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March 18 - ch18 shoulder.doc

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Physical Education and Sport
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Brad Kern

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March 18 – Ch 18 – shoulder • The shoulder is an extremely complicated region of the body • The sternal calvicular joint is the only connection between the upper extremity and your axial skeleton. Its a weak joint and connected by sternal clavicular ligaments • The acromioclavicular joint is a gliding joint and held together by 3 ligaments. The acriomioclavicular ligament goes from the acromion to the clavicle. • Coracoacromial ligament goes from the coracoid process to the acromion • The glenohumeral joint is a ball and socket joint that has a lot of mobility. The humerus inserts into the shall cavity of the glenoid fossa. • We need to fix a weak scapula before we can strengthen the shoulder • Joint which has a high degree of mobility but not without compromising stability • Involved in a variety of overhead activities relative to sport making it susceptible to a number of repetitive and overuse type injuries • Movement and stabilization of the shoulder requires integrated function of the rotator cuff muscles, joint capsule and scapula stabilizing muscles Anatomy of the shoulder 3 groups of muscles 1.)Ones that originate on the axial skeleton and insert on the humerus (latissimus dorsi and pec major) 2.)Ones that originate from the scapula to the humerus (include delts, teres major, coracobrachialis and rotator cuff muscles) 3.)Those that originate from the axial skeleton to the scapula (include levator scap, trap, rhomboids, and seratus anterior and posterior) Rotator cuffs are responsible for internal and external rotation Supraspinatus is involved in abduction Muscles involved in external rotation – EXIT – external rotation infraspinatus and teres minor Look the table for all these muscles Prevention of Shoulder Injuries • Proper physical conditioning is key • Develop body and specific regions relative to sport Strengthen through a full ROM • Focus on rotator cuff muscles in all planes of motion • Be sure to incorporate scapula stabilizing muscles (enhances base of function for glenohumeral joint) • Warm-up should be used before explosive arm movements are attempted • Contact and collision sport athletes should receive proper instruction on falling • Protective equipment (acromion process should be protected) • Mechanics vs. Overuse injuries Throwing Mechanics • Instruction in proper throwing mechanics is critical for injury prevention • The most common elbow injuries for throwing happens at the UCL (ulnar collateral ligament) • Most common shoulder injuries happen in deceleration and follow through phase of a throw. There should be natural follow through and avoid the snap back after throwing Windup Phase • First movement until ball leaves gloved hand • Lead leg strides forward while both shoulders abduct, externally rotate and horizontally abduct Cocking Phase • Hands separate (achieve maximum external rotation) while lead foot comes in contact with ground Acceleration • Maximum external rotation until ball release (humerus adducts, horizontally adducts and internally rotates) • Scapula elevates and abducts and rotates upward
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