Shoulder Girdle

Shoulder Girdle

1. Scapula winging

   • Scapula setting
     • Level One
       • 10 x 10 seconds hold
       • prone, sitting or standing
       • make use of visula and sensory feedback
         • hand on coracoid process
     • Level Two
       • Dynamic control of movement
         • unilateral arm lift
           • maintain scapula neutral
     • Level there
       • stabilising
         • overhead arm movmetns with scapula control maintained
         • Prone or 4 point kneeling with arm lifts
           • hold against resistance
     • Level four
       • Lengthening
         • only if control can be maintained
   • Postural reeducation
   • Faulty movement can cause pathology and not just be the cause of it
     • Need to manage it and reducate before it causes more problems

2. Retaction

   • Rhomboid minor
     • O - Lower end of ligumentum nuchae and spinous processes of C7 - T1
     • I - Posterior medial scapula
     • N - Dorsal scapula nerve
   • Rhomboid major
     • O- spinous processes of T2-T5
     • I- Posterior medial scapula
     • N - Dorsal scapula nerve
   • Trapezius
     • O- Medial 1/3 superior nuchal line, exteran loccipital protuberance, ligamentum nuchae, spinous processes and supra spinous ligaments of C7 - T12
     • Middle fibres I - acromion and superior crest of spine of scapula
     • N - Accessory never / Ventral rami
   • Levator scapulae
     • O - Transverse processes of C1 - C4
     • I - medial border of scapula
     • N - Ventral rami / dorsal scapula nerve

3. Protraction

   • Pectoralis minor
     • O - outer surface of 3rd-5th rib
     • I - Coracoid process
     • N- Medial pectoral nerve
   • Serratus anterior
     • O - Lateral surface of 1 -8th rib
     • I - Costal surface of medial scapula
     • N -Long thoracic nerve

4. Elevation

   • Trapezius
     • O- Medial 1/3 superior nuchal line, exteran loccipital protuberance, ligamentum nuchae, spinous processes and supra spinous ligaments of C7 - T12
     • Upper fibres I - Posterior lateral 1/3 clavical
     • N- Accessory nerve and ventral rami
   • Levator scapulae
     • O - Transverse processes of C1 -C4
     • I - Medial border of scapula
     • N - Ventral rami/dorsal scapula nerve

5. Depression

   • Trapezius
     • O- Medial 1/3 superior nuchal line, exteran loccipital protuberance, ligamentum nuchae, spinous processes and supra spinous ligaments of C7 - T12
     • I -Lower fibres - tubercle at medial end of scapula
     • N - Accessory nerve/ ventral rami

6. Lateral Roatation

   • Trapezius
     • O- Medial 1/3 superior nuchal line, exteran loccipital protuberance, ligamentum nuchae, spinous processes and supra spinous ligaments of C7 - T12
     • Upper fibres I - Posterior lateral 1/3 clavical, Lower Fibres I - tubercle at medial end of scapula
     • N - Accessory nerve/ ventral rami
   • Serratus anterior
     • O - Lateral surface of 1 -8th rib
     • - Costal surface of medial scapula
     • N - Long thoracic nerve

7. Medial roation

   • Rhomboid minor
     • O- Lower end of ligumentum nuchae and spinous processes of C7 - T1
     • I - Posterior medial scapula
     • N - Dorsal scapula nerve
   • Rhomboid major
     • O- Spinous processes T2-T5
     • I- Posterior medial scapula
     • N - Dorsal scapula nerve
   • Pec minor
     • O - outer surface of 3rd-5th rib
     • I - Coracoid process
     • N - medial pectoral nerve
   • Levator scapulae
     • O Transverse processes of C11-C4
     • I medial scapula
     • N - vental rami/dorsal scapula nerve

8. Brachial plexus

9. Scapula should not move in first 60 degrees of motion

10. Muscle balance

    • muscles that stabilis
      • Become stretched and ineefective
    • muscles that mobilise
      • become short and tight