It happens that after a load or for no reason, it suddenly “shoots through” the shoulder, as people say. It is impossible to raise a hand, let alone move it. Many due to severe pain can not perform their duties and lead a normal life. Or maybe your shoulder just hurts and you don't know why. To find out what it is and start treating it faster, you should immediately contact a specialist, because periarthritis can be the cause of pain.
Shoulder periarthritis is an inflammatory process in the tendons of the joint and capsule, while the articulation and cartilage tissue is not affected.
How is the treatment?
For effective treatment disease, it is necessary to eliminate the cause of its occurrence. Here are a few reasons and one possible solution:
- displacement of the vertebrae - manual therapy;
- impaired blood circulation shoulder joint- angioprotective agents.
- liver disease - diet and drugs to restore liver function, etc.
Also, at different stages of periarthritis of the shoulder joint, the treatment is different.
They are divided into 3 stages:
Stage 1 - simple form("painful shoulder"). It is characterized by mild pain in the shoulder joint during movement, does not bother at rest;
Stage 2 - acute form. Severe pain, both at rest and in motion. The temperature may rise to 37.5 degrees, markers of the inflammatory process appear in urine tests. During this period, it is necessary to immobilize the shoulder joint, make a garter, no load on the joint.
Stage 3 - chronic form ("frozen shoulder", "blocked shoulder"). The pains become tolerable, worse at night or closer to the morning. Sometimes at this stage, the disease goes away on its own. And it can go into ankylosing periarthritis. The shoulder joint grows together, which interferes with the normal functioning of the arm.
Comprehensive treatment will help to defeat periarthritis faster. And return healthy lifestyle life.
Conservative treatment. 
For a sore shoulder, in order to relieve inflammation and pain, nonsteroidal anti-inflammatory drugs (diclofenac, butadion, celebrex, etc.) are prescribed. With 1 degree of flow, sometimes this is enough for a complete recovery. But these drugs must be taken very carefully, they irritate the gastric mucosa, with ulcers and other diseases. gastrointestinal tract consultation with a doctor is necessary.
Compresses with dimexide or bischofite also help to cure the disease. But with exacerbation, bischofite is contraindicated.
It happens that anti-inflammatory drugs do not help, then the attending physician may prescribe treatment with hormonal drugs (flosteron, diprospan).
Usually, they are prescribed in the form of injections that are injected into the muscles of the diseased shoulder. This drug is very strong, so the duration of the course is short: 2-3 injections.
If for 15-20 days, no other actions have led to an improvement in the patient's condition, periarticular novocaine blockades are placed.
Novocaine is injected into the affected tissue with a certain frequency, sometimes together with a glucocorticoid agent. This procedure is done to relieve pain that makes movement impossible.
Within a month, the procedure can be repeated 1-3 more times.
Physiotherapy.
The patient is referred for physiotherapy in order to restore the full motor function of the shoulder, remove inflammation, muscle spasms.
Ultrasound - relieves pain, relieves spasm, improves blood circulation.
Shock wave therapy - infrasonic waves, penetrating, create an impulse vibration. This helps improve blood flow and tissue regeneration.
Magnetotherapy - activates immune system, restoration of affected tissues, anesthetizes.
Hirudotherapy - medical leeches that are placed on a sore shoulder. It is almost painless and very effective method help yourself get well. By-effect: an allergic reaction may occur, if it intensifies, this procedure is simply canceled.
Physiotherapy.
Properly selected exercises will not only not harm, but also help to recover. Everything must be done slowly, without sudden movements, gradually increasing the load. If there is severe pain, it is recommended to stop the session, and during an exacerbation, you can not do physical education.
A few exercises:
- Clasp your hands in a “lock” in front of you and slowly raise up and lower down.
- Flexion and extension of the arms at the elbow joint.
- With a sick hand, we slowly try to “draw” a circle in the air, the more it turns out, the better.
- We make a “lock” behind our back, try not to bend our arms.
- We throw the ball into an imaginary ring.
- We press the ball to the chest, the elbows are laid to the sides as much as possible without a painful syndrome, then we slowly straighten it, as if pushing the ball away from us, forward.
- Kick the ball on the floor with your sore hand.
Exercises are done regularly, without overloading the diseased ligaments.
Diet.
You don't need to follow a special diet. The main thing is to eat right and consume enough vitamins, proteins, minerals, so that with periarthritis, the tissues of the shoulder joint receive sufficient nutrition.
Folk treatment.
In the folk piggy bank, there are many recipes that help with various ailments. How to treat shoulder periarthritis can answer ethnoscience, but only in the first stages of the disease or as an additional treatment, after consulting a doctor.
If the symptoms of periarthritis of the shoulder joint last more than a week, during treatment folk remedies need to see a doctor urgently.
We can offer you some recipes from traditional medicine:
- An infusion (tea) is made from yarrow, St. John's wort, wild rose, lingonberry leaves and currants (black).
- Compresses, rubbing, which warm the diseased joint.
- Apply honey to the affected area, wrap and leave overnight.
- Apply burdock or cabbage leaves to the sore spot, hold as long as possible, after fixing.
Tibetan medicine.
For the treatment of shoulder periarthritis is used:
- acupuncture - anesthetizes, removes the inflammatory process;
- acupressure - relieving spasms, improving blood flow;
- manual therapy - unloads the joints, thus helping recovery;
- warming with wormwood cigars along with Tibetan fees.
