5. The dynamic-stabilizing structures include the rotator cuff muscles and the other muscular structures surrounding the shoulder joint. NIH 1999; 51-76.]. World J Orthop. 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. 42-1 ), consisting of four joints or articulations (all with important stabilizing ligaments), two spaces, and more than 30 muscles and their respective tendons. A Hill–Sachs lesion is an impact fracture occurring after one or more traumatic anterior shoulder dislocations and involves the posterior-lateral articular surface of the humeral head (Fig. Acromioclavicular (AC) joint 3. 2018 Mar;232(3):422-430. doi: 10.1111/joa.12753. 2004 Jun;44(6):556-61. doi: 10.1007/s00117-004-1046-4. [10], could be used to calculate bone deficiency produced by a bony Bankart lesion: it needs Computed Tomography Multiplanar Reconstruction of both shoulder and defects and is calculated as a ratio between the surface of the damaged glenoid and the surface of not damaged glenoid. T he joints of the shoulder com plex have to rely on adjacent ligam ents and m uscles to provide stability. Shoulder Anatomy & Biomechanics SKU: 206 By Jeffrey K. McCamman, BS, MPT Reviews anatomy and biomechanics of the human shoulder. The superior half of glenoid labrum is more movable than the inferior half that is tenaciously connected to the glenoid rim. Effect of flexibility deficit on scapular asymmetry in individuals with and without shoulder pain. The ball-shaped humeral head rotates and glides on a shallow scapular cup. (2010). Moreover, SLAP lesions are common in contact athletes: Funk and Snow [30] reported a 35% incidence of SLAP tears, arthroscopically diagnosed, in 51 rugby players’ shoulders. On the other hand, during adduction, flexion and internal rotation, the IGHLC moves posteriorly, forming a restraint to posterior translation. Negative intracapsular pressure plays a role in shoulder stability. 2018 Jun 19;6(2):68. doi: 10.3390/healthcare6020068. 2019 Feb;92(1094):20180527. doi: 10.1259/bjr.20180527. The posterior capsular also can be damaged, seeing that recurrent posterior subluxations or luxations produce capsular redundancy and increase joint volume, resulting in posterior instability. Biomechanics of posterior shoulder instability - current knowledge and literature review. Its structural limitations indicate that the primary source of joint stability must be balanced muscle control. Despite its frequency, it cannot be considered a cause of instability in isolation, seeing that a concomitant plastic deformation needs to produce certain instability [22]. SC joint connects the … J Orthop Sports Phys Ther. 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 [. Course Length: 3.0 contact hours Instructional Level: Beginner Course Goals and Objectives: Goal: To instruct the student, through self-paced study, of the anatomy and basic biomechanics of the human shoulder. Anatomy and Biomechanics of the Sporting Shoulder. 29 pages. 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 … 2018 Nov 18;9(11):245-254. doi: 10.5312/wjo.v9.i11.245. Glenohumeral ligaments act at maximum degrees of range of motion, when they appear in tension; at middle degrees of motion, when they are slack, stability depends on rotator cuff and long head biceps activities, those compress the humeral head inside the glenoid concavity. This site needs JavaScript to work properly. Doukas WC(1), Speer KP. Epub 2018 Nov 28. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Lennard Funk The shoulder is potentially one of the most unstable joints of the body, with very little bony stability or containment and has been likened to a golf ball on a golf tee. The anatomies and biomechanics of the glenohumeral joint and the scapulothoracic articulation are the subjects of this article. She teaches how you can be more effective in the execution of the exercises as well as teaching clients with injuries and injury prevention. As far as the superior labrum is concerned, a very common lesion in throwing overhead athletes is the SLAP (superior labrum anterior and posterior) tear. 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. 2 Outline Anatomy Biomechanics 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 other hand, capsular stretching is noted along with a Bankart lesion and it’s present in up to 28% of patients with recurrent anterior instability [31]. Reverse Bankart lesions are quite frequent in athletes, in particular contact athletes such as rugby players, being reported with a 20% incidence in a study of 142 elite rugby player shoulder arthroscopies [27]. The effect of internal and external rotation on the IGHLC (courtesy of Lennard Funk, www.shoulderdoc.co.uk). Author information: (1)Sports Medicine and Shoulder Section, Division of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA. The ST joint involves the gliding movement of the scapula along the rib cage during upper extremity movements and does not include a physical bone-to-bone attachment. iomechanics and treatment of acromioclavicular and sternoclavicular joint injuries. | Bony Bankart lesions become significant when they involve more than 20% of the length of the glenoid and are predisposed to recurrence despite correct soft tissues repair; if the bony Bankart lesion involves more than 50% of the length of the glenoid, shoulder stability is reduced by more than 30% [7]. Snyder has classified SLAP tear in 4 different types: type II and IV are the most significant in determining instability because they involve both labrum and long head of the biceps, so resulting in an increased total range of motion, particularly in antero posterior and superior inferior translation. The unstable shoulder. The inferior glenohumeral ligament, better-called the inferior glenohumeral ligament complex (IGHLC), is formed by 3 parts: two thicker bands on the anterior and posterior and an axillary thinner recess, assuming a sling-like structure. Describe the role of the accessory structures of the human shoulder during the shoulder’s biomechanics. En: Warren RF, Craig EV, Altchek DW. Biomechanics of the Shoulder DENNIS L. HART, MPA, PT,* STEPHEN W. CARMICHAEL, PhDt The terminology of engineering has made bio- mechanics unnecessarily confusing and intimidat- ing to many clinicians. Labrum ( SLAP ) ( courtesy of Lennard Funk, www.shoulderdoc.co.uk ) altered with interval... 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