At the examination of the extension of the active
movement of the glenohumeral articulation we examine not only a normal state
of articular structures, but simultaneously a function of muscles which move
with the joint during the active movement. And it is another reason for an exact
examination of the motility under standard conditions because a proper examining
method is able to examine roughly a functional fitness of muscles responsible
for this movement. Right and used examining technique prevents participation of
other muscles which could substitute the function of examined muscles10
by their agonistic reaction.
If we were finding out the extension of the active movement during a correct examination, then the following movements are connected to the activity of these muscles11:
| flexion is ensured with the activity of |
m. coracobrachialis
m. deltoideus – clavicular part
| abduction is ensured with the activity of |
m. deltoideus
m. supraspinatus
| extension is ensured with the activity of |
m. latissimus dorsi
m. teres major
m. deltoideus
|
outer rotation is ensured with the activity of
|
m. infraspinatus
m. teres minor
|
inner rotation is ensured with the activity of
|
m. subscapularis
m. pectoralis minor
m. latissimus dorsi
m. teres major
With regarding to the fact that the muscular function is not
sufficiently examined by a bare making of the active movement because also an
expressively weakened muscle makes the movement in the full extension, it would
be suitable to examine the activity of muscles by a
muscular test, but it is too time-consuming, and it is also demanding
technically. Therefore we try at least to diagnose the disorders of the muscle
by a comparison of a muscular strength of both limbs, see orienting
examining methods of individual muscles by a method of isometric contraction.
10f.
e. m. pectoralis major also participates in flexion in the area of the
glenohumeral articulation, and so it can compensate the disorders of m.
coracobrachialis. Therefore f. e. a weakness of m. coracobrachialis, otherwise a
very important muscle, would not show during the examination of flexion of the
glenohumeral articulation at outer rotation of the limb, and not in a
recommended standard position
11this survey shows only the most important muscles which participate in the movement, but for a common clinical practice this simplification should be enough