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Evaluation and Treatment of Rotator Cuff Impairments: Summary
SCAPULAR MOVEMENTS The scapula is capable of six main types of motion, which are essential for maintaining proper shoulder function and the wide range of motion that the joint offers. These movements fall into two main categories: translational and Translational movements occur when the entire scapula moves along the rib cage without changing its orientation. These movements are vital for daily tasks and sports where the shoulder needs to remain stable and mobile. Examples of translational movements include: • Elevation : This motion lifts the scapula upward, like when you shrug your shoulders. The entire scapula moves upward without tilting or rotating. Muscles like the upper trapezius and levator scapulae are rotational movements. Translational Motions responsible for this action, which allows for arm elevation and plays a big role in carrying objects • Depression : Depression is the opposite of elevation, moving the scapula downward. This occurs when you push yourself up from a seated position or when using crutches. Depression keeps the shoulders stable during downward movements and weight- bearing tasks and involves muscles like the pectoralis minor • Protraction (scapular abduction): In protraction, the scapula moves forward along the rib cage, away from the spine. This happens in movements like pushing or during a plank position. The serratus anterior plays a major role in controlling this forward motion • Retraction (scapular adduction): Retraction is the reverse of protraction, with the scapula moving backward toward the spine. This is seen in pulling actions, like rowing exercises, where muscles like the rhomboids and middle trapezius help bring the scapulae together
INTRODUCTION
Rotator cuff injuries are a frequent cause of shoulder pain and disability, particularly in people over age 40. However, younger individuals who engage in repetitive overhead activities, such as sports or manual labor, are also prone to developing them. These injuries often stem from the mechanics of the shoulder girdle, which is made up of the clavicle and scapula. The interaction between these bones allows for a wide range of arm movements, but it also presents vulnerabilities that can lead to The shoulder is often referred to as a ball- and-socket joint, but it’s unique because of the significant size difference between the humeral head and the glenoid fossa. LEARNING TIP! dysfunction if disrupted. The Shoulder Complex
The humeral head is much larger than the shallow, concave cavity or socket of the glenoid fossa, which allows for greater mobility but also reduces the stability of the joint.
This structural imbalance leaves the shoulder reliant on the muscles, tendons, and ligaments around it to maintain alignment and function. In terms of shoulder mechanics, two key structures—the acromion and coracoid processes—play protective roles. These bony extensions of the scapula form an arch that shields important structures, such as muscles, tendons, nerves, and blood vessels. The acromion process is the highest point of the scapula and acts like a protective canopy, especially for the deltoid muscle. Just below it, the coracoid process projects forward from the scapula, providing additional stability for the shoulder and anchoring muscles involved in arm movement.
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