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Muscles of the Shoulder

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The muscles surrounding the shoulder girdle, including the clavicle and scapula, primarily stabilize the scapula. This stable base allows other muscles to move the humerus effectively. Scapular movements often mirror those of the humerus and extend its range of motion. For instance, raising the arm above the head would not be feasible without simultaneous upward rotation of the scapula.
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The pectoralis major has two origins. Its clavicular head originates on the medial half of the clavicle. In contrast, the sternocostal head originates on the costal cartilages of ribs 1-6, the sternum, and the aponeurosis of the external oblique of the...

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Posterior Shoulder Instability in Overhead Athletes.

Edward S Chang¹, Nicholas J Greco², Michael P McClincy²

¹Department of Orthopaedic Surgery, Sports Medicine Institute at Inova Medical Group, Inova Health System, 8501 Arlington Boulevard, Suite 200, Fairfax, VA 22031, USA.

The Orthopedic Clinics of North America

|November 29, 2015

Summary

Diagnosing posterior shoulder instability in overhead athletes is challenging due to inherent laxity. Differentiating adaptive laxity from pathology and preserving range of motion during surgery are key difficulties.

Keywords:

Arthroscopic posterior capsulolabral reconstruction Overhead athletes Posterior shoulder instability Surgical technique Throwers Zone-specific repair

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Area of Science:

Orthopedic Surgery
Sports Medicine
Biomechanics

Background:

Overhead athletes often exhibit capsular laxity and humeral retroversion for enhanced range of motion.
This physiological adaptation complicates the diagnosis of posterior shoulder instability.
Distinguishing between adaptive laxity and true pathology is critical for accurate diagnosis.

Purpose of the Study:

To highlight the diagnostic challenges of posterior shoulder instability in overhead athletes.
To emphasize the need to differentiate adaptive capsular laxity from pathologic instability.
To discuss the surgical goal of achieving stability while maintaining range of motion.

Main Methods:

Clinical examination techniques for assessing posterior shoulder laxity.
Diagnostic imaging modalities for evaluating posterior capsulolabral pathology.
Surgical considerations for managing posterior shoulder instability in athletes.

Main Results:

Posterior shoulder instability presents unique diagnostic hurdles in overhead athletes.
Capsular laxity and humeral retroversion are common adaptations that mimic instability.
Intraoperative management requires balancing stability with functional range of motion.

Conclusions:

Accurate diagnosis of posterior shoulder instability requires careful differentiation from adaptive laxity.
Surgical interventions must carefully consider the athlete's need for extensive range of motion.
Further research into optimal management strategies for this population is warranted.