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Lecture 10 shoulder rehab
1.
2.
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
5.
6.
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
11.
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
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
17.
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