What is the anatomy of the glenohumeral joint relevant to hemiplegic shoulder pain?

Updated: Feb 08, 2019
  • Author: Robert Gould, DO; Chief Editor: Stephen Kishner, MD, MHA  more...
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In order to understand the pathologic processes and changes that occur in the hemiplegic shoulder, the factors that contribute to normal shoulder position need to be understood. Cailliet has proposed that normal anatomic position involves a well-approximated glenohumeral joint, proper glenoid fossa angle (forward and upward), and proper scapular alignment with the vertebral column. [10]

The joint is stabilized by musculature (ie, supraspinatus, [11] deltoid, latissimus) and, to a smaller degree, the shoulder capsule, which supports the humerus. The trapezius, serratus anterior, and rhomboids provide proper scapular alignment. The latissimus also works to depress the scapula.

Erector spinae muscle tone, along with the righting reflex, maintains the vertebral column in an upright alignment. If any of these components are disrupted during the recovery process, then shoulder function may be compromised or a painful shoulder may result.

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