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Evaluation and Treatment of the Shoulder Complex: Summary
Shoulder Complex Ligaments (continued) Ligament
Motion Limited
Origin and Insertion
Middle
Excessive external rotation
Glenoid by way of the labrum to the anterior aspect of the anatomic neck of the humerus, just medial to the lesser tuberosity
Inferior
Excessive abduction, excessive external rotation, excessive internal rotation
Glenoid labrum and into the humeral neck
The joint capsule is attached to the glenoid labrum. The labrum provides passive stabilization of the humeral head in multiple directions. The glenoid labrum develops out of the connective tissue in a developing fetus. Unidirectional restrictions in the joint capsule can be anterior, posterior, or inferior. Multiple plane restrictions are associated with capsular dysfunction, which is also known as adhesive capsulitis.
The glenoid labrum form developmentally around the humeral head as an extension of the glenoid fossa. This enables stability at the shoulder and end-range of motion without excessive movement beyond normal range. Labral tears create multidirection instability of the humeral head on the glenoid fossa. The anterior muscular anatomy of the shoulder complex includes the pectoralis major, pectoralis minor, biceps brachii, and coracobrachialis.
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