Shoulder 3 (1)


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Shoulder 3 (1)

  1. 1. A Review of the ShoulderMuscles and Their Actions
  2. 2. Questions• What muscle works closely with the anterior deltoid?• Pectoralis major• What muscle is involved in any lifting movements?• Deltoid• What is the major (strongest) extensor muscle?• Latissimus Dorsi• Name the four rotator cuff muscles.• Subscapularis, Supraspinatus, Infraspinatus, and Teres minor.• What muscle works closely with the infraspinatus?• Teres minor
  3. 3. Practice• Name the muscles • Name the muscles for Horizontal for Horizontal Adduction Abduction• Pect Major (both) • Deltoid (post)• Corachobrachialis • Infraspinatus• Deltoid (anterior) • Teres minor • Lats
  4. 4. Practice• List the muscles that • List the muscles that do flexion of the do extension of the shoulder shoulder• Coracobrachialis • Latissimus dorsi• Pectoralis major • Teres major (upper to 60°) • Posterior deltoid• Anterior Deltoid • Pectoralis major (lower fibers to neutral)
  5. 5. Practice• List the muscles that List the muscles that do do adduction of the abduction of the shoulder shoulder• Pectoralis major • Deltoid (all sections) (lower and upper • Supraspinatus below 90°) • Pectoralis major• Coracobrachialis (upper past 90°)• Latissimus dorsi• Teres major
  6. 6. Practice• List the muscles that • List the muscles that do internal rotation do external rotation of the shoulder of the shoulder• Subscapularis • Infraspinatus• Latissimus dorsi • Teres minor• Teres major • Posterior deltoid• Anterior deltoid• Pect. major
  7. 7. Name the muscle.CoracobrachialisName the actionAdduction ofthe shoulderAlso, flexionand hor. add.
  8. 8. Name the muscle.Pectoralis Major
  9. 9. Name the muscle.SubscapularisName the actionInternalrotation of theshoulder
  10. 10. Name the muscle.DeltoidName the actionAbduction ofshoulder
  11. 11. Name the muscle.InfraspinatusName the actionExternalrotation
  12. 12. Name the muscle. Name the actionTeres Major Adduction of scapula
  13. 13. Name the muscle. Teres MinorName the action if the humerus move directly to the posteriorExtension of the shoulder
  14. 14. Name the muscle.SupraspinatusName the actionAbduction of the shoulder
  15. 15. Coracobrachialis Pect. Major Subscapularis Deltoid
  16. 16. Supraspinatus Teres Major Infraspinatus Teres Minor
  17. 17. What position are her shoulders in? Flexion
  18. 18. What position is his right shoulder in? Horizontal Abduction and External Rotation
  19. 19. What rotation action is his shoulder performing as he continues to through the ball? Internal Rotation
  20. 20. What position are her shoulders in? Flexion
  21. 21. What position are his shoulders in? Horizontal abduction or Extension
  22. 22. Position of their shoulders? 2. 1. ExtensionFlexion
  23. 23. What is the position of shoulders? Extension
  24. 24. Shoulder Muscle Exercises
  25. 25. Major Muscles of the Shoulder• Pectoralis major • Latissimus dorsi – Push-ups – Chinning – Pull-ups – Robe climb – Bench press – Dips on parallel bars – Throwing – Pullover exercises – Tennis serve – Pulldown exercises – Rowing
  26. 26. Shoulder action = ? Deltoid AbductionShoulder muscle(s) = ? Supraspinatus
  27. 27. Shoulder action = ? Shoulder muscle(s) = ?FlexionAnt DeltoidUpper Pect MajorCoracobrach.
  28. 28. Shoulder action = ? Ant. DeltoidShoulder muscle(s) = ? Horizontal Add. Pect. Major (both) Coracobrachialis
  29. 29. Shoulder action = ? Horizontal AbductionShoulder muscle(s) = ? Latissimus Dorsi Post. Deltoid Teres Minor Infraspinatus
  30. 30. Shoulder action = ? Shoulder muscle(s) = ?AdductionPect. Major (both)CoracobrachialisLatissimus DorsiTeres Major
  31. 31. Shoulder action = ? Horizontal AddShoulder muscle(s) = ? Ant. Deltoid Pect. Major (both) Coracobrachialis
  32. 32. Shoulder action = ? Shoulder muscle(s) = ?Extension Lats Teres Major Post. Deltoid Pectoralis Major (lower) Infraspinatus Teres minor
  33. 33. Shoulder action = ? External RotationShoulder muscle(s) = ? Infrspinatus Teres Minor Post. Deltoid
  34. 34. Name a shoulder muscle isolatedwith the following exercises.• Side arm dumbbell raises• Deltoid• Push-ups• Pectoralis major• Rowing and pull-overs• Latissimus dorsi
  35. 35. What is the action to the left? Whatmuscles perform that action? External Rotation Internal Rotation Internal Rotation Subscapularis, Ant. Deltoid, Pect, Major, Lats. And Teres Major
  36. 36. Rotator Cuff Exercises External Rotation Internal Rotation External Rotation Abduction (to work the supraspinatus)
  37. 37. Shoulder Related Injuries • The shoulder is built for motion, not stability • Injury rate depends on… – Shallowness of glenoid fossa – Laxity of ligaments – Strength of muscles
  38. 38. • Shoulder subluxation – Incomplete or partial dislocation• Shoulder dislocation – Complete dislocation of the GH joint – Most common anteriorly and inferiorly• Shoulder separation – Complete dislocation of the AC joint
  39. 39. Shoulder Dislocation
  40. 40. Impingement Syndrome
  41. 41. Impingement Syndrome• A condition that decreases the subacromial space – Acromion process – Coracoacromial ligament• Causes – Swelling – Bone spurs – Anatomical structure
  42. 42. Impingement Syndrome
  43. 43. Rotator Cuff Tears
  44. 44. Rotator cuff• Subscapularis• Supraspinatus• Infraspinatus• Teres minor
  45. 45. Movement of RC Muscles• Subscapularis is an internal rotator of the arm.• Supraspinatus assists the deltoid in abducting the arm, with its greatest contribution being the initiation of abduction.• Infraspinatus and teres minor muscles both externally rotate the arm.
  46. 46. Rotator Cuff Injury • The throwing motion has been divided into five phases: wind-up, cocking, acceleration, and follow-through. • Cocking phase – Subscapularis fires in late cocking phase to decelerate the shoulders external rotation. Also, it is stretched during the cocking phase.
  47. 47. Rotator Cuff Injury• Follow-through (muscles fire most intensely) – Subscapularis internally rotates the shoulder, – The infraspinatus and teres minor contract eccentrically to decelerate the arm and are stretched.• During this repetitive eccentric loading, the rotator cuff is prone to overload, fatigue, tendinitis, and even a partial undersurface tear.
  48. 48. Note: Surgery needsto be performedwithin 3 months orthe supraspinatusmuscle will atrophyand be too short toreattach
  49. 49. Glenoid Labrum
  50. 50. Labral Tear• The glenoid cavity makes up the “socket” of the shoulder joint.• The labrum acts sort of like a gasket, turning the flat surface of the glenoid into a deeper socket that molds to the head of the humerus for a better fit.• A tear of labrum can cause pain and a catching sensation with movement of the shoulder.
  51. 51. Labral Tear• Most labral tears are probably the result of an injury to the shoulder, such as falling on an outstretched hand.• There is reason to believe that the excess motion of the humerus moving around on the glenoid may cause damage to the labrum over time.• An unstable shoulder may also cause injury to the labrum, if it repeatedly dislocates out of the glenoid.