Bones of the upper limb girdle, their structure, connections, movements. Muscles, innervation, blood supply

The upper limb girdle (shoulder girdle) is a set of bones and muscles that provide support and movement of the arms. It covers the area from the shoulder joint to the elbow. The bone structure consists of the clavicle, shoulder blades and humerus, followed by the forearm and hand.

The bones of the shoulder girdle connect the acormioclavicular joints (the bony connection between the acromion and the collarbone). The shoulder girdle is attached to the skeleton using the sternoclavicular joints, muscles and ligaments that hold the scapula and upper limb.

Shoulder injuries are common, especially among professional athletes and people who do heavy physical work with their hands. Pathologies are manifested by pain, crepitus, and deformation. Conservative treatment is usually carried out, but in severe cases surgery is necessary.

Shoulder anatomy

Not all people know how many bones make up the shoulder girdle. The skeleton of the upper limb girdle is formed by the following bones: 2 shoulder blades, 2 clavicles, humerus.

The scapula is a triangle-shaped bone that is located on the back surface of the body. The clavicle is a paired bone that is curved along its long axis in the shape of the letter S. It is located horizontally along the front and upper surface of the body. The shoulder girdle includes the humerus.

A diagram of the bones of the shoulder girdle is presented below.

Bones of the shoulder girdle

Some people are interested in the question of what type of bones of the upper limb girdle are. The scapula is a flat bone, while the clavicle and humerus are tubular.

The ligamentous apparatus of the shoulder consists of the acromioclavicular joint and the shoulder joint. The acromioclavicular joint is strengthened by the coracoclavicular ligament. The scapula is supported by the coracoacromial and superior transverse ligaments. The shoulder joint is strengthened by the coracobrachial ligament, as well as the fibers of the supraspinatus, infraspinatus, subscapularis, and teres minor muscles.

Thanks to the muscles, tendons and ligaments, the upper limb has the correct position, it is strengthened and is capable of performing a variety of movements.

The muscles of the shoulder girdle include: motors, coordinators, stabilizers of the scapula. The motor muscles include the deltoid, latissimus dorsi, and pectoralis major. They are involved in performing basic arm movements (extension, adduction, abduction, rotation). The group of coordinating muscles may include: subscapularis, supraspinatus, infraspinatus, teres minor. They are necessary to ensure that movements in the shoulder are coordinated. Scapula stabilizers include the trapezius, rhomboid major, rhomboid minor, serratus anterior, pectoralis minor, and levator scapulae muscles. They regulate the movement of the shoulder blades.

Ligamentous apparatus

The connection between the acromion and the collarbone is called the acromioclavicular joint. It is formed by flat articulated surfaces. The joint is stabilized by the coracoclavicular ligament, which arises from the coracoid process and reaches the inferior surface of the clavicle.

Shoulder joint ligaments

The scapula has its own ligaments – the coracoacromial and superior transverse. The first looks like a triangle-shaped plate that runs from the acromion to the coracoid process of the scapula. The coracoacromial ligament forms the arch of the shoulder.

The structure of the humeral joint is simple: a spherical head and an articular recess of the scapula.

Reference. The articulating depression of the scapula is equal to 1/3 of the surface of the head. The labrum is a ring-shaped cartilaginous formation that is attached along the edge of the glenoid fossa, increasing its depth.

The articular capsule is adjacent to the anatomical neck of the shoulder. It is quite thin and large. Between the tubercles of the bony structure of the shoulder is the synovial sheath (inner layer of the capsule), which surrounds the tendon and facilitates its gliding.

Auxiliary elements of the shoulder joint capsule: coracobrachial ligament, supraspinatus, infraspinatus, subscapularis and teres minor muscles. The ligament stabilizes the joint capsule, and the muscles not only strengthen it, but also protect it from pinching.

Reference. The humeroulnar joint is formed by the humerus and ulna. The humeral joint is formed by the humerus and radius bones.

