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Biomechanics of the Shoulder

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Book cover Shoulder Arthroscopy

Abstract

The glenohumeral (GH) joint has the greatest range of motion of any joint in the human body. As such, it has inherent instability, as its great range of motion is afforded by the lack of bony restraint. Its functional structure permits significant rotation while maintaining the humeral center of rotation to within 1–2 mm with respect to the glenoid. Limitation of translation during active shoulder motion occurs through complex interactions between passive structures (ligaments, capsule, labrum, articular surfaces) and active structures (rotator cuff muscles, biceps brachii muscle, deltoid), which produce a concavity-compression effect of the humeral head on the glenoid. The humeral head has an articulating surface area that is approximately three times that of the glenoid despite a similar radius of curvature, which means the humerus is only loosely constrained by the glenoid bony anatomy. Simple geometry shows that dislocation of the humeral head from the glenoid fossa should require a translation approximately half of the sum of the glenoid and humeral head axes in the direction of dislocation. In the normal shoulder, passive and active stabilizing mechanisms prevent such translations. As the shoulder changes position, different structures are responsible for stabilizing the GH joint. Damage to various anatomic structures can produce shoulder instability through different mechanisms. For example, the mechanics of atraumatic multidirectional instability are usually very different from those of posttraumatic unidirectional anterior instability.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Columbia University Medical Center, 622 West 168th street, PH11C, New York, NY, 10032, USA

    Christopher S. Ahmad MD

  2. Department of Orthopaedic Surgery, New York Orthopaedic Hospital, Columbia University, 622 West 168th Street, PH11C, New York, NY, 10032, USA

    Marc D. Dyrszka MD

  3. Department of Orthopaedics, Columbia University, 622 West 168th Street, PH11C, New York, NY, 10032, USA

    Dennis H. Kwon BS

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  1. Christopher S. Ahmad MD
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Correspondence to Christopher S. Ahmad MD .

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Editors and Affiliations

  1. Department of Orthopaedics, Catholic University of Rome, Rome, Roma, Italy

    Giuseppe Milano

  2. Department of Orthopaedics and Traumatology, Casa di Cura Villa Valeria, Rome, Roma, Italy

    Andrea Grasso

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Ahmad, C.S., Dyrszka, M.D., Kwon, D.H. (2014). Biomechanics of the Shoulder. In: Milano, G., Grasso, A. (eds) Shoulder Arthroscopy. Springer, London. https://doi.org/10.1007/978-1-4471-5427-3_2

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