All treatment takes place in a complex, which helps speedy recovery. Also, the technique is selected individually for each patient.
Surgical intervention.
Surgery, subacromial decompression, is done when other treatments have failed. The pain syndrome remains physical activity decreases.
During surgery, the acromion and one ligament in the same place is removed. Motor functions return completely or to a greater extent than before.
Remember, this is important!
Periarthritis of the shoulder joint - for a speedy recovery, it is necessary to treat it comprehensively: with medicines, physiotherapy and physiotherapy exercises.
Consult a doctor at the first symptoms of the disease, do not start the disease and do not self-medicate.
If treatment within 5-6 weeks does not give a result, surgery should be performed.
In order to understand how the shoulder works, it is necessary to understand what mechanisms and elements are involved in this process. The shoulder joint has a complex structure and is part of shoulder girdle.
The scientific definition of the concept of "shoulder" does not coincide with the everyday idea of the meaning of this term. From the point of view of anatomy, only a segment of the arm from the shoulder joint to the elbow bend belongs to this part of the body. What we call a shoulder in everyday life is called a shoulder girdle in scientific language. Due to its unique structure, it allows you to perform hand movements in all planes.
Structure
The shoulder joint is at the top of the arm. It is closest to the body and is the largest part of the upper limb. It consists of:
- Articular surface on the scapula.
- The humerus, which is surrounded by longitudinal muscles.
- connective tissue.
- Subcutaneous adipose tissue.
- Skin.
- Synovial lip.
- An elastic capsule containing the shoulder joint.
- Ligaments and a thick layer of muscles that strengthen the shoulder.
Communication with the central nervous system is carried out through the axillary nerve, as well as branches of the long thoracic, radial and subscapular nerves.
Movement in the shoulder joint can be carried out by a person in all planes. Thanks to the special mobility of this joint, the arms can be freely raised, wound behind the head and back. The unusual anatomy of the shoulder joint has led to its instability and a high risk of injury.
Functions
The high mobility of the shoulder is due to the effective work of not only its articulation. All the necessary range of motion is available due to the combined work of all joints of the arms and shoulder girdle. There are three axes of movement of this joint:
- front axis. Responsible for the function of flexion and extension.
- Sagittal axis. Involved in abduction of hands.
- vertical axis. Organizes rotation.
The shoulder articulation itself is capable of providing mobility of the upper limbs only up to the line of the shoulders. To perform certain movements, different segments are connected to the work:
- In order to raise or lower the arms, as well as to bring them behind the back, flexion or extension is carried out. The shoulder joint in this case works only up to the horizontal axis. Next, the clavicle and scapula are connected to work.
- When performing movements resembling flapping wings, after the joint brings the limbs to shoulder level, the shoulder blades and the spinal column are included in the work. Thus, the arms rise to the vertical axis.
- The shrug requires the simultaneous work of the shoulder joints, collarbones and shoulder blades.
- The rotational movements of the arms around the three main axes are performed with the interaction of the upper limbs, shoulder blades and collarbones.
Bones
The shoulder joint is formed by the connection of the upper part of the shoulder bone (head) with the scapula. Otherwise, it is called spherical due to the rounded head. Its shape exactly matches the outlines articular surface. The junction is called the articular (glenoidal) cavity. At this point, the humerus and scapula form a joint. The humerus is held in the joint by a cartilaginous plate. It is formed along the edges of the glenoid cavity and completely repeats its shape, covering the head of the tubular bone.
The structure of the shoulder joint has two interesting features:
- The size of the spherical head is several times the volume of the scapular cavity.
- The joint capsule that unites the bone of the shoulder and the scapula does not have additional cartilage, partitions and disks.
The collarbone plays an important role. Effective work of the shoulder joint is impossible without this small tubular bone.
Periarticular tissues
The shoulder joint is surrounded by three main formations - the cartilage plate, the articular capsule and ligaments. All these tissues differ in their structure, origin and basic functions. But thanks to their interaction, the upper limbs of a person are quite mobile. In addition, periarticular tissues perform a protective function, reducing the risk of possible damage.
The cartilaginous plate evens out the difference in size between the head of the humerus and the glenoid cavity. It softens minor bumps and bumps, but its durability may not be enough with a strong physical impact.
joint capsule
The head of the human spherical joint retains its correct position due to the system of ligaments of the joint of the shoulder. This strong connective tissue grows together with a thin joint capsule. The thickness of its surface is not uniform. The densest layer is on the outer surface of the shell. It includes the coraco-brachial ligament. Starting from the coracoid process, it spreads over the head of the same-named bone and is attached to outside. Performs a holding function, preventing excessive extension of the joint from the outside of the shoulder. Is different high level strength.
Other articulation sites strengthen the less developed articular-shoulder ligaments (formed by the upper, middle and lower bundles). Even though they play less important role in the work of the joint, in the places of their dislocation there are characteristic thickenings. The segments of the joint capsule located between the ligaments are thinner and weaker.
Articular bags
Normal sliding of the tendons of the shoulder joint is ensured by the synovial bags located in the tissues surrounding it. They are cavities filled with intraarticular fluid. The number of bags, their structure and shape depends on the individual characteristics of each person:
- The most common is the subscapular joint bag. It is located in the area between the subclavian and deltoid areas or in the region of the neck of the scapula.