Structure and functions of the clavicle

The clavicle is the only bone in the human body that connects the skeleton to the upper limb. Tubular bone mainly consists of spongy substance. It has a horizontal position and runs along the upper edge of the chest. The clavicle consists of a body and 2 ends:

• The medial (sternal) end connects to the sternum.
• Lateral (acromial) faces the collarbone.

The clavicle consists of a body and 2 ends

The medial end, like the sternum, has a convex curve forward, and its other part is curved backward. The middle part of the bone is slightly compressed from top to bottom. On its lower surface there is an opening through which blood vessels and nerves pass. On the lower surface of the medial end there is a depression to which the ligament connecting the clavicle and the cartilage of the first rib is attached. At the humeral end there is a cone-shaped tubercle and a trapezoidal line. Closer to the lateral end of the lower surface of the body of the clavicle there is a recess for the attachment of the subclavian muscle.

The front and top parts of the bone are smooth, and the lower surfaces to which the muscles and ligaments are attached have roughness in the form of tubercles and lines. On the inner surface of the thick medial end there is a large oval joint - this is the junction of the clavicle with the sternum. The lateral end is wider than the medial end, but not as thick. Above its lower surface is the acromioclavicular joint, which connects the collarbone to the bony outgrowth of the scapula (acromion).

The bony joints of the acromioclavicular joint are oblique, flat, and elliptical in shape. There is a dense fibrous membrane around it, which is strengthened by ligaments. The sternoclavicular joint is also surrounded by a wide fibrous membrane and 3 powerful ligaments. This joint is involved in movements along axes that are perpendicular to each other.

The collarbone performs a supporting function, since the scapula and arm are attached to it. In addition, the bone connects the upper limb to the skeleton, providing it with a wide range of movements. Together with the scapula and muscles, the clavicle transmits forces that affect the arms and the rest of the skeleton. In addition, the bone protects blood, lymphatic vessels, and nerves that are located between the neck and upper limb from pinching.

Content

• 1 In humans 1.1 Joints 1.1.1 Shoulder joint
• 1.1.2 Acromioclavicular joint
• 1.1.3 Clavicular joint
• 1.1.4 Scapulocostal joint
• 1.1.5 Shoulder joint

Clavicle injuries

As you can see, the collarbone performs important functions, but it bears a large load, so it is susceptible to various injuries:

Dislocation of the acromial end of the clavicle with ligament rupture

• Fracture. In most cases, the fracture occurs in the middle of the bone body. There is a left and right clavicle, usually one of them is injured, a bilateral fracture rarely occurs. A fracture most often occurs when a person falls on their arm or receives a direct blow. There is a risk of injury to the fetus' collarbone as it passes through the birth canal. After a fracture of the collarbone, the arm lengthens, the limb in the collarbone area becomes deformed, and the victim cannot lift it.
• Dislocation of the acromial end. The articular surfaces are displaced after a fall on the shoulder. Features of the injury: after the impact, the scapula is pushed down, the collarbone is not so mobile, so it does not move behind it, as a result, the ligaments connecting the bones are torn, and the acromioclavicular joint is dislocated. The injury is manifested by elongation of the arm, swelling and deformation. When you press on the collarbone, it falls into place; after the pressure stops, it rises again.
• Osteolysis of the clavicle. This is a rare disease characterized by complete destruction (resorption) of bone without replacement by other tissue. The exact causes of the pathology are not known, but doctors suggest that it is associated with autoimmune diseases of bone tissue. The only symptom is slowly healing fractures.

If a clavicle injury is suspected, MSCT (multispiral computed tomography) is prescribed - this is a modern study that uses X-rays and conducts a multi-slice scan of the clavicle. Multislice CT allows for qualitative and detailed examination of morphological changes in bones and surrounding tissues.

For ordinary clavicle fractures, conservative treatment is carried out, and the patient is given a fixing bandage. If fragments are displaced and soft tissue is damaged, surgery is performed, and bone fragments are connected using special plates, knitting needles or rings. The rehabilitation period plays an important role, when the patient is taught to move the injured arm again.

Diseases and treatment

Inflammatory diseases of the PP include syphilis (sternoclavicular joints become swollen), osteomyelitis, and tuberculosis. Arthritis is less commonly diagnosed.

