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The rotator cuff is a group of muscles and their tendons that act to stabilize the human shoulder and allow for its extensive range of motion. Of the seven scapulohumeral muscles, four make up the rotator cuff. The four muscles are:
Shoulder problems including pain, are one of the more common reasons for physician visits for musculoskeletal symptoms. The shoulder is the most movable joint in the body. However, it is an unstable joint because of the range of motion allowed. This instability increases the likelihood of joint injury, often leading to a degenerative process in which tissues break down and no longer function well.
The human shoulder is made up of three bones: the clavicle (collarbone), the scapula, and the humerus as well as associated muscles, ligaments and tendons.
The deltoid muscle is the muscle forming the rounded contour of the human shoulder. It is also known as the 'common shoulder muscle', particularly in other animals such as the domestic cat. Anatomically, the deltoid muscle appears to be made up of three distinct sets of muscle fibers, namely the
- anterior or clavicular part
- posterior or scapular part
- intermediate or acromial part
The rhomboid major is a skeletal muscle of the back that connects the scapula with the vertebrae of the spinal column. It originates from the spinous processes of the thoracic vertebrae T2-T5 and supraspinous ligament; it inserts onto the lower portion of the medial border of the scapula. It acts together with the rhomboid minor to keep the scapula pressed against thoracic wall and to retract the scapula toward the vertebral column.
The pectoralis major is a thick, fan-shaped or triangular convergent muscle of the human chest. It makes up the bulk of the chest muscles and lies under the breast. Beneath the pectoralis major is the pectoralis minor muscle.
Rotator cuff tendinopathy is a process of senescence. The pathophysiology is mucoid degeneration. Most people develop rotator cuff tendinopathy within their lifetime.
Adhesive capsulitis, also known as frozen shoulder, is a condition associated with shoulder pain and stiffness. It is a common shoulder ailment that is marked by pain and a loss of range of motion, particularly in external rotation. There is a loss of the ability to move the shoulder, both voluntarily and by others, in multiple directions. The shoulder itself, however, does not generally hurt significantly when touched. Muscle loss around the shoulder may also occur. Onset is gradual over weeks to months. Complications can include fracture of the humerus or biceps tendon rupture.
The serratus anterior is a muscle of the chest. It originates at the side of the chest from the upper 8 or 9 ribs; it inserts along the entire length of the anterior aspect of the medial border of the scapula. It is innervated by the long thoracic nerve from the brachial plexus. The serratus anterior acts to pull the scapula forward around the thorax.
The supraspinatus is a relatively small muscle of the upper back that runs from the supraspinous fossa superior portion of the scapula to the greater tubercle of the humerus. It is one of the four rotator cuff muscles and also abducts the arm at the shoulder. The spine of the scapula separates the supraspinatus muscle from the infraspinatus muscle, which originates below the spine.
The shoulder joint is structurally classified as a synovial ball-and-socket joint and functionally as a diarthrosis and multiaxial joint. It involves an articulation between the glenoid fossa of the scapula and the head of the humerus. Due to the very loose joint capsule that gives a limited interface of the humerus and scapula, it is the most mobile joint of the human body.
The shoulder girdle or pectoral girdle is the set of bones in the appendicular skeleton which connects to the arm on each side. In humans it consists of the clavicle and scapula; in those species with three bones in the shoulder, it consists of the clavicle, scapula, and coracoid. Some mammalian species have only the scapula.
A SLAP tear or SLAP lesion is an injury to the superior glenoid labrum that initiates in the back of the labrum and stretches toward the front into the attachment point of the long head of the biceps tendon. SLAP is an acronym for "Superior Labrum Anterior and Posterior". SLAP lesions are commonly seen in overhead throwing athletes but middle-aged labor workers can also be affected, and they can be caused by chronic overuse or an acute stretch injury of the shoulder.