- A little higher, between the coracoid process and the tendon of the subscapularis muscle, a subcoracoid bag is formed.
- The largest bag (its dimensions coincide with the palm of a person) is called a deltoid. It is located on the outside of the shoulder joint, in the region of the deltoid muscle. Represents one large a large number of small formations.
Articular bags provide smooth movements and protect the joint shell from sprains.
Muscle structure
The normal mobility of the joint is provided by the articular capsule and the system of ligaments around it, and the muscles of the shoulder play the main strengthening and motor role. muscle tissue and tendons form a strong and elastic holding frame.
The shoulder joint is surrounded by the following muscles:
- From the outside and from above, the articulation covers deltoid. It does not have a direct connection with the joint capsule, but at the same time protects the joint from three sides. The deltoid muscle combines three bones at once - the shoulder, shoulder blade and collarbone.
- On the front side, the joint is covered by the biceps muscle (biceps). At one end, it is attached to the scapula, passes through the joint and goes inside the shell into the intertubercular groove to the humerus.
- WITH inside joint is triceps ( triceps). It consists of three parts - a long, literal and medial head. Responsible for pulling the arm back and involved in the extension of the forearm.
- On the inside, under the head of the biceps, the coracoid muscle protects the joint. She is responsible for flexing the shoulder, is involved in raising the arm up.
Basically, the muscles strengthen the human shoulder joint from the outside, while the inner and lower parts are practically not protected. Most of the injuries are related to this.
Development
During the formation of the fetus in the womb, the bones of the shoulder joint are disconnected. After giving birth, his shoulder development goes through several stages:
- When a child is born, the rounded head of the spherical joint is almost completely formed, the articular cavity is underdeveloped, and the cartilaginous plate is not fully developed.
- Throughout the first year of a child's life, the shoulder joint is in the process of strengthening. The joint capsule contracts, thickens and fuses with the coracobrachial ligament. As a result of this process, the mobility of the joint and the risk of injury are reduced.
- In the next two years, the segments of the shoulder joint significantly increase their size and take their final shape. Growing bones stretch the ligaments and joint capsules. Mobility becomes maximum.
The head of the shoulder bone is the least subject to metamorphosis. In the process of formation, it only slightly changes its shape. The head reaches its maximum size already closer to the period of puberty.
blood supply
The main source of blood flow to the shoulder is the main axillary artery. It crosses the cavity of the same name and goes into the shoulder muscle. The removal of metabolic products is carried out through the brachial and axillary veins. A supporting role is assigned to the scapular and acromial-deltoid vascular circles. They form a dense network of vessels in the depths of the deltoid and subscapularis muscles.
The special arrangement of the auxiliary circles allows direct blood supply brachial artery in case of disruption of the main blood flow.
Pathology
Most often, shoulder diseases are associated with injuries - dislocations, damage to muscles and ligaments. This is due to the special structure of the joint. Most often, pathologies develop as a result of such traumatic factors as:
- Sharp movements of the upper limbs.
- Wrong physical exercise, lifting weights.
- Falls and bruises of the shoulder joint.
- Violation of blood circulation in the ligaments.
Therapy in such cases is conservative in nature - immobilization (wearing orthoses), physiotherapy. Surgical intervention is allowed only in case of chronic injuries.
There are a number of diseases that can cause pain in the shoulder. These include arthrosis of the acromioclavicular joint, arthritis; osteochondrosis, neuritis, plexitis, etc. Therefore, it is very important to immediately consult a doctor if pain occurs.
The anatomy of the human shoulder is unique and has its own weaknesses. Therefore, it is very important that all its segments interact accurately and smoothly. Only in this case the joint will effectively cope with its functions.
Shoulder joint: structure and functions
The shoulder joint is one of the largest joints in the human musculoskeletal system. Its spherical design, as well as the equipment with a powerful muscular and ligamentous apparatus, make it very strong, but also vulnerable at the same time.
Vulnerability lies in the enormous stresses to which it is subjected throughout a person's life. We can say that the shoulder joint is the source from which all the most important movements originate - from the usual ability to hold a glass of water in your hand, ending with the most high achievements in the professional sports arena.
Other structures of the shoulder joint
Having become acquainted with the structure of the joint and its features closer, you can easily understand how much he needs to be treated with care.
Shoulder Functions
First of all, it should be clarified: the shoulder and the shoulder joint (words that have acquired the status of synonyms in everyday speech) are completely different concepts. The shoulder joint is the connection of the articular surface of the scapula with the articular head of the humerus. Actually, the shoulder originates from the shoulder joint - a tubular bone, which at one end is attached to the shoulder joint, and at the other - to the elbow. 
The main function of the shoulder joint is to stabilize the movements of the upper limbs while increasing the amplitude of their movements.
Simply put, the biomechanics of the shoulder joint allows you to move your arms in several projections at a wide angle and at the same time provide a strong attachment of a freely movable element (shoulder) to a conditionally movable one (scapular bone).
Due to the structure of the shoulder joint, a person is able to make movements with his hands in wide range: adduction and abduction of the arms, flexion and extension, rotation.
