Shoulder and Upper Arm

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242 Part Three Injuries and Conditions of the Upper Body, Thorax, Abdomen, and Spine Shoulder and Upper Arm Glenohumeral joint Humeral head Greater tubercle Bicipital groove Lesser tubercle Humerus

8 1 Anterior view of the bones and joints of the shoulder. Humerus Clavicle Deltoid Fig. 8 3 Deep muscles of the posterior shoulder and upper arm.

Coracoacromial ligament Acromion Tendon of supraspinatus muscle Coracohumeral ligaments Transverse humeral ligament Tendon of subscapularis muscle Tendon of biceps brachii muscle Acromioclavicular

glenohumeral (GH) joint sprain (Fig. 8 4).

4 242 Part Three Injuries and Conditions of the Upper Body, Thorax, Abdomen, and Spine Shoulder and Upper Arm Glenohumeral joint Humeral head Greater tubercle Bicipital groove Lesser tubercle Humerus Acromioclavicular joint Scapula Sternoclavicular joint Clavicle Supraspinatus Spine of scapula Infraspinatus Teres minor Teres major Lateral head Long head Medial head Triceps brachii Fig. 8 1 Anterior view of the bones and joints of the shoulder. Humerus Clavicle Deltoid Fig. 8 3 Deep muscles of the posterior shoulder and upper arm. Biceps brachii Pectoralis major Coracobrachialis Medial head of triceps brachii Brachialis Fig. 8 2 Superficial muscles of the anterior shoulder and upper arm. Coracoacromial ligament Acromion Tendon of supraspinatus muscle Coracohumeral ligaments Transverse humeral ligament Tendon of subscapularis muscle Tendon of biceps brachii muscle Acromioclavicular ligament Coracoid process Glenohumeral ligaments Humerus Coracoclavicular ligaments Clavicle Articular capsule Scapula Fig. 8 4 Anterior view of the glenohumeral and acromioclavicular joints. glenohumeral (GH) joint sprain (Fig. 8 4). A sprain, for instance, could result from a football linebacker tackling a running back, using only the right arm and causing violent abduction, external rotation, and extension of the arm. Sprains to the sternoclavicular (SC) joint are caused by indirect forces placed on the clavicle, which may occur with a fall on the outstretched arm, direct compression on the lateral shoulder, or traction and torsion forces. Acromioclavicular (AC) joint sprains are the result of the acromion process being forced away from the clavicle or the clavicle being forced away from the acromion. This mechanism can occur with a fall on the outstretched hand, flexed elbow, or tip of the shoulder; direct force to the acromion; or repetitive forces and overhead activities (Fig. 8 5). AC joint sprains

38 276 Part Three Injuries and Conditions of the Upper Body, Thorax, Abdomen, and Spine Shoulder and Upper Arm range of motion [abstract]. J Athl Train 34(suppl):84, DeSavage, M, Sitler, M, Swanik, K, Stansbury, D, and Moyer, R: Effectiveness of glenohumeral joint stability braces on restricting active shoulder range of motion during physiological loading [abstract]. J Athl Train 35(suppl):90, Weise, K, Sitler, MR, Tierney, R, and Swanik, KA: Effectiveness of glenohumeral-joint stability braces in limiting active and passive shoulder range of motion in collegiate football players. J Athl Train 39: , Lephart, SM, Warner, JP, Borsa, PA, and Fu, FH: Proprioception of the shoulder joint in healthy, unstable, and surgically repaired shoulders. J Shoulder Elbow Surg 3: , Smith, RL, and Brunolli, J: Shoulder kinesthesia after anterior glenohumeral joint dislocation. Phys Ther 69: , Warner, JJ, Lephart, S, and Fu, FH: Role of proprioception in pathoetiology of shoulder instability. Clin Orthop 330:35 29, Chu, JC, Kane, EJ, Arnold, BL, and Gansneder, BM: The effect of a neoprene shoulder stabilizer on active joint-reposition sense in subjects with stable and unstable shoulders. J Athl Train 37: , Khabie, V, Schwartz, MC, Rokito, AS, Gallagher, MA, Cuomo, F, and Zuckerman, JD: The effect of intraarticular anesthesia and elastic bandaging on elbow proprioception. J Shoulder Elbow Surg 7: , Lephart, SM, Kocher, MS, Fu, FH, Borsa, PA, and Harner, CD: Proprioception following anterior cruciate ligament reconstruction. J Sport Rehabil 1: , Ulkar, B, Kunduracioglu, B, Cetin, C, and Güner, RS: Effect of positioning and bracing on passive position sense of shoulder joint. Br J Sports Med 38: , Dickens, JF, Owens, BD, Cameron, KL, Kilcoyne, K, Allred, CD, Svoboda, SJ, Sullivan, R, Tokish, JM, Peck, KY, and Rue, JP: Return to play and recurrent instability after in-season anterior shoulder instability: A prospective multicenter study. Am J Sports Med 42: , Buss, DD, Lynch, GP, Meyer, CP, Huber, SM, and Freehill, MQ: Nonoperative management for in-season athletes with anterior shoulder instability. Am J Sports Med 32: , Sawa, TM: An alternate conservative management of shoulder dislocations and subluxations. J Athl Train 4: , Reuss, BL, Harding, WG, and Nowicki, KD: Managing anterior shoulder instability with bracing: An expanded update. Orthopedics 27: , Lenza, M, Belloti, JC, Andriolo, RB, and Faloppa, F: Conservative interventions for treating middle third clavicle fractures in adolescents and adults. Cochrane Database Syst Rev (5);CD007121, Johnson, RJ: Acromioclavicular joint injuries: Identifying and treating separated shoulder and other conditions. Physician Sportsmed 29:31 35, LaPrade, RF, Wijdicks, CA, and Griffith, CJ: Division I intercollegiate ice hockey team coverage. Br J Sports Med 43: , National Collegiate Athletic Association: Sports Medicine Handbook, 25th ed. NCAA, Indianapolis, National Federation of State High School Associations: Ice Hockey Rules Book. National Federation of State High School Associations, Indianapolis, 2014.

Joint GH. Joint SC. Joint A*C. Labrum. Humerus. Sternum. Scapula. Clavicle. Thorax. Articulation. Scapulo- Thoracic

Joint G*H. Joint S*C. Joint A*C. Labrum. Humerus. Sternum. Scapula. Clavicle. Thorax. Articulation. Scapulo- Thoracic A*C Joint Scapulo- Thoracic Articulation Thorax Sternum Clavicle Scapula Humerus S*C Joint G*H Joint Labrum AC Ligaments SC Ligaments SC JOINT AC Coracoacromial GH GH Ligament Complex Coracoclavicular