What is the functional anatomy of shoulder stabilizers in rotator cuff injuries?

Updated: Oct 25, 2018
  • Author: Gerard A Malanga, MD; Chief Editor: Craig C Young, MD  more...
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Answer

The shoulder is considered a ball-in-socket joint, although the glenoid fossa is flat. In addition, the surface area of the glenoid is much smaller than that of the contacting humeral head (25-30%). The cartilaginous labrum provides much of the socket function and increases the surface area of contact for the humeral head.

Together, these components provide a great amount of shoulder mobility with limited stability. Shoulder stabilizers can be grossly categorized as static or dynamic. Dynamic stabilizers require an intact neuromuscular system to function, whereas static stabilizers help maintain congruity.

The static stabilizers have been studied well in cadaver specimens to understand their stabilizing effects. Static stabilizers continue to function in the setting of neurologic or intrinsic muscle pathology in conditions such as hemiplegia, spinal cord injury, brachial plexus injury, suprascapular nerve injury, and myopathies. This is not true for the dynamic stabilizers (eg, rotator cuff muscles). With neuromuscular injury or intrinsic muscle damage, the dynamic stabilizers lose their ability to exert dynamic motor control of the humeral head, ultimately leading to GH laxity and shoulder pain.


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