In addition, the listed movements can be "subtle" - with a deviation from the conditional axis within a few degrees, up to a rotation close to 360 degrees, and also aimed at the accuracy of movements or their strength. All this becomes possible due to the complex structure of the shoulder joint, which includes a variety of "mounting elements".
Features of the structure of the shoulder joint
Perhaps the most “unpleasant” difference between the shoulder joint and other joints of the body is the mismatch in the size of its structures.
The recess in the shoulder blade, into which the head of the humerus is inserted, resembles a flat saucer. The diameter of this "saucer" is much less than the diameter of the articular head of the shoulder. Visually, this can be imagined as a big ball lying on a small plate, and ready to fall off it at any moment.
On the one hand, this feature serves as a guarantor of free range of motion in the shoulder joint. On the other hand, too sudden a movement or a movement accompanied by the use of force (a jerk by the arm, a fall with a blow to the shoulder joint, etc.) can lead to the loss of the head of the shoulder from the joint.
And although the head is surrounded by an elastic cuff, which serves as a kind of limiter, shoulder dislocations are a very common injury. With a dislocation with a significant displacement of the structures, even ruptures of the ligaments and muscles are possible.
Bony structures of the shoulder joint
As already mentioned, the shoulder joint is formed by two main bone elements: the head of the shoulder bone and the articular part of the scapula. The main part of the movements in this joint is provided by the mobility of the head in the deepening of the scapula.
Since the shoulder joint accounts for most of all the loads that the shoulder girdle is subjected to, it is not surprising that the wear and tear of its bone structures and inflammatory processes in them are quite common.
The most common diseases that affect the bones of the joint are the following:
- traumatic - dislocations, subluxations, fractures of the neck of the shoulder;
- congenital - dysplasia of the shoulder joint (underdevelopment of one or more bone structures or discrepancy in size relative to each other);
- degenerative - arthrosis of the shoulder joint, in which cartilage and bone tissues become thinner, deformed, and the joint loses its motor functions. The disease most often develops against the background of age-related changes in the body, as well as with a deterioration in the nutrition of the tissues of the joint - conditions caused by metabolic disorders, frequent injuries, a decrease in the intensity of blood supply to the shoulder joint;
- inflammatory - arthritis of the shoulder joint, which develops against the background of trauma or previous systemic infectious diseases. With arthritis, an inflammatory process develops in the cartilage and underlying bone tissues, which, without treatment, is dangerous for its complications.
Ligament apparatus of the shoulder joint
Far from the largest, but - without exaggeration - the most important components of the ligamentous apparatus are small muscles rotator cuff of the shoulder. This complex includes supraspinatus, infraspinatus, small round and subscapularis.
They serve as fixators that prevent damage and displacement of the head of the humerus during the work of the largest muscles of the shoulder girdle - the deltoid, biceps, pectoral and dorsal. 
Articular-shoulder ligaments are represented by strong fibrous tissues that rigidly connect bone structures. Unfortunately, it is their strength and rigidity that is the main cause of ruptures: not having the ability to significantly stretch, ligaments can be damaged under significant loads.
From all of the above, one may get the impression that the shoulder joint is an extremely fragile structure. But this statement is applicable only in cases where a person neglects physical activity and sports, leads a sedentary lifestyle. The joints (not just the shoulders) of such people are characterized by insufficient blood supply, a poor supply of nutrients, and therefore, with any, even minor loads, they are injured.
With healthy activity, compliance with norms healthy eating and mode of work and rest, the shoulder joint can be called one of the most durable and hardy in the human body.
But excessive stress on the shoulder joint, especially those that do not alternate with proper rest, can provoke a condition known as “joint fatigue”. In this case, any factors can cause inflammation or damage to muscle tissues and tendons:
- periarthritis of the shoulder joint (inflammation of the tendons) is a common disease that develops in response to injury (fall, bruise) or excessive loads;
- sprains follow any kind of injury and can lead to a significant loss of motor functions of the upper limb. If left untreated, an inflammatory process often develops and spreads to the tissues surrounding the ligament.
Circulatory and nervous network of the joint
Any diseases or injuries of the shoulder joint are accompanied by pain, which can rarely be described as "minor". The pain can be so severe that even the simplest movements become impossible.
This is a protective mechanism due to the functions of the thoracic, radial, subscapular and axillary nerves, which ensure the conduction of signals through the shoulder joint.
Due to the pain syndrome, the damaged or diseased joint is forcibly “deactivated” (with severe pain it is difficult to make any movements), which gives injured or inflamed tissues time to recover.
Important: Pain in the shoulder joint can be caused by injuries or diseases of the cervical and thoracic spine, which requires immediate medical attention.
An extensive network of vessels is responsible for blood supply, which transport nutrients and oxygen to the tissues of the articulation, and together with the blood remove decay products. But two large arteries lie next to the shoulder joint, which makes injuries dangerous: with a significant displacement of the head or a fragmental fracture, there is a risk of squeezing or rupture of blood vessels.
Important: any shoulder injury, accompanied by numbness of the arm on the injured side and a general feeling of weakness (even in the absence of bleeding), needs to see a doctor as soon as possible. a short time after injury. These signs may indicate a circulatory disorder that requires qualified medical attention.
