Scapulohumeral Rhythm: Difference between revisions

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==  Introduction  ==
==  Introduction  ==
<div>Optimal function of the shoulder is reliant on the coordinated movement of the scapula and the humerus. <ref name="1">Kibler WB. The role of the scapula in athletic shoulder function. Am J Sports Med 1998;26:325-337</ref>&nbsp;Various studies of the mechanism of the shoulder joint have attempted to describe the global motion capacity of the shoulder and explain the complex interactions between components involved in placing the hand in space.<ref>Cathcart CW: Movements of the shouLder girdle involved in those of the arm on the trunk. J Anat Physiol 1884; 18:209-218</ref>&nbsp;<ref>Cleland J: A lecture on the shoulder girdle and its  movements. Lancet 1881;1:11-12.</ref>&nbsp;Specifically, the kinematic interaction between the scapula and the humerus was introduced in the 1930s and termed "scapula-humeral rhythm” by Codman.<ref>Codman EA: The Shoulder,Boston: G.Miller &amp;amp;amp; Company,1934</ref><br></div><div></div><div>
<div>Optimal function of the shoulder is reliant on the coordinated movement of the scapula and the humerus. <ref name="1">Kibler WB. The role of the scapula in athletic shoulder function. Am J Sports Med 1998;26:325-337</ref>&nbsp;Various studies of the mechanism of the shoulder joint have attempted to describe the global motion capacity of the shoulder and explain the complex interactions between components involved in placing the hand in space.<ref>Cathcart CW: Movements of the shouLder girdle involved in those of the arm on the trunk. J Anat Physiol 1884; 18:209-218</ref>&nbsp;<ref>Cleland J: A lecture on the shoulder girdle and its  movements. Lancet 1881;1:11-12.</ref>&nbsp;Specifically, the kinematic interaction between the scapula and the humerus was introduced in the 1930s and termed "scapula-humeral rhythm” by Codman.<ref>Codman EA: The Shoulder,Boston: G.Miller &amp;amp;amp;amp; Company,1934</ref><br></div><div></div><div>
<br> 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 upward rotation (SUR).<ref>Inman VT, Saunders JB, Abbott LC. Observations of the function of the shoulder joint. 1944. Clin Orthop Relat Res 1996; 330: 3-12</ref> Since then imaging modalities (X-ray and magnetic resonance imaging)<ref>Poppen NK, Walker PS. Normal and abnormal motion of the shoulder. J Bone Joint Surg Am 1976;58: 195-201</ref>, cinematography <ref>Bagg SD, Forrest WJ. A biomechanical analysis of scapular rotation during arm abduction in the scapular plane. Am J  Phys Med Rehabil 1988; 67: 238-245</ref>, goniometry <ref>Doody SG, Freedman L, Waterland JC. Shoulder movements during abduction in the scapular plane. Arch Phys Med Rehabil 1970; 51: 595-604</ref>&nbsp;<ref>Doody SG, Waterland JC, Freedman L. Scapulo-humeral goniometer. Arch Phys Med Rehabil 1970; 51:711-713</ref>&nbsp;<ref>Johnson MP, McClure PW, Karduna AR. New method to assess scapular upward rotation in subjects with shoulder pathology. J Orthop Sports Phys Ther 2001;31: 81-89</ref>, and more recently 3-dimensional tracking systems <ref>An KN, Browne AO, Korinek S, Tanaka S, Morrey BF. Three-dimensional kinematics of glenohumeral elevation. J Orthop Res 1991; 9: 143-149</ref>&nbsp;<ref>Johnson G, Stuart P, Mitchell S. A method for the measure-ment of three-dimensional scapular movement. Clin Biomech 1993; 8: 269-273</ref><ref>Meskers CG, Fraterman H, van der Helm FC, Vermeulen HM, Rozing PM. Calibration of the “Flock of Birds” elec-tromagnetic tracking device and its application in shoulder motion studies. J Biomech 1999; 32: 629-633</ref>have been used to gain a better appreciation of shoulder kinematics.


