Specialists

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Dynamic Stability Factors

Glenohumeral stability is mainly achieved through dynamic factors. Active contraction of the rotator cuff contributes to joint stabilization by coordinated muscular activity and by secondary tightening of the ligamentous constraints. This effect works in combination with the concavity-compression mechanism, in which muscle contraction causes compression of nearly congruent articular surfaces into one another.

The rotator […]

Nonoperative Treatment

A trial of nonoperative care is implemented before surgical intervention is considered. The majority of patients with impingement syndrome can be managed conservatively. The treatment program consists of formal physical therapy, activity modification, anti-inflammatory, and the judicious use of steroid injections into the subacromial space.

By emphasizing the importance of following the rehabilitation protocol and […]

Scapula

The scapula is a flat, triangular-shaped bone that serves as the articulating surface for the head of the humerus as well as provides areas for 17 muscle attachments. With the arm at the side, the scapula overlaps the dorsal surfaces of the second to seventh ribs. It has three prominent projections: the spine, the coracoid […]

Evaluation-Physical Examination

The physical examination of athletes with axillary nerve injury should include evaluation for range of motion (passive and active) as well as strength (abduction, forward elevation, external rotation, and internal rotation). Patients with a chronic history of the problem may demonstrate atrophy or asymmetry of the deltoid muscle mass.

A neurovascular examination should be performed […]

Anatomy

The main function of the axillary nerve is to provide the motor supply to the deltoid. The axillary nerve originates from the spinal cord at the C5 and C6 levels, with occasional contribution from the C4 level. The nerve travels below the coracoid process, then obliquely along the anterior surface of the subscapularis.

Approximately 3 […]

Palpation of the subscapularis tendon

The subscapularis muscle belly can only be reached by bringing the hand in between the scapula and the thorax. It cannot really be palpated. The tendinous insertion on the lesser tuberosity, however, can easily be palpated. The subject is in a half lying position on a couch, the upper arm along the body and the […]

Palpation of soft tissue

Palpation of the deltoid muscle The deltoid muscle is easy to recognize. It forms the most important muscular mass of the shoulder and is responsible for its round look.The anterior portion overlies the anterior border of the acromion and the lesser tuberosity. The middle portion lies over the lateral border of the acramion and the […]

Tear and Inflammation of the Deltoid Muscle

Tears of the deltoid muscle, though infrequent, do occur in team handball and volleyball players, American footballers, weightlifters, wrestlers, and other athletes. The muscle is damaged in most cases by direct impact, but it can also be injured by overuse. The tear affects only a small part of the muscle, making it difficult to raise […]

Injuries to the Axillary Nerve

The axillary nerve supplies the deltoid and teres minor muscles and runs close to the shoulder joint. Damage to this nerve usually occurs as a complication of dislocation or fracture of the upper part of the humerus. The symptoms include radiating pain and impaired sensation over the lateral aspect of the upper arm, along […]

Subacromial Bursitis

One large bursa in the shoulder is located between the supraspinatus muscle and the deltoid muscle and acromion process of the scapula. In its inflamed state the bursa is about the size of a golf ball. Inflammation of the bursa (subacromial bursitis) commonly occurs.

Causes

– A fall or blow to the shoulder or a […]