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Biomechanics-
Shoulder Joint
Dr. Quazi Ibtesaam Huma
MPT (Neurosciences)
Asst Professor
Objectives
• At the end of the lecture learner should be able
• Introduction
• Structures: Articular Surface
Articular Disk Capsule
Ligaments
• Kinematics and Kinetics
• Clinical Anatomy
Introduction
• Shoulder joint (GH joint) synovial; ball and socket type of joint
• Has more mobility than stability.
• Three degree of freedom
• Only SC joint connects the components of shoulder joint to the axial
skeleton.
• This puts greater demands on the muscle for securing the shoulder
joint on thorax during static and dynamic conditions
Components of shoulder complex
• Clavicle, humerus and scapula are linked with 3 interdependent
linkages: SC joint, AC joint and GH joint
• Additionally a functional joint called scapulothoracic joint (ST joint) is
considered as s part of shoulder complex
Components of shoulder complex
Action of Shoulder joint
• Flexion
• Extension
• Abduction
• Adduction
• External rotation
• Internal rotation
Sternoclavicular joint
• SC joint : Synovial type, consist joint capsule, disk and ligament
• Movement of the clavicle at the SC joint inevitably produces movement
of the scapula under conditions of normal function, because the
scapula is attached to the lateral end of the clavicle
• Articulating surface: two saddle-
shaped, incongruent surface
• Sternal or medial end of the
clavicle
• At the notch formed by the
manubrium of the sternum
Sternoclavicular disk
• Fibrocartilaginous disk – to increase
the congruency between
incongruent articular surfaces
• Attachment: upper portion –
posterosuperior clavicle
• Lower portion- manubrium and
first coastal cartilage
• Disk diagonally transects the SC
joint space and divides the joint
into 2 separate cavities
SC joint stress tolerance
• Sternoclavicular joint is considered incongruent, it does not undergo
the degree of degenerative change common to the other joints of the
shoulder complex
• Strong force-dissipating structures such as the sternoclavicular disc
and the costoclavicular ligament minimize articular stresses
• Prevent excessive intra-articular motion, which could lead to
subluxation or dislocation.
Ligaments
• Three ligaments:
1. Sternoclavicular ligament
2. Costoclavicular ligament
3. Interclavicular ligament
Sternoclavicular motions
• 3 rotatory degrees of freedom
• Elevation/ Depression
• Protraction/ Retraction
• Anterior/ Posterior rotation
• 3 degrees of translatory motion
• Anterior/ posterior translation
• Medial/ lateral translation
• Superior/ inferior translation
Clavicular Elevation: 48°
Depression: 15°
Protraction: 15-20°
Retraction: 20-30°
Posterior rotation: 50°
Anterior rotation: less than10°
• Elevation and depression of the clavicle, the medial articular surface rolls
and slides on the relatively stationary disc, with the upper attachment of
the disc serving as a pivot point.
• During protraction and retraction of the clavicle, the sternoclavicular disc
and medial articular surface roll and slide together on the manubrial
facet, with the lower attachment of the disc serving as a pivot point.
• The disk functions to absorb the medially directed force transmitted along
along the clavicle from its lateral end.
Acromioclavicular Joint
• Synovial type of joint
• 3 rotational and 3 translational
degree of freedom
• Primary function - to allow the
scapula to rotate in three
dimensions during arm movement
so that upper extremity motion is
increased.
Articulating surface and disc
• ARTICULATING SURFACE
• Lateral end of the clavicle and a
small facet on the acromion of
the scapula
• Flat, reciprocally concave-convex
• ARTICULAR DISC
• Capsule of the acromioclavicular
joint is weak
As the joint capsule is weak it
cannot maintain integrity of
the joint without the
reinforcement of the superior
and inferior acromioclavicular
ligaments and the
coracoclavicular ligaments
Ligaments
• Superior Acromioclavicular
ligament
• Inferior Acromioclavicular
ligament
• Coracoclavicular ligament
• Coracoclavicular ligament:
• Trapezoid portion: oriented more horizontally. It resists posterior fossa
on distal clavicle
• Conoid portion: oriented more vertically. It resists superior and inferior
forces
• Both limits upward rotation of scapula on AC joint.
• Prevents medial displacement of
acromion on clavicle when
leaning on one hand
• Coracoclavicular ligament helps in
coupling post clavicular rotation
with scapular upward rotation
during elevation of arm.
Acromioclavicular Motions
• Three rotatory motions
• Internal/external rotation
• Anterior/posterior tilting or
tipping
• Upward/ downward rotation.
