Skip to main content

Abstract

The glenohumeral joint allows extensive mobility to the shoulder therefore requiring a complex integration of both passive and active stabilizers to provide adequate stability. To provide this stability, a complex interplay of ligamentous, muscular, and bony stabilizers acts to maintain reduction of the head of the humerus to the glenoid. These structures include the fibrous joint capsule and its associated ligaments providing passive stability to the joint, as well as the surrounding muscular structures providing dynamic muscular stability during motion including the rotator cuff muscles, deltoid, and pectoral muscles. Despite these stabilizers, episodes of instability are not uncommon and often result in the disruption of these soft tissues. The purpose of this chapter is to describe the clinical anatomy of the stabilizers of the glenohumeral joint. Description of these structures will focus on the glenoid labrum , its soft tissue stabilizers including the superior, middle, and inferior glenohumeral ligaments, and the dynamic muscle stabilizers including the rotator cuff muscles, deltoid, and pectoral muscles.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Ahrens PM, Boileau P. The long head of biceps and associated tendinopathy. J Bone Joint Surg Br. 2007;89(8):1001–9.

    Article  CAS  PubMed  Google Scholar 

  2. Bain GI, Galley IJ, Singh C, Carter C, Eng K. Anatomic study of the superior glenoid labrum. Clin Anat. 2013;26:367–76.

    Article  PubMed  Google Scholar 

  3. Bents RT, Skeete KD. The correlation of the Buford complex and SLAP lesions. J Shoulder Elbow Surg. 2005;14(6):565–9.

    Article  PubMed  Google Scholar 

  4. Blasier RB, Guldberg RE, Rothman ED. Anterior shoulder stability: contributions of rotator cuff forces and the capsular ligaments in a cadaver model. J Shoulder Elbow Surg. 1992;1(3):140–50. PubMed PMID: 12072743.

    Google Scholar 

  5. Burkart AC, Debski RE. Anatomy and function of the glenohumeral ligaments in anterior shoulder instability. Clin Orthop Relat Res. 2002;(400):32–9.

    Google Scholar 

  6. Carroll KW, Helms CA. Magnetic resonance imaging of the shoulder: a review of potential sources of diagnostic errors. Skeletal Radiol. 2002;31(7):373–83.

    Article  CAS  PubMed  Google Scholar 

  7. Davidson PA, Rivenburgh DW. Mobile superior glenoid labrum: a normal variant or pathologic condition? Am J Sports Med. 2004;32(4):962–6.

    Article  PubMed  Google Scholar 

  8. DeLee J, Drez Jr D, Miller M. Orthopaedic sports medicine: principles and practice. Philadelphia: Saunders Elsevier; 2010.

    Google Scholar 

  9. DePalma A, Callery G, Bennett G. Variational anatomy and degenerative lesions of the shoulder joint. In: Instructional course lectures of the American Academy of Orthopaedic Surgeons. 1949. p. 255–80.

    Google Scholar 

  10. Dunham KS, Bencardino JT, Rokito AS. Anatomic variants and pitfalls of the labrum, glenoid cartilage, and glenohumeral ligaments. Magn Reson Imaging Clin N Am. 2012;20(2):213–28, x.

    Article  PubMed  Google Scholar 

  11. Dwight T, Hamann C, McMurrich J, Piersol G, White J. Human anatomy, including structure and development and practical considerations. Philadelphia: J.B. Lippincott Company; 1907.

    Google Scholar 

  12. Elser F, Braun S, Dewing CB, Giphart JE, Millett PJ. Anatomy, function, injuries, and treatment of the long head of the biceps brachii tendon. Arthroscopy. 2011;27:581–92.

    Article  PubMed  Google Scholar 

  13. Flood V. Discovery of a new ligament of the shoulder joint. Lancet. 1829–1830;13:672–3.

    Google Scholar 

  14. Gaskill TR, Braun S, Millett PJ. Multimedia article. The rotator interval: pathology and management. Arthroscopy. 2011;27(4):556–67.

    Article  PubMed  Google Scholar 

  15. Glousman R, Jobe F, Tibone J, Moynes D, Antonelli D, Perry J. Dynamic electromyographic analysis of the throwing shoulder with glenohumeral instability. J Bone Joint Surg Am. 1988;70(2):220–6.

    CAS  PubMed  Google Scholar 

  16. Gottschalk MB, Karas SG, Ghattas TN, Burdette R. Subpectoral biceps tenodesis for the treatment of type II and IV superior labral anterior and posterior lesions. Am J Sports Med. 2014;42(9):2128–35.

