicular, Sternoclavicular
    • Plane: Frontal
    • Axis: Sagittal
    • Limiting Factors: Tension in interclavicular and sternoclavicular ligaments, and other muscles.

  • Protraction (Abduction):

    • Joints: Scapulothoracic, Acromioclavicular, Sternoclavicular
    • Plane: Horizontal
    • Axis: Vertical
    • Limiting Factors: Tension in trapezoid and posterior sternoclavicular ligaments.

  • Retraction (Adduction):

    • Joints: Scapulothoracic, Acromioclavicular, Sternoclavicular
    • Plane: Horizontal
    • Axis: Vertical
    • Limiting Factors: Tension in conoid and anterior sternoclavicular ligaments.

  • Upward Rotation (Lateral Rotation):

    • Joints: Scapulothoracic, Acromioclavicular, Sternoclavicular
    • Plane: Frontal
    • Axis: Sagittal
    • Limiting Factors: Tension in conoid ligaments.

  • Downward Rotation (Medial Rotation):

    • Joints: Same as above
    • Limiting Factors: Tension in trapezoid ligament and other muscles.

Palpation of Scapular Bony Landmarks

  • Key landmarks to palpate:
  • Medial Border
  • Inferior Angle
  • Acromion Process
  • Spine of the Scapula
  • Coracoid Process

Scapular Movements

  • Practice the following movements:
  • Elevation (Active Range of Motion - AROM)
  • Depression (AROM)
  • Abduction (AROM)
  • Adduction (AROM)
  • Medial & Lateral Rotation (AROM):
    • Client places hands along the small of the back.
    • Elevate the arm through flexion or abduction.

Special Notes

  • Observe scapular mobility during active movements (AROM).
  • If scapula doesn't move, passive range of motion (PROM) might be needed.
  • Scapular dyskinesis could result in improper movement of the humeral head, potentially causing impingement.
  • Maximum passive range suggested is to 90 degrees.

Practice with Partners

  • Recognize important structures around the shoulder complex:
  • Acromion
  • Acromioclavicular Joint
  • Coracoid Process
  • Clavicle
  • Rotator Cuff Muscles:
    • Supraspinatus
    • Subscapularis
    • Teres Minor
    • Infraspinatus
  • Understanding these structures is essential for a comprehensive grasp of shoulder anatomy and function.