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Shoulder Joint Muscles and Impingement Syndrome Overview

Learn about shoulder joint muscles, impingement syndrome causes, stages, treatment, and elbow joint muscle structures. Understand bone and wrist joint muscles functions with relevant illustrations. Enhance your biomechanics knowledge for effective study.

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Shoulder Joint Muscles and Impingement Syndrome Overview

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  1. Method of Study for This Section • Read assigned readings of text • Use Thompson Manual and the Dynamic Human CD-ROM to help review structure of bones, joints, and muscles as necessary. This is the purpose of lab • Complete labs conscientiously and study models of articulated skeleton, shoulder, spine, and knee • Lecture will only provide a selective review of structure, muscles & movements, and movement-related issues • For exams, review lecture notes and understanding questions in both lecture and labs

  2. Sh Jt & Girdle Ant Musculature

  3. Sh Jt & Girdle Post Musculature

  4. Upper Extremity – Chapter 7 Shoulder Girdle Structure:

  5. Muscles and Movement of Shoulder Girdle • Illustrations on next three slides • Trapezius (large, superficial medial and sup to scapulae) • Upper portion - elevation, upward rotation • Middle portion - adduction, or retraction • Lower portion - depression, upward rotation • Rhomboids - • elevation, downward rotation, adduction, or retraction • Serratus anterior (underneath scapulae) • abduction, upward rotation • Pectoralis minor (underneath pectoralis major) • downward rotation, abduction, or protraction • Levator Scapulae (underneath upper trapezius) • elevation, downward rotation

  6. Elevation and Depression

  7. Upward & Downward Rotation

  8. Protraction & Retraction

  9. Shoulder Joint Structure

  10. Shoulder Joint Stabilizers • Stabilizers and rotators - Rotator cuff muscles – • Teres minor - external rotation • Infraspinatus - external rotation • Supraspinatus - abduction • Subscapularis - internal rotation

  11. Shoulder Joint Primary Movers • Anterior movers – Anterior deltoid, pectoralis major • Superior movers - middle deltoid • Posterior movers - posterior deltoid • Inferior movers - latissimus dorsi, teres major, lower pectoralis m. • Force vectors of muscles (see next slide)

  12. Shoulder Jt Muscles

  13. Shoulder Joint Impingement Syndrome • What is it? Pain from shoulder area resulting from impingement of structures between humeral head, acromion, and coracromial arch. Three stages: • Stage I - edema and hemorrhage of subacromial structures • Stage II - tendon fibrosis and bursal thickening • Stage III - rotator cuff tears, biceps tendon ruptures, and bone spurs II: III: I:

  14. Sh Jt Impingement (2) • Causes? • Primary impingement: • Repeated movements requiring elevated and/or medially rotated humerus, compounded by weak rotator cuff muscles, causing: impingement of long head of biceps, supraspinatus • Secondary Impingement: • Decreased volume of subacromial space due to glenohumeral joint instability, and perhaps joint capsular tightness • Structural abnormalities: • hooked or curved acromion, calcium deposits, bone spurs, thickened bursa, thickened ligaments

  15. Shoulder Jt Impingement (3) • Treatment: • Related to the cause - may involve surgery, rotator cuff strengthening, and flexibility exercises. • Later, avoid humeral elevation and rotation movements. • Good website: MMG - Patient Education Impingement Syndrome

  16. Elbow Joint Structure

  17. Elbow and Wrist Joint Muscles • True Flexor - Brachialis • Flexor-Supinator - Biceps brachii • Extensor - Triceps brachii • Wrist flexors (medial epicondyle of humerus) • Flexor carpi ulnaris and flexor carpi radialis • Wrist extensors (lateral epicondyle of humerus) • Extensor carpi ulnaris & extensor carpi radialis • Force vectors of muscles on next slide KIN 330 Biomechanics

  18. Muscles of elbow joint:

  19. Muscles and Movements of Radioulnar Joint • Elbow Flexion - • Forearm Supination - Biceps Brachii • Forearm Pronation - Pronator Teres • Elbow Extension - • Forearm Supination - Supinator • Forearm Pronation -Pronator Quadratus • Muscle force vectors on next slide • Epicondylitis • The most common cumulative trauma disorder (CTD), repetitive stress injury (RSI), repetitive motion disorder (RMD), or overuse syndrome (OS) is epicondylitis • Epicondylitis website: • MMG - Patient Education Cumulative Trauma Disorders TOC

  20. Radioulnar Jt Muscles

  21. Bones of Wrist and Hand

  22. Carpal Tunnel Syndrome • Background MMG - Patient Education Cumulative Trauma Disorders TOC Carpal tunnel includes median nerve and 9 flexor tendons ( 4 flex dig sup, 4 flex dig prof, 1 fl pol l)

  23. Carpal Tunnel Syndrome (cont’d) • Symptoms • Pain in wrist area, or referred proximally or distally • Tingling of thumb, fingers, or palmar side of hand • Loss of control of muscles affected by median nerve blockage • Causes • Enlargement of tissues within tunnel • Decreased size of tunnel • Extraneous tissue in tunnel • Treatment • Related to cause • Website for prevention of repetitive stress injury at computer workstations: CUergo: Neutral Posture Typing KIN 330 Biomechanics

  24. Review & Homework Problems for Chapter 7 • Review problems: • Torque at shoulder with elbow flexed vs extended • Fig 7-15, 7-16 • Compressive force at shoulder jt • Fig 7-17, sample problem 1 p 197 • Elbow flexion force • Figure 7-25, sample problem 2 p 206 • Homework – due Wed March 17 • Introductory problems, p 217: # 8,9,10 • Additional problem, p 218: #10

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