Electromyographic analysis of the rotator cuff and deltoid. Scapula position movements of scapula on thoracic cage shoulder impingement syndrome anterior. Scapular dyskinesia, the forgotten culprit of shoulder pain. Anterior locked shoulder dislocation with large hill sachs lesion. Sep 07, 2015 overview of shoulder anatomy, biomechanics, and pathomechanical principles. Despite the essential role played by the scapula in shoulder function, current. The scapulothoracic articulation is a sliding junction between the deep aspect of the scapula and thoracic rib cage at the levels of ribs 2 through 7. T he shoulder com plex has the greatest m o bility of all joints. The primary function of the shoulder complex is to position the upper extremity in space to allow the hand to perform its tasks. Clinical implications of scapular dyskinesis in shoulder injury. Biomechanics of the shoulder complex look at how the entire shoulder complex moves and start to get a feel for where the restrictions are and where they compensate. More frequent, occur in a combination of lateral and posterior movement of the forearm resulting from a force directed laterally on the distal forearm.
Motion at this articulation is dynamically stabilized by a variety of muscular attachments, allowing for controlled positioning of the glenoid to assist in glenohumeral joint function. Using range of motion exercises and abduction maneuvers, the scapula tends to adhere to the humerus and rotation is accomplished in a 1. Shoulder impingement is a common condition presumed to contribute to rotator cuff disease. Straincounterstrain john christiansen, ms pt, ocs, atc advanced rehabilitation clinics. Protraction the scapula moves away from the spine and around the side of the ribcage. Duration, location, severity, and distribution of pain help to. The shoulder complex mechanics, muscle function and exercise. Normal scapulothoracic motions that occur during arm elevation include upward rotation, posterior tilting, and either internal or external rotation. Integrating the shoulder complex to the body as a whole. Scapular positioning in athletes shoulder physical therapy ceu. Scapular dyskinesia, the forgotten culprit of shoulder pain and how.
Shoulder motion impairments in mobility can affect any of the four joints of the shoulder complex. In particular, during elevation, anterior shoulder girdle muscle tension may affect the tension on the leading edge of the coracoacromial ligament, predisposing it to tightness ultimately leading to structural impingement. Pathomechanics of shoulder by mohamed arafat on prezi. Second, this study aimed to enhance understanding of how scapular muscles are recruited during the back and forth phases of plyometric shoulder exercises. The aim of this study was first to investigate scapular muscle activity in a variety of commonly used plyometric shoulder exercises to support exercise selection in clinical practice. In three different position there is significant different in hand position. Scapulothoracic anatomy and snapping scapula syndrome. Successful rehabilitation of the unstable shoulder presents a challenge. Pathomechanics definition of pathomechanics by medical.
If you continue browsing the site, you agree to the use of cookies on this website. Dont wait until later to see if your treatment affected the. Current evidence for stretching of the posterior shoulder. Scapular dyskinesia, the forgotten culprit of shoulder. Shoulder pain is the second most common musculoskeletal complaint, with a reported point prevalence of 20. There are interactive popup questions throughout this lecture.
Pdf balancing mobility and stability, the biomechanics of the shoulder provides optimal use of the thumb. Glenohumeral joint anatomy, stabilizer, and biomechanics. You will be glad to know that right now kinesiology the mechanics and pathomechanics of human movement pdf is available on our online library. To a physiologist it seems much more reasonable that the limitation and resistance to motion of a joint that characterizes an osteopathic lesion do not arise within the joint, but are imposed by. O n one hand, this m obility is because of little bony congruity of its artic ulating surfaces. The wonder of the shoulder complex is the spectrum of positions that it can achieve. Normal alignment 2 changes in bony alignment following fractures. Scapula shoulder girdle scapula position scapula position it forms 40with frontal plane. Depends upon the analysis, scapular protraction and vas for neck pain right and left is low when hand in rest, high in hand in hip, followed that hand. Overview of shoulder anatomy, biomechanics, and pathomechanical principles. Shoulder pain is a very prevalent musculoskeletal disorder, with a lifetime prevalence of up to 66. Comparison of 3dimensional shoulder complex kinematics in. Discuss glenohumeral internal rotation deficit and its association with shoulder conditions. Slight shoulder protraction and push elbow forward.
There is a threedimensional scapular kinematic pattern during normal arm elevation that include upward rotation, posterior tilting and varying internalexternal rotation dependent on the plane and angle of elevation. Furthermore, the scapula shows less upward rotation when the scapular plane is elevated. Impingement can occur externally with the coracoacromial arch or internally with the glenoid rim. Pathomechanics of the throwing shoulder request pdf. Shoulder impingement is associated with greater scapular protraction in the resting positions, greater posterior tilt during abduction and greater internal rotation during plane elevation. Biomechanics and pathomechanics of the shoulder joint with. The shoulder complex mechanics, muscle function and exercise marilyn m. T he joints of the shoulder com plex have to rely on adjacent ligam ents and m uscles to provide stability.
