Shoulder Complex Introduction Flashcards
What are common/ normal side dominance asymmetries?
- Ipsilateral shoulder depression (dominant side depression)
- Less shoulder internal rotation/ reaching behind the back
- Ipsilateral thoracolumbar side bend and rotation
- More hyperextended knee
- Flatter foot
What kind of ROM do you need to wash you hair and trunk?
- 120 degrees of flexion to wash your hair
- 75 degrees of flexion to wash your trunk
What kind of ROM do you need to Don/Doff a shirt?
90 degrees of flexion
What kind of ROM do you need to reach a high shelf? (this is considered overhead reaching)
150 degrees of flexion
What kind of ROM do you need to fasten a bra behind your back?
- 50+ degrees of extension
- 70 degrees of horizontal adduction
- Full internal rotation
What bones and joints move with shoulder complex motions?
- Bones: Humerus, Scapula, Clavicle, Spine
- Joints: GH, SC, AC, ST
Movement of the humerus is accompanied by movements of what?
These joints are companions (friends), they move together
- The scapula (this is the primary accompanied movement)
- Other small joints like the acromioclavicular (AC), sternoclavicular (SC), upper thoracic and upper costotransverse joints (secondary movement)
What are companion motions? (they do 3 things)
- Assist with optimal motion
- Prevent impingement
- Keeps actin/myosin overlap efficient to prevent active insufficiency
What is active insufficiency?
- Decreased tension of a muscle when it is shortened across a joint
- Basically if a muscle shortens too much it cant shorten more, so now it is insufficient
What humeral motions happen during 150 degrees of reaching overhead?
- Flexion
- Abduction
- External Rotation
What provides concentric control and eccentric control at the humerus during 150 degrees of over head reaching?
- Concentric Control: Flexors, Abductors, and External Rotators
- Eccentric Control: opposite muscles
What scapular motions happen during 150 degrees of reaching overhead?
- Elevation
- Upward Rotation
- Protraction (primarily at the AC joint)
What provides concentric control and eccentric control at the scapula during 150 degrees of over head reaching?
- Concentric Control: Elevators, Upwards Rotators, and Protractors
- Eccentric Control: Opposite Muscles
What kind of tension is placed on the brachial plexus at 150 degrees as the clavicle posteriorly rotates?
Max Tension
What humeral motions happen during 150-200 degrees of reaching overhead?
same as below 150 degrees
- Flexion
- Abduction
- External Rotation
What provides concentric control and eccentric control at the humerus during 150-200 degrees of over head reaching?
same as below 150 degrees
- Concentric Control: Flexors, Abductors, and External Rotators
- Eccentric Control: opposite muscles
What scapular motions happen during 150-200 degrees of reaching overhead?
this is different then below 150 degrees
- Depression
- Retraction
- Posterior Tilt (primarily at the SC joint)
What provides concentric control and eccentric control at the scapula during 150-200 degrees of over head reaching?
this is different then below 150 degrees
- Concentric Control: muscle groups for depression, retraction, and posterior tilt, especially the lower traps
- Eccentric Control: opposite muscles
The lower traps are important for concentric control when what occurs at the scapula?
- 150 degrees of glenohumeral and scapulothoracic motion
- Upper thoracic spine extension
What muscles make up the rotator cuff?
- Supraspinatus (ABD)
- Infraspinatus (ER)
- Teres Minor (ER)
- Subscapularis (ADD/IR)
(S.I.T.S)
What motions do the upper thoracic spine produce?
- Ipsilateral Side Bend
- Ipsilateral Rotation
- Extension
Why are unilateral motion important? (3 reasons)
- Triggers concentric control of the lower traps along with the subclavius for scapular and clavicle movement
- Prevents excessive tension tension on the brachial plexus by limiting more posterior clavicular rotation
- If they are hypomobile then the GH and AC joints may become hypermobile to compensate
What happens if the upper t-spine is hypomobile?
- Inhibits lower trap activity and leads to impaired scapular motion
- Allows excessive posterior clavicular rotation and excessive tension on the medial cord of the brachial plexus
What is a part of the medial cord of the brachial plexus?
- Median Cutaneous Nerve
- Ulnar Cutaneous Nerve