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Wheeless' Textbook of Orthopaedics
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Abductors of the Shoulder





See: Rotator cuff
- Discussion:
    - abduction of shoulder is a smooth, integrated motion which has been termed
          scapulohumeral rhythm by Codman;
            - disruption of this smooth motion is important since asymmetrical movement
                  usually indicates a chronic pathological disorder of the shoulder;
            - there is a 2:1 ratio of movement in GHJ & scapulothoracic joints;
    - Clavicle also plays part in elevation of the arm, w/ about 40 deg of motion
            occurring at sternoclavicular joint & 20 deg in AC joint   during full
            abduction of the shoulder;
- Role of Rotator Cuff in Shoulder Abduction:
    - w/ suprascapular nerve block (which elminates supraspinatus &
          infraspinatus function) there is still full abduction of arm although it is
          about 50% weaker;
          - remaining teres minor and subscapularis provide glenohumeral
                compression and humeral depression;
    - as arm is abducted to 90 deg direction of pull of deltoid approximates
          that of the supraspinatus;
          - hence pts w/ large tears of Rotator cuff can often actively keep the arm
                abducted to 90 deg but may not be able to initiate abduction to 90 deg;



Original Text by Clifford R. Wheeless, III, MD.