== Description ==


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 upward rotation (SUR).<ref>Inman VT, Saunders JB, Abbott LC. Observations of the function of the shoulder joint. 1944. Clin Orthop Relat Res 1996; 330: 3-12</ref> Since then imaging modalities (X-ray and magnetic resonance imaging)<ref>Poppen NK, Walker PS. Normal and abnormal motion of the shoulder. J Bone Joint Surg Am 1976;58: 195-201</ref>, cinematography <ref>Bagg SD, Forrest WJ. A biomechanical analysis of scapular rotation during arm abduction in the scapular plane. Am J Phys Med Rehabil 1988; 67: 238-245</ref>, goniometry <ref>Doody SG, Freedman L, Waterland JC. Shoulder movements during abduction in the scapular plane. Arch Phys Med Rehabil 1970; 51: 595-604</ref>&nbsp;<ref>Doody SG, Waterland JC, Freedman L. Scapulo-humeral goniometer. Arch Phys Med Rehabil 1970; 51:711-713</ref>&nbsp;<ref>Johnson MP, McClure PW, Karduna AR. New method to assess scapular upward rotation in subjects with shoulder pathology. J Orthop Sports Phys Ther 2001;31: 81-89</ref>, and more recently 3-dimensional tracking systems <ref>An KN, Browne AO, Korinek S, Tanaka S, Morrey BF. Three-dimensional kinematics of glenohumeral elevation. J Orthop Res 1991; 9: 143-149</ref>&nbsp;<ref>Johnson G, Stuart P, Mitchell S. A method for the measure-ment of three-dimensional scapular movement. Clin Biomech 1993; 8: 269-273</ref><ref>Meskers CG, Fraterman H, van der Helm FC, Vermeulen HM, Rozing PM. Calibration of the “Flock of Birds” elec-tromagnetic tracking device and its application in shoulder motion studies. J Biomech 1999; 32: 629-633</ref>&nbsp;have been used to gain a better appreciation of shoulder kinematics.
The scapula on the thorax contributes to elevation (flexion and abduction) of the humerus by upwardly rotating the glenoid fossa 50° to 60° from its resting position.<ref>McClure P: Direct 3-dimensional measurement of scapular kinematics during dynamic movements in vivo.J Shoulder Elbow Surg 2001;10:269–277.</ref>&nbsp;If the humerus were fixed to the fossa, this alone would result in up to 60° of elevation of the humerus. The humerus, of course, is not fixed but can move independently on the glenoid fossa. The GH joint contributes 100° to 120° of flexion and 90° to 120° of abduction. The combination of scapular and humeral movement results in a maximum range of elevation of 150° to 180°.
 
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Revision as of 19:21, 4 December 2013

 Introduction[edit | edit source]

Optimal function of the shoulder is reliant on the coordinated movement of the scapula and the humerus. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Various studies of the mechanism of the shoulder joint have attempted to describe the global motion capacity of the shoulder and explain the complex interactions between components involved in placing the hand in space.[1] [2] Specifically, the kinematic interaction between the scapula and the humerus was introduced in the 1930s and termed "scapula-humeral rhythm” by Codman.[3]


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 upward rotation (SUR).[4] Since then imaging modalities (X-ray and magnetic resonance imaging)[5], cinematography [6], goniometry [7] [8] [9], and more recently 3-dimensional tracking systems [10] [11][12]have been used to gain a better appreciation of shoulder kinematics.

Description[edit | edit source]

The scapula on the thorax contributes to elevation (flexion and abduction) of the humerus by upwardly rotating the glenoid fossa 50° to 60° from its resting position.[13] If the humerus were fixed to the fossa, this alone would result in up to 60° of elevation of the humerus. The humerus, of course, is not fixed but can move independently on the glenoid fossa. The GH joint contributes 100° to 120° of flexion and 90° to 120° of abduction. The combination of scapular and humeral movement results in a maximum range of elevation of 150° to 180°.

  1. ↑ Cathcart CW: Movements of the shouLder girdle involved in those of the arm on the trunk. J Anat Physiol 1884; 18:209-218
  2. ↑ Cleland J: A lecture on the shoulder girdle and its movements. Lancet 1881;1:11-12.
  3. ↑ Codman EA: The Shoulder,Boston: G.Miller &amp;amp;amp; Company,1934
  4. ↑ Inman VT, Saunders JB, Abbott LC. Observations of the function of the shoulder joint. 1944. Clin Orthop Relat Res 1996; 330: 3-12
  5. ↑ Poppen NK, Walker PS. Normal and abnormal motion of the shoulder. J Bone Joint Surg Am 1976;58: 195-201
  6. ↑ Bagg SD, Forrest WJ. A biomechanical analysis of scapular rotation during arm abduction in the scapular plane. Am J Phys Med Rehabil 1988; 67: 238-245
  7. ↑ Doody SG, Freedman L, Waterland JC. Shoulder movements during abduction in the scapular plane. Arch Phys Med Rehabil 1970; 51: 595-604
  8. ↑ Doody SG, Waterland JC, Freedman L. Scapulo-humeral goniometer. Arch Phys Med Rehabil 1970; 51:711-713
  9. ↑ Johnson MP, McClure PW, Karduna AR. New method to assess scapular upward rotation in subjects with shoulder pathology. J Orthop Sports Phys Ther 2001;31: 81-89
  10. ↑ An KN, Browne AO, Korinek S, Tanaka S, Morrey BF. Three-dimensional kinematics of glenohumeral elevation. J Orthop Res 1991; 9: 143-149
  11. ↑ Johnson G, Stuart P, Mitchell S. A method for the measure-ment of three-dimensional scapular movement. Clin Biomech 1993; 8: 269-273
  12. ↑ Meskers CG, Fraterman H, van der Helm FC, Vermeulen HM, Rozing PM. Calibration of the “Flock of Birds” elec-tromagnetic tracking device and its application in shoulder motion studies. J Biomech 1999; 32: 629-633
  13. ↑ McClure P: Direct 3-dimensional measurement of scapular kinematics during dynamic movements in vivo.J Shoulder Elbow Surg 2001;10:269–277.
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