Other structures
The structure of the shoulder joint includes other structures whose health is essential for the ability to move: 
- synovial membrane - a thin layer of tissue lining the inner surface of the joint (with the exception of areas covered with cartilage). This shell, rich in blood vessels, serves as the main source of nutrition for cartilage and bone tissues. In addition, the shell releases a fluid that softens friction during movement and protects internal structures from wear. With injuries, as well as as a complication of arthritis and systemic infections, synovitis can develop - inflammation of the synovial membrane.
- periarticular bags perform two functions simultaneously. They facilitate the movement of all articular and periarticular elements and at the same time prevent their premature wear. These are small "pockets" located next to the joint and filled with a special fluid that allows the periarticular structures not to "rub" against each other, but to slide. Inflammation of these bags - bursitis - is a frequent occurrence in injuries (especially with infected skin wounds) and general infectious diseases.
By taking care of healthy activity, proper nutrition, proper rest, and also by contacting a doctor if there are any signs of trouble in the joint, you can extend its “life” and save high quality own life for many years.
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The special anatomy of the shoulder joint provides high mobility of the arm in all planes, including 360-degree circular movements. But the price for this was the vulnerability and instability of the articulation. Knowledge of anatomy and structural features will help to understand the cause of diseases that affect the shoulder joint.
But before proceeding to detailed review of all the elements that make up the formation, two concepts should be differentiated: the shoulder and the shoulder joint, which many confuse.
The shoulder is top part arms from the armpit to the elbow, and the shoulder joint is the structure by which the arm connects to the torso.
Structural features
If we consider it as a complex conglomerate, the shoulder joint is formed by bones, cartilage, articular capsule, synovial bags (bursae), muscles and ligaments. In its structure, it is a simple, consisting of 2 bones, a complex articulation of a spherical shape. The components that form it have a different structure and function, but are in strict interaction, designed to protect the joint from injury and ensure its mobility.
Shoulder components:
- scapula
- brachial bone
- articular lip
- joint capsule
- synovial bags
- muscles, including the rotator cuff
- bundles
The shoulder joint is formed by the scapula and humerus enclosed in a joint capsule.
The rounded head of the humerus is in contact with a fairly flat articular bed of the scapula. In this case, the scapula remains practically motionless and the movement of the hand occurs due to the displacement of the head relative to the articular bed. Moreover, the diameter of the head is 3 times the diameter of the bed.
This discrepancy between shape and size provides a wide range of motion, and articulation stability is achieved due to muscle corset and liaison apparatus. The strength of the joint is also given by the articular lip located in the scapular cavity - cartilage, the curved edges of which extend beyond the bed and cover the head of the humerus, and the elastic rotator cuff surrounding it.
Ligament apparatus
The shoulder joint is surrounded by a dense articular bag (capsule). The fibrous membrane of the capsule is of varying thickness and is attached to the scapula and humerus to form a spacious pouch. It is loosely stretched, which makes it possible to freely move and rotate the arm.
From the inside, the bag is lined with a synovial membrane, the secret of which is the synovial fluid that nourishes the articular cartilage and ensures that there is no friction when they slide. Outside, the articular bag is strengthened by ligaments and muscles.
The ligamentous apparatus performs a fixing function, preventing displacement of the head of the humerus. Ligaments are formed by strong, poorly extensible tissues and are attached to the bones. Poor elasticity is the reason for their damage and rupture. Another factor in the development of pathologies is the insufficient level of blood supply, which is the cause of the development of degenerative processes of the ligamentous apparatus.
Ligaments of the shoulder joint:
- coracohumeral
- upper
- average
- lower
Human anatomy is a complex, interconnected and fully thought out mechanism. Since the shoulder joint is surrounded by a complex ligamentous apparatus, for the latter to slide in the surrounding tissues, mucous synovial bags (burses) are provided that communicate with the joint cavity. They contain synovial fluid, ensure smooth operation of the articulation and protect the capsule from stretching. Their number, shape and size are individual for each person.
Muscular frame
The muscles of the shoulder joint are represented by both large structures and small ones, due to which the rotator cuff of the shoulder is formed. Together they form a strong and elastic frame around the articulation.
Muscles surrounding the shoulder joint:
- Deltoid. It is located above and outside the joint, and is attached to three bones: the humerus, scapula, and collarbone. Although the muscle is not directly connected to the joint capsule, it reliably protects its structures from 3 sides.
- Double-headed (biceps). It is attached to the scapula and humerus and covers the joint from the front.
- Triceps (triceps) and coracoid. Protect the joint from the inside.
The rotator cuff of the shoulder joint provides a wide range of motion and stabilizes the head of the humerus, keeping it in the joint bed.
It is made up of 4 muscles:
- subscapular
- infraspinatus
- supraspinous
- small round
The rotator cuff is located between the head of the shoulder and the acromin, a process of the scapula. If the space between them narrows due to various reasons, the cuff is infringed, resulting in a collision between the head and the acromion, and is accompanied by severe pain.
Doctors gave this condition a name "impingement syndrome". With impingement syndrome, the rotator cuff is injured, leading to its damage and rupture.
blood supply
The blood supply to the structure is carried out with the help of an extensive network of arteries, through which nutrients and oxygen enter the tissues of the joint. Veins are responsible for the removal of metabolic products. In addition to the main blood flow, there are two auxiliary vascular circles: the scapular and acromio-deltoid. The risk of rupture of the large arteries passing near the joint greatly increases the risk of injury.
