The Journal of Bone and Joint Surgery (American). 2009;91:378-389.
doi:10.2106/JBJS.G.01483
© 2009 The Journal of Bone and Joint Surgery, Inc.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the activities for this article:
 Shoulder/Elbow Test 26: Spring 2009 (publication date May 15, 2009; expirat...
Basic Science Test 11: Summer 2009 (publication date August 14, 2009; expir...
CME 1: January, February, March 2009 (publication date April 3, 2009; expir...
Right arrow [Supplementary Material]
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow Rights and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ludewig, P. M.
Right arrow Articles by LaPrade, R. F.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Ludewig, P. M.
Right arrow Articles by LaPrade, R. F.
Related Collections
Right arrow Shoulder
Right arrow Sports
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Facebook   Add to Technorati   Add to Twitter  
What's this?

Motion of the Shoulder Complex During Multiplanar Humeral Elevation

Paula M. Ludewig, PT, PhD1, Vandana Phadke, BPT1, Jonathan P. Braman, MD2, Daniel R. Hassett, PT1, Cort J. Cieminski, PT, PhD, ATC, CSCS1 and Robert F. LaPrade, MD, PhD2

1 Department of Physical Medicine and Rehabilitation, University of Minnesota, MMC 388, 420 Delaware Street S.E., Minneapolis, MN 55455. E-mail address for P.M. Ludewig: ludew001{at}umn.edu
2 Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue, Suite R200, Minneapolis, MN 55454

Investigation performed at the Orthopaedic Biomechanics Laboratory, University of Minnesota, Minneapolis, Minnesota

Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from the National Institute of Child Health and Human Development (NIH grant #K01HD042491). Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the views of the National Institute of Child Health and Human Development or the National Institutes of Health.

Background: Many prior studies have evaluated shoulder motion, yet no three-dimensional analysis comparing the combined clavicular, scapular, and humeral motion during arm elevation has been done. We aimed to describe and compare dynamic three-dimensional motion of the shoulder complex during raising and lowering the arm across three distinct elevation planes (flexion, scapular plane abduction, and coronal plane abduction).

Methods: Twelve subjects without a shoulder abnormality were enrolled. Transcortical pin placement into the clavicle, scapula, and humerus allowed electromagnetic motion sensors to be rigidly fixed. The subjects completed two repetitions of raising and lowering the arm in flexion, scapular, and abduction planes. Three-dimensional angles were calculated for sternoclavicular, acromioclavicular, scapulothoracic, and glenohumeral joint motions. Joint angles between humeral elevation planes and between raising and lowering of the arm were compared.

Results: General patterns of shoulder motion observed during humeral elevation were clavicular elevation, retraction, and posterior axial rotation; scapular internal rotation, upward rotation, and posterior tilting relative to the clavicle; and glenohumeral elevation and external rotation. Clavicular posterior rotation predominated at the sternoclavicular joint (average, 31°). Scapular posterior tilting predominated at the acromioclavicular joint (average, 19°). Differences between flexion and abduction planes of humerothoracic elevation were largest for the glenohumeral joint plane of elevation (average, 46°).

Conclusions: Overall shoulder motion consists of substantial angular rotations at each of the four shoulder joints, enabling the multiple-joint interaction required to elevate the arm overhead.

Clinical Relevance: Improved knowledge of the normal motion of the shoulder during humeral elevation will improve the assessment of patients with shoulder motion abnormalities, planning for rehabilitation programs, and performance of stabilization procedures.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Facebook Facebook   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Am J Sports MedHome page
K. Miyashita, H. Kobayashi, S. Koshida, and Y. Urabe
Glenohumeral, Scapular, and Thoracic Angles at Maximum Shoulder External Rotation in Throwing
Am. J. Sports Med., February 1, 2010; 38(2): 363 - 368.
[Abstract] [Full Text] [PDF]