All muscles of the upper limb are usually divided into 2 groups: muscles shoulder girdle and the free upper limb, which in turn consist of 3 topographic sections - the muscles of the shoulder, the muscles of the forearm and the hand. Many mistakenly think that the muscles of the shoulder girdle also belong to the muscles of the shoulder, but according to the accepted anatomical classification, this is not the case. The shoulder is a part of the free upper limb, starting from the shoulder joint and ending with the elbow joint.

All muscles of the shoulder anatomical region can be divided into posterior and anterior groups.

Anterior shoulder muscle group

These include:

• biceps brachii,
• coracobrachialis muscle,
• shoulder muscle.

two-headed

It has two heads, from where it got its characteristic name. The long head originates with the help of a tendon from the supraarticular tubercle of the scapula. The tendon passes through the articular cavity of the shoulder joint, lies in the intertubercular groove humerus and passes into muscle tissue. In the intertubercular groove, the tendon is surrounded by a synovial membrane, which connects to the cavity of the shoulder joint.

short head originates from the apex of the coracoid process of the scapula. Both heads merge together and pass into the spindle-shaped muscle tissue. A little above the ulnar fossa, the muscle narrows and passes again into the tendon, which is attached to the tuberosity of the radius of the forearm.

Functions:

• flexion of the upper limb in the shoulder and elbow joints;
• supination of the forearm.

Coracohumeral

Begins muscle fiber from the coracoid process of the scapula, is attached to the humerus approximately in the middle with inside.

Functions:

• flexion of the shoulder in the shoulder joint;
• bringing the shoulder to the body;
• takes part in turning the shoulder outward;
• pulls the scapula down and forward.

Shoulder

This is a fairly wide muscle that lies directly under the biceps. It starts from the anterior surface of the upper part of the humerus and from the intermuscular septa of the shoulder. Attaches to the tuberosity of the ulna. Function - flexion of the forearm at the elbow joint.

Posterior muscle group

This group includes:

• triceps shoulder,
• elbow,
• muscle of the elbow joint.

three-headed

This anatomical formation has three heads, hence the name. The long head originates from the subarticular tubercle of the humerus and below the middle of the humerus passes into the tendon common to the three heads.

Lateral head starts from rear surface humerus and lateral intermuscular septum.

The median head starts from the posterior surface of the humerus and both intermuscular septa of the shoulder. It is attached by a powerful tendon to the olecranon of the ulna.

Functions:

• extension of the forearm in the elbow joint;
• adduction and extension of the shoulder due to the long head.

Elbow

It is, as it were, a continuation of the median head of the triceps muscle of the shoulder. It originates from the lateral epicondyle of the humerus, and is attached to the posterior surface of the olecranon of the ulna and to its body (proximal part).

Function - extension of the forearm in the elbow joint.

Elbow muscle

This is a non-permanent anatomical formation. Some experts consider it as part of the fibers of the median head of the triceps muscle, which are attached to the capsule of the elbow joint.

Function - stretches the capsule of the elbow joint, which prevents it from being pinched.

Muscles of the shoulder girdle

It is worth mentioning the muscles of the girdle of the upper limb, which are often considered to be muscle formations of the shoulder:

• deltoid muscle of the shoulder,
• supra- and infraspinatus muscle,
• small and large round
• subscapular.

Both groups of muscles of the shoulder are separated from each other by two connective tissue intermuscular septa, which stretch from the common shoulder fascia (enveloping the entire muscular frame of the shoulder) to the lateral and median edges of the humerus.

Shoulder muscle pain

Pain in the shoulder and shoulder girdle is a common complaint of people of various age groups. Such a symptom may be associated with pathology of the skeleton, joints, ligaments, but most often the cause is hidden in damage to muscle tissue.

Causes

Consider the most common causes of pain in the shoulder region:

• overstrain and sprain of ligaments, tendons, muscles;
• diseases or traumatic injuries of the shoulder joint;
• inflammation of the ligaments and tendons of the muscles (tendinitis);
• rupture of tendons and muscles;
• joint capsulitis (inflammation of the joint capsule);
• inflammation of the periarticular bags - bursitis;
• frozen shoulder syndrome;
• humeroscapular periarthrosis;
• myofascial pain syndrome;
• vertebrogenic causes of pain syndrome (associated with damage to the cervical and thoracic spine);
• impingement syndrome;
• rheumatic polymyalgia;
• myositis of infectious (specific and non-specific) and non-infectious nature (with autoimmune, allergic diseases, ossifying myositis).

