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Upper Limb Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo
Mori (1964) studied the attachments of latissimus dorsi on 100 sides from 50 cadavers. This author found that the upper limit of the aponeurosis from the vertebral column was the spinous process of the fifth thoracic vertebra on two sides (2%), sixth thoracic vertebra on 16 sides (16%), seventh thoracic vertebra on 44 sides (44%), eighth thoracic vertebra on 30 sides (30%), and ninth thoracic vertebra on eight sides (8%). Mori (1964) studied the costal origins of this muscle on 60 sides and found that latissimus dorsi had origins from ribs 9–12 on 25 sides (41.7%) and ribs 10–12 on 35 sides (58.3%). This author also observed an attachment to the inferior angle of the scapula in 53.3% of cases.
Functional Rehabilitation
Published in James Crossley, Functional Exercise and Rehabilitation, 2021
If an instructor sees a ‘winging scapula’, when the inferior angle of the scapula pulls away from the rib cage during a ‘press-up’, for example, they might prescribe corrective exercise to strengthen the serratus anterior muscle. This exercise would theoretically strengthen the muscle responsible for keeping the scapula adhered to the rib cage, improving scapulo-thoracic rhythm to prevent future shoulder injury. There are several flaws with a biomechanical approach though. There is little clinical evidence to support the noton that: A ‘winging scapular’ is actually ‘abnormal’ or ‘dysfunctional’Altered scapula-thoracic rhythm predisposes injuryClients can isolate individual musclesThat strengthening muscles alters movement behaviorThat gains in strength transfer to functionIn conventional training, instructors encourage everyone to try to maintain ‘correct’ form and technique. Variations are considered as dysfunctions to be corrected. More often than not, instructors fall for the ‘physiological fallacy’ that suggests that asymmetries and altered patterns of movement arise due to tight or weak muscle.
Examination of Pediatric Shoulder
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
A quick method to test all the movements of the shoulder is to perform the Apley’s scratch test, which involves reaching behind the head and touching the superior medial angle of the opposite scapula to assess abduction and external rotation. This is followed by reaching in front of the head and touching the opposite acromion to assess internal rotation and adduction. Touching the inferior angle of the scapula by reaching behind the back also allows the assessment of internal rotation.
Live and video observations of scapular dyskinesis in individuals with nonspecific neck pain: A reliability study
Published in Physiotherapy Theory and Practice, 2023
Nipaporn Wannaprom, Supatcha Konghakote, Rungtawan Chaikla, Sureeporn Uthaikhup
The presence or absence of scapular dyskinesis was identified using two methods: 1) simple classification (yes/no); and 2) specific type of abnormality (winging, dysrhythmia, mixed or normal), consistent with previous studies (Madsen, Bak, Jehinsen, and Welter, 2011; McClure et al., 2009). For the simple classification, “yes” was categorized when the presence of abnormal scapular motion (winging or dysrhythmia) was presented in 3 out of 5 trials and “no” when relatively normal scapular motion was observed. For the specific type of dysfunction, abnormal scapular motion was defined as “winging” when the medial border and/or inferior angle of the scapula was displaced posteriorly away from the posterior thorax, “dysrhythmia” when premature or excessive elevation or protraction, non-smooth or stuttering motion during arm raising or lowering, or rapid downward rotation during arm lowering was observed, and “mixed abnormality” when there was a combination of winging and dysrhythmia (McClure et al., 2009).
The three-dimensional shoulder pain alignment (3D-SPA) mobilization improves pain-free shoulder range, functional reach and sleep following stroke: a pilot randomized control trial
Published in Disability and Rehabilitation, 2020
Liza A. M. Pain, Ross Baker, Qazi Zain Sohail, Debbie Hebert, Karl Zabjek, Denyse Richardson, Anne M. R. Agur
An assistant provided three-dimensional passive and active/assisted ROM exercises for the hemiparetic arm, including sagittal and coronal plane humeral elevation, horizontal abduction/adduction, and axial external rotation (i.e., external rotation of the humerus along its long axis) within a maximum pain-free range. The moment discomfort/pain was experienced during exercise/activity performance, the therapists in each group provided different mobilizations to optimize alignment and minimize pain. In the control group, uni-dimensional scapular lateral rotation was provided by placing one hand over the inferior angle of the scapula and mobilizing it into lateral rotation in synchronized alignment with the humerus [19]. In the 3D-SPA group, three-dimensional clavicular mobilizations (i.e., elevation/depression, protraction/retraction, and anterior/posterior axial rotation) and scapular mobilizations (i.e., scapular medial/lateral rotation, protraction/retraction and anterior/posterior tilt) were provided in synchronized alignment with the position of the humerus (Figure 2).
Scapular muscle balance and spinal stabilizer recruitment during an inverted row
Published in Physiotherapy Theory and Practice, 2020
James W. Youdas, Justin W. Hubble, Peter G. Johnson, Megan M. McCarthy, Michelle M. Saenz, John H. Hollman
During the IR, the UTP/LTP median scapular balance ratio for the four exercise conditions ranged from 1.6 to 2.2 and favored the UTP by a 2:1 ratio. While a participant was suspended from the Work Horse, the very high UTP EMG activity resulted from a traction effect placed on the shoulder girdle by the body mass. By attaching to the lateral end of the clavicle, the UTP functioned like a suspensory ligament to keep the clavicle from becoming depressed around the sternoclavicular and acromioclavicular joints (Neumann, 2017). The high LTP EMG activity resulted from scapular depression (Jenkins, 2009) and posterior tilting of the scapula (Neumann, 2017) relative to a medial-lateral axis traversing the acromioclavicular joint. The LTP and SA muscles also functioned as a force couple to prevent winging of the inferior angle of the scapula (Neumann, 2017) during the concentric phase of the IR.