    Article  PubMed  Google Scholar 

  17. Howell SM, Galinat BJ, Renzi AJ, Marone PJ. Normal and abnormal mechanics of the glenohumeral joint in the horizontal plane. J Bone Joint Surg Am. 1988;70(2):227–32.

    CAS  PubMed  Google Scholar 

  18. Howell SM, Galinat BJ. The glenoid-labral socket. A constrained articular surface. Clinical orthopaedics and related research. 1989(243):122–25.

    Google Scholar 

  19. Itoi E, Newman SR, Kuechle DK, Morrey BF, An KN. Dynamic anterior stabilisers of the shoulder with the arm in abduction. J Bone Joint Surg Br. 1994;76(5):834–6.

    CAS  PubMed  Google Scholar 

  20. Karduna AR, Williams GR, Williams JL, Iannotti JP. Kinematics of the glenohumeral joint: influences of muscle forces, ligamentous constraints, and articular geometry. J Orthop Res. 1996;14(6):986–93.

    Article  CAS  PubMed  Google Scholar 

  21. Kelkar R, Wang VM, Flatow EL, Newton PM, Ateshian GA, Bigliani LU, Pawluk RJ, Mow VC. Glenohumeral mechanics: a study of articular geometry, contact, and kinematics. J Shoulder Elbow Surg. 2001;10(1):73–84.

    Article  CAS  PubMed  Google Scholar 

  22. Labriola JE, Lee TQ, Debski RE, McMahon PJ. Stability and instability of the glenohumeral joint: the role of shoulder muscles. J Shoulder Elbow Surg. 2005;14(1):32S–8.

    Article  PubMed  Google Scholar 

  23. Mangels Jr M, Robinson CA. Modified Nicola operation for correction of recurring anterior dislocations of the shoulder. South Med J. 1947;40(9):784–6.

    Article  PubMed  Google Scholar 

  24. Mileski RA, Snyder SJ. Superior labral lesions in the shoulder: pathoanatomy and surgical management. J Am Acad Orthop Surg. 1998;6:121–31.

    CAS  PubMed  Google Scholar 

  25. Moore K, Dalley A, Agur A. Clinically oriented anatomy. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2013.

    Google Scholar 

  26. Moseley H, Övergaard B. The anterior capsular mechanism in recurrent anterior dislocation of the shoulder. J Bone Joint Surg Br. 1962;44B(4):913–26.

    Google Scholar 

  27. Moseley H, Övergaard B. The anterior capsular mechanism in recurrent anterior dislocation of the shoulder. J Bone Joint Surg Br. 1962;44(4):913–27.

    Google Scholar 

  28. Motamedi D, Everist BM, Mahanty SR, Steinbach LS. Pitfalls in shoulder MRI: part 1–normal anatomy and anatomic variants. AJR Am J Roentgenol. 2014;203(3):501–7.

    Article  PubMed  Google Scholar 

  29. Nishida K, Hashizume H, Toda K, Inoue H. Histologic and scanning electron microscopic study of the glenoid labrum. J Shoulder Elbow Surg. 1996;5:132–8.

    Article  CAS  PubMed  Google Scholar 

  30. O’Brien SJ, Neves MC, Arnoczky SP, Rozbruck SR, Dicarlo EF, Warren RF, Schwartz R, Wickiewicz TL. The anatomy and histology of the inferior glenohumeral ligament complex of the shoulder. Am J Sports Med. 1990;18(5):449–56.

    Article  PubMed  Google Scholar 

  31. O’Connor SJ, Klaaren HE. Recurrent anterior superior dislocation of the glenohumeral joint. J Bone Joint Surg Am. 1956;38-A(4):889–90.

    PubMed  Google Scholar 

  32. Perry J. Anatomy and biomechanics of the shoulder in throwing, swimming, gymnastics, and tennis. Clin Sports Med. 1983;2(2):247–70.

    CAS  PubMed  Google Scholar 

  33. Poppen NK, Walker PS. Normal and abnormal motion of the shoulder. J Bone Joint Surg Am. 1976;58(2):195–201.

    CAS  PubMed  Google Scholar 

  34. Prodromos CC, Ferry JA, Schiller AL, Zarins B. Histological studies of the glenoid labrum from fetal life to old age. J Bone Joint Surg Am. 1990;72:1344–8.

