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Evaluation and Treatment of the Shoulder Complex: Summary
Dysfunctions associated with the anterior fascia include headaches from cervical forward head postures; deviations of scapula that can lead to subacromial impingement; increased humeral IR leading to subacromial
impingement; and median nerve entrapment at the pronator teres, elbow, biceps and tricps brachii, and underneath the pectoralis minor .
Lateral Muscular Anatomy of the Shoulder Complex
Proximal Attachment
Distal Attachment
Muscle
Function
Dysfunction
Superior translation of humerus on scapula, which leads to subacromial impingement
Deltoid (anterior, posterior and middle fibers)
Spine of scapula (posterior fibers), acromion process (middle fibers), and lateral third of clavicle (anterior fibers)
Deltoid tuberosity
Shoulder flexion/ IR (anterior fibers); shoulder abduction (all fibers); shoulder extension/ external rotations (posterior fibers)
Posterior Muscular Anatomy of Shoulder Complex
Proximal Attachment
Distal Attachment Intertubercular groove of humerus
Muscle
Function
Dysfunction
Latissimus dorsi Spinous process T7–T12,
Shoulder extension, adduction, and IR
Limited shoulder flexion
thoracolumbar fascia, inferior angle of scapula, and iliac crest
Pectoralis minor (deep muscle)
Ribs 3–5
Coracoid process of scapula
Anterior tilt of scapula; protraction of scapula
Anterior tilt of scapula and restricted range of motion in all planes at shoulder Anterior tilt of the scapula; humeral IR as a result of shortening of the short head; limited shoulder extension and ER
Biceps brachii (superficial muscle)
Short head– coracoid process; long head– supraglenoid tubercle
Radial tuberosity
Shoulder flexion and IR; elbow
flexion and supination
Coracobrachialis Coracoid process Midshaft of humeral
Shoulder flexion; shoulder IR
Anterior tilt of scapula; protraction of scapula
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