SHOULDER ARTICULATIONSSHOULDER ARTICULATIONS

• Sternoclavicular (SC) Joint

• Acromioclavicular (AC) Joint– “False Joint” = Arch Ligament Coracoacromial

Ligament between Acromion Process & Coraco Process of Scapula

• Coracoclavicular Joint

• Glenohumaral Joint

• Scapulothoracic Joint

SHOULDER ARTICULATIONSSHOULDER ARTICULATIONS

• Sternoclavicular (SC) JointSternoclavicular (SC) Joint – Articulation of Superior Sternum & Proximal Clavicle– 4 Ligaments

• Interclavicular = between the 2 sternoclavicular joints provides minimal support to the joint

• Costoclavicular = clavicle to 1st rib• Anterior Sternoclavicular = broad band support anterior

capsule• Posterior Sternoclavicular = small + weak support

posterior capsule– Fibrocartilage Disc - Prevent medial clavicle displacement

Function = Movement of Distal Clavicle

Test = Max shoulder Elevation cause close packed SC

SHOULDER ARTICULATIONSSHOULDER ARTICULATIONS

• Acromioclavicular (AC) JointAcromioclavicular (AC) Joint– Articulation of Medial Facet of Scapula’s Acromion Process

& Distal Clavicle (allow minimal movement)– 2 Ligaments

• Superior acromioclavicular = acromion and clavicle• Inferior acromioclavicular = acromion and clavicle

• Arch “Joint” (Acromiocoraco “AC”) of ScapulaArch “Joint” (Acromiocoraco “AC”) of Scapula– Coracoacromial (Arch) Ligament = Buffer between Rotator

Cuff muscles and bony acromion process

Test = Humerus abduction 90° cause close packed AC

See Type IV to VISee Type IV to VITearing of Deltoid andAnd Trapezius Fascia

Acromioclavicular SprainAcromioclavicular Sprain

SHOULDER ARTICULATIONSSHOULDER ARTICULATIONS

• Coracoclavicular Joint Coracoclavicular Joint (Syndesmosis)– Coracoclavicular Ligament = Inferior Clavicle &

Anterior-superior Coracoid process of the Scapula

Function• Resist independent upward movement of the clavicle• Resist downward movement of the scapula• Resist anterior / posterior movement of scapula and

clavicle

Very little movement in this joint

SHOULDER ARTICULATIONSSHOULDER ARTICULATIONS• Glenohumaral (GH) JointGlenohumaral (GH) Joint

– Articulation between• Glenoid Fossa of Scapula• Head of Humerus

– Humeral head 3-4x articulation surface than Glenoid = instability

– Ligaments• Anterior = Superior, Middle, Inferior glenohumeral lig.• Inferior lig very thick = main stabilizer in abduction• Superior = Coracohumeral lig. (very strong)

– Muscles (SITS muscles) joins joint capsule• Tension holds the humerus head into the glenoid fossa (stability)

– Test• Close packed position = Abduction & Lateral rotation

Glenohumeral DislocationGlenohumeral Dislocation

Anterior Glenohumeral DislocationAnterior Glenohumeral Dislocation

See See Bankart LesionBankart Lesion

Bankart LesionBankart Lesion = Inferior Glenohumeral Ligament = Inferior Glenohumeral Ligament is avulsed from the anterior lip of the labrumis avulsed from the anterior lip of the labrum

SLAP LesionSLAP LesionInjury to the superior labrum begin Injury to the superior labrum begin posteriorly and extend anteriorlyposteriorly and extend anteriorlydisrupting the long head of the biceps tendon disrupting the long head of the biceps tendon to the superior glenoid tubercleto the superior glenoid tubercle

SHOULDER ARTICULATIONSSHOULDER ARTICULATIONS• Scapulothoracic JointScapulothoracic Joint

– Muscles joining scapula to trunk• Levator Scapula• Rhomboids• Serratus Anterior• Pectoralis Minor• Subclavius• Deltoid• Subscapularis• Supraspinatus• Infraspinatus• Teres major• Teres Minor• Coracobrachialis• Short head of the Biceps Brachii• Long head of the Triceps Brachii• Trapezius

– Functions• Stability• Movement

SUBACROMIAL BURSITISSUBACROMIAL BURSITIS

SUBACROMIAL BURSITISSUBACROMIAL BURSITIS

SUBACROMIAL BURSITISSUBACROMIAL BURSITIS