Pain in the shoulder area can be associated with both damage to bones, joints, ligaments, and damage to muscle tissue.

Differential Diagnosis

The following criteria will help distinguish shoulder pain caused by muscle damage from joint diseases.

sign	Joint diseases	Muscular lesions
The nature of the pain syndrome	The pain is constant, does not disappear at rest, slightly increases with movement	Pain occurs or increases significantly with a certain type of motor activity (depending on the damaged muscle)
Pain localization	Unlimited, diffuse, spilled	It has a clear localization and certain boundaries, which depends on the localization of the damaged muscle fiber
Dependence on passive and active movements	All types of movements are limited due to the development of pain syndrome	Due to pain, the amplitude of active movements decreases, but all passive ones are preserved in full
Additional diagnostic features	Change in the shape, contours and size of the joint, its swelling, hyperemia	The joint area is not changed, but there may be swelling in the soft tissue area, slight diffuse redness and an increase in local temperature with inflammatory causes of pain

What to do?

If you are suffering from shoulder pain, which is associated with damage to muscle tissue, the first thing to do in order to get rid of such an unpleasant symptom is to identify the provoking factor and eliminate it.

If after that the pain still returns, you need to visit a doctor, perhaps the cause of the pain syndrome is completely different. The following tips will help you get rid of pain quickly:

• in case of acute pain, it is necessary to immobilize the sore arm and provide it with complete rest;
• on your own, you can take 1-2 tablets of an over-the-counter pain reliever of a non-steroidal anti-inflammatory drug or apply it to the affected area in the form of an ointment or gel;
• massage can be used only after the elimination of acute pain syndrome, as well as physiotherapy;
• after the pain subsides, it is important to exercise regularly physical therapy for the development and strengthening of the muscles of the shoulder;
• if a person, on duty, is forced to perform daily monotonous hand movements, it is important to take care of protecting the muscles and preventing their damage (wear special bandages, protective and supporting orthoses, perform gymnastics to relax and strengthen, undergo regular therapeutic and preventive massage courses, etc.).

Typically, treatment muscle pain, caused by overstrain or mild injury, lasts no more than 3-5 days and requires only rest, minimal stress on the hands, correction of the rest and work regimen, massage, and sometimes taking non-steroidal anti-inflammatory drugs. If the pain does not go away or it initially has a high intensity, is accompanied by other alarming signs, it is imperative to visit a doctor for examination and correction of treatment.

There are no special muscles that would cross the sagittal axis of the shoulder joint and be located medially from it, therefore, adduction of the shoulder according to the rule of a parallelogram of forces is carried out while simultaneously contracting the muscles located in front (large pectoral muscle) and behind the shoulder joint (the widest and large round). These muscles are helped by:

1) infraspinatus;

2) small round;

3) subscapular;

4) long head of the triceps muscle of the shoulder (see p. 160);

5) coracobrachial muscle (see p. 156).

abdominal muscle(see Fig. 38) is located in the infraspinatus fossa of the scapula, from which it starts. In addition, the place of origin of this muscle is the infraspinatus fascia. Muscle attached to the greater tubercle of the humerus, being partly covered by the prominent trapezium, and partly by the deltoid muscle.

The function of the infraspinatus muscle is to adduct, supine the nation and extend the shoulder in the shoulder joint. Since this muscle is attached to the capsule of the shoulder joint, when the shoulder is supinated, it simultaneously pulls the capsule away, protecting it from infringement.

teres minor muscle(see Fig. 38) is located below the infraspinatus muscle. She starts from the shoulder blade, and attached to the greater tubercle of the humerus and promotes adduction, supination and extension of this bone.

teres major muscle(see fig. 38) starts from the inferior angle of the scapula and attached to the crest of the lesser tubercle of the humerus, often with one tendon with latissimus dorsi back. When contracting, the teres major muscle acts as a rounded elevation when the pronated shoulder is adducted. The function of the muscle is to adduct, pronate and extend the humerus. Subscapularis located on the anterior surface of the scapula, filling the subscapular fossa, from which starts. attached muscle to the lesser tubercle of the humerus. Contracting together with the previous muscles, it produces shoulder adduction; acting in isolation, it is its pronator. Since this muscle is multi-feathered, it has a significant

