 Diagnosis (Shoulder) |
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Doctors |
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Rehabilitation |
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Service |
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 Anatomy |
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The extremely broad range of functions of the arm as a whole, including those of the hand carrying out the function, are primarily dependent on the extraordinary mobility of the shoulder joint, which comprises the large head of the humerus and the relatively small joint socket (ratio 3 : 1). The complicated system of interaction involves three joints and two secondary joints. The relatively small joint socket is extended and deepened by a sealing ring made of fibrous cartilage known as the labrum (similar to the meniscus in the knee). The capsule ligament structures are attached to this ring of fibrous cartilage. These together form the labrum-capsule-ligament aggregate and are of great importance for the static stability of the shoulder. These structures are damaged if the shoulder is dislocated. As well as the static stability, the dynamic stability provided by the muscle/tendon groups of the rotator cuff and the shoulder-stabilising muscle groups are of great significance. The complicated system of interaction between the joint capsule, the reinforcing ligament structures and the muscle groups necessary for the perfect function of the shoulder is not only of major significance when subjected to the stresses and strains experienced in sport. |
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The rotator cuff, a functional unit made up of five muscle/tendon-groups, separates the actual shoulder joint
from the subacromial space, which is situated beneath the bony acromion (shoulder roof). The rotator cuff is
primarily responsible for centering the head of the humerus, lateral lifting of the arm and rotational movements.
It coordinates, accelerates and decelerates the throwing or hitting movements in racket or throwing-intensive
sports. The rotator cuff is therefore not just subject to high levels of tractional exertion but also to mechanical
irritations below the bony acromion. Over the course of time, the bony structures of the shoulder may be subject to degenerative changes and increased narrowing. These changes in the bones are a common problem in older patients with painful shoulder complaints. Between the acromion and the rotator cuff there is a synovial bursa, which should ease and lubricate the motion of the rotator cuff below the bony acromion. Fissures in the rotator cuff, tendon degeneration, changes to the bones in the acromion, calcium deposits in one or more of the tendons in the rotator cuff and the associated inflammation of the synovial bursa are very often responsible for painful shoulder complaints. A further cause of painful, traumatic and degenerative changes is often the acromioclavicular joint, which forms the important joint connection between the collar bone and the acromion. |
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| Head of the humerus and joint socket (left shoulder) |
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| System of ligaments and long biceps tendon (left shoulder/front view) |
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| Tendons and muscles of the rotator cuff (left shoulder/side view) |
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