Elements of the blood supply
- suprascapular
- anterior
- rear
- thoracoacromial
- subscapular
- shoulder
- axillary
innervation
Any damage or pathological processes in the human body are accompanied by pain. Pain can signal the presence of problems or perform security functions.
In the case of joints, tenderness forcibly "deactivates" the diseased joint, preventing its mobility to allow injured or inflamed structures to recover.
Shoulder nerves:
- axillary
- suprascapular
- chest
- ray
- subscapular
- axillary
Development
When a child is born, the shoulder joint is not fully formed, its bones are disconnected. After the birth of the child, the formation and development of the structures of the shoulder continues, which takes about three years. During the first year of life, the cartilaginous plate grows, the articular cavity is formed, the capsule contracts and thickens, the surrounding ligaments strengthen and grow. As a result, the joint is strengthened and fixed, and the risk of injury is reduced.
Over the next two years, the articulation segments increase in size and take their final form. The humerus is the least susceptible to metamorphosis, since even before birth, the head has a rounded shape and is almost completely formed.
Shoulder instability
The bones of the shoulder joint form a mobile joint, the stability of which is provided by muscles and ligaments.
This structure allows for a large range of motion, but at the same time makes the articulation prone to dislocations, sprains and ruptures of the ligaments.
Also, often people are faced with such a diagnosis as joint instability, which is put in the case when, with the movements of the arm, the head of the humerus goes beyond the articular bed. In these cases, we are not talking about trauma, the consequence of which is dislocation, but about the functional inability of the head to remain in the desired position.
There are several types of dislocations depending on the displacement of the head:
- front
- rear
- lower
The structure of the human shoulder joint is such that the scapular bone covers it from behind, and the deltoid muscle from the side and from above. The frontal and internal parts remain insufficiently protected, which leads to the predominance of the anterior dislocation.
Shoulder Functions
The high mobility of the articulation allows for all movements available in 3 planes. Human hands can reach any point of the body, carry weights and perform delicate work that requires high precision.
Movement options:
- abduction
- cast
- rotation
- circular
- bending
- extension
It is possible to perform all the listed movements in full only with the simultaneous and coordinated work of all elements of the shoulder girdle, especially the clavicle and the acromioclavicular joint. With the participation of one shoulder joint, the arms can only be raised to shoulder level.
Knowledge of the anatomy, structural features and functioning of the shoulder joint will help to understand the mechanism of the occurrence of injuries, inflammatory processes and degenerative pathologies. The health of all joints in the human body directly depends on lifestyle.
Overweight and absence physical activity damage them and are risk factors for the development of degenerative processes. Careful and attentive attitude to your body will allow all its constituent elements to work for a long time and flawlessly.
Lab
"Muscles of the Upper Limb"
Muscles that produce movements of the girdle of the upper limb
Schematically, the movements of the belt of the upper limb (scapula and collarbone) are divided into:
1. Movement forward and backward with abduction of the scapula from the spinal column and adduction to it.
2. Raising and lowering the scapula and collarbone.
3. Movement of the scapula around the sagittal axis with the lower angle to the medial and lateral sides.
4. Circular movement with the lateral end of the clavicle and at the same time with the shoulder blade.
These movements involve six functional muscle groups.
Forward movement
The movement of the girdle of the upper limb forward is produced by muscles that cross the vertical axis of the sternoclavicular joint and are located in front of it. These include:
1) a large pectoral, acting on the belt of the upper limb through the humerus;
2) small chest;
3) anterior dentate.
backward movement
Exercise muscles that cross the vertical axis of the sternoclavicular joint and lie behind it. This muscle group includes:
1) trapezius muscle;
2) rhomboid muscle, large and small;
3)latissimus dorsi back.
Upward movement
Raising the girdle of the upper limb is produced by the following muscles:
1) the upper bundles of the trapezius muscle, which pulls up the lateral end of the clavicle and the acromion of the scapula;
4) the muscle that raises the scapula;
5) rhomboid muscles, in the decomposition of the resultant of which there is some component directed upwards;
6) the sternocleidomastoid muscle, which, attaching with one of its heads to the collarbone, pulls it, and, consequently, the scapula up.
Downward movement
Lowering is facilitated by muscles that go from bottom to top, from the chest or spinal column to the bones of the girdle of the upper limb:
1) small pectoral muscle;
2) subclavian muscle;
3) lower bundles of the trapezius muscle;
4) lower teeth of the anterior serratus muscle.
In addition, the muscles that go from the trunk to the shoulder, namely the pectoralis major and the latissimus dorsi, help lowering, mainly with their lower parts.
Rotation of the scapula (movement of the lower angle inward and outward)
The rotation of the scapula inward, with the lower angle to the spinal column, produces a pair of forces formed by:
1) pectoralis minor
2) the lower part of the rhomboid muscle.
The rotation of the scapula outward, with the lower angle from the spinal column to the lateral side, occurs as a result of the action of a pair of forces formed by the upper and lower parts of the trapezius muscle.
This movement is supported by:
1) serratus anterior with its lower and middle teeth;
2) a large round muscle with a fixed free upper limb.