Essay

Shoulder extensor exercises

Introduction

push-up exercise dumbbell barbell

The muscles of the shoulder girdle surround the shoulder joint, providing numerous movements in it. All of them start from the scapula and are attached in different places of the humerus. The deltoid muscle abducts, flexes and extends the shoulder. The supraspinatus and infraspinatus muscles abduct and rotate the shoulder. The teres minor and teres major rotate and lower the shoulder. The subscapularis is also involved in rotation in the shoulder joint. The muscles of the free upper limb are subdivided into sections of the arm. The muscles of the shoulder have an anterior flexor group and a posterior extensor group. Flexors: biceps brachii (biceps). Extensors: triceps muscle (triceps).

Triceps(triceps; lat. musculus triceps brachii) - the triceps muscle of the shoulder, extends the elbow, is located on the back of the humerus, consists of three bundles or heads - long (caput longum), lateral (caput laterale) and medial (caput mediale).

Many athletes, especially beginners, neglect triceps training, as they believe that the main role in appearance hand plays biceps. This is not true, since when looking at a person (both from the front and from the back), it is the triceps, not the biceps, that determines the thickness of the shoulder.

As mentioned above, the triceps consists of three heads that form the so-called triceps horseshoe. Bodybuilding literature and articles often describe exercises that target one of the heads of the triceps so that only that head can be selectively trained. In fact, almost all triceps exercises involve all three of its heads, and the mass fraction of a particular head is determined by the athlete's genetic data.

Triceps require a lot of concentration, so avoid cheating when doing exercises. For good results the most precise technique is required.

There are a large number of exercises for triceps, but not all of them are equally effective. Here is the list the best exercises, which give best results in increasing the volume of the triceps.

1. Bench Press

The bench press is a basic exercise in bodybuilding and powerlifting. free weights, designed to develop the muscles of the chest and arms (triceps) and the anterior bundle of the deltoid muscles.

Initial position. Lying face up on a special bench for the press, legs bent at the knees and spaced shoulder-width apart, feet firmly pressed to the floor. The back of the head, shoulder blades and pelvis are firmly pressed against the bench. The bar is held on straightened hands in front of you, the grip is wide, from above. The width of the grip must be selected in such a way that when the projectile is lowered to the chest, the forearms are parallel to each other. It is necessary to lie down on the bench in such a way that the bar of the bar while on the racks is opposite your eyes.

Execution technique.Gently lower the barbell down until it touches the middle of the chest, then, without stopping and rebounding, squeeze it up until the arms are fully extended. To increase the load on the muscles of the chest, the elbows should be kept apart all the time when doing the press.

Safety technique. It is not recommended to tear off the pelvis from the bench - this is traumatic for the lumbar spine. When performing the exercise, you should not tear your feet off the floor or put them on a bench - loss of balance and injury to the shoulder joint is possible. When the back of the head is separated from the bench during the bench press, the trajectory of the projectile is distorted and the traumatic load on the cervical region spine. The projectile must be lowered to the middle of the chest, when lowering the projectile to the neck or to the lower part of the chest, a traumatic load is created on the shoulder joint. This exercise is recommended to be performed with a safety net, if the athlete cannot lift the barbell, then it will press him to the bench and it will be very difficult to get rid of it on his own.

Trained muscle groups.

2. Dumbbell bench press

This exercise is one of the variations of the bench press. The difference lies in the inventory used. The use of dumbbells provides an isolated load on each arm, makes higher demands on intermuscular coordination.

Initial position.Lying face up on a bench, legs bent at the knees and shoulder-width apart, feet firmly pressed to the floor. The back of the head, shoulder blades and pelvis are firmly pressed against the bench. The dumbbell is held on straightened arms in front of him, the palms of the hands are turned to the legs.

Execution technique.The dumbbells go down to chest level, while the arms are spread apart so that the forearms are parallel to each other, after which the dumbbells are lifted up while bringing the arms together, the position of the hands does not change during the exercise. When performing the exercise, the forearms should be parallel to each other at all times.