• Three translatory motions
• Anterior/posterior
• Medial/lateral
• Superior/ inferior
(UPWARD/DOWNWARD ROTATION)
(ANTERIOR/POSTERIOR TIPPING)
(INTERNAL/EXTERNAL ROTATION)
Scapulothoracic Joint
• Not a true anatomic joint
• It is not a union of bony
segments by fibrous,
cartilaginous, or synovial
tissues.
RESTING POSITION OF SCAPULA
Motions of the Scapula
Scapulothoracic Stability
Glenohumeral Joint
• Glenohumeral joint is a ball-and-
socket synovial joint with three
rotary and three translatory
degrees of freedom.
• Sacrificed articular congruency to
increase the mobility of the
upper extremity and hand
• susceptible to degenerative
changes, instability, and
derangement
Glenohumeral Articulating Surfaces
• Proximal articular
surface- Glenoid fossa of
the scapula
• Distal articular surface-
Humeral head
• Humeral head have larger
surface are than glenoid
fossa
Angle of
Inclination
• An axis through the
humeral head and
neck in relation to a
longitudinal axis
through the shaft of
the humerus and
• 130° to 150° in the
frontal plane
Angle of
torsion
• An axis through the
humeral head and neck
in relation to an axis
through the humeral
condyles.
• This transverse plane
angle varies but is
approximately 30°
posterior
Glenoid Labrum
• Articular surface is enhanced by
densely packed fibrous
connective tissue covered by a
fine superficial mesh consistent
with cartilaginous tissue known
as Glenoid Labrum
• Enhancing the depth or concavity
of the fossa by approximately
50%
Glenohumeral Capsule
• Superior, Anterior and Inferior
Capsule
• Weak, Large and Loose
• Close-packed position: abduction
and medial rotation
• Superiorly capsule is taut
• Slacks anteriorly and inferiorly
Glenohumeral Ligaments
• Capsular Ligaments
I. Superior Glenohumeral
Ligament
II. Middle Glenohumeral
Ligament
III. Inferior Glenohumeral
Ligament
• Extracapsular Ligaments
I. Coracohumeral Ligament
Glenohumeral Ligaments
• Tendons provide dynamic
reinforcement to the capsule
through their anatomical proximity
to the joint and because the
tendons insert directly onto and
blend into the glenohumeral
capsule.
Rotator Interval Capsule
• Superior glenohumeral
ligament, the superior capsule,
and the coracohumeral ligament
as interconnected structures that
bridge the space between the
supraspinatus and subscapularis
muscle tendons and form the
rotator interval capsule (RIC)
Inferior GH ligament complex (IGHLC)
• Three components
1. Anterior band
2. Posterior bands and
3. The axillary pouch in between
Coracoacromial Arch
• An osteoligamentous vault over the
humeral head
• Formed by the coracoid process, the
acromion, the coracoacromial ligament,
and the inferior surface of the
acromioclavicular joint
• Subacromial space- the region
between the arch and the humeral head.
• Subacromial bursa, the rotator cuff
tendons, and a portion of the tendon of
the long head of the biceps brachii lie
within the subacromial space
Bursae
• SUBACROMIAL BURSA
• SUBDELTOID BURSA
• Subacromial bursa permits
smooth gliding between the
humerus and supraspinatus
tendon and surrounding
structures
Subacromial Bursitis
Glenohumeral Motions
• Three degree of Freedom
(Triaxial joint)
• Flexion/Extension
• Abduction/Adduction
• Medial/Lateral rotation
Intra-articular Contribution to
Glenohumeral Motions
Static Stabilization of the Glenohumeral
Joint
• RIC
• Negative intraarticular
pressure in Capsule create a
vacuum which pulls the humeral
head towards the glenoid fossa
• Orientation of Glenoid fossa
• Arm loaded Supraspinatus
Dynamic Stabilization of the
Glenohumeral Joint
• Four factor responsible for dynamic stabilization of
glenohumeral joint
1. The Deltoid and Glenohumeral Stabilization
2. The Rotator Cuff and Glenohumeral Stabilization
3. The Supraspinatus and Glenohumeral Stabilization
4. The Long Head of the Biceps Brachii and Glenohumeral
Stabilization
Dynamic Stabilization of the
Glenohumeral Joint
Dynamic Stabilization of the
Glenohumeral Joint
Integrated Function of the Shoulder
Complex
• Distributes the motion between the joints, permitting a large ROM with less
compromise of stability than would occur if the same range occurred at one joint
• Maintains the glenoid fossa in an optimal position in relation to the head of the
humerus, increasing joint congruency while decreasing shear forces; and
• Permits muscles acting on the humerus to maintain a good length-tension relation
while minimizing or preventing active insufficiency of the GH muscle
THANK-YOU!!!!

