Motion of the Shoulder Complex During Multiplanar Humeral Elevation
- 1 February 2009
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Bone and Joint Surgery
- Vol. 91 (2), 378-389
- https://doi.org/10.2106/jbjs.g.01483
Abstract
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.Keywords
This publication has 34 references indexed in Scilit:
- Kinematic Evaluation of the Modified Weaver-Dunn Acromioclavicular Joint ReconstructionThe American Journal of Sports Medicine, 2008
- Three-Dimensional Acromioclavicular Joint Motions During Elevation of the ArmJournal of Orthopaedic & Sports Physical Therapy, 2008
- Three-dimensional scapular kinematics and scapulohumeral rhythm in patients with glenohumeral osteoarthritis or frozen shoulderJournal of Biomechanics, 2007
- Differences in 3-Dimensional Shoulder Kinematics between Persons with Multidirectional Instability and Asymptomatic ControlsThe American Journal of Sports Medicine, 2007
- 3D kinematic analysis of the acromioclavicular joint during arm abduction using vertically open MRIJournal of Orthopaedic Research, 2006
- Accuracy of an electromagnetic tracking device: A study of the optimal operating range and metal interferenceJournal of Biomechanics, 1996
- A standardized method for the assessment of shoulder functionJournal of Shoulder and Elbow Surgery, 1994
- Humeroscapular positions in a shoulder range-of-motion-examinationJournal of Shoulder and Elbow Surgery, 1992
- A system for describing positions of the humerus relative to the thorax and its use in the presentation of several functionally important arm positionsJournal of Shoulder and Elbow Surgery, 1992
- The shoulder complex in elevation of the arm: A mechanism approachJournal of Biomechanics, 1978