Safety equipment. When performing the exercise, it is not recommended to lower the dumbbells below chest level and deviate the forearms from the vertical floor - this is traumatic for the shoulder joint. It is forbidden to lift dumbbells from the floor or put them on the floor while lying on the bench - this is traumatic for the shoulder joints, it is desirable that partners give and take dumbbells. It is not recommended to tear off the pelvis from the bench - this is traumatic for the lumbar spine. When performing the exercise, you should not tear your feet off the floor or put them on a bench - loss of balance and injury to the shoulder joint is possible. When the back of the head is separated from the bench during the bench press, the trajectory of the projectile is distorted and the traumatic load on the cervical spine increases. The projectile must be lowered to the middle of the chest, when lowering the projectile to the neck or to the lower part of the chest, a traumatic load is created on the shoulder joint.

Trained muscle groups. big muscle chest, triceps muscle of the shoulder, anterior and lateral bundle of the deltoid muscle, coracobrachialis muscle.

3. Push-ups

Push ups- basic, multi-joint exercise performed on the floor. The main muscles involved are the chest and triceps.

Initial position.Lying emphasis, legs together, back arched, legs straightened and together with the body form one line, arms straightened at the elbows and spaced slightly wider than shoulder level, look straight ahead.

Technique execution.Keeping the straight position of the body, due to flexion in the elbow and shoulder joint, go down until the shoulders are parallel to the floor, and then return to initial position. When performing the exercise, the torso and legs should remain straight.

Technique injury safety. In this case, the so-called deep push-ups should be avoided, when the hands are placed on stands and the athlete lowers the body below the level of the hands, such an exercise is traumatic for the shoulder joints.

Trained muscular groups. Pectoralis major, triceps brachii, anterior and lateral bundle of the deltoid, coracobrachialis.

4. Bench press from the shoulders (" Army press»)

Army press- one of the best exercises for developing the muscles of the shoulder girdle: deltas, upper chest, and triceps.

Initial position. Standing (or sitting), feet shoulder-width apart, back arched, shoulders turned, the barbell rests on the shoulders in front, the grip from above is slightly wider than shoulder level, the elbows are raised slightly up and turned outward.

Technique fulfillment. Without tilting the body back, squeeze the bar up behind the head until the arms are fully extended in the elbow joints, and then lower it back onto the shoulders. You need to look forward, do not raise your head up.

Technique injury safety. It is not recommended to tilt the body back during the exercise - it is traumatic for the lumbar spine and lowering the barbell below shoulder level is traumatic for the shoulder joints. When performing the exercise, it is not recommended to raise your head up (often done by beginners), in this case, the body deviates back and creates a traumatic load on lumbar spine.

Trained muscular groups. Anterior deltoid, trapezius, triceps brachii, top part pectoralis major.

5. Bench press from behind the head wide grip

Initial position. Standing (or sitting), feet shoulder-width apart, back arched, shoulders turned. The barbell rests on the shoulders behind the head, grip from above, wide.

Technique fulfillment. Without tilting the body back and without bending the legs at the knees, squeeze the barbell up until the arms are fully extended in the elbow joints, and then lower it back.

Technique injury safety. It is not recommended to lower the barbell below shoulder level - it is traumatic for the shoulder joints, it is not recommended to tilt the body back during the lifting of the projectile - it is traumatic for the lumbar spine. When performing the exercise, it is not recommended to raise your head up (often done by beginners), in this case, the body deviates back and creates a traumatic load on the lumbar spine.

Trained muscular groups. Anterior and lateral bundle of the deltoid muscle, trapezius muscle, triceps muscle of the shoulder.

6. French press

french press- an exercise in bodybuilding and powerlifting for the development of triceps.

Initial position. Standing, feet shoulder-width apart, the barbell is on the arms extended upwards, the grip is on top, the width of the grip is narrow.

Technique fulfillment. Keeping your shoulders perpendicular to the floor and not spreading your elbows to the sides, lower the bar down behind your head to the level of the forearms parallel to the floor, and then return to the starting position. During the exercise, do not spread your elbows to the sides and do not lower your shoulders forward.

Technique injury safety. It is not recommended to use limit and near-limit training weights in this exercise, since this can lead to damage to the tendons in the area of ​​the elbow joint, it is recommended to use a weight with which the athlete can perform at least 12-15 lifts.

Trained muscular groups. Triceps muscle of the shoulder.

7. Tate Press

The Tate bench press is one of the varieties the so-called "triceps presses" , in terms of the nature of the work, it is similar to the French bench press, but unlike it, it does not load the elbow joints so much.