Subacromial bursitis is a condition caused by inflammation of the bursa that separates the superior surface of the supraspinatus tendon from the overlying coraco-acromial ligament, acromion, and coracoid and from the deep surface of the deltoid muscle. The subacromial bursa helps the motion of the supraspinatus tendon of the rotator cuff in activities such as overhead work.
A winged scapula is a skeletal medical condition in which the shoulder blade protrudes from a person's back in an abnormal position.
Shoulder surgery is a means of treating injured shoulders. Many surgeries have been developed to repair the muscles, connective tissue, or damaged joints that can arise from traumatic or overuse injuries to the shoulder.
Shoulder replacement is a surgical procedure in which all or part of the glenohumeral joint is replaced by a prosthetic implant. Such joint replacement surgery generally is conducted to relieve arthritis pain or fix severe physical joint damage.
Shoulder impingement syndrome is a syndrome involving tendonitis of the rotator cuff muscles as they pass through the subacromial space, the passage beneath the acromion. It is particularly associated with tendonitis of the supraspinatus muscle. This can result in pain, weakness, and loss of movement at the shoulder.
A proximal humerus fracture is a break of the upper part of the bone of the arm (humerus). Symptoms include pain, swelling, and a decreased ability to move the shoulder. Complications may include axillary nerve or axillary artery injury.
Rounded shoulder posture (RSP), also known as “mom posture”, is a common postural problem in which the resting position of the shoulders leans forward from the body’s ideal alignment. Patients usually feel slouched and hunched, with the situation deteriorating if left untreated. A 2022 study concluded that 73% of workers aged 20 to 50 years have a right rounded shoulder, and 66% of them have a left rounded shoulder. It is commonly believed that digitalisation combined with the improper use of digital devices have resulted in the prevalence of sedentary lifestyles, which contribute to bad posture. Symptoms of RSP will lead to upper back stiffness, neck stiffness and shoulder stiffness. It can be diagnosed by several tests, including physical tests and imaging tests. To prevent RSP from worsening, maintaining a proper posture, doing regular exercise, and undergoing therapeutic treatments could be effective. If the situation worsens, patients should seek help from medical practitioners for treatments. If RSP is left untreated, chronic pain, reduction in lung capacity and worsened psychosocial health are likely to be resulted.
References
- ↑ Decker, Michael J.; Hintermeister, Robert A.; Faber, Kenneth J.; Hawkins, Richard J. (1999). "Serratus Anterior Muscle Activity During Selected Rehabilitation Exercises". The American Journal of Sports Medicine. 27 (6): 784–791. doi:10.1177/03635465990270061601. PMID 10569366. S2CID 18789366.
- ↑ Castelein, Birgit; Cagnie, Barbara; Parlevliet, Thierry; Cools, Ann (2016). "Serratus anterior or pectoralis minor: Which muscle has the upper hand during protraction exercises?". Manual Therapy. 22: 158–164. doi:10.1016/j.math.2015.12.002. ISSN 1356-689X. PMID 26749459.
- ↑ McKenna, Leanda J; Bonnett, Luke; Panzich, Kelly; Lim, Jacinta; Hansen, Snorre K; Graves, Anna; Jacques, Angela; Williams, Sian A (2021). "The Addition of Real-time Ultrasound Visual Feedback to Manual Facilitation Increases Serratus Anterior Activation in Adults With Painful Shoulders: A Randomized Crossover Trial". Physical Therapy. 101 (3). doi: 10.1093/ptj/pzaa208 . PMID 33336703.
- ↑ Liebenson, Craig (2012). "The Serratus Punch". Journal of Bodywork and Movement Therapies. 16 (2): 268–269. doi:10.1016/j.jbmt.2012.01.017. PMID 22464128.
- ↑ Kuhn, John E.; Blalock, Richard (2018). "Nonoperative Treatment of Rotator Cuff Tears". Rotator Cuff Injuries: A Clinical Casebook. Springer International Publishing. p. 348. ISBN 978-3-319-63668-9.