Current Concepts: The Stabilizing Structures of the Glenohumeral Joint

Wilk, Kevin E.; Arrigo, Christopher A.; Andrews, James R.

doi:10.2519/jospt.1997.25.6.364

Cited by 227 publications

(197 citation statements)

References 54 publications

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“…Note that an optimal level of stabilization is essential at the scapula to maximize the force-generating capability of these two key muscle groups acting at the shoulders (scapulohumeral joints) [42]. Hence, specific muscles key in stabilizing the scapulothoracic functional articulation (serratus anterior, rhomboids, upper trapezius, levator scapulae, pectoralis major) may also need to be strengthened [43][44]. Finally, the importance of preserving the agonist and antagonist muscle strength balance at the shoulders should not be neglected.…”

Section: Clinical Relevancementioning

confidence: 99%

Comparison of peak shoulder and elbow mechanical loads during weight-relief lifts and sitting pivot transfers among manual wheelchair users with spinal cord injury

Gagnon

Nadeau²,

Noreau³

et al. 2008

JRRD

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Abstract-This study compared shoulder and elbow joint forces and moments between weight-relief lifts (WRLs) and sitting pivot transfers (SPTs) among manual wheelchair users with spinal cord injury (SCI) (N = 13) during biomechanical laboratory assessment. Minimum and maximum values were reported for each triaxial component of the joint force at the dominant shoulder and elbow during SPTs (leading and trailing roles) and WRLs. Peak shoulder flexor and adductor moments, along with elbow flexor and extensor moments, observed during the same period were also analyzed. The SPTs predominantly exposed (p < 0.001) the shoulder joints to substantial posteriorly directed forces (leading = -2.6 N/kg; trailing = -3.1 N/kg) compared with WRLs (-2.2 N/kg), whereas superiorly directed forces (2.9 N/kg) were principally sustained (p < 0.001) during WRLs compared with SPTs (leading = 1.5 N/kg; trailing = 1.5 N/kg). High superiorly directed forces (3.6 to 3.9 N/kg) were observed at the elbow, which were comparable (p = 0.33) between the two tasks. The peak shoulder flexor (leading = 1.36 N·m/kg; trailing = 1.45 N·m/kg) and adductor moments (leading only = -0.46 N·m/kg), along with the peak elbow flexor moments (leading = 0.24 N·m/kg; trailing = 0.15 N·m/kg), were significantly more elevated (p < 0.021) during SPTs than during WRLs. Peak shoulder adductor (-0.46 vs -0.24 N·m/kg) and elbow flexor moments were also more elevated (p = 0.03) at the leading upper limb compared with the trailing one. The peak elbow extensor moments did not differ (p = 0.167) between the two tasks (-0.17 to -0.25 N·m/kg). SPTs exposed the shoulder and elbow joints to greater mechanical loads than WRLs among individuals with SCI.

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Section: Clinical Relevancementioning

confidence: 99%

Comparison of peak shoulder and elbow mechanical loads during weight-relief lifts and sitting pivot transfers among manual wheelchair users with spinal cord injury

Gagnon

Nadeau²,

Noreau³

et al. 2008

JRRD

View full text Add to dashboard Cite

show abstract

“…The authors consider an inferior displacement of greater than 8-10mm during the sulcus maneuver (Figure 2) with the arm adducted to the side as significant hypermobility, thus suggesting significant congenital laxity. 2 Due to the atraumatic mechanism and lack of acute tissue damage, ROM is often normal to excessive. Patients with recurrent shoulder instability due to MDI generally have weakness in the rotator cuff, deltoid 1c.…”

Section: Direction Of Instabilitymentioning

confidence: 99%

“…Neuromuscular control may be defined as the efferent, or motor, output in reaction to an afferent, or sensory input. 2,10 The afferent input is the ability to detect the glenohumeral joint position and motion in space with resultant efferent response by the dynamic stabilizers as they blend with the joint capsule to assist in stabilization of the humeral head. Injury with resultant insufficient neuromuscular control could result in deleterious effects to the patient.…”

Section: Neuromuscular Controlmentioning

confidence: 99%

“…Functional exercise drills that include positions of instability to induce a reflexive muscular response may protect against future injury or recurring episodes of instability. 2,61,62 Active joint repositioning tasks, proprioceptive neuromuscular facilitation (PNF) and plyometric exercises may be beneficial as well to evoke a neuromuscular response.…”

Section: Figure 10mentioning

confidence: 99%

“…1 Due to the joint's poor osseous congruency and capsular laxity, it greatly relies on the dynamic stabilizers and neuromuscular system to provide functional stability. 2 Therefore, differentiation between normal translation and pathological instability is often difficult to determine. A wide range of shoulder instabilities exist from subtle subluxations to gross instability.…”

Section: Introductionmentioning

confidence: 99%

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