Roundabout Circulation
The circular movement of the belt of the upper limb occurs as a result of the alternate contraction of all its muscles.
Muscles that produce movement in the shoulder joint
In the shoulder joint, movements are possible around three mutually perpendicular axes:
1) abduction and adduction around the anteroposterior axis;
2) flexion and extension around the transverse axis;
3) pronation and supination around the vertical axis;
4) Roundabout Circulation(circumduction).
These movements are provided by six functional muscle groups.
Shoulder abduction
The abductors of the shoulder cross the sagittal axis of rotation at the shoulder joint and are located laterally from it. The humerus is abducted by the muscles:
1) deltoid and
2) supraspinous.
Shoulder adduction
Special muscles that would cross the sagittal axis of the shoulder joint and be located medially from it, no, therefore, the reduction of the shoulder according to the rule of a parallelogram of forces is carried out with simultaneous contraction of the muscles located in front (pectoralis major muscle) and behind the shoulder joint (latissimus dorsi and teres major). These muscles are helped by:
1) infraspinatus;
2) small round;
3) subscapular;
4) long head of the triceps muscle of the shoulder;
5) coracobrachial muscles.
Shoulder flexion
Shoulder flexor muscles cross the frontal (transverse) axis of the shoulder joint and are located in front of it.
Flexion of the shoulder (moving it forward) is produced by the muscles:
1) deltoid, its anterior part;
2) large chest;
3) coraco-humeral;
4) the biceps of the shoulder.
Shoulder extension
The muscles that extend the shoulder (moving it back) cross, like the shoulder flexors, the frontal axis of the shoulder joint, but are located behind it. Shoulder extension is produced by the following muscles:
1) its deltoid back part;
2) the latissimus dorsi muscle;
3) infraspinatus;
4) small round;
5) big round;
6) the long head of the triceps muscle of the shoulder.
Shoulder pronation
Shoulder pronation, i.e. turning inward, produce muscles; which cross the vertical axis of the shoulder joint, attaching in front of it. These include:
1) subscapular;
2) large pectoral;
3) deltoid, its anterior part;
4) the latissimus dorsi muscle;
5) large round;
6) coraco-humeral.
Shoulder supination
Supination, i.e. turning the shoulder outward, produce muscles that, like pronators, cross the vertical axis of the shoulder joint, but are located behind it:
1) the back of the deltoid muscle
2) small round muscle
3) infraspinatus muscle
4) biceps brachii
The muscles of the arms include the muscles of the forearm and shoulder. The muscles of the shoulder are divided into two categories: the flexors or anterior group of muscles and the extensors - the posterior group.
Anterior muscle group shoulder is formed by three main muscles:
- coraco-humeral;
- two-headed;
- shoulder muscle.
Extensors in turn are represented by two muscles:
- elbow muscle;
- triceps brachialis muscle.
Shoulder flexors
Coracobrachial muscle (m.coracobrchialis)
Coraco- shoulder muscle belongs to the group of flexors. It originates from the top of the coracoid process, and with its other end, passing into a flat tendon, it is fixed on the humerus, just below the crest of the lesser tubercle. Approximately there it is attached.
Main functions: The coracobrachialis muscle is involved in shoulder flexion at the shoulder joint. It brings the shoulder to the body, and also turns the shoulder outward when pronating. When the shoulder is fixed, m.coracobrchialis pulls the scapula forward and downward.
Biceps - biceps muscle of the shoulder (m.biceps brachii)
As the name suggests, the biceps brachii has two heads. One of these heads is long, the other is short. The long head starts from the supraarticular tubercle of the scapula. The short head begins in the same place where the coracobrachial muscle originates - at the coracoid process. Merging at shoulder level, both heads form a spindle-shaped muscle, passing into a tendon, which is attached to the tuberosity of the radius.
Main functions: The biceps is involved in flexion at the shoulder joint of the shoulder and in flexion of the forearm at the elbow. With the forearm turned inward, the biceps brachii helps to return it to its original position.
Shoulder muscle (m.brachialis)
The shoulder muscle is deeper than the biceps, however, it also belongs to the anterior shoulder group. The beginning of the muscle is two-thirds of the lower surface of the humerus, limited by the deltoid tuberosity and the capsule of the elbow joint, as well as the lateral and medial intermuscular septum of the shoulder. The shoulder muscle ends on the tuberosity of the ulna. The deeper part of the tendon of the brachialis muscle is woven into the capsule of the elbow joint.
Main function: the brachialis muscle flexes the forearm at the elbow joint.
Shoulder extensors
Shoulder triceps (m.triceps brachii)
The triceps of the shoulder is represented by a large powerful muscle, which is divided into three heads and is located on rear surface shoulder. The long head begins on the scapula, medial and lateral - on the humerus.
Main functions: the triceps muscle of the shoulder is an extensor, it is involved in extension in the elbow joint of the forearm. In addition, through the long head, the triceps also extends the shoulder and brings it to the body.
Elbow muscle (m.anconeus)
The elbow muscle has a triangular shape and belongs to the extensor group. The beginning of m.anconeus lies on the posterior surface of the external epicondyle of the shoulder. fastened ulnar muscle to the posterior edge of the ulna.
Main functions: the ulnar muscle extends the arm at the elbow.
