The shoulder complex is an intricately designed combination of three joints that link the upper extremity to the thorax – it is composed of the clavicle, scapula and humerus. What can you tell us about the complex?
90 degrees of shoulder humeral flexion or shoulder humeral abduction
180 degrees of shoulder humeral flexion or shoulder humeral abduction
45 degrees of shoulder humeral flexion or shoulder humeral abduction
120 degrees of shoulder humeral flexion or shoulder humeral abduction
Shoulder sublaxation is complete separation of the GH joint where the head of the humerus is torn from the glenoid fossa
Shoulder sublaxation is incomplete or partial separation of the GH joint where the head of the humerus has partially slipped out of the glenoid fossa without tearing or rupturing of soft tissue structures
Shoulder sublaxation occurs when the AC joint is dislocated.
Shoulder sublaxation occurs when the SC joint is dislocated and/or the clavicle is fractured
Anterior Deltoid
Middle Traps
Upper Traps
Coracobrachialis and Subscapularis (assister)
Biceps Brachii (assist)
GH and AC joints
AC and SC joints
GH and SC
AC, SC, and ST
Coordinated movement of the GH & SC joints where 5 degrees of GH motion follows 2 degrees of SC motion. GH motion occurs with the first 90 degrees of shoulder flex/ext. and abd/add.
Coordinated movement of the AC & SC joints where 2 degrees of AC motion follows 4 degrees of SC motion throughout ROM
Coordinated movement of the GH & SC & AC joints that generally occurs in a 2:1 ratio of GH motion to SC & AC joint motion. GH motion occurs at the beginning and end of the shoulder flex/ext & abd/add. Scapular movement occurs between 80 to 140 degrees of flex/abd.
Coordinated movement of the scapulothoracic motion and AC & SC joints that occurs in a 2:1 ratio. Scapulothoracic motion occurs within 40 to 120 degrees of shoulder flex/ext & abd/add.
Pectoralis Major
Lower Traps
Middle Deltoid
Serratus Anterior
SC joint
AC joint
ST joint
GH joint
Tying a tie
Brushing your teeth
Buttoning a polo shirt
Brushing/combing your hair on the back of your head
Levator Scapulae
Serratus Anterior
Rhomboids
Subscapularis
Serratus Anterior
Posterior Deltoid
Middle Traps
Serratus Anterior
Upper & Middle Traps
Levator Scapulae
Rhomboid Major & MInor
Infraspinatus & Teres Minor
Posterior Deltoid (assister)
Anterior Deltoid
Supraspinatus (assister)
Reaching an object on top of the refrigerator
Pushing down on arm rests of a chair in order to stand up
Lifting a cup to take a drink
Putting a hat on top of your head
GH and AC joints
AC and SC joints
GH and SC
AC, SC, and ST
Closed packed position is maximal internal rotation and adduction; end feel is soft
Closed packed position is maximal shoulder extension; End feel is firm
Closed packed position is maximal shoulder abduction and external rotation; End feel is firm
Closed packed position is maximal horizontal adduction and internal rotation; end feel is soft
Rotator Cuff Muscles
Upper Trapezius
Pectoralis Major
Long Head of Biceps
Anterior Deltoid
Pectoralis Major
Latissimus Dorsi
Teres Major & Subscapularis
Only 20 degrees of shoulder flexion and abduction would be available because no motion is available at AC & SC joints
20 degrees of GH motion, plus 30 degrees from SC joint (movement from AC joint unavailable) = approx. 50 degrees available for flex/abd
20 degrees of GH motion, plus 30 degrees from AC joint (movement from SC joint unavailable) = approx. 50 degrees available for flex/abd
20 degrees of GH motion, 120 degrees from ST motion = approx. 140 degrees available for shoulder flex/abd
Shoulder protraction
Lateral trunk extension toward weak side
Trunk Flexion
Bringing head down to shoulder by tipping head to side
No movement issues would be seen at the shoulder girdle complex
Movement of the shoulder would be limited to 30 degrees of shoulder flex/abd
Only approximately 90 to 110 degrees of shoulder flex/abd would be possible
Movement of the shoulder would be limited to internal rotation
Shoulder Shrug
Scapular Extension
Contralateral or Ispilateral trunk side flexion
Bringing head down to shoulder by tipping head to side
Shoulder sublaxation would occur
Shoulder disclocation would occur
Frozen shoulder would occur
Shoulder bursitis
Tying a tie
Brushing your teeth
Buttoning a polo shirt
Brushing/combing your hair on the back of your head
Tying a tie
Brushing your teeth
Buttoning a polo shirt
Brushing/combing your hair on the back of your head
Reaching an object on top of the refrigerator
Pushing down on arm rests of a chair in order to stand up
Lifting a cup to take a drink
Putting a hat on top of your head