Soft tissue static stabilisers include glenoid labrum, glenohumeral capsule, glenohumeral ligaments, rotator interval, negative intracapsular pressure and the adhesion-cohesion mechanism. The PICO method, suggested by Baudi et al. eCollection 2018 Nov 18. The evaluation of shoulder disorders is challenging because of anatomic and biomechanical complexities. The following description is based on sound anatomic knowledge along with integration of the pertinent literature. It is the synergism of these joints and the muscles acting on them that produce smooth and full movement while we perform pressing and pulling exercises in … The anatomies of bones, joints, ligaments, and muscles are described in detail, and current biomechanical concepts concerning motion, stability, and force are presented. There is a fine balance between the mobility to perform athletic activities and stability required to power and stabilise the arm. Scapulothoracic (ST) joint - known as a "functional joint". Try using search on phones and tablets. The shoulder ligamentous anatomy is clearly different from the knee ligaments, as there are no shoulder ligaments that maintain tension throughout the complete movement arch of the shoulder. Shoulder function: the perfect compromise between mobility and stability. The acromioclavicular system (ACS) is formed by a complex of ligaments (conoid, trapezoid and acromioclavicular capsular ligaments) that stabilize the acromioclavicular joint (Fig. [8]: type I, a displaced avulsion fracture with attached capsule; type II, a medially displaced fragment malunited to the glenoid rim; type III, an erosion of the glenoid rim lower than 25% (III A) and more than 25% (III B). The suction effect of the glenoid labrum, the negative intracapsular pressure and the adhesion-cohesion mechanism are the three mechanisms providing the vacuum effect. Bony Bankart lesion (courtesy of Lennard Funk, www.shoulderdoc.co.uk). Radiologe. This area’s width is 84% of the glenoid width, therefore, any glenoid articular surface loss (as in bony Bankart lesions) greatly influences the width of the glenoid track. Friedman et al. She teaches how you can be more effective in the execution of the exercises as well as teaching clients with injuries and injury prevention. An excessive retroversion of the glenoid could be a rare cause of posterior instability, but more frequently it is only a contributory factor. NIH Intracapsular pressure is about −42 mmHg H2O and it acts especially when rotator cuff muscles are not contracted and glenohumeral ligaments and capsular structure are not in tension. Bony geometry of the scapula and glenoid (courtesy of Lennard Funk, www. The rotator interval contains multiple static stabilizers of the shoulder, and its integrity is important for anterior and inferior stability of the shoulder, especially when the shoulder is adducted. The rotator interval is a triangular space, with medial base and lateral apex, limits of which are the coracoid medially, the long head of biceps and its groove laterally, the superior fibres of subscapularis inferiorly and the anterior fibres of supraspinatus superiorly. | MR arthrographic characterization of posterior capsular folds in shoulder joints. Only a maximum of 30% of the humeral articular surface articulates with glenoid articular surface at any time [5]; bearing in mind the importance of soft tissue static and dynamic restrains in shoulder stability. Another lesion that involves anteroinferior aspect of the labrum is the anterior labro-ligamentous periosteal sleeve avulsion (ALPSA) lesion: the anterior labro-ligamentous complex rolls up in a sleeve-like fashion and becomes displaced medially and inferiorly on the glenoid neck [24]. The glenoid labrum acts on the humeral head like a plunger: loss of the glenoid labrum reduces depth of the glenoid socket more than 50%, reducing stability [19]. Epub 2018 Apr 4. Epub 2007 Jan 12. Please enable it to take advantage of the complete set of features! NLM Introduction The shoulder is composed of 3 Synovial Joints : 1) The Glenohumeral joint (GH) 2) The Acromioclavicular joint (AC) 3) The Sternoclavicular joint ( SC) The scapulothoracic joint also functions as joints in the shoulder complex. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Shoulder Anatomy and Biomechanics The shoulder can really be considered a complex ( Fig. It’s different according to different planes: 0.75 in the sagittal plane and 0.6 in the coronal plane [6]. C onse- … Fig. Philadelphia. 2 Outline Anatomy Biomechanics There are different kinds of labrum lesions and it’s very important not to confuse tears with anatomical variants that don’t require surgical repair, like sublabral foramen associated with cord-like middle glenohumeral ligament or meniscoid labrum [. Furthermore, external rotation of the shoulder is altered with rotator interval pathology. The incidence of humeral avulsion of the glenohumeral ligament (HAGL) has been reported as high as 10%, but they are often unrecognised [34]. Its jobs are to make the glenoid socket deeper, to increase contacting area and congruity, to generate a suction effect, to function as an insertion area for capsular-ligamentous structures and to help muscles to compress the humeral head within the glenoid. 2018 Nov 18;9(11):245-254. doi: 10.5312/wjo.v9.i11.245. Functional anatomy of the shoulder complex. [29], SLAP lesions occur during the ending deceleration phase of throwing, because of a traction force wielded by the long head of biceps on the glenoid labrum. The constitutional trait of laxity facilitates extensive motion in multiple planes and may be essential to athletic performance. This chapter analyses the clinical functional anatomy and biomechanics of shoulder structures, with some insight regarding their pathologic changes associated with shoulder instability in the athlete. Anatomy and Biomechanics of the Unstable Shoulder This knowledge allows the surgeon to evaluate the possible causes of instability, to assess which are the structures that must be reconstructed and to decide which surgical technique must be performed. Shoulder ligaments only act in the extreme positions of the range of motion (ROM), and remain lax if the shoulder is at rest or during non-extreme ROM . | It is retroverted on average 1.2° (range 9.5° of anteversion to 10.5° of retroversion) and inclined superiorly on average 5° (range 7° of inferior inclination to 15.8° of superior inclination) [3]. J Biomech. The following principles are important to establish an accurate anatomic diagnosis and to develop a treatment plan: (1) perform a careful history and physical examination; (2) determine whether or not … Affiliation 1 Orthopedic Biomechanics Laboratory, Mayo Clinic Rochester, The Mayo Foundation, Rochester, MN 55901, USA. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on Anatomy and Biomechanics of the Sporting Shoulder. On the contrary, if a Hill–Sachs lesion extends over the medial margin of the glenoid track, risk of engagement rises according to the lesion’s position [17, 18]. The most common injury to the labrum, found in more than 90% of traumatic anterior instability [21], is a Bankart lesion. During abduction, external rotation and extension the IGHLC moves anteriorly, forming a restraint to anterior translation of the humeral head (Fig. Hill-Sachs lesion of the posterior humeral head (courtesy of Lennard Funk, www.shoulderdoc.co.uk). Uscles to provide stability clipboard, Search History, and tennis | Read by QxMD biomechanics Lecture originally developed Bryan. Glides on a shallow scapular cup the other muscular structures surrounding the in! Suction effect of the human shoulder joint ):245-254. doi: 10.5312/wjo.v9.i11.245 MP... Inferior and posterior, is a fine balance between the mobility to perform athletic and. Bility of all joints authors a M Halder 1, E Itoi, K N.! Rj, Roda O. 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