Forearm muscles
The muscles of the forearm, like the muscles of the shoulder, are represented by extensors and flexors. Many muscle groups forearms are multi-joint muscles, their action is directed to movements in such joints as the wrist, elbow, joints of the fingers and hands. largest muscle forearms - brachioradial, engaged in flexion of the limb in the elbow joint.
I. Muscles that produce movements of the spinal column(movements of the body, neck and head).
Flexion of the spinal column: rectus abdominis, external and internal obliques, iliopsoas, longus muscle head and neck (with bilateral muscle contraction).
Extension: erector spinae muscle, transversospinous muscle, splenius head and neck muscle, trapezius muscle (with bilateral muscle contraction).
Tilt to the side: muscles that produce flexion of the spinal column and its extension while simultaneously contracting both muscle groups on one side.
Twisting (rotation): internal oblique muscle of the abdomen on the side where the rotation occurs, and the external oblique muscle of the abdomen on the opposite side, transversospinous muscle, trapezius muscle of its top and others (with unilateral contraction).
II. Muscles involved in respiratory movements.
Inspiratory muscles: diaphragm, external intercostal muscles, levator ribs, scalene muscles, back dentate (in some cases, with deep breathing, other muscles that attach to chest such as pectoralis major and minor).
Muscles that produce exhalation: internal intercostal muscles, rectus, oblique and transverse abdominal muscles.
III. Muscles that move the shoulder girdle.
Back movements: trapezius muscle, rhomboid muscle, latissimus dorsi muscle.
Forward movement: pectoralis major and minor, serratus anterior.
Movement up (lifting): the trapezius muscle with its upper part, the muscle that lifts the scapula, the rhomboid muscle.
Downward movement (lowering): trapezius muscle with its lower part, anterior serratus muscle with lower bundles, pectoralis minor muscle, subclavian muscle (muscles increase the lowering that occurs under the influence of gravity).
IV. Muscles that produce movements in the shoulder joint (shoulder movements).
Shoulder (humerus) flexion: anterior deltoid, pectoralis major, biceps brachii, coracobrachialis.
Extension: rear deltoid, latissimus dorsi, teres major.
Abduction: deltoid muscle, supraspinatus muscle.
Adduction: pectoralis major, latissimus dorsi, all muscles of the shoulder girdle except the deltoid and supraspinatus.
Inward rotation (pronation): pectoralis major, latissimus dorsi, subscapularis, teres major.
External rotation (supination): infraspinatus, teres minor.
V. Muscles that produce movements in the elbow joint (movements of the forearm).
Flexion of the forearm: biceps brachii, brachialis, brachioradialis, pronator teres (when the forearm is fixed, these muscles are involved in flexing the shoulder in relation to the forearm).
Extension: triceps brachii, ulna.
Rotation inside (pronation): round and square pronators, brachioradialis muscle (partially).
External rotation (supination): supinator, brachioradialis (partial).
VI. Muscles that produce movements in the wrist and hand joints.
Flexion of the hand: radial and elbow flexors wrists, superficial and deep finger flexors.
Extension of the hand: long and short radial and ulnar extensors of the wrist, extensors of the fingers.
Wrist abduction: extensor carpi radialis long and short and flexor carpi radialis (with simultaneous contraction).
Adduction of the hand: ulnar extensor and flexor of the wrist (with simultaneous contraction).
bending thumb Hands: long and short flexors of the thumb.
Extension of the thumb: long and short extensors of the thumb.
Thumb abduction: long and short muscle abducting the thumb of the hand.
Adduction of the thumb: the muscle that adducts the thumb.
Thumb Opposition: The muscle that opposes the thumb to the hand.
Flexion II - V fingers: superficial and deep flexors of the fingers.
Extension II - V fingers: extensors of the fingers.
Breeding II - V fingers: dorsal interosseous muscles.
Adduction of II-V fingers: palmar interosseous muscles.
VII. Muscles that produce movement in the hip joint.
Hip (thigh) flexion: iliopsoas, rectus femoris, sartorius.
Extension: gluteus maximus, back muscles hips.
Abduction: gluteus medius and minimus.
Adduction: long, large and short adductor muscles, thin muscle.
External rotation (supination): iliopsoas (partially), gluteus maximus (also partially), posterior bundles of the middle and small gluteal muscles, obturator and piriformis muscles.
Inward rotation (pronation): anterior bundles of the middle and small gluteal muscles.
VIII. Muscles that produce movement knee joint(leg movements).
Flexion of the lower leg: posterior thigh muscles, calf muscle, sartorius muscle.
Extension: quadriceps femoris.
Outward rotation: biceps femoris, lateral head of gastrocnemius.
Internal rotation: semitendinosus, semimembranosus, sartorius, medial head of gastrocnemius.
IX. Muscles that produce movement ankle joint and joints of the foot.
Foot flexion (plantar flexion): triceps calf, tibialis posterior, long flexor fingers, long flexor of the big toe, long and short peroneal muscles.
Pronation of the foot (lowering the medial edge with simultaneous raising lateral edge of the foot): long and short peroneal muscles.
Supination of the foot: tibialis anterior, extensor hallucis longus.
Foot extension (dorsiflexion): tibialis anterior, long extensor fingers and extensor thumb.
Flexion of the toes: flexors of the fingers.
Finger extension: finger extensors.
