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The scapula also rotates through upward and downward rotation, internal and external rotation, and anterior and posterior tilt. Scapular elevation: 40 degrees. Scapular depression: 10 degrees. Scapular protraction: 20 degrees. Scapular retraction: 15 degrees. Scapula rotation: Upwards rotation : 60 degrees. Downwards rotation : 30 degrees.
- Introduction
- Clinical Relevant Anatomy
- Epidemiology / Etiology
- Characteristics / Clinical Presentation
- Differential Diagnosis
- Diagnostic Procedures
- Outcome Measures
- Examination
- Medical Management
- Physical Therapy Management
Scapulohumeral rhythm (also referred to as glenohumeral rhythm) is the kinematic interaction between the scapula and the humerus, first published by Codman in the 1930s. This interaction is important for the optimal function of the shoulder. When there is a change of the normal position of the scapula in relation to the humerus, this can cause a dy...
Shoulder Movements
The interplay of 4 articulations (Sternoclavicular Joint, Acromioclavicular Joint, Scapulothoracic Joint and Glenohumeral Joint) of the shoulder complex, results in a coordinated movement pattern of the arm elevation. The involved movements at each joint are continuous, although occurring at various rates and at different phases of arm elevation. The movement of the scapula can be described by rotations in relation to the thorax. The scapula moves around a dorso-ventral axis, resulting in a r...
Scapulohumeral Rhythm
It describes timing of movement at glenohumeral and scapulothoracic joint during shoulder elevation. First 30 degrees of shoulder elevation involves a "setting phase": 1. The movement is largely glenohumeral. 2. Scapulothoracic movement is small and inconsistent. And after the first 30 degrees of shoulder elevation: 1. The glenohumeral and scapulothoracic joints move simultaneously. 2. Overall 2:1 ratio of glenohumeral to scapulothoracic movement. Scapulohumeral rhythm can be observed by palp...
Scapulohumeral Ratio
Scapulohumeral rhythm or ratio is significantly greater (less scapular motion and more humeral motion) in the sagittal plane than other planes. Consistent with the findings, the dominant side demonstrated significantly higher values for SH rhythm than the non-dominant side but only in the coronal and scapular planes but not in the sagittal plane. By healthy male is a significant difference by hand dominance only in scapular upward rotation during scapular plane arm elevation. The scapulohumer...
It has been reported that scapular dyskinesis occurs in 68 - 100% of patients with shoulder injuries (including glenohumeral instability, rotator cuff abnormalities, and labral tears. Other studies showed that scapular upward rotation is significantly increased in patients with full-thickness rotator cuff tears compared with controls in both sagitt...
Scapulohumeral rhythm is a common metric for assessing muscle function and shoulder joint motion. There is a three-dimensional scapular kinematic pattern during normal arm elevation that include upward rotation, posterior tilting and varying internal/external rotation dependent on the plane and angle of elevation. When there is change of the normal...
There isn’t really a differential diagnosis for scapulohumeral rhythm disorders. But there are multiple causes for scapular dyskinesia and scapulohumeral rhythm disorders. Causative factors can be grouped into: 1. Bony causes include thoracic kyphosis or clavicula fracture. 1. Joint causes include high grade AC instability, AC arthrosis and instabi...
Inman, Saunders and Abbott were the first to measure scapulohumeral rhythm using radiography and suggested what became the widely accepted 2:1 ratio between glenohumeral elevation and scapulothoracic (ST) upward rotation (SUR). Since then imaging modalities (X-ray and magnetic resonance imaging), cinematography , goniometry , and more recently 3-di...
The Simple Shoulder Test (SST) is an internationally used patient-reported outcome for clinical practice and research purposes. It was developed for measuring functional limitations of the affected shoulder in patients with shoulder dysfunction and contains 12 questions (yes/no). It is a reliable and valid instrument for evaluating functional limit...
Observation and examination of the scapulohumeral rhythm is commonly performed by physical therapists during postural and shoulder examinations. The notion of a proper "rhythm" is routinely used to describe the quality of movement at the shoulder complex. Clinical measures (inclinometer, tape measure) are only capable of measuring scapular kinemati...
Optimal rehabilitation of scapulohumeral rhythm disorders requires addressing all the causative factors that can create the dyskinesis and then restoring the balance of muscle forces that allow scapular position and motion.
It is essential to make a diagnosis about the cause of the scapulohumeral rhythm dysfunction before starting physical therapy. For example ‘Winged scapula’ of the scapula may be caused by a paresis of the muscle Serratus Anterior or by a dysfunction of the muscle Trapezius. Both passive and active movement disturbances can cause a scapulohumeral rh...
People also ask
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Flexibility exercises: To increase the flexibility of the pectoralis minor and the external rotation and posterior tilt of the scapula, shoulder horizontal abduction at 90 degrees and 150 degrees of elevation.
Apr 21, 2019 · Humerothoracic elevation (in degrees) during various scapular movements of arm elevation. A, Scapular upward rotation. B, Scapular posterior tilting. C, Scapular external rotation. D, Clavicle retraction. E, Clavicle elevation.
Jul 15, 2020 · Wire frames represent different segments of the upper limb including the scapula. Orange: thorax, red: left side, green: right side. (C) This image shows raw data (degrees) for global arm elevation (black), glenohumeral elevation (red), and scapular rotation (green). The rows have different lengths because each participant may have a different ...
- Vilijam Zdravkovic, Vilijam Zdravkovic, Nathalie Alexander, Nathalie Alexander, Regina Wegener, Regi...
- 10.1097/CORR.0000000000001406
- 2020
- 2020/11
As we progress beyond 90-120 degrees of flexion, the scapula will eventually externally rotate and posteriorly tilt to help flex the humerus towards end-range. What is also necessary here is appropriate coupling between the thoracic spine/rib cage & scapula to encourage this scapular external rotation.
From 0 -30 degrees: ± Setting of scapula ± Primarily glenohumeral movement From 30 -150 degrees: ± Scapulohumeral rhythm (2:1 GH:scapula) ± External rotation and depression of humeral head to clear acromial arch Beyond 150 degrees: ± Thoracic extension to complete elevation _____
