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Related Concept Videos

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Nine muscles are involved in arm movements. Two of these, the pectoralis major and latissimus dorsi, originate from the axial skeleton and are called axial muscles. The other seven originate from the scapula and are called the scapular muscles.
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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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Related Experiment Video

Updated: Mar 8, 2026

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Does the Critical Shoulder Angle Correlate With Rotator Cuff Tear Progression?

Peter N Chalmers1, Dane Salazar2, Karen Steger-May3

  • 1Department of Orthopaedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA. p.n.chalmers@gmail.com.

Clinical Orthopaedics and Related Research
|January 26, 2017
PubMed
Summary

The critical shoulder angle (CSA) is not reliably measurable and shows minimal association with rotator cuff disease progression or size. This study suggests CSA is unlikely to be a cause of rotator cuff tears.

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Area of Science:

  • Orthopedics
  • Radiology
  • Shoulder Biomechanics

Background:

  • The critical shoulder angle (CSA) is theorized to contribute to rotator cuff disease.
  • Previous studies are retrospective, limiting causal inference.
  • The relationship between CSA and rotator cuff tears remains unclear.

Purpose of the Study:

  • Assess the reliability of CSA measurement.
  • Determine if CSA is associated with rotator cuff disease.
  • Correlate CSA with rotator cuff tear size and progression.
  • Evaluate changes in CSA over time.

Main Methods:

  • Longitudinal study of patients with asymptomatic rotator cuff tears and control subjects.
  • Ultrasonography and AP radiographs collected over a median of 4 years.
  • Blinded CSA measurements by two observers, adhering to reliability criteria.

Main Results:

  • Only 21% of radiographs were suitable for CSA measurement.
  • CSA was slightly higher in patients with cuff tears (34° ± 4°) vs. controls (32° ± 4°), a small, potentially clinically insignificant difference.
  • CSA did not correlate with tear size, enlargement, or change over time.

Conclusions:

  • Most radiographs lack sufficient quality for reliable CSA measurement.
  • The observed association between CSA and rotator cuff disease is minimal and likely clinically unimportant.
  • CSA is not a predictor of tear progression and does not change over time, suggesting it's not a primary factor in rotator cuff disease etiology.