An x-ray can confirm the development of aseptic necrosis of the bones of the shoulder joint.
With aseptic necrosis, pain occurs when a person changes position and moves his arms back. When making a diagnosis, they rely on the results of an external examination and x-ray examination. Conservative therapy is used. It includes light exercise, taking anti-inflammatory drugs and medications that help improve blood circulation.

Neoplasms of the shoulder girdle can be of primary and secondary types. As they develop, both bones and soft tissues swell. The correct treatment is selected depending on the severity of the disease and its type. Osteoarthrosis is often accompanied by periarthrosis. They are characterized by swelling, joint deformation, and pain. The treatment complex includes both conservative methods and surgical intervention.

Anatomical structure and functions of the scapula

A paired triangular bone is located on the back surface of the body on both sides of the spine. Its base is at the top and the pointed end is at the bottom. It is a flat, wide bone that is slightly curved backwards.

The scapula is a paired triangular bone

The scapula consists of an anterior (costal) and posterior (dorsal) surface.

Anatomy of the posterior part of the scapula:

• The spine is a protruding plate of bone that crosses ¼ of the bone and separates the supra- and infraspinatus fossae.
• The acromion process is an elongated, triangular-shaped process at the top of the bone that ends at the spine.
• The coracoid process is the hamate bone. Which is located between the upper edge, the neck of the scapula.
• The neck is the slight narrowing that separates the rest of the scapula from the outer corner.
• Body of the scapula.
• Inner edge of the shoulder blade.
• External corner.

The structure of the scapula in front is simple; it has a wide fossa to which the subscapularis muscle is attached. The inside of the cavity is covered with ridges to which tendons and muscle fibers are attached. In the upper part of the socket there is a transverse depression where the scapula bends along a line that runs at an angle of 90° through the middle of the glenoid fossa, which includes the head of the humerus.

There are 3 angles:

• The superior angle is formed by the superior and medial borders of the bone. It is thin, has a smooth surface and a rounded shape, and fibers of the muscle that elevate the scapula are attached to it.
• Lower. The lateral border of the scapula forms a lower angle with the medial border. This is the lowest thick section of bone with a rough texture. The teres major and several fibers of the latissimus dorsi muscle are attached to it posteriorly.
• Lateral. This is the thickest part of the scapula and contains the articular socket that connects to the humerus. At the apex of the lateral angle is the supraglenoid tuberosity, to which the head of the biceps is attached.

There are 3 edges of the scapula:

• The top one is considered the thinnest and shortest. It has a concave shape, occupies the area from the upper angle to the coracoid process.
• Lateral - the thickest edge of the scapula. It starts from the lower edge of the articular socket, passes down and back to the lower corner of the bone.
• The medial edge is the longest edge, which occupies the area from the upper to the lower corner of the bone.

Thanks to the articulations, the scapula connects the humerus and collarbone, providing mobility to the upper limb. The paired bone protects important organs and blood vessels from damage. And also the scapula, together with the muscles, performs a motor function, it allows you to rotate, abduct (to the side, back, forward), and understand the arms.

Muscles

The upper limb girdle includes the following muscles:

• Deltoid. The fibers of this muscle extend from the spine, acromion, acromial end of the clavicle, and adjoin the deltoid tuberosity of the humerus. The posterior part (scapular) extends the shoulder, and the anterior (clavicular) flexes.
• Supraspinatus. This anatomical structure originates from the supraspinatus fossa of the scapula and is attached to the superior portion of the greater tubercle of the humerus. The supraspinatus muscle abducts the shoulder.
• Infraspinatus. It is localized in the infraspinatus recess of the scapula, and is attached to the greater tubercle of the shoulder. The infraspinatus muscle helps adduct, rotate and extend the shoulder.
• Small round. It arises from the scapula and is adjacent to the greater tubercle. It allows you to rotate your shoulder outward.
• Big round. It starts from the lower angle of the scapula and is attached to the crest of the lesser tubercle. Functions: adduction, internal rotation, shoulder extension.
• Subscapular. It starts from the outer edge of the scapula, fills the subscapular cavity, and is attached to the lesser tubercle of the shoulder. It helps move the arm inward and bring it toward the body.