The shoulder complex defined as the humerus, clavicle, sternum, and scapula bones that form a girdle or. Clinical implications of scapular dyskinesis in shoulder. It is important to reevaluate functional mechanics before and after each treatment intervention. Pdf measures of shoulder protraction and thoracolumbar. Profiling physical characteristics of the swimmers shoulder.
Glenohumeral ligaments static ligamentous restraints in different arm positions. Scapular protraction, upward rotation scapular depression lower fibers scapular elevation upper fibers. Methods for manual and selfstretching of the posterior. Workplace msd pathomechanics and risk factors lauren hebert pt, dpt, ocs note to participants. Shoulder pain and associated glenohumeral joint movement. Shoulder articulations, movements, and muscles that are. For everyday activities, scapulothoracic motion provides only 15 of internal rotation. The association of scapular kinematics and glenohumeral joint. This recommendation is based on the biomechanical capabilities of the serratus anterior, as the only scapulothoracic muscle that can produce all of the desired 3dimensional scapular rotations of upward rotation, ac joint posterior tilting, and ac joint external rotation. Measures of shoulder protraction and thoracolumbar rotation article pdf available in journal of orthopaedic and sports physical therapy 255. Correlation of the scapular position and neck pain in auto. Comparison to baseball pitchers and nonoverhead athletes bs, oregon state university, 2004 sakiko oyama by of the requirements for the degree of master in science school of health and rehabilitation science in partial fulfillment submitted to the graduate faculty of 2006. Methods for manual and selfstretching of the posterior shoulder region cory manton, pt, dpt, ocs, cscs sunday, october 25, 2015 11.
The extremely large range of motion of the upper arm is made possible by the coordinated interaction of multiple joints, and the biomechanics of the glenohumeral joint can be studied and understood only in relation to the biomechanics of the shoulder as a whole. Shoulder girdle protraction abduction pectoralis minor serratus anterior shoulder girdle retraction adduction rhomboidus major rhomboidus minor trapezius ii and iv. Pdf measures of shoulder protraction and thoracolumbar rotation. Scapulohumeral rhythm is a common metric for assessing muscle function and shoulder joint motion. The association of scapular kinematics and glenohumeral. Our increased understanding of the pathomechanics of shoulder instability and the spectrum that it encompasses enable us to design effective evidencebased rehabilitation protocols after instability surgery. Electromyographic analysis of the rotator cuff and deltoid musculature during common shoulder external rotation exercises michael m. Muscle tightness has been implicated in subacromial impingement. Furthermore, the scapula shows less upward rotation when the scapular plane is elevated 9.
A thorough patient history is helpful in discerning the etiology and diagnosis of an overhead athletes problem. Discuss how the structures of the shoulder complex contribute. The scapula has a different performance pattern in shoulder. The scapular movement in relation to humeral abduction and the corresponding muscle vectors that affect it. Among the static stabilizers or a part of the dynamic stabilizer, the glenohumeral capsule would contribute little to the stability of the joint. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Shoulder anatomy biomechanics pathomechanics youtube. Care of shoulder pain in the overhead athlete healio. Chapter 5 the shoulder joint manual of structural kinesiology r. With abduction and external rotation er the anterior. If the scapula is fused, limitation occurs mostly with extension and internal rotation 4. Loss of glenohumeral or scalpulothoracic joint motion absence of glenohumeral motion results in 5065% loss in overall shoulder flexion and abduction and the loss of all normal shoulder rotation rom. Normal kinematics of glenohumeral joint is dependent on the coordinated function of dynamic and static stabilizers. If you choose to pause the lecture and return at a later time, a natural break time would be after answering the interactive questions.
Kinesiology the mechanics and pathomechanics of human movement pdf are you looking for ebook kinesiology the mechanics and pathomechanics of human movement pdf. Sep 24, 20 shoulder pathomechanics musculoskeletal physical examination with chimwemwe masina slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Shoulder girdle permits largest rom of any complex in the body shoulder girdle increases rom with less compromise of stability scapulohumeral rhythm 4 joints vs. Scapular muscle activity in a variety of plyometric exercises. In that study, the scapular abduction maximal effort as many times possible. Pathomechanics in atraumatic shoulder instability request pdf. During cocking, when the humerus is terminally externally rotated and abducted, upward scapular rotation helps maintain glenohumeral articular congruency. Pdf biomechanical basis of common shoulder problems. Anatomy and biomechanics of the shoulder request pdf.
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