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Shoulder Anatomy

The bones of the shoulder

Shoulder anatomy is made up primarily of bones, muscles, ligaments, nerves and blood vessels. The arm bone (humerus), the shoulder blade (scapular), the collar bone (clavicle), and the rib cage (bony thorax).

Note particularly the ACROMION (part of the shoulder blade) and the ACROMIOCLAVICULAR joint (AC joint).








ROTATOR CUFF MUSCLES



Supraspinatus muscle

This important muscle lies just below the neck, and just above the so-called "spine of the shoulder blade". You may find yourself rubbing it frequently as it may feel as though the pain is in the upper back. It travels through a tunnel in the shoulder and inserts into the upper arm. It is the primary lifter of the arm at 45 degrees with the thumb pointing down.







Infraspinatus

This large muscle is found "infra" or below the spine of the shoulder blade, and also inserts into the shoulder. It rotates the arm outwards.

Next time you carve the Sunday roast lamb shoulder, look out for the spine of the shoulder blade, with the Supraspinatus above it, and the large flat muscle, the Infraspinatus below it.

Sorry, anatomy is rather macabre. Chiropractors spend the best part of a year in the anatomy lab, so we become accustomed to such things ...





Biceps muscle






Subscapularis muscle

This large flat muscle lies on the underside of the shoulder blade, between the scapula and the ribs. Opposite side to the Infraspinatus. It attaches to the arm at the Lesser Tuberosity (LT in the scan below). Have a good look for it too when carving the Sunday roast! The Subscapularis rotates the arm inwards.

In the author's experience the SUBSCAPULARIS MUSCLE (SSC in the scan below) is a much neglected muscle in shoulder anatomy conditions. It is best approached in the armpit with the arm flexed above the head. If it is involved, it may be exquisitely painful on palpation.

For interesting cases of shoulder pain (and other) at the Chiropractic Coalface, click here. Chiropractic Coalface.



After serious soft tissue injury, a Doppler ultrasound scan often yields information that cannot be obtained from the clinical examination alone. It does however require specialised interpretation, and is best left to the specialist. This scan of the subscapular tendon (SSC) shows scar tissue (arrows) in the deltoid muscle (D). However that scar tissue can produce a confusing shadow (arrowheads) that mimics a tear.

See www.radiographics.rsna.org

Regular stretching in the healing phase is what prevents the ugly scar tissue in muscles that can turn a relatively minor shoulder injury into a frozen shoulder. Read more about FROZEN SHOULDER …

Teres Minor muscle



Strains and tears can occur in all muscles in the body.

Usually these occur from:

* Injury eg a fall

* Disturbed nerve innervation of the muscle eg a irritated nerve in the neck

* Overuse eg. repetitive action

* Improper warmup in sport eg Tennis players who do inadequate prematch preparation.

ANATOMY LAB

Yes, indeed, grotesque, but an important place where your chiropractor spent many long hours studying shoulder anatomy, preparing him or herself for a lifetime of helping you recover from your injury.




Return from SHOULDER ANATOMY to the ROTATOR CUFF SYNDROME

Shoulder conditions are often associated with NECK PAIN …





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