Initial position. Lying on a bench face up, legs bent at the knees and spaced shoulder-width apart, feet firmly pressed to the floor. The pelvis, shoulder blades and the back of the head are firmly pressed against the bench. Dumbbells are held by the hands at the chest in a vertical position, the palms of the hands are turned to the pelvis.

Technique fulfillment. Due to the extension of the arms in the elbow joints, raise the dumbbells up until the arms are fully extended, while the dumbbells must be kept as close to each other as possible throughout the exercise.

Technique injury safety. It is not recommended to perform this exercise with maximum and near-limit weights, this can lead to the development of inflammatory processes in the tendons in the area of ​​the elbow joint, it is necessary to use such a weight with which the athlete can perform at least 12-15 lifts.

Trained muscular groups. Triceps.

8. Dips

Push-ups on the uneven bars- a basic exercise in bodybuilding and powerlifting performed on uneven bars, which develops the pectoral muscles and triceps.

Initial position.Emphasis on parallel bars, arms straightened, legs bent at the knees and connected together, grip with palms inward.

Technique fulfillment. By pulling the shoulders back and bending the arms in the elbow joints, lower the torso down until the shoulders are parallel to the floor, and then return to the starting position. When performing the exercise, it is necessary to avoid rocking the body, as this significantly reduces the effectiveness of the exercise.

Technique injury safety. It is not recommended to fall below the level of the parallel of the shoulders to the floor and use limit and near-limit weights - it is traumatic for the shoulder joints, it is recommended to use such a weight with which the athlete is able to do at least 8-10 approaches.

Trained muscular groups.Pectoralis major, anterior deltoid, triceps brachii.

9. Extension of arms on the upper block (press on the upper block)

The extension of the arms on the upper block is a local exercise for the development of the triceps, the structure of the movement is similar to the French press, but does not load the elbow joints so much. The exercise is local (when correct execution) and is performed on the simulator " upper block».

Initial position.Standing facing the simulator, feet shoulder-width apart (one of the legs can be slightly forward for stability), the body is slightly tilted forward, the handle of the simulator is pulled up to the chest, the grip is narrow from above, the elbows are tightly pressed to the body.

Technique fulfillment. Without straightening the torso and without spreading the elbows to the sides, lower the handle of the simulator down until the arms are fully extended in the elbow joints, and then return to the starting position. When performing the exercise, it is necessary to avoid spreading the elbows to the sides, since in this case the main part of the load is shifted from the triceps to the deltoid muscle.

Technique injury safety. It is not recommended to use limit and near-limit weights - this is traumatic for the elbow joints, it is recommended to set a weight with which the athlete is able to do at least 12-15 lifts.

Trained muscular groups. Triceps muscle of the shoulder.

10. Extension of the arm in an inclination

The bent over arm extension is a local exercise for the development of the triceps. Due to the specifics of the movement, the elbow joint experiences a significantly lower load than when performing french press which is a significant plus this exercise.

Initial position. Standing in an inclination, the shoulder of the working hand is pressed to the body, the forearm is lowered down, the hand from the dumbbells is turned with the palm inward. The leg opposite from the working hand is bent at the knee and put forward, the forearm of the free hand rests on the thigh of this leg and performs the function of a support, the leg of the same name from the working hand is set back and to the side and stands on the entire foot. The head is raised.

Technique fulfillment. Keeping the original position of the body and not moving the shoulder of the working arm to the side, raise the dumbbell back and up due to the full extension of the arm in the elbow joint, and then smoothly lower the forearm to its original position. At the top point, you can slightly raise the shoulder of the working arm up to increase the load. The exercise must be performed without jerking and swinging.

Technique injury safety. It is not recommended to use limit and near-limit weights - this is traumatic for the elbow joints, it is recommended to set such a weight with which it is possible to do at least 12-15 lifts.

Trained muscular groups. Triceps brachii, posterior deltoid muscle.

Conclusion

Do not train triceps more than 1 time per week. Don't forget that many chest exercises work the triceps, so make up training program so that the triceps and pectoral muscles are trained on different and distant days from each other. To increase efficiency, do triceps workouts of different intensity: light - medium - heavy and so on. After a hard workout, let's rest for at least 1 week.

In classic splits, triceps are usually the most overloaded muscle, due to the very specifics of training in split programs. To increase the volume of the triceps muscle, perform 8-15 repetitions. The total number of sets for triceps (the sum of sets of all exercises for triceps) 1-3.