Muscles of the upper limb girdle

Classification of shoulder muscles:

• The anterior group (flexors) includes the coracobrachialis, brachialis, and biceps muscles.
• Posterior group (extensors): triceps and ulnaris muscles.

The structure of the muscles of the humerus:

• Coracobrachial. It arises from the coracoid process and attaches under the crest of the lesser tubercle to the humerus. Responsible for bending the arm.
• Shoulder. It arises from the lower two-thirds of the humerus, adjacent to the tuberosity of the elbow. Participates in flexion of the forearm.
• Double-headed. The long head of the muscle comes from the supraglenoid tubercle of the scapula, and the short one comes from the coracoid process, connects with the tuberosity of the radius and the fascia of the forearm (the connective tissue membrane that covers organs, vessels and nerves). The biceps muscle flexes the shoulder, forearm, and allows you to rotate your arm from the elbow to the wrist.
• Three-headed. The long head extends from the tubercle of the scapula under the joint, and the inner and outer heads arise from the posterior surface of the humerus. They are adjacent to the tendon, which is attached to the olecranon process. Helps to make extension, adduction movements of the shoulder, forearm and straighten the elbow.
• Elbow. It starts from the external epicondyle of the shoulder, the ligament of Henle, as well as the fascia, and connects to the ulna in its upper part on the posterior surface. Helps extend the forearm.

All muscles in the area of ​​the shoulder joint are located on top. Below the bony junction is the axillary depression, through which the nerves and blood vessels of the arm pass.

Pathologies of the scapula

When the scapula is injured, the quality of life decreases; people are not able to care for themselves or perform physical work. The shoulder blades can be damaged by a fall on your back, shoulder or arm, a direct blow, an accident, or a work-related injury.

There is a possibility of bone fracture in the following areas: neck, glenoid, spine, coracoid process, acromion, superior or inferior angle. And longitudinal, transverse or multi-fragmented damage is also possible.

When a fracture occurs, the “Comolli triangle” appears - this is a swelling in the shape of a triangle. On palpation, the pain in the damaged area intensifies. A displaced fracture is accompanied by a crunching sound from bone fragments. In case of intra-articular injury, the shoulder and arm are raised. Blood accumulates in the cavity of the bone connection, so the size of the shoulder increases. When the neck is damaged, the shoulder drops slightly, the acromion protrudes forward, and the coracoid process moves slightly back. With an open fracture, a wound appears through which bone fragments are visible.

Dislocation of the scapula is a rare occurrence. The injury occurs if a person makes a strong jerk with his arm or shoulder, as a result, the bone is displaced. After a dislocation, the coracoid process of the scapula protrudes through the skin, causing sharp pain that intensifies with movement.

Bursitis is an inflammation of the synovial (periarticular) bursae of the shoulder joint. Typically, the disease develops against the background of infection, injury, or an autoimmune disease. With bursitis, pain occurs, the damaged area turns red, swells, a feeling of numbness appears, and it is difficult for the victim to move his arm.

Multi-slice computed tomography will help detect scapular pathologies.

For ordinary fractures, a special splint is placed on the arm on the damaged side, which must be worn for 4 weeks. Then physiotherapy and massage are prescribed, the patient must develop the limb with the help of special exercises. For intra-articular injuries, surgery is indicated.

Bursitis is treated with the use of NSAIDs, steroid hormones, antibacterial agents, analgesics, chondroprotectors, and vitamin-mineral complexes.

Anatomy of the humerus

The humerus is a wide, long tubular structure. It is part of the movable upper limb, unites the ulna, radius, and hand with the human skeleton. Around the humerus there are muscles, nerve trunks, and lymphatic vessels.

Brachial bone

The shoulder structure has the following structure:

• The body of the bone (diaphysis), which is located between the epiphyses.
• Metaphysis is the section of bone that is adjacent to the epiphyseal plate.
• Epiphysis – upper proximal, lower distal end of the structure.
• Apophysis is a process of bone next to the epiphysis, to which muscle fibers are attached.

