Glenohumeral Movements of the Involuntary Inferior and Multidirectional Instability

Ozaki, J

doi:10.1097/00003086-198901000-00016

Cited by 95 publications

(52 citation statements)

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“…Abnormal scapulothoracic kinematics have been identified in a number of shoulder dysfunctions such as impingement, instability, rotator cuff pathology, and shoulder pain. 6,17,19,24,30 Specifically, increased internal rotation, decreased upward rotation, and decreased posterior tilting of the scapula on the thorax have been described in subjects with impingement and instability. 6,17,19,24,30 These shoulder pathologies are commonly treated through exercise programs aimed at correcting aberrant scapular kinematics.…”

Section: Discussionmentioning

confidence: 99%

“…6,17,19,24,30 Specifically, increased internal rotation, decreased upward rotation, and decreased posterior tilting of the scapula on the thorax have been described in subjects with impingement and instability. 6,17,19,24,30 These shoulder pathologies are commonly treated through exercise programs aimed at correcting aberrant scapular kinematics. 16 As scapulothoracic motion is a combination of motion occurring at both the AC and SC joints, to fully understand scapulothoracic and AC-joint-related shoulder pathologies greater knowledge is needed regarding how AC and SC joint motions are coupled with scapulothoracic movement.…”

Section: Discussionmentioning

confidence: 99%

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Three-Dimensional Acromioclavicular Joint Motions During Elevation of the Arm

Teece¹,

Lunden²,

Lloyd³

et al. 2008

J Orthop Sports Phys Ther

109

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Acromioclavicular Joint Motions During Elevation of the Arm

Teece¹,

Lunden²,

Lloyd³

et al. 2008

J Orthop Sports Phys Ther

109

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“…Abnormal scapular motions and positions relative to the thorax have been linked with various shoulder pathologies, including tendonitis, impingement, rotator cuff tears, and glenohumeral inferior instability. 10,17,20,25,32,35,36 Several investigators studying various patient populations have described abnormal scapulothoracic kinematics. In subjects with shoulder tendonitis or impingement, scapular ''winging,'' decreased upward rotation, increased internal rotation, and decreased posterior tipping have all been demonstrated under certain conditions.…”

mentioning

confidence: 99%

“…19,20,35 In subjects with glenohumeral inferior instability, decreased scapular upward rotation has been identified as a possible contributing mechanism. 25 Because scapular motion on the thorax results in motion at the sternoclavicular (SC) joint and/or acromioclavicular (AC) joint, 7,12 abnormal scapular motions must be associated with abnormal motion at 1 or both of these joints. Due to the ligamentous and capsular attachments of the scapula to the clavicle and clavicle to the thorax, scapulothoracic motion requires SC or AC joint motion, or some combination of motion at both joints.…”

mentioning

confidence: 99%

Three-Dimensional Clavicular Motion During Arm Elevation: Reliability and Descriptive Data

Ludewig¹,

Behrens²,

Meyer³

et al. 2004

J Orthop Sports Phys Ther

103

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Study Design: Cross-sectional. Objectives: To determine the reliability of a surface sensor measurement of clavicular motion during arm elevation and to describe 3-dimensional clavicular motion in an asymptomatic population. Background: Abnormal scapular motion on the thorax has been implicated in shoulder pathology. Without the ability to measure clavicular motion, it is not possible to identify if abnormal scapular motions derive from the sternoclavicular or acromioclavicular joints. Methods and Measures: Thirty-nine subjects participated in the investigation, including an asymptomatic group (n = 30) and a group with a history or current symptoms of shoulder pathology (n = 9). Clavicular angles relative to the thorax were tracked with surface electromagnetic sensors on the thorax, clavicle, and humerus as subjects completed humeral flexion, scapular plane abduction, and abduction. Within-day reliability was assessed using intraclass correlation coefficients and SEM. Descriptive statistics quantified sternoclavicular joint motions for the various arm movements. Results: Reliable measurements were obtained, with intraclass correlation coefficients ranging from 0.93 to 0.99, and SEMs from 0.9°to 1.8°. Between-day reliability SEM values were generally 2°to 4°. During elevation of the arm, the clavicle with respect to the thorax generally undergoes elevation (11°-15°maximum), retraction (15°-29°maximum), and posterior long-axis rotation (15°-31°maximum), with variability between subjects and planes of motion regarding the magnitude of motion. Conclusion: Rehabilitation approaches attempting to improve shoulder motion should benefit from improved knowledge of 3-dimensional contributions of the clavicle to normal and abnormal scapular kinematics.

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“…Clinically, several investigators have reported abnormal motion of the scapula in patients with inferior instability (Endo et al 1971;Ozaki 1989; O'Driscoll 1991; Warner et al 1991) and a surgical procedure to correct scapular inclination has been performed (Endo et al 1971;Suzuki et al 1987). A recent experimental study (Itoi et al 1992) examined the relationship between scapular inclination and inferior stability of the glenohumeral joint, showing that inferior stability of the glenohumeral joint with the arm hanging freely increases with increased scapular inclination.…”

mentioning

confidence: 99%

Bulk Effect of Rotator Cuff on Inferior Glenohumeral Stability as Function of Scapular Inclination Angle: A Cadaver Study.

Itoi¹,

Motzkin²,

Morrey³

et al. 1993

Tohoku J. Exp. Med.

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Eleven fresh cadaver shoulders were studied to determine the static contribution (bulk effect) of the rotator cuff on inferior glenohumeral stability provided by scapular inclination. All musculature, including the rotator cuff, was removed. The position of the humerus relative to the scapula was recorded using an electromagnetic tracking device under conditions of no force and 1.5 kg of inferior translation force applied to the humerus, with the arm in the hanging position (sulcus test) and then in 90° abduction (Abduction-Inferior Stability test=ABIS test), with the scapula inclined referable to the vertical line at -15°, 0°, 15° and 30° in the sulcus test and at 15°, 30°, 45° and 60° in the ABIS test. In the sulcus test without load, all shoulders dislocated at scapular inclination angles of -15° and 0°, whereas no shoulders dislocated at 30°. The angle of scapular inclination had a significant effect on humeral head positions (p <0.0001), with the head position at -15° and 0° being lower than at 15°, which was lower than at 30°. In the ABIS test, none of the shoulders dislocated, although the effect of the angle of scapular inclination was significant (p <0.0001), with the position of the Numeral head being higher at 15° than at other angles of inclination. Comparison of these data and previously reported data with the cuff intact showed no significant effect of rotator cuff removal on humeral head position and displacement in both tests. Therefore, we conclude that the static condition of the rotator cuff has no significant effect on the stabilizing function of scapular inclination. The stabilizing mechanism of scapular inclination seems to be associated with the bony configuration and/or anatomy and biomechanical properties of the superior capsuloligamentous structures.shoulder; stability; scapular inclination; rotator cuff Since Basmajian and Bazant (1959) first observed a relationship between the slope of the glenoid fossa and inferior stability of the glenohumeral joint, few studies have been performed to further understanding of this relationship.

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Glenohumeral Movements of the Involuntary Inferior and Multidirectional Instability

Cited by 95 publications

References 0 publications

Three-Dimensional Acromioclavicular Joint Motions During Elevation of the Arm

Three-Dimensional Acromioclavicular Joint Motions During Elevation of the Arm

Three-Dimensional Clavicular Motion During Arm Elevation: Reliability and Descriptive Data

Bulk Effect of Rotator Cuff on Inferior Glenohumeral Stability as Function of Scapular Inclination Angle: A Cadaver Study.

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