It is a mistake to believe that for the muscles of the hands, the best choice is isolation. Triceps, like other muscles, swing best basic exercises, in particular the bench press narrow grip and push-ups on the uneven bars. For athletes with less than 2 years of experience, it is optimal not to use isolation exercises.

List of sources used

1. Homotomy. [Electronic resource]. - Access mode: URL - http://www.homotomia.ru/smert/155-myshczy.html [accessed 03.04.2013];

2.SportWiki - encyclopedia of scientific bodybuilding. [Electronic resource]. - Access mode: URL - http://sportswiki.ru/ [accessed 03.04.2013];

URAL STATE UNIVERSITY OF PHYSICAL CULTURE. Exercises for the muscles of the chest, shoulders and upper back [Electronic resource]. - Access mode: URL - http://atletikgymnastik.narod.ru/index21.htm [accessed 04/03/2013].

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47. Age and gender characteristics of the development of muscles, the impact of work and physical education and sports on the development of muscles.

48. Formations of the auxiliary muscle apparatus (fascia, fascial ligaments, fibrous and bone-fibrous channels, synovial sheaths, mucous bags, sesamoid bones, blocks) and their functions.

49. Abdominal muscles: topography, origin, attachment and functions.

50. Inspiratory muscles. Exhalation muscles.

52. Muscles of the neck: topography, origin, insertion and functions.

53. Muscles that bend the spine.

54. Muscles that extend the spine.

55. Muscles of the anterior surface of the forearm: origin, insertion and functions.

56. Muscles of the posterior surface of the forearm: origin, insertion and functions.

57. Muscles that produce movements of the belt of the upper limb forward and backward.

58. Muscles that produce movements of the belt of the upper limb up and down.

59. Muscles that flex and extend the shoulder.

60. Muscles that abduct and adduct the shoulder.

61. Muscles supinating and penetrating the shoulder.

62. Muscles that flex (basic) and extensor the forearm.

63. Muscles supinating and penetrating the forearm.

64. Muscles that flex and extend the hand and fingers.

65. Muscles that abduct and adduct the hand.

66. Thigh muscles: topography and functions.

67. Muscles that flex and extend the thigh.

68. Muscles that abduct and adduct the thigh.

69. Muscles supinating and penetrating the thigh.

70. Leg muscles: topography and functions.

71. Muscles that flex and extend the lower leg.

72. Muscles supinating and penetrating the lower leg.

73. Muscles that flex and extend the foot.

74. Muscles that abduct and adduct the foot.

75. Muscles supinating and penetrating the foot.

76. Muscles that hold the arches of the foot.

77. General center of gravity of the body: age, sex and individual characteristics of its location.

78. Types of balance: the angle of stability, the conditions for maintaining the balance of the body.

79. Anatomical characteristics of the anthropometric, calm and tense position of the body.

80. Hanging on straightened arms: anatomical characteristics, features of the mechanism of external respiration.

81. General characteristics of walking.

82. Anatomical characteristics of 1,2 and 3 phases of a double step.

83. Anatomical characteristics of 4, 5 and 6 phases of a double step.

84. Standing long jump: phases, muscle work.

85. Anatomical characteristics of back flips.

59. Muscles that flex and extend the shoulder.

Flex your shoulder: deltoid muscle (anterior bundles), pectoralis major muscle, biceps brachii, coracobrachialis muscle.

Deltoid starts from the clavicle (anterior part of the muscle), acromion (middle part) and spine of the scapula (back part), and is attached to the deltoid tuberosity of the humerus. If either the anterior or the posterior part alternately works, then the upper limb moves forward and backward, i.e. flexion and extension. If the whole muscle is tensed, then its anterior and posterior parts form a resultant, the direction of which coincides with the direction of the fibers of the middle part of the muscle, contributing to the abduction of the shoulder to a horizontal level.

pectoralis major muscle starts from the medial half of the clavicle (clavicular part), the anterior surface of the sternum and the cartilaginous parts of the upper five or six ribs (sternocostal part), the anterior wall of the sheath of the rectus abdominis muscle (abdominal part) and is attached to the crest of the large tubercle of the humerus. It refers to the muscles that go from the trunk to the free upper limb. This muscle pulls the scapula forward and removes it from the spinal column. But this function is secondary. Basically, it is involved in the movements of the humerus. If the torso is fixed, then this muscle adducts, pronates and flexes the humerus.