At the proximal end of the humerus is the smooth round head of the humerus, the articular cavity of the scapula, which form the shoulder joint. Next comes the anatomical neck - this is a narrow groove between the head and the body of the shoulder. Just below the neck there are 2 muscle tubercles (large and small), to which the rotator cuff muscles are attached. Under the tubercles it narrows again, forming a body. On its outer part, almost in the middle, there is a deltoid tuberosity, to which the fibers of the muscle of the same name are attached. On its posterior edge there is a groove of the radial nerve in the form of a flat, gentle groove.

The lower edge of the bone is wide, bent anteriorly, muscle fibers are attached to it, and it also participates in the structure of the elbow joint. The joint consists of the condyle of the humeral structure with the bones of the forearm. The inner edge of the condyle is the block of the humerus that connects to the ulnar structure. The head of the condyle, together with the radial structure, forms the humeroradial articulation. Above the condylar head is the radial fossa. On both sides of the trochlea are the ulnar and coronoid fossa. The humerus has lateral and medial epicondyles (rough convexities) on the outside and inside. On the surface of the medial process there is a groove with the ulnar nerve trunk.

The functions of the humerus, despite its simple structure, are important. It increases the swing when a person moves his arm. This structure helps maintain balance when the center of gravity shifts during walking. It helps determine the correct support of a person on the upper limbs in various specific body positions (for example, while climbing stairs).

Human skeleton

Functions of the human skeleton

The human skeleton is the passive part of the musculoskeletal system. The axial skeleton, bones of the limb girdles, and bones of the upper and lower extremities are distinguished. The skeleton performs a number of important functions:

• Protective

Protects internal organs from mechanical influences. The skull is the seat of the brain and sensory organs: it reliably protects them. Connecting to each other, the vertebrae form the vertebral (spinal) canal, in which the well-protected spinal cord is located.

• Support

The supporting function of the skeleton is to attach soft tissues and internal organs to various parts of the skeleton.

• Spring (French ressort, literally - elasticity, spring)

This function of the skeleton is also called shock-absorbing (French amortir - to weaken, soften, dampen). The structure of the skeleton (curvatures of the spine, arched foot, intervertebral discs) ensures softening of shocks and shocks during movement, uniform distribution of the load.

• Motor (locomotor - lat. locus - place + motor - engine)

The bones at the joints (movable joints) form levers that, when contracted, move the muscles.

• Metabolic (biological)

Bones actively participate in mineral metabolism: bones are a depot of calcium and phosphorus. When mineral metabolism is disturbed, many diseases occur, the most famous is rickets, we will discuss this disease in this article.

• Hematopoietic

Having studied the structure of bones, you understand very well that the spongy substance is the location of the red bone marrow, in which blood cells appear and differentiate: red blood cells, leukocytes and platelets.

Inside the long bones is the medullary canal, which contains yellow bone marrow. It performs a nutritional function (fat accumulation); in case of blood loss, it can turn into red bone marrow (reserve function).

Axial skeleton

The axial skeleton is the main axis of the body, the support of the entire skeleton. The axial skeleton includes the spine, rib cage (sternum and ribs), and skull. The spine (spinal column) consists of 32-34 vertebrae and has the following sections:

• Cervical - 7 vertebrae
• Breast - 12
• Lumbar - 5
• Sacral - 5
• Coccygeal - 3-5

Each vertebra (with the exception of the first cervical - atlas, which has only anterior and posterior arches) is formed by a body and an arch that limit the opening of the spinal canal with the spinal cord passing through it. The vertebra also contains processes: articular and transverse, and the spinous process. Connecting to each other with articular processes, the vertebrae form the spinal column with the spinal canal inside - a reliable container for the spinal cord.

The lumbar vertebrae have the most massive and large bodies: proportionate to the load they have to carry (compared to the cervical vertebrae).

The structure of the cervical, thoracic and lumbar vertebrae differs from each other. The first cervical vertebra - the atlas (lat. atlantus - load-bearing) connects to the occipital bone of the skull and forms a joint with it. Atlas has no body, he only has anterior and posterior arches. The second cervical vertebra - axis (axial vertebra, epistrophy) has an outgrowth of the body - a tooth, and is involved in turning the head.

