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The most common causes in adults over 40 to 60: shoulder impingement and rotator cuff problems
Athletic Injuries, most common in overhead activities, 8 - 13%
Shoulder Anatomy:
Bones: Scapula, Clavicle, Humerus, Sternum
Joints: Acromioclavicular, Glenohumeral, Sternoclavicular
Articulation: Scapulothoracic
Clavicle: Medial 2/3rd's is mostly convex
Later 1/3rd takes on a flattened appearance and bends concavely
Where it bends is the point of weakness - point of change; where most fractures occur
Scapula:
Flat, triangular shaped bone
Landmarks: Acromion, Coracoid - more anterior, and Spine
Curvature of acromion can affect shoulder impingement
Humerus:
long bone of the upper arm,
Contains greater and lesser tuberosities
The lesser tuberosity is anterior and medial
The greater tuberosity is superior and lateral
Bicipital glove between tuberosities is where biceps tendon is located
Sternoclavicular Joint:
Connects the sternum and the clavicle
Only direct articulation between upper extremity and trunk; not much motion
Acromioclavicular Joint:
Connects the clavicle to the scapula; lateral end of clavicle with the acromion process on scapula
3 main ligaments include:
Acromioclavicular
Coracoclavicular
Coracoacuromial - weird because these landmarks are both on the scapula and don't really have a function
Glenohumeral Joint:
Ball and socket vs Golf Ball on a tee - represents more of a golf ball on a tee because the socket is sos shallow compared to that of the femur and hip. It is much easier to dislocate this joint. Less stability allows for more mobility. True shoulder joint. Humerus sits in glenoid fossa. Passive Stability: glenoid labrum, joint capsule, and ligaments. Supported by the orator cuff muscles.
Glenoid Labrum:
Deepens fossa by about 50%
provides support
increases total surface contact area
and controls glenohumeral translation
Rotator Cuff:
S - suprspinatus
I - infraspinatus
T - Teres Minor
S - subscapularis
Function: External rotation of the humerus
Scapulothoracic Articulation: (Movements of scapula)
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