Biceps shoulder has two heads, long and short. The long head starts from the supraarticular tubercle of the scapula, and the short head from the coracoid process. The muscle is attached to the tuberosity of the radius and to the fascia of the forearm. This muscle is biarticular. It flexes the shoulder and fixes the head of the humerus in this joint; in relation to elbow joint it is a flexor and supinator of the forearm. Since the heads of the biceps muscle begin on the scapula at a certain distance from each other, their functions in relation to the movement of the shoulder are not the same: the long head flexes and abducts the shoulder, the short one flexes and adducts it. In relation to the forearm, the biceps brachii is an energetic flexor, as it has a significant shoulder of power.

Coracobrachial muscle starts from the coracoid process of the scapula, grows together with the short head of the biceps muscle and the pectoralis minor muscle, and is attached to the humerus at the level of attachment of the deltoid muscle. The function of the coracobrachialis muscle is not only to move the shoulder anteriorly, but also to adduct and pronate it.

Extend the shoulder: deltoid (posterior bundles), triceps brachii (long head), latissimus dorsi, teres major, infraspinatus.

Deltoid

Triceps brachii has three heads: long, medial and lateral. The long head starts from the subarticular tubercle of the scapula, and the medial and lateral heads start from the posterior surface of the humerus and the intermuscular septa. All three heads converge together into one tendon, which is attached to the olecranon of the ulna. The muscle, contracting, causes extension and adduction in the shoulder joint (long head) and extension in the elbow. The long head of the triceps brachii can function independently.

Latissimus dorsi muscle starts from the spinous processes of the lower five or six thoracic vertebrae, all lumbar, upper sacral vertebrae and from the back of the iliac crest, four teeth from the four lower ribs, is attached to the crest of the small tubercle of the humerus. Bringing and penetrating the humerus, it causes the lowering of the belt of the upper limb and bringing the scapula to the spinal column; that part of the muscle that starts from the ribs can raise them and have some effect on increasing the volume of the chest during inspiration.

teres major muscle starts from the lower angle of the scapula and is attached to the crest of the lesser tubercle of the humerus, often with one tendon from the latissimus dorsi muscle. When contracting, the teres major muscle acts as a rounded elevation when the pronated shoulder is adducted. The function of the muscle is to adduct, pronate and extend the humerus.

infraspinatus muscle starts from the infraspinatus fossa of the scapula. In addition, the place of origin of this muscle is the infraspinatus fascia. Attaches to the greater tubercle of the humerus. The function of the infraspinatus muscle is to adduct, supinate and extend the shoulder in the shoulder joint.

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 in the 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. shoulder joint grows together, which interferes with the normal functioning of the hand.

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:

1. Clasp your hands in a “lock” in front of you and slowly raise up and lower down.
2. Flexion and extension of the arms at the elbow joint.
3. With a sick hand, we slowly try to “draw” a circle in the air, the more it turns out, the better.
4. We make a “lock” behind our back, try not to bend our arms.
5. We throw the ball into an imaginary ring.
6. 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.
7. 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:

1. An infusion (tea) is made from yarrow, St. John's wort, wild rose, lingonberry leaves and currants (black).
2. Compresses, rubbing, which warm the diseased joint.
3. Apply honey to the affected area, wrap and leave overnight.
4. 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 the 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 the emergence of 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:

1. front axis. Responsible for the function of flexion and extension.
2. Sagittal axis. Involved in abduction of hands.
3. 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:

1. 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.
2. 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.
3. The shrug requires the simultaneous work of the shoulder joints, collarbones and shoulder blades.
4. 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 coincides with the outlines of the 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:

1. The size of the spherical head is several times the volume of the scapular cavity.
2. 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 from the 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:

1. 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.
2. Slightly higher, between coracoid process and tendon subscapularis, a sub-beak-shaped bag is formed.
3. 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 or 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:

1. From the outside and from above, the articulation is covered by the deltoid muscle. It does not have a direct connection with the joint capsule, but at the same time protects the joint from three sides. Deltoid unites three bones at once - the shoulder, shoulder blade and collarbone.
2. 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.
3. On the inside of the joint is the triceps (triceps muscle). 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.
4. 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. She crosses the depression of the same name and goes into 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 the supraspinatus, infraspinatus, teres minor, 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 sports and lead 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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