You've probably noticed that the human spine is not straight: it curves forward and backward. I note that the baby’s spine does not have these bends - it is absolutely straight. These curves begin to form after the child takes an upright position and begins to walk.

In connection with upright posture, a person develops 4 physiological curves, that is, everyone has them normally: cervical lordosis (forward bend), thoracic kyphosis (backward bend), lumbar lordosis and sacral kyphosis. Kyphosis and lordosis allow you to evenly distribute the load across the entire spine.

To easily remember two new terms for yourself, I recommend using the following association: ask yourself, how does an English lord walk? Imagine all its importance and pretentiousness, the chest thrust forward and the back arched forward (that’s lordosis!). By associating the word lord with the word lordosis, you will not be confused

Posture is the habitual position of the back. Teenagers often experience poor posture due to poor development of the back muscles. Lordosis and kyphosis may be too pronounced, or, conversely, very poorly expressed, a flat back. There may be a curvature of the spine to the right or left: in this case, they speak of the presence of scoliosis.

Forming correct posture is a very important task. You need to know a few fundamental points that relate to this topic:

• Do not carry heavy objects in one hand, heavy bags, briefcases on one shoulder
• Organize your study space correctly - your back should be pressed tightly against the back of the chair, slightly arched in the lower back
• Shoulders should be at the same level, not tense
• Girls should avoid high-heeled shoes - this leads to lumbar hyperlordosis

Consequences of incorrect posture: impaired blood supply, displacement and compression of internal organs, deformation of the chest.

The chest skeleton consists of 12 pairs of ribs and the sternum. The skull is divided into two sections: facial and cerebral.

The facial part of the skull includes the upper and lower jaws, zygomatic, nasal, lacrimal, palatine and hyoid bones. The only movable bone of the skull is the lower jaw, with teeth located in the dental alveoli, used for grinding food.

Paired bones of the facial part of the skull: zygomatic, nasal, lacrimal, palatine and maxilla. Unpaired bones of the facial part of the skull: lower jaw, hyoid bone.

The brain section of the skull includes the occipital, frontal, temporal and parietal bones, as well as the ethmoid and sphenoid bones.

Paired bones of the brain part of the skull: temporal and parietal bones. Unpaired bones of the brain part of the skull: frontal, occipital, sphenoid, ethmoid.

Skeleton of limb belts

We move on to studying the limb belts, I want to note one detail. In the zoology chapter, we studied the girdles of the limbs, using the terms - girdle of “front, hind” limbs. Since a person occupies a vertical position, when studying human anatomy, we will talk about the girdle of the “upper and lower” limbs.

The upper limb girdle (shoulder girdle) consists of paired clavicles and shoulder blades. The clavicle is attached at one end to the sternum, and at the other to the acromion (process of the scapula). The shoulder girdle provides support for the upper limbs and a variety of their movements: a large number of muscles are attached to the scapula and collarbone.

The lower extremity girdle (pelvic) consists of two pelvic bones, each of which is formed by the fused ilium, pubis and ischium. The pelvic girdle serves as a support for the internal organs and the attachment point for many muscles.

Limb skeleton

The skeleton of the lower extremity includes the femur and patella (thigh), fibula and tibia (shin), tarsus, metatarsus and phalanges (foot). The upper limb skeleton consists of the humerus (upper arm), radius and ulna (forearm), wrist, metacarpus, and phalanges (hand).

The femur articulates with the pelvic girdle using the head of the femur, which forms the hip joint with the acetabulum of the pelvic bone. The head of the humerus forms the shoulder joint with the articular surface of the scapula.

Sometimes in a drawing you need to determine where the radius and ulna are, this is quite easy to do if you remember that the radius is always located closer to the thumb, and the ulna is closer to the little finger. Regardless of the location of the hand on the diagram, this rule will apply.

