The Shoulder Girdle

The Shoulder Girdle

The shoulder girdle is a very moveable joint, but one which sacrifices structural stability for the movement. Therefore, it is quite susceptible to injury. Often, the shoulder girdle and shoulder joint work together to create movements, and many times the shoulder girdle acts as the stabilizer.

Bones of the Shoulder Girdle

What are the two bones that comprise the shoulder girdle?
Clavicle Scapula
These bones generally move as a unit, and most if not all shoulder girdle movement can be described by observing the scapula.

Articulations
What four joints compose the shoulder girdle, and where can these joints be found? A. Sternoclavicular - joins the clavicle to the sternum. This synovial joint provides the only bony link between the shoulder girdle and the axial skeleton.

B. Acromioclavicular - joins the clavicle and the acromion process of the scapula.

Articulations
C. Coracoclavicular - joins the clavicle and the coracoid process of the scapula. Syndesmosis type of joint (little movement). D. Scapulothoracic - joins anterior scapula with thoracic rib cage. Not synovial

Spend some time and familiarize yourself with the drawings on page 88 of the Floyd book.
Dont worry about memorizing all of the ligaments or fossas, but understand where they are based on their name.

Shoulder Girdle Movements

Name the 6 motions that can occur at the shoulder girdle.

1. Protraction (abduction)
2. Retraction (adduction) 3. Upward rotation

4. Downward rotation
5. Elevation 6. Depression

Shoulder Girdle Muscles

Name the 6 muscles that comprise the shoulder girdle.
1. Trapezius 4. Serratus anterior

2. Levator scapulae
3. Rhomboid

5. Pectoralis minor
6. Subclavius

Shoulder Girdle Movements

Directions muscles exert force on the scapula

Stabilize

scapula when shoulder is loaded Move and position scapula to facilitate movement at glenohumeral joint.

Upper trapezius elevate Middle, lower trapezius retract Lower trapezius - depress

Trapezius

Shoulder Girdle Muscles

A. Trapezius muscle - the trapezius muscle is a triangular shaped muscle which, when paired forms a trapezium. It is divided into upper, middle and lower fibers.
What actions do the upper fibers perform?

Elevation and upward rotation

What actions do the middle fibers perform?

Retraction, elevation and upward rotation

Shoulder Girdle Muscles

What actions do the lower fibers of the trapezius perform? Retraction, depression, upward rotation. Strengthening exercises for the trapezius include: Shrugs Bent Rows Arm abduction The trapezius is often used to stabilize the scapula. Seated Rows

Shoulder Girdle Muscles

Note: the trapezius muscle is called into action when holding objects such as suitcases, or when holding the arms above the head.

What type of contraction would these describe?

Isometric

Levator Scapulae

Shoulder Girdle Muscles

B. Levator scapulae - this muscle is an elevator. Together with the upper trapezius, this muscle shrugs your shoulders.
What actions does the levator scapulae perform? Elevation, possibly some downward rotation Strengthening exercises would include shoulder shrugs and other exercises that elevate the scapula.

Rhomboid Major

Rhomboid Minor

Shoulder Girdle Muscles

C. Rhomboid -major and minor Named for the shape of the muscle. A rhomboid is a parallelogram. It is deep to the trapezius. What are the actions of the rhomboid muscle? Retraction Downward Rotation Elevation

Shoulder Girdle Muscles

Exercises that will strengthen the rhomboid muscles include:

Seated and bent rows, dips, chinning. Note: The rhomboid muscles will fixate the scapula in retraction when the muscles of the shoulder adduct or extend the arm.

Serratus Anterior
Serratus (Late Latin): past participle of serrare to saw, from Latin serra. Appears notched like a saw with teeth.

Shoulder Girdle Muscles

D. Serratus anterior - The serratus anterior holds the scapula against the chest wall to provide a fixed origin for muscles acting on the scapula. Weakness causes winged scapula.
What actions are caused by the serratus anterior? Protraction Upward rotation

Exercises that will strengthen the serratus anterior:

Push-ups

Bench press

Overhead Press

Shoulder Girdle Muscles

The serratus anterior is the most powerful protractor of the shoulder girdle.
What condition is this?
Scapular Winging due to weak or paralyzed serratus anterior

Pectoralis Minor

Shoulder Girdle Muscles

E. Pectoralis minor - The pectoralis minor forms bridge over the brachial plexus and vessels of the arm.
What actions are caused by the pectoralis minor? Protraction Downward rotation

Depression
Exercises to strengthen include: Push-ups Bench press Dips

Shoulder Girdle Muscles

Note: When doing push-ups, the serratus anterior and pectoralis minor work in conjunction to produce true protraction without rotation. They do this because they have opposite rotational actions (neutralize).

Subclavius

Shoulder Girdle Muscles

F. Subclavius What actions are caused by the subclavius?
Depression What other functions does the subclavius provide? Stabilization of the scapula Stabilization of the sternoclavicular joint.

Clavicle Fracture

Caused by landing on the hand from a fall with the arm rigidly outstretched, or a direct downward blow to the acromium process.

Shoulder Separation (Acromioclavicular Sprain)

Caused by downward blow to outer edge of shoulder, or falling with outstretched hand or flexed elbow.

Acromioclavicular Injury
A sprain (partial or complete tearing) of the acromioclavicular and coracoclavicular ligaments may be categorized into one of three groups:
1. First degree (mild) separation some stretching or partial tear of a ligament has occurred. 2. Second degree (moderate) separation severe stretching or complete tear of a ligament has occurred. 3. Third degree (severe) separation complete tearing of the ligaments has occurred.