Download Shoulder Girdle—Dynamic Stability

4-1
Kinesiology for Manual Therapies
Chapter 4
The Shoulder Girdle—Dynamic Stability for the
Shoulder Joint
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4-2
Learning Outcomes
4-1 Define key terms.
o 4-2 Identify on the skeleton all
bony landmarks of the shoulder
girdle.
o 4-3Label on a skeletal chart all bony
landmarks of the shoulder girdle.
o
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4-3
Learning Outcomes (cont.)
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4-4 Draw on a skeletal chart the
muscles of the shoulder girdle and
indicate shoulder girdle movements
using arrows.
4-5 Demonstrate all the
movements of the shoulder girdle
using a partner.
4-6 Palpate the bony landmarks of
the shoulder girdle on a partner.
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4-4
Learning Outcomes (cont.)
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4-7 Give examples of agonists,
antagonists, stabilizers, and
synergists of the shoulder girdle
muscles.
4-8 Explore the origins and
insertions of shoulder girdle
muscles on a partner.
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4-5
Learning Outcomes (cont.)
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4-9 Discuss the principles of
different forms of stretching.
4-10 Practice basic stretching and
strengthening appropriate for the
shoulder girdle.
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4-6
Introduction
The
shoulder girdle surrounds the trunk
and provides a mechanism for the upper
extremity to attach to the body.
Without scapular movement, the actions
of the upper extremity would be severely
limited.
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Introduction (cont.)
Repetitive actions performed by the
upper extremity lead to fatigue of the
shoulder girdle and shoulder joint muscles.
 This may affect the position of the
scapulae and the posture of the body.

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Bones
The shoulder girdle consists of the
scapula and clavicle.

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4-9
Bones (cont.)
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Bones (cont.)
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Joints
Actions of the scapula over the rib cage
are called scapulothoracic actions.
 Sternoclavicular joint
 Acromioclavicular joint
 Scapulothoracic joint

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Joints (cont.)
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Joints (cont.)
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Joints (cont.)
Scapulohumeral rhythm is the
synergistic movement of the
scapulothoracic joint with the shoulder
joint.

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4-15
Movements
Abduction
 Adduction
 Upward rotation
 Downward rotation
 Elevation
 Depression

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Movements (cont.)
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Movements (cont.)
Accessory Movements of the Scapula
include:

Lateral tilt

Medial tilt

Anterior tilt

Posterior tilt
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Movements (cont.)
Synergy with the muscles of the
glenohumeral joint – the shoulder joint and
the shoulder girdle work together in
performing upper-extremity activities.

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4-19
Muscles
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Muscles (cont.)
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Muscles (cont.)
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Muscles (cont.)
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Nerves
Cervical plexus
 Brachial plexus

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Nerves (cont.)
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Nerves (cont.)
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Nerves (cont.)
The brachial plexus is vulnerable to
nerve impingements.
 Nerve compressions are caused by
abnormal bony growth or disk issues.
 Nerve entrapments are caused by softtissue structures applying pressure on
nerves.

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4-27
Clinical Flexibility and Therapeutic
Exercise
Clinical Flexibility and Therapeutic
Exercise (CFTE) is a modality composed
of stretching and strengthening the
muscles of the body.

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Understanding Flexibility
Flexibility – end motion of a segment
 Stretching – taking a muscle in its
resting length and expanding it

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Understanding Flexibility (cont.)
Two neurologic properties:

Myotatic reflex arc

Golgi tendon organ
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Types of Flexibility
Ballistic stretching
 Passive stretching
 Static stretching
 Proprioceptive neuromuscular
facilitation stretching (PNF)
 Active Isolated Stretching (AIS)

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Types of Flexibility (cont.)
Clinical flexibility is used in a clinical
setting as it is stretching that is assisted by
a therapist.

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Types of Flexibility (cont.)
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Individual Muscles of the Shoulder
Girdle
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Individual Muscles of the Shoulder
Girdle (cont.)
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Individual Muscles of the Shoulder
Girdle (cont.)
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Individual Muscles of the Shoulder
Girdle (cont.)
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Individual Muscles of the Shoulder
Girdle (cont.)
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Individual Muscles of the Shoulder
Girdle (cont.)
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Individual Muscles of the Shoulder
Girdle (cont.)
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Individual Muscles of the Shoulder
Girdle (cont.)
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Individual Muscles of the Shoulder
Girdle (cont.)
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Individual Muscles of the Shoulder
Girdle (cont.)
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Individual Muscles of the Shoulder
Girdle (cont.)
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Individual Muscles of the Shoulder
Girdle (cont.)
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Chapter Summary
The bones, joints, movements, muscles,
and nerves of the shoulder girdle are
explored in this chapter.
 Clinical flexibility and therapeutic
exercise is defined and explained for
practice purposes.

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4-46
Chapter Summary (cont.)
Flexibility is defined to better
understand the principles and different
types of safe stretching.
 Types of stretching include ballistic,
passive, static, proprioceptive
neuromuscular facilitation (PNF), and
Active Isolated Stretching (AIS).

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4-47
Chapter Summary (cont.)
Individual muscles of the shoulder girdle
are reviewed in depth with regard to
palpation, origin, insertion, action, and
innervation.
 Each muscle includes information with
clinical notes, muscle specifics, clinical
flexibility, and strengthening.

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4-48
Chapter Review
The Chapter Review is divided into true
and false, short answers, and multiple
choice questions.
 The questions are designed for the
students to test their knowledge.
 Worksheets are at the end of the text as
an aid for learning.

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Explore and Practice

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Students should utilize the questions and
charts at the end of the chapter to help
focus on the content of the chapter.
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