Features of the human skeleton

We have already studied the human skeleton, but we should pay attention to some of its details. They may seem insignificant and too obvious to you, but they are what distinguish humans from many other animals. Some of these features are associated with upright posture and work activity.

• The cerebral part of the skull predominates over the facial part (in monkeys it’s the other way around)
• Weakly defined brow ridges
• Less massive jaw than apes
• The chin protrusion is well developed, which indicates the possibility of articulate speech in humans
• The skull is placed on top of the spine, and is not suspended from the front, like in animals
• The spinal column has 4 physiological curves: 2 anteriorly (lordosis) and 2 posteriorly (kyphosis)
• The mass of the vertebrae from top to bottom (from the cervical to the lumbar) increases in proportion to the load
• The chest is flattened (in the dorso-abdominal direction)
• Massive lower limbs
• Wide, low pelvis (in monkeys it is narrow, high and long)
• Arched foot - helps to distribute the load evenly; monkeys have flat feet
• The opposition of the thumb to all the rest is the basis of the grasping function of the hand

Diseases of the musculoskeletal system

Most often, with weakness of the muscles of the lower leg and foot, the ligamentous apparatus, the shape of the foot changes, its transverse and longitudinal arch drops: this disease is called flat feet.

Causes: incorrect shoes, excess weight, prolonged walking or standing (excessively increased or decreased load). Accompanied by pain in the foot and unnatural gait. Due to a shift in the body's center of gravity, flat feet can lead to poor posture.

Treatment: physical exercises, orthopedic insoles (Greek orthos - straight, correct + paedos - child).

Arch supports (lat. supino - overturn) - an internal part of the bottom of the shoe, raising the inner edge of the foot, attached to the insole, or between the insole and half-insole. Arch supports are designed to reduce the load on the arch of the foot and the dimensional stability of the sole.

Rickets (Greek rhachis - spine) is a disease of infants and young children associated with impaired bone formation and insufficient bone mineralization.

Causes of rickets: insufficient intake of vitamin D from food, insufficient exposure to the sun (insufficient ultraviolet irradiation - necessary for the synthesis of vitamin D in the body), prematurity of the child.

© Bellevich Yuri Sergeevich 2018-2021

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Shoulder injuries

Shoulder dislocation is a common occurrence that is associated with arm mobility. The displacement can be anterior, posterior, or inferior. When a dislocation occurs, the mobility of the limb is limited, pain and swelling appear. When the nerve is compressed, a feeling of numbness occurs.

A fracture most often occurs from a direct blow to the shoulder, falling backwards onto the elbows, or falling forward onto the arms. Typically, the integrity of bones is compromised in weak areas:

• Anatomical and surgical neck of the humerus.
• The area near the condyles.
• The area near the head of the humerus.
• The middle of the bone.

The injury is manifested by severe pain and impaired mobility. After some time, the shoulder swells, hematomas appear, and the damaged area becomes deformed.

Osteomyelitis is a purulent inflammation of the bone due to the penetration of microbes into the bone marrow through the blood. This disease is common because the humerus is abundantly supplied with blood. The pathological process provokes the destruction of bone tissue, as a result, fractures form without significant external influence.

Reference. Among the commonly diagnosed pathologies of the humerus are arthritis (inflammation of the joint).

Pseudarthrosis is also a common pathology. Not all patients know what it is. This is an abnormally formed joint that appears at the site of a non-union fracture of the humerus. With pathology, the functionality of the hand is impaired, but there is no pain.

Palpation and visual inspection can identify injuries and diseases of the humerus. X-rays can help differentiate a fracture from a dislocation. MRI and multi-slice computed tomography can detect malignant tumors. A multislice tomograph will help to examine the bone structure in detail and determine pathological changes.

When a dislocation occurs, a health care worker gives the victim a painkiller, compares the fragments of the joint, and then immobilizes the limb. Simple fractures are also treated conservatively. If the bone fragments are displaced, then surgery is necessary. The bone fragments are connected using knitting needles or screws, and then a Turner plaster splint is applied. If necessary, skeletal traction is performed first.

Exercise therapy will help develop the shoulder joint for flexibility. During rehabilitation, mechanotherapy and physiotherapy are indicated.