    CAS  PubMed  Google Scholar 

  35. Provencher M, Romeo A. Shoulder instability: a comprehensive approach. Philadelphia: Saunders Elsevier; 2012.

    Google Scholar 

  36. Rodosky MW, Harner CD, Fu FH. The role of the long head of the biceps muscle and superior glenoid labrum in anterior stability of the shoulder. Am J Sports Med. 1994;22(1):121–30.

    Article  CAS  PubMed  Google Scholar 

  37. Rothman RH, Marvel Jr JP, Heppenstall RB. Anatomic considerations in glenohumeral joint. Orthop Clin North Am. 1975;6(2):341–52.

    CAS  PubMed  Google Scholar 

  38. Schlemm F. Ueber die Verstarkungsbander am Schultergelenk. Arch Anat. 1853;22:45–8.

    Google Scholar 

  39. Smith DK, Chopp TM, Aufdemorte TB, Witkowski EG, Jones RC. Sublabral recess of the superior glenoid labrum: study of cadavers with conventional nonenhanced MR imaging, MR arthrography, anatomic dissection, and limited histologic examination. Radiology. 1996;201(1):251–6.

    Article  CAS  PubMed  Google Scholar 

  40. Snodgrass LE. Anterior dislocation of the shoulder-joint by abduction and internal rotation. Ann Surg. 1934;100(3):539–43.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  41. Soslowsky LJ, Malicky DM, Blasier RB. Active and passive factors in inferior glenohumeral stabilization: a biomechanical model. J Shoulder Elbow Surg. 1997;6(4):371–9.

    Article  CAS  PubMed  Google Scholar 

  42. Stoller DW. MR arthrography of the glenohumeral joint. Radiol Clin North Am. 1997;35(1):97–116.

    CAS  PubMed  Google Scholar 

  43. Townley C. The capsular mechanism in recurrent dislocation of the shoulder. J Bone Joint Surg. 1950;32(2):370–80.

    Google Scholar 

  44. Tuite MJ, Orwin JF. Anterosuperior labral variants of the shoulder: appearance on gradient-recalled-echo and fast spin-echo MR images. Radiology. 1996;199(2):537–40.

    Article  CAS  PubMed  Google Scholar 

  45. Turkel SJ, Panio MW, Marshall JL, Girgis FG. Stabilizing mechanisms preventing anterior dislocation of the glenohumeral joint. J Bone Joint Surg Am. 1981;63(8):1208–17.

    CAS  PubMed  Google Scholar 

  46. Walch G, Nove-Josserand L, Levigne C, Renaud E. Tears of the supraspinatus tendon associated with “hidden” lesions of the rotator interval. J Shoulder Elbow Surg. 1994;3(6):353–60.

    Article  CAS  PubMed  Google Scholar 

  47. Warner JJ, Deng XH, Warren RF, Torzilli PA. Static capsuloligamentous restraints to superior-inferior translation of the glenohumeral joint. Am J Sports Med. 1992;20(6):675–85.

    Article  CAS  PubMed  Google Scholar 

  48. Werner A, Mueller T, Boehm D, Gohlke F. The stabilizing sling for the long head of the biceps tendon in the rotator cuff interval. A histoanatomic study. Am J Sports Med. 2000;28(1):28–31.

    CAS  PubMed  Google Scholar 

  49. Wilk K, Reinold MM, Andrews J. The athlete’s shoulder. Philadelphia: Churchill Livingstone/Elsevier; 2009.

    Google Scholar 

  50. Wuelker N, Korell M, Thren K. Dynamic glenohumeral joint stability. J Shoulder Elbow Surg. 1998;7(1):43–52.

    Article  CAS  PubMed  Google Scholar 

  51. Xia Y. Magic-angle effect in magnetic resonance imaging of articular cartilage: a review. Invest Radiol. 2000;35(10):602–21.

    Article  CAS  PubMed  Google Scholar 

  52. Zlatkin MB, Sanders TG. Magnetic resonance imaging of the glenoid labrum. Radiol Clin North Am. 2013;51(2):279–97.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Augustus D. Mazzocca MS, MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 ISAKOS

About this chapter

Cite this chapter

Apostolakos, J. et al. (2015). Glenoid Labrum. In: Bain, G., Itoi, E., Di Giacomo, G., Sugaya, H. (eds) Normal and Pathological Anatomy of the Shoulder. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45719-1_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-45719-1_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-45718-4

  • Online ISBN: 978-3-662-45719-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics