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The Journal of Bone and Joint Surgery, Vol 76, Issue 5 667-676, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
Changes in the moment arms of the rotator cuff and deltoid muscles with abduction and rotation
JC Otis, CC Jiang, TL Wickiewicz, MG Peterson, RF Warren and TJ Santner
Department of Biomechanics, Hospital for Special Surgery, New York, N.Y. 10021.
The behavior of the moment arms of the rotator cuff and deltoid muscles was
studied during simple and combine movements of abduction and rotation about
the glenohumeral joint. This was done by experimental measurement of
excursions of the muscles in an in vitro cadaver model and by use of a
multiple-regression analysis to delineate the changes in the moment arms as
a function of abduction and rotation. The results demonstrated the
potential of some rotator cuff muscles to contribute to both abduction and
rotation, the sensitivity of the abductor moment-arm lengths to internal
and external rotation and of the rotator moment-arm lengths to the degree
of abduction, and the capacity of the abductor moment-arm lengths of the
deltoid to increase with increasing abduction. Characterization of this
behavior resulted in an increased understanding of the complex role of the
rotator cuff and deltoid muscles about the gleno-humeral joint and provided
quantitative descriptions of functional relationships. This study
demonstrates the capacity of the infraspinatus and subscapularis muscles to
contribute not only to external and internal rotation, respectively, but
also to elevation of the arm in the plane of the scapula, a role for which
these muscles have been given little or no consideration. Furthermore, it
demonstrates that the contribution of the infraspinatus to abduction is
enhanced with internal rotation while that of the subscapularis is enhanced
with external rotation. Thus, dysfunction of the supraspinatus muscle need
not preclude good elevation of the arm, and rehabilitation to reprogram and
strengthen the remaining muscles becomes an important consideration.
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