Exercises to develop the muscles of the shoulder girdle

Barbell or dumbbell overhead press

The main basic exercises for developing deltoid muscles are overhead presses. You can work with both a barbell and dumbbells. In addition, the exercises are performed in different styles. Standing, a more basic option, involves the abdominal and leg muscles, which act as stabilizers of the torso. There is a sitting version with your back resting on a bench. It allows you to slightly relieve the torso muscles and focus all your attention on training your shoulders. These exercises involve the main function of all three bundles of deltoid muscles, namely abduction of the humerus. When working with a barbell, it is best to lower the bar from the front to your chest. This position is more natural for our joints. If you lower the barbell behind your head, then excessive rotation of the humerus will occur. Which can lead to injury to the supraspinatus muscle due to the collision of the humerus and acromion.

Raising your arms in front of your body

This exercise will allow you to shift the emphasis to the anterior bundle of deltoid muscles. You can perform it with dumbbells, a barbell, or in a crossover. There are several types of grip on the projectile. Neutral, allows you to perform the exercise more comfortably with minimal risk of injuring the supraspinatus muscle due to impact. Pronated, more popular among all grips. But this position is less natural for this movement. Therefore, some may experience discomfort and sometimes pain when performing. Supinated, very effective and comfortable grip. Not recommended for beginner athletes. Their neuromuscular connection is poorly developed and instead of the deltoids, the load can go to the biceps and pectoral muscles. The exercise involves the function of flexing the arm at the shoulder joint.

Dumbbell lateral raises

Another exercise with a shift in emphasis. In this case, on the middle bundle of the deltoid muscles. The exercise engages the shoulder abduction function. You can perform flyes in different styles, standing or sitting, with one hand or two at the same time. All this will load the deltoid muscles in different ways and give impetus to their development. When doing extensions, the main task is on the technique of the exercise, and not on the weights. After all, the deltoid muscle is weak and will not be able to cope with bulky dumbbells. Over time, this can lead to serious rotator cuff injuries. There is a less popular option: ARM RAISE LYING ON A BENCH. Although it can be met less frequently by raising your arms while standing, this does not mean that it is ineffective.

Cravings to face

This exercise is aimed at developing the posterior deltoid muscles. It involves the function of extension of the humerus in the horizontal plane. This thrust is performed from the upper block of the crossover. Basically they use a rope handle and pull it towards the nose. You can additionally work the infraspinatus and teres minor muscles. To do this, at the moment of traction, we add a rotational movement in the humerus, suppinating it outward. In this exercise, the technique is important, not the amount of working weight. At the beginning we work out all the moments, and then we increase the number of blocks.

If you want to know what other exercises there are to develop the deltoid muscles, go to the “SHOULDER EXERCISES” section.

As for the rotator cuff muscles, there are special movements that can strengthen them. You can work with dumbbells, rubber bands, crossovers or TRX loops. It is necessary to rotate the humerus in different directions, using the function of supination and pronation. Below is a video that describes some of these movements. It is important not to use huge weights, as the rotator cuff is not a strong muscle. You can work in multi-repetition mode for 20-30 repetitions per set. It is advisable to warm up your rotators before each workout, especially if you plan to TRAIN your shoulders.

In conclusion, I would like to say a few words about what exercises will help use the teres major muscle. I already said above that this muscle performs a similar function to the latissimus. Therefore, there is no need to perform separate exercises for their development. They will receive their load during TRAINING THE BACK MUSCLES.

Good luck to everyone in your training!

The most important

Now you know which bones form the shoulder girdle. The shoulder blades, collarbone and humerus take part in the formation of important joints, and thanks to muscles and ligaments, they provide mobility of the upper limb. Fractures of the clavicle and humerus occur more often than injuries to the scapula. This is due to the fact that the scapula is a fairly strong bone, which is protected by a thick layer of muscle. After identifying an injury, the affected limb is immobilized, and in case of complex fractures, an operation is performed to compare bone fragments. Therapeutic gymnastics and physiotherapy will help speed up recovery.

Links[edit]

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