Bony Landmarks of the Shoulder with Bonnie Southgate
Bony Landmarks of the Shoulder:
We’re back for our next instalment of Landmarks – This time we’re looking at the bony landmarks of the shoulder. The shoulder can seem like a really complex joint, but taking it back to the bones is a really great place to start! It may feel like there’s too many bones to remember, but thankfully Bonnie is at hand to walk us through the basics!
Understanding the anatomy and biomechanics of the shoulder are of utmost importance. Recognising how they should work in relation to movement can be the difference between optimal and sub-optimal movement…Ultimately, cueing the correct movement can help our clients to move optimally without pain.
Today, Bonnie is demonstrating the bony landmarks of the shoulder. Once we know which bones are which and where they’re situated through palpation we can then look to explore their ligamentous and muscular attachments. Understanding this, can be really significant when observing movement, performing screens and treating your clients. If something isn’t moving correctly in the shoulder, chances are it’s going to have a knock-on effect up and down the chain.
At Pilates Therapy, we’re fanatic about movement and ensuring that the body is able to move correctly and optimally so if you’re looking to further help your clients then you’ve arrived at the right place!
Here is the full video, but for those of you who like to read, we’ve also outlined the landmarks covered so you can follow along too! You can also visit our YouTube channel and subscribe to view all of the latest content!
The shoulder is made up of 3 main bones: The Scapula, Clavicle and the Humeral Head.
There are 4 joints which make up the shoulder complex: Sternoclavicular, Acromioclavicular, Glenohumeral and the Scapulothoracic Joint.
The Sternoclavicular, Acromioclavicular and Glenohumeral joint are all classified as true joints however, the Scapulothoracic Joint is considered a false joint since it lacks some of the structures which typically form a joint. The Scapulothoracic Joint does not include, a joint capsule, synovial membrane, and synovial fluid. Moreover, it has no ligamentous support.
Despite this being a false joint, it doesn’t discredit it as part of the shoulder. True or false, the Scapulothoracic Joint still plays a vital role within the shoulder girdle.
Clavicle – More commonly referred to as the ‘collar bone’ this is a really easy landmark to palpate. The clavicle forms 2 joints – Medially, it articulates with the sternum and this is where you will find the Sternoclavicular Joint (SC), and then laterally where you come to the end of the clavicle and the beginning of the acromion, you will find the Acromioclavicular Joint (AC). At the end of the clavicle and beginning of the acromion, you will feel a slight dip – and this is typically the palpation point for the Acromioclavicular Joint.
Spine of Scapula – Once you’ve palpated and found the AC Joint, continue to follow that line around the shoulder in back, and you should start to feel the Spine of the Scapula.
Medial Border – Following the spine of the scapula, you will eventually meet the end of the shoulder blade. This then forms the medial border of your scapula. Asking your client to take their hand behind their back slightly, will allow the medial border of the scapula to show a little clearer.
Inferior Angle – Once you’ve located the Medial Border of the Scapula, you can continue to follow this down until you meet the bottom of the Scapula. This is known as the Inferior Angle and it feels a bit like a point (almost like the apex of your patella)
Lateral Border – You can now follow the edge of the scapula as it goes up onto the lateral edge. This is known as the lateral border which serves as attachment points to the Teres Major and Minor muscles…more of that to come in following posts! Asking your client to flex their arm or take it into something called Scaption, will allow you to palpate this landmark a little easier.
Whilst not covered in the video, Scaption is an abbreviation for scapular plane elevation. This is essentially where the scapula is taken into elevation however it does not denote whether the elevation is with an internal, external or neutral rotation.
Glenoid Fossa – This is not an easy nor recommended place to try to palpate on a person! As you’ll see in the video, this is where you’ve followed the lateral border up and the Glenoid Fossa is the socket to the ball and socket joint of the shoulder. it is also the articulation point between itself and the humeral head – hence Glenohumeral Joint (GH)
Head of the Humerus – More commonly known as the ball to the ball and socket! Ask your client to bend their arm so that their fingers touch their shoulder – If you look closely, you should be able to see a slight indentation at the shoulder – this is known as the Bicipital groove and it’s a landmark where the tendon of the long head of the Biceps sits into. You can then take your forefinger and thumb either side of the humeral head and ask them to flex the arm to a 90° angle with palm facing up, and rotate the arm laterally and medially. With your forefinger and thumb holding the humeral head, you should be able to feel the bicipital groove flicking under your fingers.
Coracoid Process – Coming round to the front of the shoulder just off of the humeral head, you’ll now be looking for the Coracoid Process. Your client can continue to rotate their arm at that flexed 90° angle because what you’re feeling for is a bony protuberance which isn’t moving. The Coracoid Process forms the anterior aspect of your scapula and it can be often confused with the head of the humerus however by asking you client to continue that movement, it should help you to distinguish the bone which is moving versus the bony protuberance which is static.
Superior Border – Starting at the medial border, you can palpate superiorly (upwards) For a lot of people, there will be what feels like a ropy muscle at the top and this is the attachment point for the Levator Scapula (more on that in future posts!)
That concludes our exploration of the Landmarks of the Shoulder for today – We hope you’ve found this interesting!
Interested in learning more?
If you’re looking to learn more about the shoulder, we have our 2019 courses coming up over 2 weekends in 2 separate locations which are:
6th July in Ferndown
15th August in Gatwick
For more information you can either click here, or to book onto the course, please feel free to email us at firstname.lastname@example.org