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Biomechanics- Shoulder Joint!!!!!!!!!!!!

  • 1. Biomechanics- Shoulder Joint Dr. Quazi Ibtesaam Huma MPT (Neurosciences) Asst Professor
  • 2. Objectives • At the end of the lecture learner should be able • Introduction • Structures: Articular Surface Articular Disk Capsule Ligaments • Kinematics and Kinetics • Clinical Anatomy
  • 3. Introduction • Shoulder joint (GH joint) synovial; ball and socket type of joint • Has more mobility than stability. • Three degree of freedom • Only SC joint connects the components of shoulder joint to the axial skeleton. • This puts greater demands on the muscle for securing the shoulder joint on thorax during static and dynamic conditions
  • 4.
  • 5. Components of shoulder complex • Clavicle, humerus and scapula are linked with 3 interdependent linkages: SC joint, AC joint and GH joint • Additionally a functional joint called scapulothoracic joint (ST joint) is considered as s part of shoulder complex
  • 7. Action of Shoulder joint • Flexion • Extension • Abduction • Adduction • External rotation • Internal rotation
  • 8. Sternoclavicular joint • SC joint : Synovial type, consist joint capsule, disk and ligament • Movement of the clavicle at the SC joint inevitably produces movement of the scapula under conditions of normal function, because the scapula is attached to the lateral end of the clavicle
  • 9. • Articulating surface: two saddle- shaped, incongruent surface • Sternal or medial end of the clavicle • At the notch formed by the manubrium of the sternum
  • 10. Sternoclavicular disk • Fibrocartilaginous disk – to increase the congruency between incongruent articular surfaces • Attachment: upper portion – posterosuperior clavicle • Lower portion- manubrium and first coastal cartilage • Disk diagonally transects the SC joint space and divides the joint into 2 separate cavities
  • 11. SC joint stress tolerance • Sternoclavicular joint is considered incongruent, it does not undergo the degree of degenerative change common to the other joints of the shoulder complex • Strong force-dissipating structures such as the sternoclavicular disc and the costoclavicular ligament minimize articular stresses • Prevent excessive intra-articular motion, which could lead to subluxation or dislocation.
  • 12. Ligaments • Three ligaments: 1. Sternoclavicular ligament 2. Costoclavicular ligament 3. Interclavicular ligament
  • 13.
  • 14. Sternoclavicular motions • 3 rotatory degrees of freedom • Elevation/ Depression • Protraction/ Retraction • Anterior/ Posterior rotation • 3 degrees of translatory motion • Anterior/ posterior translation • Medial/ lateral translation • Superior/ inferior translation
  • 17. Posterior rotation: 50° Anterior rotation: less than10°
  • 18. • Elevation and depression of the clavicle, the medial articular surface rolls and slides on the relatively stationary disc, with the upper attachment of the disc serving as a pivot point. • During protraction and retraction of the clavicle, the sternoclavicular disc and medial articular surface roll and slide together on the manubrial facet, with the lower attachment of the disc serving as a pivot point. • The disk functions to absorb the medially directed force transmitted along along the clavicle from its lateral end.
  • 19. Acromioclavicular Joint • Synovial type of joint • 3 rotational and 3 translational degree of freedom • Primary function - to allow the scapula to rotate in three dimensions during arm movement so that upper extremity motion is increased.
  • 20. Articulating surface and disc • ARTICULATING SURFACE • Lateral end of the clavicle and a small facet on the acromion of the scapula • Flat, reciprocally concave-convex • ARTICULAR DISC • Capsule of the acromioclavicular joint is weak
  • 21. As the joint capsule is weak it cannot maintain integrity of the joint without the reinforcement of the superior and inferior acromioclavicular ligaments and the coracoclavicular ligaments
  • 22. Ligaments • Superior Acromioclavicular ligament • Inferior Acromioclavicular ligament • Coracoclavicular ligament
  • 23. • Coracoclavicular ligament: • Trapezoid portion: oriented more horizontally. It resists posterior fossa on distal clavicle • Conoid portion: oriented more vertically. It resists superior and inferior forces • Both limits upward rotation of scapula on AC joint.
  • 24. • Prevents medial displacement of acromion on clavicle when leaning on one hand • Coracoclavicular ligament helps in coupling post clavicular rotation with scapular upward rotation during elevation of arm.
  • 25. Acromioclavicular Motions • Three rotatory motions • Internal/external rotation • Anterior/posterior tilting or tipping • Upward/ downward rotation. • Three translatory motions • Anterior/posterior • Medial/lateral • Superior/ inferior
  • 27.
  • 28.
  • 29. Scapulothoracic Joint • Not a true anatomic joint • It is not a union of bony segments by fibrous, cartilaginous, or synovial tissues.
  • 31. Motions of the Scapula
  • 32.
  • 33.
  • 35. Glenohumeral Joint • Glenohumeral joint is a ball-and- socket synovial joint with three rotary and three translatory degrees of freedom. • Sacrificed articular congruency to increase the mobility of the upper extremity and hand • susceptible to degenerative changes, instability, and derangement
  • 36. Glenohumeral Articulating Surfaces • Proximal articular surface- Glenoid fossa of the scapula • Distal articular surface- Humeral head • Humeral head have larger surface are than glenoid fossa
  • 37. Angle of Inclination • An axis through the humeral head and neck in relation to a longitudinal axis through the shaft of the humerus and • 130° to 150° in the frontal plane
  • 38. Angle of torsion • An axis through the humeral head and neck in relation to an axis through the humeral condyles. • This transverse plane angle varies but is approximately 30° posterior
  • 39. Glenoid Labrum • Articular surface is enhanced by densely packed fibrous connective tissue covered by a fine superficial mesh consistent with cartilaginous tissue known as Glenoid Labrum • Enhancing the depth or concavity of the fossa by approximately 50%
  • 40. Glenohumeral Capsule • Superior, Anterior and Inferior Capsule • Weak, Large and Loose • Close-packed position: abduction and medial rotation • Superiorly capsule is taut • Slacks anteriorly and inferiorly
  • 41. Glenohumeral Ligaments • Capsular Ligaments I. Superior Glenohumeral Ligament II. Middle Glenohumeral Ligament III. Inferior Glenohumeral Ligament • Extracapsular Ligaments I. Coracohumeral Ligament
  • 43. • Tendons provide dynamic reinforcement to the capsule through their anatomical proximity to the joint and because the tendons insert directly onto and blend into the glenohumeral capsule.
  • 44. Rotator Interval Capsule • Superior glenohumeral ligament, the superior capsule, and the coracohumeral ligament as interconnected structures that bridge the space between the supraspinatus and subscapularis muscle tendons and form the rotator interval capsule (RIC)
  • 45. Inferior GH ligament complex (IGHLC) • Three components 1. Anterior band 2. Posterior bands and 3. The axillary pouch in between
  • 46. Coracoacromial Arch • An osteoligamentous vault over the humeral head • Formed by the coracoid process, the acromion, the coracoacromial ligament, and the inferior surface of the acromioclavicular joint • Subacromial space- the region between the arch and the humeral head. • Subacromial bursa, the rotator cuff tendons, and a portion of the tendon of the long head of the biceps brachii lie within the subacromial space
  • 47. Bursae • SUBACROMIAL BURSA • SUBDELTOID BURSA • Subacromial bursa permits smooth gliding between the humerus and supraspinatus tendon and surrounding structures
  • 49. Glenohumeral Motions • Three degree of Freedom (Triaxial joint) • Flexion/Extension • Abduction/Adduction • Medial/Lateral rotation
  • 51. Static Stabilization of the Glenohumeral Joint • RIC • Negative intraarticular pressure in Capsule create a vacuum which pulls the humeral head towards the glenoid fossa • Orientation of Glenoid fossa • Arm loaded Supraspinatus
  • 52. Dynamic Stabilization of the Glenohumeral Joint • Four factor responsible for dynamic stabilization of glenohumeral joint 1. The Deltoid and Glenohumeral Stabilization 2. The Rotator Cuff and Glenohumeral Stabilization 3. The Supraspinatus and Glenohumeral Stabilization 4. The Long Head of the Biceps Brachii and Glenohumeral Stabilization
  • 53. Dynamic Stabilization of the Glenohumeral Joint
  • 54. Dynamic Stabilization of the Glenohumeral Joint
  • 55. Integrated Function of the Shoulder Complex • Distributes the motion between the joints, permitting a large ROM with less compromise of stability than would occur if the same range occurred at one joint • Maintains the glenoid fossa in an optimal position in relation to the head of the humerus, increasing joint congruency while decreasing shear forces; and • Permits muscles acting on the humerus to maintain a good length-tension relation while minimizing or preventing active insufficiency of the GH muscle